15 February 2011

Unhealthful News 46 - Only meta-analysis can provide evidence of the obvious

Still too busy for a full post, but I had to say something about this one that Paul Bergen suggested I cover. 
ADHD Linked to Higher Risk of Substance Abuse
By TRACI PEDERSEN Associate News Editor
Reviewed by John M. Grohol, Psy.D. on February 14, 2011

In the first large-scale comprehensive analysis exploring the link between children with attention deficit hyperactivity disorder (ADHD) and future drug abuse, researchers reveal that those diagnosed with ADHD are two to three times more likely to experience serious substance abuse problems throughout their teen and adult years than those without the disorder.
...
“The greater risk for developing significant substance problems in adolescence and adulthood applies across substances, including nicotine, alcohol, marijuana, cocaine and other drugs.”
So let me get this straight:  People who have a condition that is known to be alleviated by the use of particular drugs (e.g., nicotine) are more likely to use those drugs.  People who have a condition that makes it harder to cope with life in our society are more likely to use drugs that promote escape.  People with short attention spans are likely to seek risky entertainment.  People who are less accomplished at most of what we are judged on are more likely to turn to drugs.

Um, which part of that were we not supposed to already know?

I guess we did not know, which is odd since the article goes on to mention that there were,

27 long-term studies that followed approximately 4,100 children with ADHD and 6,800 children without ADHD into adolescence and young adulthood, some for more than 10 years
Contrary to this being a "first" study as the lead paragraph breathlessly proclaimed, it was a meta-analysis of those 27, and:
“Any single study can be spurious,” [Dr. Steve S. Lee, lead author of the study and UCLA assistant professor of psychology] said, “but our review of more than two dozen carefully designed studies provides a compelling analysis.”
And since, before doing this meta-analysis, apparently no one had thought to read all 27 studies and notice that their implications conformed with what we would predict, we had no compelling evidence before.  Also it is good to know that following children for ten years allows us to make generalizations about their "adult years", at least when you run those results through a meta-analysis.  Good thing someone thought to do it, then.

Ah, but what we did not know was that to use, say, nicotine to treat attention deficits is "abuse".  Good thing we have prescription drugs that have roughly the same effects and risks so that such abuse can be avoided.

Also interesting news is that,
According to Lee, as children with ADHD enter adolescence and adulthood, they will generally fall into one of the following three groups: one-third will have significant social and academic problems; one-third will have moderate impairment; and one-third will do reasonably well or have only slight impairment.
I guess that means that none of them become prolific geniuses, start companies, create inventions, write great books – perhaps with the help of those drugs.  Too bad.  I'll bet the world would be a much more interesting place if that happened sometimes.

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