Three months ago, the only randomized trial to study future substance abuse by ADHD kids refuted the notion that stimulants, when taken in childhood, have a protective effect. Investigators found strong evidence that ADHD itself in fact predisposes children to later substance abuse—but no evidence that stimulant medication reduces this rate any better than treating ADHD with behavioral approaches. Further evidence that stimulants do not protect children from addiction was provided in a comprehensive review published last month in JAMA Psychiatry.

We still do not have a single randomized trial to help determine if starting stimulants as an adolescent or adult further increases the risk of future substance abuse, although the long and checkered history of medical stimulants would suggest it does. Certainly, the risks from recreationally using stimulants are already well-documented.

In 2010, Adderall was second only in popularity to the painkiller Vicodin as a prescription drug of abuse among high-school seniors, according to the National Institute on Drug Abuse. Adolescents often perceive prescription drugs as safer than illicit ones, but abusing prescription amphetamines can lead to seizures, psychosis and life-threatening heart disease.