• Posted March 20, 2026

Some Patients With ADHD and Addiction History Missing Out

For millions of teens living with ADHD, the transition into adulthood adds more complexity and temptation to daily life. Substance abuse, on top of ADHD, can become a tricky landscape to navigate.

New research from Penn State College of Medicine reveals that the very patients who could benefit from ADHD medication the most — those also struggling with drug or alcohol addiction — are the least likely to receive it.

The study — published recently in the Journal of the American Academy of Child and Adolescent Psychiatry — analyzed the health records of more than 1.2 million people between 15 and 25 years of age with ADHD.

The findings suggest that withholding standard ADHD treatment due to fears of drug misuse may be putting them at greater risk.

ADHD affects roughly 12% to 17% of U.S. teens, according to data from the U.S. Centers for Disease Control and Prevention. 

It can cause impulsive, hyperactive behavior and trouble paying attention that make daily life a struggle. For about half of these individuals, those symptoms eventually lead to a substance use disorder (SUD), according to researchers.

Among those with a SUD in the study, the most common substances used were nicotine (65%), cannabis (42%) and alcohol (27%).

While clinicians often worry that prescribing stimulants like Adderall or Ritalin to someone with an addiction history is adding fuel to the fire, the data tells a different story.

The researchers found that when young adults with both conditions stayed on their ADHD medication, they saw a 30% reduction in their risk of death over five years. These patients also had fewer accidental overdoses and were less likely to harbor thoughts of self-harm.

“For young adults with ADHD and substance use disorder, appropriate treatment for ADHD could potentially save lives,” lead author Dr. Raman Baweja, a professor of psychiatry at Penn State University, said in a news release. “Clinicians shouldn’t hesitate to provide evidence-based ADHD treatment when it is indicated.”

Despite the benefits of treatment, the study pointed to hesitation on the part of some doctors because some ADHD meds, particularly central nervous system stimulants, are controlled substances. 

Once a young person was diagnosed with a substance use problem, prescriptions for new stimulants dropped by 17%, the study found. Ongoing treatments were also cut by 15%.

The study noted that patients on stimulants had a 4% lower rate of suicide attempts compared to those on non-stimulant alternatives.

“Although CNS stimulants are first-line, evidence-based treatments for ADHD, some clinicians appear hesitant to prescribe them in patients with substance use disorder,” Baweja noted. “Our findings suggest that, when used appropriately, treating ADHD  — including with stimulants — can be associated with significantly better outcomes.”

Researchers are now expanding their work to look at adults up to age 65. They plan to investigate how factors like race, ethnicity and gender play into these treatment gaps.

More information

The National Institute on Drug Abuse provides resources on the connection between substance use disorders along with other disorders.

SOURCES: Penn State College of Medicine, news release, March 12, 2026; Journal of the American Academy of Child and Adolescent Psychiatry, Dec. 17, 2025