The study conducted by funding from NIH’s “Helping to End Addiction Long-Term (HEAL) Initiative” discussed in MGH’s 2022 Annual Report, addresses the wide range of people who live in pain and those that use drugs, and also reports that one half of psychiatric and Substance Use Disorders (SUD) start by age 18 and three quarters by 24.
While these are concerning statistics, a new study titled “The Impact of Pharmacotherapy of Childhood-Onset of Psychiatric Disorders” published in the Journal of Child and Adolescent Psychopharmacology, in a study at Massachusetts General Hospital (MGH) https://www.massgeneral.org found treating psychiatric disorders with psychotropic medications in children and adolescents does not increase the risk of developing substance use, misuse, or SUD.
The study was conducted through findings from NIH’s “Helping to End Addiction Long-Term (HEAL) Initiative. The author of the study Timothy Wilens, MD, Chief, Division of Child and Adolescent Psychiatry, Co-Director, Center for Addiction Medicine, and Director, Substance Abuse Services in Pediatric Psychopharmacology at MGH, reports, “We have known that pediatric mental illness in children doubles to triple the likelihood to develop a substance use problem.”
Dr. Wilens prompted his team to explore if this was true, if these disorders are medially treated in children, or does treating psychiatric disorders with medication actually mitigate the risk for ultimate substance use?
The research team examined 26 prior studies with long term results with 21 focused on ADHD, 2 on Major Depressive Disorder (MDD), and three on psychotic disorders to find the answer.
The researchers could find no studies available examining the impact of pharmacotherapy on the development of substance use for children or adolescents with anxiety, conduct disorder, personality disorder, and post-traumatic stress disorder.
So with NIH funding from HEAL, the research team was able to include nearly six million individuals in the 26 studies. Most studies showed either that treatment reduced substance use or had no effect plus positive results also trended for MDD.
According to Amy Berger, Research Coordinator in the Division of Child and Adolescent Psychiatry, “However, the research team was not able to make conclusions about reduced substance use after treatment of bipolar disorder due to limited literature available.
Dr. Wilens concludes, “The treatments that began before the age of nine and were more ongoing, were the most effective at reducing SUD, especially in ADHD. Therefore, it make intuitive sense that earlier and longer treatment has a much better and larger impact down the line. We also think that this thinking is probably pertinent to other psychiatric disorders.”
Go to https://heal.nih.gov/about/heal-annual-report-2022 for the NIH HEAL Initiative’s annual report and for further information on the MGH study, go to https://doi/10.1089/cap.2022.0016.