CARE Series - ADHD and Substance Use Disorder Care

Review of:

• Relationship between Substance Use Disorders (SUD) and ADHD
• Treatment strategies for SUD in ADHD
• Characteristics and methods to reduce prescription stimulant misuse
  

Presenter:

Timothy Wilens, MD
Chief of the Division of Child and Adolescent Psychiatry
Co-director of the Center for Addiction Medicine
Massachusetts General Hospital

1. Identify one confounding factor in diagnosing Attention Deficit Hyperactivity Disorder (ADHD) in an adult with a Substance Use Disorder (SUD).
2. Summarize the evidence base for the efficacy and safety of one medication treatment for ADHD.
3. Describe one strategy for mitigating the risk of ADHD medication misuse for people with an SUD.

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Medical Association (AMA)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

American Nurses Credentialing Center (ANCC)
Dartmouth Health designates this Enduring Material for a maximum of 1.00 ANCC contact hours.

All other learners may claim CME-designated participation credit. Consult your professional licensing board regarding the applicability and acceptance of CME-designated participation credit for programs certified for credit by organizations accredited by Joint Accreditation for Interprofessional Education.

Registration/Requirements for Successful Completion
You may claim credit for successful completion of this online course. In order to claim credit, you must follow these steps:

1. Click the Register tab above. If you are not logged into your account, you will need to log in. Use the Forgot Your Password? button if you need to reset your password.
2. Register for the activity.
3. Click the Content/Tests tab and then View Content to view the recording. View the entire presentation.
4. Complete the Post-Test (attestation - return to the Content/Tests tab to find it).
5. Click the Complete Evaluation button, or click My Account in the menu bar; then click Evaluations.
6. Complete and Submit the Evaluation.

Bibliographic Sources

• Adler L, et al. Am J Addict. 2009;18(5):393-401. 
  
  
• Adler, Spencer, Wilens ADHD In Children and Adults, Cambridge Press, 2016.
  
  
• Arria AM, et al. Subst Abus. 2008;29(4):19-38. 
  
  
• Boland H, DiSalvo M, Fried R, Woodworth KY, Wilens T, Faraone SV, Biederman J. A literature review and meta-analysis on the effects of ADHD medications on functional outcomes. J Psychiatr Res. 2020 Apr;123:21-30. https://doi.org/10.1016/j.jpsychires.2020.01.006. Epub 2020 Jan 27. PMID: 32014701.
  
  
• Carroll KM, et al. Compr Psychiatry. 1993;34(2):75-82. Schubiner H, et al. J Clin Psychiatry. 2000;61(4):244-251. Levin FR, et al. Drug Alcohol Depend. 1998;52(1):15-25. Levin FR, et al. Addict Behav. 2004;29(9):1875-1882. Wilens TE, et al. Am J Addict. 1998;7(2):156-163. Wilens TE, et al. Am J Addict. 2005;14(4):319-327.
  
  
• Charach A, et al. J Am Acad Child Adolesc Psychiatry. 2011;50(1):9-21.
  
  
• Cook J, Lloyd-Jones M, Arunogiri S, Ogden E, Bonomo Y. Managing attention deficit hyperactivity disorder in adults using illicit psychostimulants: A systematic review. Aust N Z J Psychiatry. 2017 Sep;51(9):876-885. https://doi.org/10.1177/0004867417714878. Epub 2017 Jun 22. PMID: 28639480.
  
  
• Cooper et al. Eur Neuropsychopharm 2017: 27:795-808
  
  
• Faraone SV, et al. Am J Psychiatry. 2006;163(10):1720-1729. 
  
  
• Faraone SV, et al. Am J Addict. 2007;16 Suppl 1:24-32. Taubin & Wilens, Child Psych Clin N Am, 2022.
  
  
• Faraone et al. J Am Acad Child Adoles Psych, 2020; 
  
  
• Froehlich TE, et al. Arch Pediatr Adolesc Med. 2007;161(9):857-864. Kessler RC, et al. Am J Psychiatry. 2006;163(4):716-723. 
  
  
• Kaminski and Wilens, Overlap of ADHD and SUD, in Textbook of SUD, 2019
  
  
• Kast K, Rao V, Wilens T. J Clin Psych: 2021
  
  
• Kollins et al., Neuropsychopharmacology volume 45, pages 851–856 (2020)
  
  
• Konstenius M, et al. Addiction. 2014;109(3):440-449. 
  
  
• McCabe SE, et al. Addiction. 2005;100(1):96-106. 
  
  
• McCabe SE, et al. J Am Acad Child Adolesc Psychiatry. 2016;55(6):479-486.
  
  
• McCabe SE, Schulenberg JE, Wilens TE, Schepis TS, McCabe VV, Veliz PT. JAMA Netw Open. 2023 Jul 3;6(7):e2322650. https://doi.org/10.1001/jamanetworkopen.2023.22650.
  
  
• Merikangas et al. J.Am.Acad.Child Adolesc.Psychiatry, 2010;49(10):980-989
  
  
• Miech RA, Johnston LD, Patrick ME, O’Malley PM, Bachman JG, Schulenberg JE. 2023. Monitoring the Future National Survey Results on Drug Use, 1975-2022: Secondary School Students. Monitoring the Future Monograph Series. Ann Arbor: Institute for Social Research, The University of Michigan.
  
  
• Levin FR, et al. Drug Alcohol Depend. 1998;52(1):15-25. Riggs PD. Sci Pract Perspect. 2003;2(1):18-29;  
  
  
• Levin FR, et al. JAMA Psychiatry. 2015;72(6):593-602.
  
  
• Park, T. W., Baul, T. D., Morgan, J. R., Wilens, T. E., & Yule, A. M. (2024). Trends in Attention-Deficit Hyperactivity Disorder Diagnosis and Pharmacotherapy Among Adults With Opioid Use Disorder. Psychiatric Services, 75(3), 214–220. https://doi.org/10.1176/appi.ps.20220400
  
  
• SAMHSA, Center for Behavioral Health Statistics & Quality, National Survey on Drug Use and Health, 2015
  
  
• Schlepis, McCabe, Ford & Wilens TE J Clin Psychiatry. 2020;81(6):20m13302. https://doi.org/10.4088/JCP.20m13302.
  
  
• Spencer TJ, et al. Am J Psychiatry. 2006;163(3):387-395.
  
  
• Taubin, Wilson and Wilens, ADHD and SUD in Young People, in Updates in Pharm of ADHD, Child Adolesc Psych Clin N America, Newcorn and Wilens (eds), Elsevier Press, 2022. 
  
  
• van Emmerik-van Oortmerssen K, et al. Drug Alcohol Depend. 2012;122(1-2):11-19.
  
  
• White BP, et al. J Am Coll Health. 2006;54(5):261-268.
  
  
• Wilens TE. Psychiatr Clin North Am. 2004;27(2):283-301. 
  
  
• Wilens TE, et al. Drug Alcohol Depend. 2008;96(1-2):145-154. 
  
  
• Wilens TE, et al. J Am Acad Child Adolesc Psychiatry. 2008;47(1):21-31. 
  
  
• Wilens TE, et al. Postgrad Med. 2010;122(5):97-109; 
  
  
• Wilens et al., J Am Acad Chld Adoles Psych: 2011
  
  
• Wilens TE, et al. Curr Opin Psychiatry. 2011;24(4):280-285. 
  
  
• Wilens TE, et al. J Clin Psychiatry. 2016;77(7):940-947. 
  
  
• Wilens T,  Kaminski T. Stimulant Misuse and Cognitive Enhancement. In L. Lundahl, D. Rosenberg (Ed.), Pediatric Clinics of North America. 2019; (66)6 
  
  
• Wilens et al. Am J Addictions 2020
  
  
• Yen et al., Addictive Behaviors Vol 64, January 2017, pp 308-313
  
  
• Zulauf CA, et al. Curr Psychiatry Rep. 2014;16(3):436.
  
  

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
CE Office
Dartmouth Health
[email protected]

Mitigation of Relevant Financial Relationships

Dartmouth Health adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education.  Any individuals in a position to control the content of a CE activity, including planners, faculty, authors, or others are required to disclose all financial relationships with ineligible companies^.  All relevant financial relationships have been mitigated prior to the commencement of the activity.

^Ineligible Company is any entity whose primary business purpose is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.