Department of Economics and Business Economics

International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Heval Özgen, Parnassia Bavo Groep
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  • Renske Spijkerman, Parnassia Bavo Groep
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  • Moritz Noack, Ruhr University Bochum
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  • Martin Holtmann, Ruhr University Bochum
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  • Arnt S.A. Schellekens, Donders Institute, Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA)
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  • Geurt van de Glind, Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), International Collaboration on ADHD and Substance Abuse (ICASA) Foundation
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  • Tobias Banaschewski, Heidelberg University 
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  • Csaba Barta, Semmelweis University, Peter Pazmany Catholic University
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  • Alex Begeman, De Hoop GGZ
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  • Miguel Casas, Autonomous University of Barcelona
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  • Cleo L. Crunelle, Vrije Universiteit Brussel
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  • Constanza Daigre Blanco, Autonomous University of Barcelona, CIBER - Center for Biomedical Research Network
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  • Søren Dalsgaard
  • Zsolt Demetrovics, Eotvos Lorand University
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  • Jacomine den Boer, De Hoop GGZ
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  • Geert Dom, University of Antwerp
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  • Valsamma Eapen, University of New South Wales
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  • Stephen V. Faraone, SUNY Upstate Medical University
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  • Johan Franck, Piteå Hospital
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  • Rafael A. González, Imperial College London, East London NHS Foundation Trust
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  • Lara Grau-López, Autonomous University of Barcelona, CIBER - Center for Biomedical Research Network
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  • Annabeth P. Groenman, University of Amsterdam, University of Groningen
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  • Malin Hemphälä, Piteå Hospital
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  • Romain Icick, AP-HP Assistance Publique - Hopitaux de Paris, université de Paris
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  • Brian Johnson, SUNY Upstate Medical University
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  • Michael Kaess, University of Bern, Heidelberg University 
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  • Máté Kapitány-Fövény, Semmelweis University, Nyírő Gyula National Institute of Psychiatry and Addictions
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  • John G. Kasinathan, Justice Health and Forensic Mental Health Network
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  • Sharlene S. Kaye, University of New South Wales
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  • Falk Kiefer, Zentralinstitut fur Seelische Gesundheit - Central Institute of Mental Health
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  • Maija Konstenius, Piteå Hospital
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  • Frances R. Levin, Columbia University
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  • Mathias Luderer, Goethe University Frankfurt
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  • Giovanni Martinotti, Gabriele d’Annunzio University
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  • Frieda I.A. Matthys, Vrije Universiteit Brussel
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  • Gergely Meszaros, Semmelweis University
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  • Franz Moggi, University of Bern
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  • Ashmita P. Munasur-Naidoo, Nelson Mandela University, Cipla Medpro Pharmaceuticals
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  • Marianne Post, Parnassia Bavo Groep
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  • Sharon Rabinovitz, University of Haifa
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  • J. Antoni Ramos-Quiroga, Autonomous University of Barcelona, CIBER - Center for Biomedical Research Network
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  • Regina Sala, Queen Mary University of London
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  • Abu Shafi, East London NHS Foundation Trust
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  • Ortal Slobodin, Ben-Gurion University of the Negev
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  • Wouter G. Staal, Radboud University Nijmegen
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  • Rainer Thomasius, University of Hamburg
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  • Ilse Truter, Nelson Mandela University
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  • Michiel W. van Kernebeek, Vrije Universiteit Brussel
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  • Maria C. Velez-Pastrana, Universidad Carlos Albizu
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  • Sabine Vollstädt-Klein, Zentralinstitut fur Seelische Gesundheit - Central Institute of Mental Health
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  • Florence Vorspan, Institut National de la Santé et de la Recherche Médicale, AP-HP Assistance Publique - Hopitaux de Paris, Universite Paris-Saclay, FHU NOR-SUD Network of Research in Substance Use Disorders
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  • Jesse T. Young, Melbourne School of Population and Global Health, Murdoch Children's Research Institute, University of Western Australia, Curtin University of Technology
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  • Amy Yule, Boston University
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  • Wim van den Brink, International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, University of Amsterdam
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  • Vincent Hendriks, Parnassia Bavo Groep, Leiden University

BACKGROUND: Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. OBJECTIVE: The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. METHOD: A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. RESULTS: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. CONCLUSION: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.

Original languageEnglish
JournalEuropean Addiction Research
Volume26
Issue4-5
Pages (from-to)223-232
Number of pages10
ISSN1022-6877
DOIs
Publication statusPublished - Aug 2020

    Research areas

  • Adolescents, Attention-deficit/hyperactivity disorder, Consensus statement, Substance use disorder

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