Drug, Alcohol Abstinence May Improve ADHD Symptoms in Polysubstance Use Disorder

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Abstinence relieves symptoms associated with attention-deficit/hyperactivity disorder among patients with polysubstance use disorder.
Abstinence relieves symptoms associated with attention-deficit/hyperactivity disorder among patients with polysubstance use disorder.

Significant improvements may be seen in attention-deficit/hyperactivity disorder (ADHD) symptoms after a year of abstinence from drugs and alcohol, according to a study published in Addictive Behaviors Report.

The investigators recruited 115 treatment-seeking patients with polysubstance use disorder and 34 control patients. Of the 115 patients examined in this study, 51 remained abstinent for the duration of the study, and 64 relapsed. A relapse was defined as a score of ≥8 on the Alcohol Use Disorders Identification Test, or ≥6 for men or ≥2 for women on the Drug Use Disorders Identification Test. Baseline severity of substance abuse was similar between groups.

ADHD symptoms were rated on the adult ADHD Self-Report Scale, and were also similar between substance-dependent groups at baseline.

Patients who were abstinent at follow-up showed notable decreases in the severity of their ADHD symptoms. Survey items that saw particular improvement included "restless," "attention," "listening," "talks excessively," and "easily distracted."

Participants who relapsed also demonstrated statistically significant improvement in the categories of "fidgets" and "organization."

At 1-year follow-up, total ADHD Self Report Scale scores decreased from 34.0 to 23.3 for the group that remained abstinent. The relapse group saw a smaller decrease, from 35.6 to 31.6. Control scores remained similar, from 21.2 to 21.0.

The investigators noted several limitations of the study, particularly that participants were only assessed at baseline and 1 year. Thus, it could not be determined when the improvements occurred. In addition, because of self-reported and missing historical data, they could not discern whether the reduction in symptom severity applied only to a subthreshold group, or whether it was associated with cases of late-onset ADHD.

Nonetheless, the study authors stated that these findings "suggest that there is a clinically (as well as a statistically) significant reduction in self-reported ADHD symptoms for [substance use disorder] patients following one year of abstinence".

Reference

Hagen E, Erga A, Nesvåg S, et al. One-year abstinence improves ADHD symptoms among patients with polysubstance use disorder. Addict Behav Rep. 2017;6:96-101.

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