Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that in most cases persists into adulthood. Often associated with other psychiatric disorders and the most frequent is substance use disorder. The ADHD-substance use comorbidity has received considerable attention in research for clinical implications. But most studies concerning the use of stimulants (amphetamines, cocaine), alcohol and cannabinoids. Few studies concern the use of heroin in patients with ADHD. The aim of this research is to evaluate the prevalence of ADHD (and its association with other psychiatric disorders) in heroin-dependent patients.
Methods: Outpatients with heroin addiction being treated with opioid agonists at a public addiction service were enrolled. They performed psychiatric examination + ASRS scale (Adult ADHD Self-Report Scale). Subjects with positive results performed another psychiatric visit + Brown scale ADD (second level test for ADHD), Mini International Neuropsychiatric Interview (M.I.N.I.), Hypomania / mania checklist (HCL-32).
Results: 111 patients were enrolled. There were no socio-demographic differences between ADHD and non-ADHD patients. The prevalence of ADHD in this sample was 18%. In ADHD patients the most frequently associated psychiatric disorders are depression and anxiety. Patients who have at least two other psychiatric diagnoses in addition to ADHD and substance use disorder are around 40%. The diagnosis of ADHD appeared very difficult also due to the high comorbidity. About 10% of the sample does not meet all the criteria but is borderline for ADHD.
Conclusion: the data of this study are compatible with the literature. There seems to be a high percentage of ADHD even among heroin addicts. Agonist therapy appears to have an effect on ADHD symptoms, but more studies are needed to confirm it.