Lead: The effect of stimulant medications on symptom and treatment outcomes in adults with comorbid attention-deficit/ hyperactivity and substance use disorder: A systematic review and meta-analysisLead: The effect of stimulant medications on symptom and treatment outcomes in adults with comorbid attention-deficit/ hyperactivity and substance use disorder: A systematic review and meta-analysis
This Week in Addiction Medicine from ASAM
A concise news briefing summarises multiple recent studies on ADHD with substance use disorder, opioid-related risks, treatment gaps, and medication side effects. The episode focuses on evidence and trends useful for addiction professionals and those interested in current research.
7:18•27 Oct 2026
Stimulants, Opioids, and Overdose Risk: A Fast Update from Addiction Research
Episode Overview
- Stimulant prescriptions for adults with both ADHD and substance use disorder showed no clear difference in substance use or abstinence outcomes, with limited evidence quality.
- Heroin overdose risk is higher among those with recent overdose, polysubstance use, depression, and trauma, suggesting risk assessments should extend beyond current opioid use.
- Few patients with opioid-positive urine tests receive medication for opioid use disorder, and adherence to these medications remains low.
- Non-pharmacologic treatment for acute low back pain is linked with reduced risk of later opioid use disorder or overdose compared with higher-dose opioid initiation.
- Oral buprenorphine and methadone are associated with increased dental caries, and practical steps such as fluoride use, water rinsing, or non-oral delivery may reduce harm.
“Among patients with co-occurring SUD and ADHD, comparing those prescribed stimulants to those not prescribed stimulants produced no evidence for a difference in substance use.”
What drives someone to seek a life without harmful substance use? This news-style episode of "This Week in Addiction Medicine" offers a rapid-fire tour of current research for clinicians, policy makers, and anyone following developments in addiction care. Hosted by Zach Caruso, the episode opens with a focus on adults living with both ADHD and substance use disorder.
A systematic review of stimulant medications is summarised, with Zach noting that “there was no evidence for a difference in substance use, SUD symptoms, substance abstinence, or ADHD treatment adherence” between those prescribed stimulants and those who weren’t. The data hint at some benefit for ADHD symptoms and treatment retention, but the quality of evidence keeps confidence low, which is important for anyone weighing treatment options.
From there, the show moves through several major studies: long-term heroin dependence and overdose risk profiles, the low rates of medication for opioid use disorder (MOUD) after opioid-positive urine drug tests, and the link between initial treatment choices for acute low back pain and later opioid use disorder or overdose.
You’ll also hear about dental problems linked to buprenorphine and methadone, including how formulation and sweetness preferences might fuel tooth decay, along with practical suggestions like fluoride treatments and post-dose water rinsing. Further sections highlight worrying gaps in evidence-based care for Medicaid-enrolled youths with opioid use disorder, national trends showing reduced benzodiazepine dispensing, and a broad portfolio review of over 200 clinical trials network studies on substance use disorder treatment.
The tone is concise and clinical but still accessible, ideal if you want to stay up to date without reading every journal yourself. If you’re curious how current research may shape future addiction treatment decisions, this round-up is worth your time.
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