MONDAY, March 23, 2026 (HealthDay News) -- Central nervous system (CNS) stimulant prescriptions are less frequent for young adults with attention-deficit/hyperactivity disorder (ADHD) with co-occurring substance use disorder (SUD), according to a study recently published in the Journal of the American Academy of Child & Adolescent Psychiatry.
Raman Baweja, M.D., from the Pennsylvania State College of Medicine in Hershey, and colleagues examined the impact of co-occurring SUD on ADHD treatment patterns in a retrospective cohort study using data on 1.23 million individuals aged 15 to 25 years with ADHD. Of these, about 23 percent had co-occurring SUD.
The researchers found that compared with ADHD without SUD, the ADHD with SUD cohort less often had CNS stimulant prescriptions (relative risk, 0.63), while new bupropion prescriptions were slightly more common (relative risk, 1.05). In patients with ADHD with SUD, ADHD treatment (including prescriptions for CNS stimulants and nonstimulants) was associated with fewer hospitalizations, reduced emergency care, a lower risk for suicidal ideation/attempts (range of relative risks, 0.74 to 0.82), and continuous use of psychiatric services (relative risk, 1.23), but fewer methadone prescriptions (relative risk, 0.74). Fewer hospitalizations, accidental overdoses, and suicidal ideation/attempts were seen in association with stimulant treatment compared with nonstimulant treatment (range of relative risks, 0.63 to 0.79). A lower risk for mortality was seen in association with ADHD treatment (adjusted hazard ratio, 0.70).
"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 said in a statement. "When used appropriately, treating ADHD -- including with stimulants -- can be associated with significantly better outcomes."
Several authors disclosed ties to industry.