How Important Is ADHD Medication in Reducing Harm?
(excerpted from www.adhdevidence.org where they curate evidence by systematically reviewing the scientific literature to select studies meeting a very high level of evidence.)
There are several arguments for including medication in ADHD treatment.
ADHD is a disorder associated with serious distress and/or impairments in living. Although, as documented below, many severe adverse outcomes have been associated with ADHD, the typical patient does not experience all, or even most, of these problems. Many patients live enjoyable and productive lives, especially if they receive treatment.
A U.S. national cohort study of 2.3 million people with ADHD examined emergency room visits for motor vehicle crashes over ten years. Males with ADHD had a 38 % lower risk of crashes in months when receiving ADHD medication compared with months when not receiving medication, and females a 42 % lower risk in months when receiving ADHD medication. About a fifth of crashes would have been avoided if they had been on medication throughout the period of the study (Chang et al., 2017).
A Swedish cohort study of over 25,000 ADHD patients found a one-third reduction in criminality among men receiving ADHD medication, and a 40 % reduction for women (Lichtenstein et al., 2012). A Danish national registry study of over 4200 individuals with childhood ADHD found that crime rates in adulthood were 30–40 % lower during periods of taking ADHD medication (Mohr-Jensen et al., 2019).
A meta-analysis of five studies with over 13,000 participants found that ADHD medications (primarily stimulants) were associated with a greater than 10 % reduction in unintentional injuries (Ruiz-Goikoetxea et al., 2018a).
A Swedish registry study of over 650,000 students found that treatment with ADHD medication for three months resulted in a more than nine-point gain in grade point sum (on a scale of 0–320); treatment was associated with an increase in the probability of completing upper secondary school by two-thirds (Jangmo et al., 2019).
A nationwide longitudinal cohort study using the Swedish national registers found that among more than 38,000 individuals with ADHD, medication for their ADHD was associated with a greater than 40 % reduction in the risk for depression three years later. The risk decreased with the duration of ADHD medication use. Depression was 20 % less common when patients received ADHD medication compared with periods when they did not (Chang et al., 2016).
A Swedish population-based study of 38,000 people with ADHD found a 20 % decline in suicide related events among those prescribed stimulants during periods when they were under treatment as opposed to during periods when they were not under treatment. No such benefit was found for non-stimulant medications (Chen et al., 2014).
A study using the Swedish national registers investigated the association between prescription stimulant medication for ADHD in 2006 and substance abuse during 2009 among all 38,753 people born between 1960 and 1998 and diagnosed with ADHD. After controlling for relevant variables, it found a greater than 30 % reduction in indicators of substance abuse among those prescribed stimulants. The longer the duration of medication, the lower the rate of substance abuse (Chang et al., 2014c).
A nationwide study of over 7500 Taiwanese adolescents with ADHD and over 30,000 matched controls found that long-term use of ADHD medication use was associated with a 30 % decrease in teenage pregnancy (Hua et al., 2020).
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