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In a long-term study, children with ADHD had higher rates of substance use and substance use disorders in adolescence than peers without ADHD, and ADHD medication neither raised nor lowered that risk.

By Aaron Wilson, FounderPreliminaryEarly or limited evidence. Suggestive, not settled. How we label evidence · 2-min read · updated September 8, 2026

This is an evidence note - our summary of a single study, kept so you can check the research behind our articles. It is not guidance on its own. Start with the library for the practical reads.

The Multimodal Treatment Study of ADHD (MTA) followed 436 children with ADHD for up to 8 years after they enrolled, until they were about 17 years old on average. The children had originally been placed at random into different 14-month treatment groups during childhood. Researchers wanted to know whether those early treatments, or later medication use, were linked to substance use or substance use disorders in the teen years. They also compared the ADHD group to 261 classmates without ADHD.

The study found that the original randomly assigned treatment groups did not differ in substance use or substance use disorders by the 8-year mark or at any earlier point. Medication at follow-up (mostly stimulants) was not linked to teen substance use, and neither was the total amount of stimulant treatment a child received over time.

At the same time, the teens who had ADHD as children showed more substance use at every time point, including use of two or more substances and substance use disorders, than the teens without ADHD. This pattern held for both boys and girls. In other words, the higher risk tied to ADHD did not appear to be reduced by stimulant medication.

The authors noted that these results point to a need for other or additional substance-use prevention and treatment approaches aimed at teens with ADHD, since their higher risk was not improved by stimulant medication. This note describes research findings and is not medical advice; anyone with questions about ADHD medication or substance use should talk to a qualified clinician.

Source: Molina B, Hinshaw S, Eugene Arnold L, et al. Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication. Journal of the American Academy of Child & Adolescent Psychiatry (2013). doi:10.1016/j.jaac.2012.12.014

Source: Molina B, Hinshaw S, Eugene Arnold L, et al.. Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication. Journal of the American Academy of Child & Adolescent Psychiatry (2013). doi:10.1016/j.jaac.2012.12.014

Before you act on this: This describes what a study found, not advice about medication. Decisions about medication belong with a prescriber who knows your situation. Crisis: 988.

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Sources

  1. Molina B, Hinshaw S, Eugene Arnold L, Swanson J, Pelham W, Hechtman L. "Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication." Journal of the American Academy of Child & Adolescent Psychiatry, 2013 · doi:10.1016/j.jaac.2012.12.014

Wellness & education only. Not medical advice, diagnosis, or treatment. Talk to a licensed clinician about what applies to you.