ADHD diagnosis in adulthood: Implications for cannabis use and consequences

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

Investigators

Linked publications, trials & patents

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a well-known risk factor for cannabis use (CU), CU-related negative consequences, and other harmful substance use through adolescence into adulthood. At the same time, cannabis is the most commonly used non-alcohol, non-nicotine drug in the US (remaining illegal for recreational use in PA). Despite absence of objective evidence, many individuals with ADHD believe it to be therapeutic. CU reached its highest levels in 2022 (44% in the past year) with the peak use at ages 27-28 (46.6%) when transitioning to adulthood independence is near-universal (e.g., most out of college; parental healthcare coverage ends). Unfortunately, research on ADHD and CU/CU consequences has primarily focused on boys and men with little data to guide understanding of the ADHD-CU association as moderated by sex. Different symptom profiles and psychiatric comorbidities from limited research between girls/women and boys/men with ADHD suggest the potential for untested sex-related variation in risk factors for CU/CU consequences. There are also findings (outside of ADHD research) that, relative to men, women have elevated risk for CU consequences or progress to disorder more rapidly. At the same time, there is a dramatic increase in diagnosis and stimulant treatment of ADHD in adulthood and especially for women. Taken together, these increasing CU and adult ADHD diagnosis trends, and lack of sex-specific data on ADHD and CU, indicate a pressing need for research on ADHD and CU in adulthood in relation to sex and age of diagnosis. We are currently conducting a longitudinal survey study of 18-22 year olds with ADHD diagnosed in adulthood (DA049721). Our preliminary data suggest elevated ADHD symptom severity and CU amongst adults diagnosed with ADHD in adulthood and even more so for women than for men which support the need to continue and expand our work with the adult diagnosed participants. We propose continued follow-up (electronic survey with a brief 6-month follow-up) of the adult-diagnosed sample (n=150), doubling of its size to 300, and recruitment/parallel survey of demographically similar comparison samples of adults with childhood-diagnosed ADHD (300) and without ADHD (300), between ages 23-28. Based on our preliminary data, the final sample will be approximately half men and approximately half women. This research will help fill a void in the literature on ADHD and CU for the most rapidly growing segment of adults diagnosed with ADHD: women. Results will inform theory on ADHD and CU/CU consequences as well as sex differences in putative causal pathways and thereby inform future treatment development. The proposed research is directly in line with the Cross-Cutting Priorities