How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning

Abstract

Objective Although substance use (SU) is elevated in attention-deficit/hyperactivity disorder (ADHD) and both are associated with disrupted emotional functioning, little is known about how emotions and SU interact in ADHD. We used a mixed qualitative-quantitative approach to explore this relationship. Method Narrative comments were coded for 67 persistent (50 ADHD, 17 local normative comparison group [LNCG]) and 25 desistent (20 ADHD, 5 LNCG) substance users from the Multimodal Treatment Study of Children with ADHD (MTA) adult follow-up (21.7–26.7 years-old). Results SU persisters perceived SU positively affects emotional states and positive emotional effects outweigh negative effects. No ADHD group effects emerged. Qualitative analysis identified perceptions that cannabis enhanced positive mood for ADHD and LNCG SU persisters, and improved negative mood and ADHD for ADHD SU persisters. Conclusion Perceptions about SU broadly and mood do not differentiate ADHD and non-ADHD SU persisters. However, perceptions that cannabis is therapeutic may inform ADHD-related risk for cannabis use.

Substance use through adolescence into early adulthood after childhood‐diagnosed ADHD: findings from the MTA longitudinal study

“…Similar large group differences were reported in smaller and/or single‐site studies (Barkley et al., ; Klein et al., ; Lambert & Hartsough, ; Rhodes et al., ). Given the well‐established negative health consequences of cigarette smoking (e.g., Lubin & Caporaso, ), and that cessation is especially difficult for those with ADHD (Humfleet et al., ; Mitchell, Weisner et al., ), the need for improved smoking prevention in ADHD is substantial. Smoking cessation treatments for this population may need to consider multiple factors; despite ADHD‐symptom relief by nicotine (Levin, Conners, Silva, Canu, & March, ), pharmacological treatment of ADHD symptoms does not improve quit rates (Kollins et al., ; Winhusen et al., ).…”

“….79*** (.05) that cessation is especially difficult for those with ADHD (Humfleet et al, 2005;Mitchell, Weisner et al, 2017), the need for improved smoking prevention in ADHD is substantial. Smoking cessation treatments for this population may need to consider multiple factors; despite ADHD-symptom relief by nicotine (Levin, Conners, Silva, Canu, & March, 2001), pharmacological treatment of ADHD symptoms does not improve quit rates (Kollins et al, 2012;Winhusen et al, 2010).…”

“…The strong clinical response of ADHD to dopaminergic psychostimulant medication and questions about its precise mechanisms (dela Peña, Gevorkiana, & Shi, 2015) have raised questions about vulnerability to other dopaminergic drugs (Lambert & Hartsough, 1998), including tobacco and cocaine, and concern about abusing prescribed stimulants (McCabe, Veliz, Wilens, & Schulenberg, 2017). Additionally, some adults with ADHD report a preference for marijuana (Mitchell, Weisner et al, 2017), perhaps due to its anxiolytic properties (Bonn-Miller, Zvolensky, & Bernstein, 2007). Hence, we examine adult SU separately by drug class to explore possible increased risk for some but not all substances by early adulthood.…”

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial (Preprint)

“…Qualitative analysis involved identification of themes that emerged from participant interviews. These themes were identified through an iterative process following procedures similar to our past qualitative analysis approach [52,53]. That is, an initial list of anticipated themes based on the study team's experience with mSMART in other populations and separate experience with young MSM (e.g., liking and disliking different features of mSMART).…”

Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial

“…Qualitative analysis involved identification of categories that emerged. These categories were identified through an iterative process following procedures similar to those involved in our past qualitative approaches [ 52 , 53 ]. That is, an initial list of anticipated categories based on the study team’s experience with mSMART in other populations and separate experiences with young MSM.…”