ATTENTION-DEFICIT HYPERACTIVITY DISORDER, SUBSTANCE-ABUSE, AND POSTTRAUMATIC-STRESS-DISORDER - A CASE-STUDY WITH IMPLICATIONS FOR HARM REDUCTION/

Substance abuse occurs in approximately half of adults who have childh ood-onset attention-deficit/hyperactivity disorder (ADHD), and in many individuals who exhibit symptoms of posttraumatic stress disorder (PT SD). This article provides clinical guidelines for working with this p opulation. The case presented illustrates how a harm reduction approac h to substance use and a ''come-as-you-are'' stance regarding both occ asional use and characteristic ADHD symptoms may better serve the ADHD adult, and individuals with PTSD, than the traditional insistence on complete abstinence from substance use as a prerequisite to psychother apy. (C) 1998 John Wiley & Sons, Inc.