Objective: Substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events.
Method: The authors analyzed 2005–2014 commercial health care claims from 2,993,887 (47.2% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not.
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The participant will recognize advantages and disadvantages of evidence from large-scale health care records data on the association between use of medication for attention deficit hyperactivity disorder and substance-related problems.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: September 1, 2017
End Date: August 31, 2019
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Title: ADHD Medication and Substance-Related Problems
Authors: Patrick D. Quinn, Ph.D., Zheng Chang, Ph.D., Kwan Hur, Ph.D., Robert D. Gibbons, Ph.D., Benjamin B. Lahey, Ph.D., Martin E. Rickert, Ph.D., Arvid Sjölander, Ph.D., Paul Lichtenstein, Ph.D., Henrik Larsson, Ph.D., Brian M. D’Onofrio, Ph.D.
Affiliations: From the Department of Psychological and Brain Sciences, Indiana University, Bloomington (P.D.Q., M.E.R., B.M.D.O.); the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago (P.D.Q., Z.C., K.H., R.D.G., B.B.L.); the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Z.C., A.S., P.L., H.L.); and the School of Medical Sciences, Örebro University, Örebro, Sweden (H.L.).
Disclosures: Dr. Gibbons has served as an expert witness in cases involving the U.S. Department of Justice and Wyeth, Pfizer, and GlaxoSmithKline. Dr. Larsson has served as a speaker for Eli Lilly and Shire and has received a research grant from Shire. Dr. Lichtenstein has served as a speaker for Medice. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
Optimal System Configuration:
- Flash Player: Adobe Flash Player 10.1+
- Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
- Operating System: Windows XP+ or Mac OS X 10.4+
- Internet Connection: 1 Mbps or higher
- Screen Resolution: 1024 x 768 pixels.
- Windows PC:500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
- Macintosh: Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit
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