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Attention-deficit hyperactivity disorder (ADHD) in adults attending addiction treatment in Ireland: preliminary international ADHD in substance-use disorders prevalence study (IASP) results

  • M. C. Van Hout (a1) and M. Foley (a2)



Attention-deficit hyperactivity disorder (ADHD) is a neuro-behavioural disorder characterised by early onset of persistent inattention–disorganisation and hyperactivity–impulsivity. Symptoms causing significant impairment in psychosocial function commence in childhood and heighten the risk for early substance experimentation and potential development of substance-use disorders (SUD). The research aimed to estimate the occurrence of adult attention-deficit hyperactivity disorder (ADHD) in new treatment cases of adults attending addiction treatment services.


The Adult ADHD Symptoms Rating Scale (ASRS) self-administered questionnaire was administered on entry and 2 weeks later for first admissions to inpatient and outpatient addiction treatment settings The ASRS is a validated and reliable 18-item self-report scale derived from the DSM-IV-TR diagnostic criteria for ADHD, comprising nine items on inattention and nine items on hyperactivity/impulsivity.


A total of 47 new treatment cases took part in the study. The occurrence of ADHD among SUDs in this sample was 13% (n = 6). Four of the participants were being treated for Problem Poly Substance use, whereas two participants were being treated for Problem Drug use. None of the participants screening positive for ADHD were being treated for Problem Alcohol use. Of the positively screened cases, all were male, predominantly single and unemployed.


The ASRS screening instrument may be a useful tool to detect ADHD co-morbidity in SUD treatment-seeking cases. More research is needed to appropriately develop the SUD treatment pathways for adolescent and adult ADHD sufferers in Ireland.


Corresponding author

*Address for correspondence: M. C. Van Hout, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland. (Email


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American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Arias, AJ, Gelernter, J, Chan, G, Weiss, RD, Brady, KT, Farrer, L, Farrer, L, Kranzler, HR (2008). Correlates of co-occurring ADHD in drug-dependent subjects: prevalence and features of substance dependence and psychiatric disorders. Addictive Behaviours 33, 11991207.
Barkley, R, Fischer, M, Smallish, L, Fletcher, K (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology 111, 279289.
Bellerose, D, Carew, AM, Lyons, S (2011). Trends in treated problem drug use in Ireland 2005–2010. HRB Trends Series 12. Health Research Board: Dublin.
Biederman, J (2005). Attention-deficit/hyperactivity disorder: a selective overview. Biological Psychiatry 57, 12151220.
Biederman, J, Farone, S, Milberger, S, Curtis, S, Chen, L, Marrs, A, Oeullette, , Moore, P, Spencer, T (1996). Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry 35, 343351.
Biederman, J, Monuteaux, MC, Mick, E, Spencer, T, Wilens, TE, Silva, JM, Snyder, LE, Faroane, SV (2000). Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychological Medicine 36, 167179.
Biederman, J, Petty, CR, Monuteaux, MC, Fried, R, Byrne, D, Mirto, T, Spencer, T, Wilens, T, Faroane, SV (2010). Adult psychiatric outcomes of girls with attention deficit hyperactivity disorder: 11-year follow-up in a longitudinal case-control study. American Journal of Psychiatry 167, 409417.
Carew, AM, Bellerose, D, Lyons, S (2011). Trends in treated problem alcohol use in Ireland 2005 to 2010. HRB Trends Series 11. Health Research Board: Dublin.
Carpentier, PJ, de Jong, CA, Dijkstra, BA, Verbrugge, CA, Krabbe, PF (2005). A controlled trial of methylphenidate in adults with attention deficit/hyperactivity disorder and substance use disorders. Addiction 100, 18681874.
Castells, X, Ramos-Quiroga, JA, Bosch, R, Nogueira, M, Casas, M (2011a). Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Systematic Review 6 doi:10.1002/14651858.CD007813.
Castells, X, Ramos-Quiroga, JA, Rigau, D, Bosch, R, Nogueira, M, Vidal, X, Casas, M (2011b). Efficacy of methylphenidate for adults with attention-deficit hyperactivity disorder: a meta-regression analysis. CNS Drugs 2, 157169.
Charach, A, Yeung, E, Climans, T, Lillie, E (2011). Childhood attention deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. Journal of the American Academy of Child & Adolescent Psychiatry 50, 921.
Chronis, AM, Lahey, BB, Pelham, WE, Kipp, HL, Baumann, BL, Lee, SS (2003). Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry 42, 14241432.
Clarke, C, Fitzpatrick, C (2005). Psychiatric problems in children exposed to opiates in utero. Irish Journal of Psychological Medicine 22, 121123.
Daly, A, Walsh, D (2010). Activities of Irish psychiatric units and hospitals 2009: main findings. HRB Statistics Series 9. Health Research Board: Dublin.
Davids, E, Gastpar, M (2003). Attention-deficit/hyperactivity disorder and substance abuse. Psychiatrische Praxis 30, 182186.
Edokpolo, O, Nkire, N, Smyth, BP (2010). Irish Adolescents with ADHD and comorbid substance use disorder. Irish Journal of Psychological Medicine 27, 148151.
Faraone, SV, Sergeant, J, Gillberg, C, Biederman, J (2003). The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2, 104113.
Fayyad, J, De Graaf, R, Kessler, R, Alonso, J, Angermeyer, M, Demyttenaere, K, De Girolamo, G, Haro, JM, Karam, EG, Lara, C, Lepine, JP, Ormel, J, Posada-Villa, J, Zaslavsky, AM, Jin, R (2007). Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. British Journal of Psychiatry 190, 402409.
Fitzgerald, M (1998). Adult attention deficit hyperactivity disorder. Irish Journal of Psychological Medicine 15, 8283.
Fitzgerald, M (2001). Psychopharmacological treatment of adolescent and adult attention deficit hyperactivity disorder. Irish Journal of Psychological Medicine 18, 9398.
Fitzgerald, M (2005). Attention Deficit Hyper Activity Disorder in adulthood. Irish Journal of Psychological Medicine 22, 134.
Goossensen, MA, van de Glind, G, Carpentier, PJ, Wijsen, RMA, van Duin, D, Kooij, S (2006). An intervention program for ADHD in patients with substance use disorders: preliminary results of a field trial. Journal of Substance Abuse Treatment 30, 253259.
Hinshaw, SP, Owens, EB, Sami, N, Fargeon, S (2006). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into adolescence: evidence for continuing cross-domain impairment. Journal of Consulting and Clinical Psychology 74, 489499.
James, PD, Smyth, BP, Apantaku-Olajide, T (2013). Substance use and psychiatric disorders in Irish adolescents: a cross sectional study of patients attending substance abuse treatment service. Mental Health and Substance Use 6 (2), 124132.
Kalbag, AS, Levin, FR (2005). Adult ADHD and substance abuse: diagnostic and treatment issues. Substance Use and Misuse 40, 19551981, 2043–2048.
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, etal. (2006). The prevalence and correlates of adult ADHD in the United States: results from the national comorbidity survey replication. American Journal of Psychiatry 163, 716723.
Kessler, RC, Adler, LA, Barkley, R, Biederman, J, Conners, CK, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2005). Patterns and predictors of attention deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biological Psychiatry 57, 14421451.
Kirley, A, Fitzgerald, M (2002). Adult attention deficit hyperactivity disorder: a controversial diagnosis. Irish Journal of Psychological Medicine 19, 8691.
Konstenius, M, Jayaram-Lindström, N, Beck, O, Franck, J (2010). Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: a pilot study. Drug and Alcohol Dependence 108, 130133.
Lee, SS, Humphreys, KL, Flory, K, Liu, R, Glass, K (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinical Psychology Review 31, 328341.
Lee, SS, Lahey, BB, Owens, EB, Hinshaw, SP (2008). Few preschool boys and girls with ADHD are well-adjusted during adolescence. Journal of Abnormal Child Psychology 36, 373383.
Levin, FR, Evans, SM, Brooks, DJ, Garawi, F (2007). Treatment of cocaine dependent treatment seekers with adult ADHD: double-blind comparison of methylphenidate and placebo. Drug and Alcohol Dependence 87, 2029.
Levin, FR, Evans, SM, Brooks, DJ, Kalbag, AS, Garawi, F, Nunes, EV (2006). Treatment of methadone-maintained patients with adult ADHD: double-blind comparison of methylphenidate, bupropion and placebo. Drug and Alcohol Dependence 81, 137148.
Lynch, F, Mills, C, Daly, I, Fitzpatrick, C (2006). Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. Journal of Adolescence 29, 555573.
Lynskey, MT, Hall, W (2001). Attention deficit hyperactivity disorder and substance use disorders: is there a causal link? Addiction 96, 815822.
Matsumoto, T, Kamijo, A, Yamaguchi, A, Iseki, E, Hirayasu, Y (2005). Childhood histories of attention-deficit hyperactivity disorders in Japanese methamphetamine and inhalant abusers: preliminary report. Psychiatry and Clinical Neurosciences 59, 102105.
Matthies, S, Philipsen, A, Svaldi, J (2012). Risky decision making in adults with ADHD. Journal of Behavior Therapy and Experimental Psychiatry 43, 938946.
Meltzer, H, Gatward, R, Goodman, R, Ford, T (2000). Mental health of children and adolescents in Great Britain: office for national statistics. Stationery Office: London.
Molina, BSG, Marshal, MP, Pelham, WE Jr, Wirth, RJ (2005). Coping skills and parent support mediate the association between childhood attention-deficit/hyperactivity disorder and adolescent cigarette use. Journal of Pediatric Psychology 30, 345357.
Owens, EB, Hinshaw, SP, Lee, SS, Lahey, BB (2009). Few girls with childhood attention-deficit/hyperactivity disorder show positive adjustment during adolescence. Journal of Clinical Child & Adolescent Psychology 38, 132143.
Polanczyk, G, Rohde, LA (2007). Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Current Opinions in Psychiatry 20, 386392.
Riggs, PD, Levin, F, Green, AI, Vocci, F (2008). Comorbid psychiatric and substance abuse disorders: recent treatment research. Substance Abuse 29, 5163.
Scahill, L, Schwab-Stone, M (2000). Epidemiology of ADHD in school-age children. Child and Adolescent Psychiatric Clinics of North America 9, 541555.
Sullivan, MA, Rudnik-Levin, F (2001). Attention deficit/hyperactivity disorder and substance abuse. Diagnostic and therapeutic considerations. Annals of the New York Academy of Sciences 931, 251270.
Syed, H, Masaud, TM, Nkire, N, Iro, C, Garland, MR (2010). Estimating the prevalence of adult ADHD in the psychiatric clinic: a cross-sectional study using the adult ADHD self-report scale (ASRS). Irish Journal of Psychological Medicine 27, 195197.
Thurstone, C, Riggs, PD, Salomonsen-Sautel, S, Mikulich-Gilbertson, CK (2010). Randomized, controlled trial of atomoxetine for attention-deficit/hyperactivity disorder in adolescents with substance use disorder. Journal of the American Academy of Child & Adolescent Psychiatry 49, 573582.
Van den Brink, W (2012). Screening for Adult ADHD in SUD Patients Reliability and Validity of the ASRS-v1 (Preliminary Results). ICASA Satellite Symposium Bordeaux, September 2012.
van Emmerik-van Oortmerssen, K, van de Glind, G, van den Brink, W, Smit, F (2012). Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug and Alcohol Dependence 122, 1119.
Wender, PH, Wolf, LE, Wasserstein, J (2001). Adults with ADHD. An overview. Annals of the New York Academy of Sciences 931, 116.
Wilens, TE (2004). Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk, and treatment issues. Psychiatric Clinics of North America 27, 283301.
Wilens, TE, Fusillo, S (2007). When ADHD and substance use disorders intersect: relationship and treatment implications. Current Psychiatry Reports 9, 408414.
Wilens, TE, Upadhyaya, HP (2007). Impact of substance use disorder on ADHD and its treatment. Journal of Clinical Psychiatry 68, e20.
Wilens, T, Martelon, MK, Joshi, G, Bateman, C, Fried, R, Petty, C, Biederman, J (2011). Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. Journal of the American Academy of Child & Adolescent Psychiatry 50, 543553.



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