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Published Online: 4 October 2023

Trends in Attention-Deficit Hyperactivity Disorder Diagnosis and Pharmacotherapy Among Adults With Opioid Use Disorder

Tae Woo Park, M.D., M.Sc. [email protected], Tithi D. Baul, M.P.H., Jake R. Morgan, Ph.D., Timothy E. Wilens, M.D., and Amy M. Yule, M.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 3
https://doi.org/10.1176/appi.ps.20220400
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Abstract

Objective:

This study aimed to assess nationwide trends in attention-deficit hyperactivity disorder (ADHD) diagnoses and pharmacotherapy among patients with opioid use disorder and ADHD and to examine factors predicting receipt of stimulant medications among patients receiving medications for opioid use disorder (MOUDs).

Methods:

A claims-based database of commercially insured patients ages 13–64 was used to conduct two analyses: an annual cross-sectional study of 387,980 patients diagnosed as having opioid use disorder (2007–2017) to estimate the prevalence of ADHD diagnoses and pharmacotherapy, and a retrospective cohort study of 158,591 patients receiving MOUDs to test, with multivariable regression, the association between patient characteristics and receipt of stimulant medication.

Results:

From 2007 to 2017, the prevalence of ADHD diagnoses increased from 4.6% to 15.1% and the rate of ADHD pharmacotherapy increased from 42.6% to 51.8% among patients with opioid use disorder. Among all patients receiving MOUDs, 10.5% received at least one prescription stimulant during the study period. Female sex; residence in the southern United States; and ADHD, mood, and anxiety disorder diagnoses were associated with increased likelihood of stimulant receipt. Stimulant use disorder and other substance use disorder diagnoses were associated with decreased likelihood of stimulant receipt.

Conclusions:

ADHD diagnoses and pharmacotherapy among patients with opioid use disorder have increased. A minority of patients with ADHD and taking MOUDs received a stimulant. Further study is needed of the benefits and risks of ADHD pharmacotherapy for patients with opioid use disorder.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 3 • March 01, 2024
Pages: 214 - 220
PubMed: 37789727

History

Received: 3 August 2022
Revision received: 11 August 2023
Accepted: 14 August 2023
Published online: 4 October 2023
Published in print: March 01, 2024

Keywords

  1. Attention-deficit disorders
  2. Amphetamines
  3. Substance use
  4. Opioid use disorder

Authors

Affiliations

Tae Woo Park, M.D., M.Sc. [email protected]
Department of Psychiatry, University of Pittsburgh, Pittsburgh (Park); Department of Psychiatry, Boston Medical Center, and Boston University School of Medicine, Boston (Baul, Yule); Boston University School of Public Health, Boston (Morgan); Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston (Wilens).
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Tithi D. Baul, M.P.H.
Department of Psychiatry, University of Pittsburgh, Pittsburgh (Park); Department of Psychiatry, Boston Medical Center, and Boston University School of Medicine, Boston (Baul, Yule); Boston University School of Public Health, Boston (Morgan); Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston (Wilens).
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Jake R. Morgan, Ph.D.
Department of Psychiatry, University of Pittsburgh, Pittsburgh (Park); Department of Psychiatry, Boston Medical Center, and Boston University School of Medicine, Boston (Baul, Yule); Boston University School of Public Health, Boston (Morgan); Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston (Wilens).
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Timothy E. Wilens, M.D.
Department of Psychiatry, University of Pittsburgh, Pittsburgh (Park); Department of Psychiatry, Boston Medical Center, and Boston University School of Medicine, Boston (Baul, Yule); Boston University School of Public Health, Boston (Morgan); Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston (Wilens).
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Amy M. Yule, M.D.
Department of Psychiatry, University of Pittsburgh, Pittsburgh (Park); Department of Psychiatry, Boston Medical Center, and Boston University School of Medicine, Boston (Baul, Yule); Boston University School of Public Health, Boston (Morgan); Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston (Wilens).
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Notes

Send correspondence to Dr. Park ([email protected]).

Competing Interests

Dr. Wilens reports receiving grant support from 3DBio Therapeutics; receiving royalties from Ironshore, Guilford Press, and Cambridge University Press; performing clinical work for Bay Cove Human Services, the Gavin Foundation, and Mass General Brigham; and serving as a consultant to Minor and Major League Baseball, the National Football League (ERM Associates), White Rhino, and 3DBio Therapeutics. Dr. Yule reports receiving funding from the Jack Satter Foundation and from Doris Duke Charitable Foundation’s COVID-19 Fund to Retain Clinical Scientists collaborative grant program, through support from the John Templeton Foundation. She reports serving as a consultant to Bay Cove Human Services, the Gavin Foundation, and the American Psychiatric Association’s Providers Clinical Support System subaward. The other authors report no financial relationships with commercial interests.

Funding Information

This work was supported by funding from the National Institute on Drug Abuse (NIDA; awards K23 DA044321 to Dr. Park and P30DA040500 to Dr. Morgan).The sponsor had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript or the decision to submit. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA or the NIH.

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