Attention deficit hyperactivity disorder and treatment outcome in opioid abusers entering treatment

Symptoms of DSM-IV attention-deficit hyperactivity disorder (ADHD) were det ermined in patients entering methadone maintenance treatment. The relations hip of ADHD to psychiatric and substance abuse comorbidity, attention testi ng, and treatment outcome was analyzed; 19% of patients had a history of AD HD, and 88% of these had current symptoms. Continuous Performance Testing i ndicated poorer attention in patients with ADHD. The only substance use dis order more common in the ADHD group was clonidine. There was significantly more current axis I, dysthymic disorder, anxiety disorder (including social phobia), and antisocial personality disorder in the ADHD patients. There w as no difference between groups at the 1-year follow-up for illicit drug us e, treatment retention, or treatment performance. The ADHD diagnosis did no t convey significant prognostic implications for methadone maintenance trea tment. A strong psychiatric assessment and treatment focus in the treatment program may help to explain the good treatment outcome.