Attention-deficit/hyperactivity disorder among chronic methamphetamine users: Frequency, persistence, and adverse effects on everyday functioning

• ADHD is prevalent among chronic methamphetamine (MA) users.
• Chronic MA users are at increased risk for persistence of ADHD symptoms.
• In MA users, ADHD diagnoses were associated with unemployment, cognitive symptoms, and declines in everyday living.
• ADHD appears to play an important role in MA-associated disability.

AimsAttention-Deficit/Hyperactivity Disorder (ADHD) is widely regarded as a common comorbidity of methamphetamine (MA) dependence, but the frequency, persistence, and real-world impact of ADHD among MA users are not known.MethodsFour hundred individuals with MA use disorders within 18 months of evaluation and 355 non-MA using comparison subjects completed a comprehensive neuropsychiatric research battery, including self-report measures of everyday functioning.ResultsIn logistic regression models adjusting for potential confounds, lifetime diagnoses of ADHD as determined by a structured clinical interview were significantly more prevalent among the MA participants (21%) versus comparison subjects (6%), particularly the hyperactive and combined subtypes. MA use was also associated with an increased persistence of combined subtype of ADHD into adulthood. Among the MA users, lifetime ADHD diagnoses were uniquely associated with greater concurrent risk of declines in instrumental activities of daily living, elevated cognitive symptoms in day-to-day life, and unemployment.ConclusionsFindings indicate that ADHD is prevalent among chronic MA users, who are at increased risk for persistence of childhood diagnoses of ADHD into their adult years. ADHD also appears to play an important role in MA-associated disability, indicating that targeted ADHD screening and treatment may help to improve real-world outcomes for individuals with MA use disorders.