%0 Journal Article
%T Male Adolescent Substance Use Disorder and Attention-Deficit Hyperactivity Disorder: A Review of the Literature
%A Robert Eme
%J ISRN Addiction
%D 2013
%R 10.1155/2013/815096
%X Approximately, one-third of male adolescents in treatment for a substance use disorder (SUD) also have an Attention-Deficit Hyperactivity Disorder (ADHD). This strongly suggests that ADHD is a major risk factor for the development of SUD which practitioners must address if they are to provide adequate treatment for adolescents with SUD/ADHD. This paper supports a causal role for ADHD in the development of SUD and examines the developmental mechanisms whereby ADHD increases risk for SUD. These mechanisms include increased risk for conduct disorder, academic failure, deviant peer affiliation, engaging in risk behaviors, and self-medication. Assessment and treatment recommendations for those comorbid for SUD/ADHD are provided. 1. Introduction Substance use, which includes smoking, drinking alcohol, or using other addictive substances, exists on a continuum ranging from no use on one end, to use that does not involve negative consequences, to risky use, to a substance use disorder (SUD) [1]. SUD is characterized by inability to consistently abstain, impairment of behavioral control, craving, and significant problems in behavior and interpersonal relationships [1]. SUDs are a worldwide major public health problem [2]. In the United States, adolescent substance use is arguably, if not incontestably, the number one public health problem for several reasons [3]. Addictive substance use is widespread as almost half of high school students (46.1 percent) are current users (used in the past 30 days) of cigarettes, alcohol, marijuana, or cocaine; one in eight (11.9 percent) meet clinical criteria for a substance use disorder (SUD) [3]. Adolescence is the critical period for the initiation of substance use and its consequences as nine out of 10 Americans who suffer from a SUD started smoking, drinking, or using other drugs before age 18 [3]. The financial and human consequences are staggering. Financially, the cost is estimated as an astonishing $1500 per year for every person in the United States [3]. The human costs include, in addition to heightened risk of addiction, reduced academic performance and educational achievement; criminal involvement; unintended pregnancies; accidents and injuries which make it among the leading causes of death among youth under 21 [3, 4]. Despite being the most important public health problem, only 15.4% of adolescents with SUD receive treatment [5], and this treatment is generally suboptimal [3]. Indeed, there is such a profound disconnect between evidence and practice that ¡°¡­the vast majority of people in need of addiction
%U http://www.hindawi.com/journals/isrn.addiction/2013/815096/