77 Scopus citations


Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with substance use and substance use disorders (SUD). However, relatively little is known about the relationship between DSM-IV ADHD subtypes and substance use or DSM-IV abuse/dependence in epidemiological samples. Methods: Data were obtained from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC, N. = 33,588). Respondents reported on ADHD symptoms (DSM-IV) for the period of time when they were 17. years or younger. Lifetime use and DSM-IV abuse/dependence of alcohol, nicotine, cannabis, cocaine, sedatives, stimulants and heroin/opiates were compared across those with ADHD symptoms but no diagnosis (ADHDsx; N. = 17,009), the Combined (ADHD-C; N. = 361), Predominantly Inattentive (ADHD-I; N. = 325), and the Predominantly Hyperactive-Impulsive (ADHD-HI; N. = 279) ADHD subtypes. Taking a more dimensional approach, inattentive and hyperactive-impulsive symptom counts and their associations with substance use and misuse were also examined. Results: After adjustments for conduct disorder, major depressive disorder, any anxiety disorder and other socio-demographic covariates, substance use and SUD were associated with ADHDsx, ADHD-C, ADHD-I and ADHD-HI. Overall, substance use and SUD were more weakly associated with the ADHDsx group compared to the three ADHD diagnostic groups.Statistically significant differences were not evident across the three diagnostic groups. Hyperactive-impulsive symptoms were more consistently associated with substance use and SUD compared to inattentive symptoms. Conclusions: ADHD subtypes are consistently associated with substance use and SUD. The relatively stronger association of hyperactive/impulsive symptoms with substance use and abuse/dependence is consistent with the extant literature noting impulsivity as a precursor of substance use and SUD.

Original languageEnglish
Pages (from-to)1278-1285
Number of pages8
JournalAddictive Behaviors
Issue number8
StatePublished - Aug 2014


  • ADHD subtypes
  • Substance use
  • Substance use disorders


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