{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T18:22:32Z","timestamp":1794507752150,"version":"4.9.1"},"reference-count":106,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adults with attention deficit\/hyperactivity disorder (ADHD) often present psychiatric comorbidities and, in particular, substance use disorder (SUD). ADHD-SUD comorbidity is characterized by greater severity of both disorders, earlier age of onset, higher likelihood of polydrug-abuse and suicidal behaviors, more hospitalizations, and lower treatment adherence. At the present stage, research focused on the pharmacological management of ADHD with comorbid SUD in both adolescents and adults is still lacking. Furthermore, while the short-term effects of stimulants are well studied, less is known about the chronic effects of these drugs on dopamine signaling. Current available evidence is consistent in reporting that high doses of stimulant medications in ADHD-SUD subjects have a mild to moderate efficacy on ADHD symptoms. Some data suggest that pharmacological treatment with stimulants may be beneficial for both ADHD symptoms and comorbid cocaine or amphetamine use. However, in the long run, stimulant medications may have a potential risk for misuse. For the absence of potential misuse, atomoxetine is often recommended for ADHD with comorbid cocaine or amphetamine use disorder. However, its efficacy in reducing addictive behavior is not demonstrated. In subjects with other subtypes of SUD, both atomoxetine and stimulant drugs seem to have scarce impact on addictive behavior, despite the improvement in ADHD symptomatology. In this population, ADHD treatment should be combined with SUD-specific strategies.<\/jats:p>","DOI":"10.3390\/jcm12093096","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T01:37:01Z","timestamp":1682386621000},"page":"3096","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Challenges of Treating ADHD with Comorbid Substance Use Disorder: Considerations for the Clinician"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0077-3815","authenticated-orcid":false,"given":"Margherita","family":"Barbuti","sequence":"first","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-753X","authenticated-orcid":false,"given":"Marco","family":"Maiello","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Spera","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7281-1337","authenticated-orcid":false,"given":"Alessandro","family":"Pallucchini","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-0406","authenticated-orcid":false,"given":"Giulio","family":"Brancati","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-3705","authenticated-orcid":false,"given":"Angelo","family":"Maremmani","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Department of Psychiatry and Addictions, North-Western Tuscany Local Health Unit, Tuscany NHS, Versilia Zone, Via Aurelia 335, 55041 Lido di Camaiore, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5556-1858","authenticated-orcid":false,"given":"Giulio","family":"Perugi","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6324-0576","authenticated-orcid":false,"given":"Icro","family":"Maremmani","sequence":"additional","affiliation":[{"name":"2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/S2215-0366(16)30190-0","article-title":"Method of adult diagnosis influences estimated persistence of childhood ADHD: A systematic review of longitudinal studies","volume":"3","author":"Sibley","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.neubiorev.2021.01.022","article-title":"The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder","volume":"128","author":"Faraone","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1093\/ije\/dyt261","article-title":"ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis","volume":"43","author":"Polanczyk","year":"2014","journal-title":"Int. J. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4009","DOI":"10.7189\/jogh.11.04009","article-title":"The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis","volume":"11","author":"Song","year":"2021","journal-title":"J. Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s00787-018-1211-3","article-title":"Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment","volume":"28","author":"Mowlem","year":"2019","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Young, S., Adamo, N., \u00c1sgeirsd\u00f3ttir, B.B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., and Gudjonsson, G. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit\/ hyperactivity disorder in girls and women. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-02707-9"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jad.2012.10.011","article-title":"Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder","volume":"147","author":"Skirrow","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1176\/ajp.2006.163.4.716","article-title":"The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication","volume":"163","author":"Kessler","year":"2006","journal-title":"Am. J. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.drugalcdep.2011.12.007","article-title":"Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: A meta-analysis and meta-regression analysis","volume":"122","author":"Smit","year":"2012","journal-title":"Drug Alcohol Depend."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Spera, V., Pallucchini, A., Maiello, M., Carli, M., Maremmani, A.G.I., Perugi, G., and Maremmani, I. (2020). Substance Use Disorder in Adult-Attention Deficit Hyperactive Disorder Patients: Patterns of Use and Related Clinical Features. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17103509"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pallucchini, A., Carli, M., Maremmani, A.G.I., Scarselli, M., Perugi, G., and Maremmani, I. (2021). Influence of Substance Use Disorder on Treatment Retention of Adult-Attention-Deficit\/Hyperactive Disorder Patients. A 5-Year Follow-Up Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10091984"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1176\/appi.ajp.161.11.2014","article-title":"Three-year predictive validity of DSM-IV attention deficit hyperactivity disorder in children diagnosed at 4-6 years of age","volume":"161","author":"Lahey","year":"2004","journal-title":"Am. J. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1080\/14656566.2019.1618270","article-title":"Current and emerging pharmacotherapy for the treatment of adult attention deficit hyperactivity disorder (ADHD)","volume":"20","author":"Perugi","year":"2019","journal-title":"Expert Opin Pharm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.jaac.2017.05.004","article-title":"Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis","volume":"56","author":"Groenman","year":"2017","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.addbeh.2013.09.002","article-title":"ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood\u2014A naturalistic long-term follow-up study","volume":"39","author":"Dalsgaard","year":"2014","journal-title":"Addict. Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1192\/bjp.bp.112.124784","article-title":"Stimulant treatment for attention-deficit hyperactivity disorder and risk of developing substance use disorder","volume":"203","author":"Groenman","year":"2013","journal-title":"Br. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1126\/science.aav3928","article-title":"Relating addiction and psychiatric disorders","volume":"361","author":"Vink","year":"2018","journal-title":"Science"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/ajad.12500","article-title":"Neuroimaging the neural correlates of increased risk for substance use disorders in attention-deficit\/hyperactivity disorder-A systematic review","volume":"26","author":"Adisetiyo","year":"2017","journal-title":"Am. J. Addict."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1176\/appi.ajp.162.8.1403","article-title":"The neural basis of addiction: A pathology of motivation and choice","volume":"162","author":"Kalivas","year":"2005","journal-title":"Am. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1038\/mp.2014.58","article-title":"Stimulant-induced dopamine increases are markedly blunted in active cocaine abusers","volume":"19","author":"Volkow","year":"2014","journal-title":"Mol. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1016\/S0140-6736(99)04030-1","article-title":"Dopamine transporter density in patients with attention deficit hyperactivity disorder","volume":"354","author":"Dougherty","year":"1999","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1192\/apt.bp.111.009340","article-title":"ADHD with comorbid substance use disorder: Review of treatment","volume":"18","author":"Magon","year":"2012","journal-title":"Adv. Psychiatr. Treat."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Brynte, C., Aeschlimann, M., Barta, C., Begeman, A.H.A., B\u00e4cker, A., Crunelle, C.L., Daigre, C., De Fuentes-Merillas, L., Demetrovics, Z., and Dom, G. (2022). The clinical course of comorbid substance use disorder and attention deficit\/hyperactivity disorder: Protocol and clinical characteristics of the INCAS study. BMC Psychiatry, 22.","DOI":"10.1186\/s12888-022-04259-6"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1111\/add.12370","article-title":"Psychiatric comorbidity in treatment-seeking substance use disorder patients with and without attention deficit hyperactivity disorder: Results of the IASP study","volume":"109","author":"Koeter","year":"2014","journal-title":"Addiction"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1080\/14656566.2022.2148830","article-title":"What value do norepinephrine\/dopamine dual reuptake inhibitors have to the current treatment of adult attention deficit hyperactivity disorder (ADHD) treatment armamentarium?","volume":"23","author":"Perugi","year":"2022","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/S2215-0366(18)30269-4","article-title":"Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis","volume":"5","author":"Cortese","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_27","unstructured":"National Institute for Health and Care Excellence (NICE) (2018). Attention Deficit Hyperactivity Disorder: Diagnosis and Management, NICE. Clinical Guideline [CG87]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.4088\/JCP.v63n1207","article-title":"Obsessive-compulsive-bipolar comorbidity: A systematic exploration of clinical features and treatment outcome","volume":"63","author":"Perugi","year":"2002","journal-title":"J. Clin. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1159\/000487767","article-title":"International Consensus Statement on Screening, Diagnosis and Treatment of Substance Use Disorder Patients with Comorbid Attention Deficit\/Hyperactivity Disorder","volume":"24","author":"Crunelle","year":"2018","journal-title":"Eur. Addict. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/j.1521-0391.2013.12047.x","article-title":"Attention deficit hyperactivity disorder in cocaine-dependent adults: A psychiatric comorbidity analysis","volume":"22","author":"Daigre","year":"2013","journal-title":"Am. J. Addict."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6","DOI":"10.20882\/adicciones.785","article-title":"Psychiatric comorbidity in a sample of cocaine-dependent outpatients seen in the Community of Madrid drug addiction care network","volume":"28","year":"2016","journal-title":"Adicciones"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.drugalcdep.2013.09.026","article-title":"Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: Results from an international multi-center study exploring DSM-IV and DSM-5 criteria","volume":"134","author":"Konstenius","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1177\/1087054716629217","article-title":"Persistence and Subtype Stability of ADHD Among Substance Use Disorder Treatment Seekers","volume":"23","author":"Kaye","year":"2019","journal-title":"J. Atten. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.addbeh.2014.04.003","article-title":"Attention-deficit\/hyperactivity disorder subtypes and substance use and use disorders in NESARC","volume":"39","author":"Lynskey","year":"2014","journal-title":"Addict. Behav."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1046\/j.1471-4159.2002.00820.x","article-title":"Dopamine transport function is elevated in cocaine users","volume":"81","author":"Mash","year":"2002","journal-title":"J. Neurochem."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wang, G.-J., Volkow, N.D., Wigal, T., Kollins, S.H., Newcorn, J.H., Telang, F., Logan, J., Jayne, M., Wong, C.T., and Han, H. (2013). Long-term stimulant treatment affects brain dopamine transporter level in patients with attention deficit hyperactive disorder. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0063023"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.euroneuro.2013.05.002","article-title":"Low dopamine transporter occupancy by methylphenidate as a possible reason for reduced treatment effectiveness in ADHD patients with cocaine dependence","volume":"23","author":"Crunelle","year":"2013","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1007\/s11695-018-3493-4","article-title":"Risk of Suicide and Self-harm Is Increased After Bariatric Surgery-a Systematic Review and Meta-analysis","volume":"29","author":"Castaneda","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/026988119901300406","article-title":"Imaging studies on the role of dopamine in cocaine reinforcement and addiction in humans","volume":"13","author":"Volkow","year":"1999","journal-title":"J. Psychopharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/14656566.2018.1551878","article-title":"Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD)","volume":"20","author":"Perugi","year":"2019","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/0269881114544777","article-title":"Pharmacological treatment of attention deficit hyperactivity disorder with co-morbid drug dependence","volume":"29","author":"Cunill","year":"2015","journal-title":"J. Psychopharmacol."},{"key":"ref_42","first-page":"CD009695","article-title":"Efficacy of psychostimulant drugs for amphetamine abuse or dependence","volume":"9","author":"Castells","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Manni, C., Cipollone, G., Pallucchini, A., Maremmani, A.G.I., Perugi, G., and Maremmani, I. (2019). Remarkable Reduction of Cocaine Use in Dual Disorder (Adult Attention Deficit Hyperactive Disorder\/Cocaine Use Disorder) Patients Treated with Medications for ADHD. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16203911"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1001\/jamapsychiatry.2015.41","article-title":"Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit\/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial","volume":"72","author":"Levin","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.drugalcdep.2018.03.043","article-title":"How treatment improvement in ADHD and cocaine dependence are related to one another: A secondary analysis","volume":"188","author":"Levin","year":"2018","journal-title":"Drug Alcohol Depend."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"300","DOI":"10.4088\/JCP.v59n0605","article-title":"Methylphenidate treatment for cocaine abusers with adult attention-deficit\/hyperactivity disorder: A pilot study","volume":"59","author":"Levin","year":"1998","journal-title":"J. Clin. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.drugalcdep.2006.07.004","article-title":"Treatment of cocaine dependent treatment seekers with adult ADHD: Double-blind comparison of methylphenidate and placebo","volume":"87","author":"Levin","year":"2007","journal-title":"Drug Alcohol Depend."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.drugalcdep.2005.09.003","article-title":"Response to cocaine, alone and in combination with methylphenidate, in cocaine abusers with ADHD","volume":"82","author":"Collins","year":"2006","journal-title":"Drug Alcohol Depend."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1590\/S0100-879X2008005000011","article-title":"A randomized crossover clinical study showing that methylphenidate-SODAS improves attention-deficit\/hyperactivity disorder symptoms in adolescents with substance use disorder","volume":"41","author":"Szobot","year":"2008","journal-title":"Braz. J. Med. Biol. Res. Rev. Bras. Pesqui. Med. E Biol."},{"key":"ref_50","first-page":"CD007380","article-title":"Psychostimulant drugs for cocaine dependence","volume":"9","author":"Castells","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1007\/s00213-020-05563-3","article-title":"Prescription psychostimulants for the treatment of stimulant use disorder: A systematic review and meta-analysis","volume":"237","author":"Tardelli","year":"2020","journal-title":"Psychopharmacology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/add.12369","article-title":"Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: A 24-week randomized placebo-controlled trial","volume":"109","author":"Konstenius","year":"2014","journal-title":"Addiction"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.drugalcdep.2009.11.006","article-title":"Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: A pilot study","volume":"108","author":"Konstenius","year":"2010","journal-title":"Drug Alcohol Depend."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Kooij, J.J.S. (2022). Adult ADHD. Diagnostic Assessment and Treatment, Springer. [4th ed.].","DOI":"10.1007\/978-3-030-82812-7"},{"key":"ref_55","first-page":"CD009504","article-title":"Bupropion for attention deficit hyperactivity disorder (ADHD) in adults","volume":"10","author":"Verbeeck","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J069v21n02_01","article-title":"Bupropion treatment for cocaine abuse and adult attention-deficit\/hyperactivity disorder","volume":"21","author":"Levin","year":"2002","journal-title":"J. Addict. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/JCP.0000000000000501","article-title":"Factors Associated With Adherence to Methylphenidate Treatment in Adult Patients With Attention-Deficit\/Hyperactivity Disorder and Substance Use Disorders","volume":"36","author":"Skoglund","year":"2016","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1159\/000508385","article-title":"International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit\/Hyperactivity Disorder and Substance Use Disorder","volume":"26","author":"Spijkerman","year":"2020","journal-title":"Eur. Addict. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.drugalcdep.2011.10.030","article-title":"The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2","volume":"123","author":"Tuithof","year":"2012","journal-title":"Drug Alcohol Depend."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/j.1530-0277.2007.00349.x","article-title":"Attention-deficit\/hyperactivity disorder risk for heavy drinking and alcohol use disorder is age specific","volume":"31","author":"Molina","year":"2007","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3359","DOI":"10.2174\/1381612821666150619093254","article-title":"Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders","volume":"21","author":"Simon","year":"2015","journal-title":"Curr. Pharm. Des."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/alcalc\/agl030","article-title":"Behavioural aspects of impulsivity in alcoholics with and without a cluster-B personality disorder","volume":"41","author":"Dom","year":"2006","journal-title":"Alcohol Alcohol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.drugalcdep.2010.07.027","article-title":"Behavioral components of impulsivity predict alcohol consumption in adults with ADHD and healthy controls","volume":"113","author":"Weafer","year":"2011","journal-title":"Drug Alcohol Depend."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.drugalcdep.2007.12.016","article-title":"Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study","volume":"95","author":"Wilens","year":"2008","journal-title":"Drug Alcohol Depend."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/1087054707311654","article-title":"ADHD, substance use disorders, and psychostimulant treatment: Current literature and treatment guidelines","volume":"12","author":"Kollins","year":"2008","journal-title":"J. Atten. Disord."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1177\/1087054717750272","article-title":"Prevalence Estimates of ADHD in a Sample of Inpatients With Alcohol Dependence","volume":"24","author":"Luderer","year":"2020","journal-title":"J. Atten. Disord."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1001\/archpsyc.64.8.932","article-title":"Depressed dopamine activity in caudate and preliminary evidence of limbic involvement in adults with attention-deficit\/hyperactivity disorder","volume":"64","author":"Volkow","year":"2007","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/S2215-0366(16)00104-8","article-title":"Neurobiology of addiction: A neurocircuitry analysis","volume":"3","author":"Koob","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.drugalcdep.2008.02.009","article-title":"Atomoxetine treatment of adults with ADHD and comorbid alcohol use disorders","volume":"96","author":"Wilens","year":"2008","journal-title":"Drug Alcohol Depend."},{"key":"ref_70","unstructured":"United Nations Publication (2021). World Drug Report 2021, Oxford University Press."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/ADM.0000000000000138","article-title":"Co-Occurrence of Substance-Related and Other Mental Health Disorders Among Adolescent Cannabis Users","volume":"9","author":"Zaman","year":"2015","journal-title":"J. Addict. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1017\/S0033291711001322","article-title":"Sub-chronic impact of cannabinoids in street cannabis on cognition, psychotic-like symptoms and psychological well-being","volume":"42","author":"Morgan","year":"2012","journal-title":"Psychol. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/ADM.0b013e31820c23fa","article-title":"An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions","volume":"5","author":"Crean","year":"2011","journal-title":"J. Addict. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1080\/09595230701247772","article-title":"The relationship between non-acute adolescent cannabis use and cognition","volume":"26","author":"Harvey","year":"2007","journal-title":"Drug Alcohol Rev."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.neuropharm.2013.05.027","article-title":"Response inhibition and elevated parietal-cerebellar correlations in chronic adolescent cannabis users","volume":"84","author":"Behan","year":"2014","journal-title":"Neuropharmacology"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3389\/fpsyg.2010.00225","article-title":"Altered frontal cortical volume and decision making in adolescent cannabis users","volume":"1","author":"Churchwell","year":"2010","journal-title":"Front. Psychol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1177\/0269881117744995","article-title":"Neuroimaging meta-analysis of cannabis use studies reveals convergent functional alterations in brain regions supporting cognitive control and reward processing","volume":"32","author":"Yanes","year":"2018","journal-title":"J. Psychopharmacol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.drugalcdep.2013.05.020","article-title":"Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder","volume":"133","author":"Wang","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13722-016-0056-7","article-title":"Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: A comprehensive review","volume":"11","author":"Angarita","year":"2016","journal-title":"Addict. Sci. Clin. Pract."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1080\/02791072.2013.785837","article-title":"Tentative evidence for striatal hyperactivity in adolescent cannabis-using boys: A cross-sectional multicenter fMRI study","volume":"45","author":"Jager","year":"2013","journal-title":"J. Psychoact. Drugs"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1111\/ejn.14407","article-title":"Modulatory effects of cannabinoids on brain neurotransmission","volume":"50","author":"Cohen","year":"2019","journal-title":"Eur. J. Neurosci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1038\/npp.2008.138","article-title":"Delta 9-tetrahydrocannabinol induces dopamine release in the human striatum","volume":"34","author":"Bossong","year":"2009","journal-title":"Neuropsychopharmacology"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"E3149","DOI":"10.1073\/pnas.1411228111","article-title":"Decreased dopamine brain reactivity in marijuana abusers is associated with negative emotionality and addiction severity","volume":"111","author":"Volkow","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Spera, V., Pallucchini, A., Carli, M., Maiello, M., Maremmani, A.G.I., Perugi, G., and Maremmani, I. (2021). Does Cannabis, Cocaine and Alcohol Use Impact Differently on Adult Attention Deficit\/Hyperactivity Disorder Clinical Picture?. J. Clin. Med., 10.","DOI":"10.3390\/jcm10071481"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3109\/10826084.2013.841251","article-title":"Subtypes of attention deficit-hyperactivity disorder (ADHD) and cannabis use","volume":"49","author":"Loflin","year":"2014","journal-title":"Subst. Use Misuse"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/HRP.0000000000000303","article-title":"Neurodevelopmental Effects of Cannabis Use in Adolescents and Emerging Adults with ADHD: A Systematic Review","volume":"29","author":"Cawkwell","year":"2021","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.drugalcdep.2016.01.032","article-title":"The impact of ADHD persistence, recent cannabis use, and age of regular cannabis use onset on subcortical volume and cortical thickness in young adults","volume":"161","author":"Lisdahl","year":"2016","journal-title":"Drug Alcohol Depend."},{"key":"ref_88","first-page":"167","article-title":"Cortical Thickness and Subcortical Volumes in Adolescent Synthetic Cannabinoid Users with or Without ADHD: A Preliminary Study","volume":"56","author":"Zorlu","year":"2019","journal-title":"Noro Psikiyatr. Ars."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1097\/RLU.0b013e31829f9119","article-title":"Searching for a neurobiological basis for self-medication theory in ADHD comorbid with substance use disorders: An in vivo study of dopamine transporters using (99m)Tc-TRODAT-1 SPECT","volume":"39","author":"Silva","year":"2014","journal-title":"Clin. Nucl. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/j.1521-0391.2010.00076.x","article-title":"A placebo-controlled trial of atomoxetine in marijuana-dependent individuals with attention deficit hyperactivity disorder","volume":"19","author":"Carter","year":"2010","journal-title":"Am. J. Addict."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1159\/000321259","article-title":"Influence of attention deficit hyperactivity disorder and conduct disorder on opioid dependence severity and psychiatric comorbidity in chronic methadone-maintained patients","volume":"17","author":"Carpentier","year":"2011","journal-title":"Eur. Addict. Res."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.psychres.2017.01.052","article-title":"Co-occurring Attention Deficit Hyperactivity Disorder symptoms in adults affected by heroin dependence: Patients characteristics and treatment needs","volume":"250","author":"Lugoboni","year":"2017","journal-title":"Psychiatry Res."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0740-5472(01)00193-3","article-title":"Dual diagnosis and successful participation of adolescents in substance abuse treatment","volume":"21","author":"Wise","year":"2001","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1016\/j.addbeh.2004.03.041","article-title":"Impact of attention-deficit hyperactivity disorder and other psychopathology on treatment retention among cocaine abusers in a therapeutic community","volume":"29","author":"Levin","year":"2004","journal-title":"Addict. Behav."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/j.pain.0000000000000730","article-title":"Incident and long-term opioid therapy among patients with psychiatric conditions and medications: A national study of commercial health care claims","volume":"158","author":"Quinn","year":"2017","journal-title":"Pain"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/1087054713518237","article-title":"Accident Proneness in Children and Adolescents Affected by ADHD and the Impact of Medication","volume":"20","author":"Lange","year":"2016","journal-title":"J. Atten. Disord."},{"key":"ref_97","first-page":"95","article-title":"Addiction from a developmental perspective: The role of conduct disorder and ADHD in the development of problematic substance use disorders","volume":"56","author":"Carpentier","year":"2014","journal-title":"Tijdschr. Psychiatr."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1080\/15504263.2013.867657","article-title":"Stimulant medication for ADHD in opioid maintenance treatment","volume":"10","author":"Abel","year":"2014","journal-title":"J. Dual Diagn."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.drugalcdep.2005.06.012","article-title":"Treatment of methadone-maintained patients with adult ADHD: Double-blind comparison of methylphenidate, bupropion and placebo","volume":"81","author":"Levin","year":"2006","journal-title":"Drug Alcohol Depend."},{"key":"ref_100","first-page":"5","article-title":"Treatment of opioid dependence and ADHD\/ADD with opioid maintenance and central stimulants","volume":"11","author":"Blix","year":"2009","journal-title":"Heroin Addict. Relat. Clin. Probl."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.euroneuro.2012.07.016","article-title":"Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: A review of controlled and naturalistic studies","volume":"23","author":"Fredriksen","year":"2013","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1542\/peds.111.1.179","article-title":"Does stimulant therapy of attention-deficit\/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature","volume":"111","author":"Wilens","year":"2003","journal-title":"Pediatrics"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1001\/jamapsychiatry.2013.1273","article-title":"Stimulant medication and substance use outcomes: A meta-analysis","volume":"70","author":"Humphreys","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.euroneuro.2017.08.435","article-title":"Methylphenidate doses in Attention Deficit\/Hyperactivity Disorder and comorbid substance use disorders","volume":"27","author":"Skoglund","year":"2017","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_105","unstructured":"Brown, T.E. (2009). ADHD Comorbidities. Handbook for ADHD Complications in Children and Adults, American Psychiatric Publishing."},{"key":"ref_106","unstructured":"Young, S., and Bramham, J. (2007). ADHD in Adults: A Psychological Guide to Practice, John Wiley & Sons."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/9\/3096\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:22:26Z","timestamp":1760124146000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/9\/3096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,24]]},"references-count":106,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["jcm12093096"],"URL":"https:\/\/doi.org\/10.3390\/jcm12093096","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,24]]}}}