1. The Factors That Link ADHD to Substance Use
2. Stimulants Do Not Increase Risk for Later Substance Use
3. Stimulants Protect Against Adverse Outcomes
4. ADHD and SUD: Implications
5. SUD and ADHD Treatment: Next Steps

Does stimulant medication increase risk for substance use disorder and developing an addiction?

The question is valid. People with ADHD are at greater risk, after all, for using substances and for developing dependence. And stimulant medication — the first-line treatment for ADHD — is classified by the FDA as a Schedule II controlled substances due to its high potential for misuse, abuse, and dependence. So it’s not surprising that some people worry stimulant medications may inadvertently increases risk for addiction in ADHD brains.

But mounting research shared during the July 2026 ADDitude webinar “ADHD Treatment and Substance Use Problems: The Latest Research on Stimulants & SUD” paints a reassuring picture.

“We’re not showing, on average, that stimulants increase risk for substance use disorder,” said Brooke Molina, Ph.D., Professor of Psychiatry, Psychology, Pediatrics, and Clinical and Translational Science at the University of Pittsburgh, during her joint webinar with Brian D’Onofrio, Ph.D.

Here are their webinar’s main takeaways on ADHD, substance use, and the impact of ADHD medication treatment on substance use-related outcomes.

From inherited family risk and symptom severity to altered reward processing, multiple factors help explain why people with ADHD face an elevated risk for substance use and substance use disorders.

[Overview: Substance Use Disorders — Signs, Symptoms, and Links to ADHD]

“There’s variation in the way that people with ADHD respond to drugs and things that are potentially rewarding,” Molina said. “This does go back to the dopamine differences in the brain.”

Difficulty translating knowledge into action — a common challenge associated with ADHD — is another factor. In this case, awareness of negative effects does not always translate to reduced substance use.

“This is really important for clinicians to be aware of,” Molina said regarding the treatment of people with ADHD and active substance use issues. “You can’t just take a standard treatment developed for something like substance use disorder and drop it on a person with ADHD. [The treatment plan] needs to consider the particular issues that go along with ADHD.”

Multiple long-scale and longitudinal studies show that stimulant treatment in childhood does not increase risk for harmful substance use later on.

One study that looked at onset and duration of stimulant treatment for ADHD found that people who started treatment before the age of 9 or who were receiving treatment for longer (i.e., six or more years compared to less than one year) were less likely to use substances.

[Read: Treating a Child with ADHD Medication Diminishes Future Risk of Substance Abuse]

It’s widely recognized that stimulants don’t increase risk for substance use, however some studies have found that stimulant medication actually protects against serious outcomes, like hospitalization, crime, and even substance-related death in patients with ADHD, regardless of age. “There is a roughly 30% reduction in the risk for these serious outcomes,” said D’Onofrio, the Sharon Stephens Brehm Endowed Professor in the Department of Psychological and Brain Sciences at Indiana University.

Even among people with ADHD and a history of substance use, initiating ADHD medication treatment reduces risk for these events, D’Onofrio said.

Well-respected research overwhelmingly shows that stimulants do not increase risk for substance problems. Still, many people with ADHD, and many clinicians, are slow to accept the evidence.

“We have an enormous number of practitioners out there who just really are very uncomfortable treating ADHD, and they’re scared of dealing with stimulant medications,” said Molina, who noted that upcoming U.S. Guidelines for the Diagnosis and Treatment of ADHD in Adulthood will aim to help clinicians become more familiar with treating complex ADHD.

D’Onofrio added other treatment options exist if stimulant abuse is a concern. “There are extended-release rather than short-acting [meds], and then there are specific types of stimulant medications, different formulations that are harder to abuse,” he said, adding that therapy and other approaches can also help.

Researchers also need to further understand why many youth with ADHD stop taking medication and what effects this trend may have on health outcomes, he said.

For more insights on ADHD, stimulants, substance use-related outcomes, and the studies highlighted during the webinar, watch the replay.

• Read: SUD Risk Is Elevated by ADHD
• Study: Prescription Stimulants Do Not Increase the Risk of Illicit Drug Use in Adolescents
• Read: No, Stimulants Don’t Cause Brain Damage

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