NC West Virginia News

Adults with ADHD who use extended-release medication are more likely to continue treatment and have a lower risk of developing substance use disorder, according to research from West Virginia University.

Abdullah Al-Mamun, a data scientist and assistant professor in the WVU School of Pharmacy Department of Pharmaceutical Systems and Policy, noted the lack of information on adult ADHD. "There is a lot of information about childhood and adolescent ADHD, but very few talk about adult ADHD," he said. Al-Mamun's studies aimed to understand factors related to medication adherence and the likelihood of developing substance use disorder based on regular prescription usage.

A national survey found that 25% of American adults suspect they may have undiagnosed ADHD. The condition is often diagnosed in childhood but can persist or develop in adulthood, with symptoms like impulsiveness and low frustration tolerance differing from those seen in children.

In the U.S., central nervous system stimulants are commonly prescribed for treating adult ADHD, although there are no standard guidelines. Other countries such as Sweden, the U.K., and Germany have emerging guidelines for treating adult ADHD. "We need more guidelines here in the United States," Al-Mamun stated.

Al-Mamun's study showed that about 80% of adults with ADHD fail to comply with their treatment plan within the first year due to social stigma or forgetfulness. Using data from the Medical Expenditure Panel Survey, researchers compared patients taking extended-release CNS stimulants with those taking instant-release forms. They found higher adherence rates among those using extended-release medications, particularly in older age groups.

Patients using instant release pills were less consistent with their medication intake and had higher healthcare utilization rates compared to those taking extended-release versions regularly. "This is a huge problem in the United States because medication non-adherence for ADHD is very costly," Al-Mamun said.

Non-adherence not only increases healthcare costs but also impacts patients' personal lives by causing agitation and misunderstandings which can lead to depression or substance use issues. Al-Mamun observed rising drug overdose deaths among adults with ADHD while analyzing West Virginia toxicology data.

The study revealed that patients taking CNS stimulants were less likely to develop substance use disorder (SUD) than those not taking them. For instance, stimulant users took longer (1,462 days) to develop SUD compared to non-users (1,077 days).

Al-Mamun emphasized the importance of these findings: "These studies are very important because we don’t know much about what is happening with the adult ADHD population in the United States." He suggested further research tracking patients from childhood into adulthood could provide valuable insights.

Al-Mamun and doctoral student Ki Jin Jeun are exploring societal costs associated with adult ADHD and plan future studies on why adults discontinue medication leading potentially to substance use disorders.