Positive and negative aspects of substance use and treatment goals among substance use disorder patients with and without attention deficit hyperactivity disorder: A qualitative study

Abstract

There is limited research on the perceptions of substance use (SU) and treatment goals among patients with substance use disorders (SUD) and attention deficit hyperactivity disorder (ADHD). We investigate whether SU perceptions and treatment goals were different among SUD patients with (SUD+ADHD) and without (SUD-ADHD) ADHD. Twelve SUD+ADHD patients (39.5 ± 8.5 years, 10 men), and 10 age- and substance severity matched SUD-ADHD patients (34.0 ± 10.0 years, six men), consecutively recruited between February 2010 and July 2012 were interviewed during the course of their SUD treatment. Interview data were analyzed using content analysis. The perceived positive aspects of SU were self-regulation of physical health, behavior, feelings, reasoning/thoughts, and the rewarding effects. The perceived negative aspects of SU included consequences on physical health, behavior, feelings, and reasoning/thoughts. SUD+ADHD patients less frequently linked SU to physical health and more frequently perceived SU as helpful to self-regulate their behavior. Four treatment goals categories emerged: total abstinence, conditional abstinence, substance reduction, and unspecified. SUD+ADHD patents less frequently chose total abstinence, and when using more than one substance, they commonly chose variable goals. In contrast, SUD-ADHD patients chose more similar goals. SUD+ADHD patients showed a more complex relation to their SUD than SUD-ADHD patients.