Adult attention-deficit hyperactivity disorders and its correlates in patients with opioid dependence: An exploratory study

Background: Adult attention-deficit hyperactivity disorder (ADHD) often remains undiagnosed and undertreated among patients with substance use disorders (SUDs). Research is lacking with regard to adult ADHD in individuals with SUD. The current work was intended to study the prevalence of adult ADHD among individuals with opioid dependence and its correlates, and to assess the attitude of the individuals with adult ADHD toward its treatment.

Methods: This cross-sectional survey was conducted in 132 consecutive inpatients with opioid-dependence syndrome. Patients were assessed using the Mini International Neuropsychiatric Interview. 5.0, adult ADHD Self-Report Screening Scale, and Maudsley Addiction Profile. Those who screened positive for adult ADHD (ADHD+) were compared with those screened negative (ADHD^-) on a number of sociodemographic, substance use, and clinical variable. Furthermore, attitude toward the treatment for ADHD was assessed among the ADHD+ individuals.

Results: About a fifth (n=24, 18.2%) of the patients with opioid dependence screened positive for adult ADHD. One-third of the participants (n=8, 33.3%) were willing for the treatment of any kind, and only a half (n=3) was willing to pay. Earlier age of onset of opioid use (relative risk: 0.01; 95% confidence interval: 0.003, 0.85; P = 0.036) had higher likelihood to ADHD+ status.

Conclusion: Despite a high rate of ADHD screen positivity among individuals with opioid dependence, a majority were not willing to receive the treatment. Sensitization of: (1) addiction psychiatrist to routinely screen for ADHD, especially in the presence of certain correlates and (2) patients-caregivers about the potential benefit of treatment in effectively addressing the symptoms of ADHD effectively in this population.