BackgroundADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group.MethodScreening for ADHD followed by a research diagnostic interview in people attending in-patient drug and alcohol detoxification units.ResultsWe estimated prevalence of undiagnosed ADHD within substance use disorder in-patients in South London around 12%. Those individuals with substance use disorders and ADHD had significantly higher self-rated impairments across several domains of daily life; and higher rates of substance abuse and alcohol consumption, suicide attempts, and depression recorded in their case records.ConclusionsThis study demonstrates the high rates of untreated ADHD within substance use disorder populations and the association of ADHD in such patients with greater levels of impairment. These are likely to be a source of additional impairment to patients and represent an increased burden on clinical services.
Failure to complete treatment during alcohol detoxification is a major complication of effective clinical management. We determined the socio-demographic characteristics, the pattern of alcohol and drug use, the hepatitis C status and the psychiatric state of these patients, using retrospective data on 470 first admissions to a specialist alcohol in-patient unit. The 316 patients (67.2%) who had a planned discharge (PD group) were compared with the 154 patients (32.8%) who had unplanned discharges (UPD group). Patients in the UPD group were younger on admission, had higher Alcohol Problems Questionnaire scores, had started to drink heavily at a younger age, were more likely to have previously used cocaine, amphetamines and heroin, and to have smoked cannabis in the 30 days prior to admission. They were more likely to be positive for markers of hepatitis C infection, to have a borderline personality disorder, antisocial personality disorder, or to have concurrent opiate or benzodiazepine dependence. PD was associated with depressive disorder. Early identification can be made of alcohol-dependent individuals at risk of premature drop-out during in-patient treatment. Interventions to retain patients at risk of premature UPD should be developed.
Illicit drug use appears to have a significant detrimental effect on the success of an attempt to stop smoking. This effect is not explained by differences between drug users and nonusers on established prognostic factors. These first results in a prospective sample support findings from a large U.S. population survey of smoking cessation rates in drug users and nonusers. If these results are corroborated, clinicians treating smokers should consider developing new protocols to improve outcomes in smokers using illicit drugs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.