PDF(Pubmed)
Abstract：
Attention-deficit/hyperactivity disorder (ADHD) often co-occurs with substance use (SU) and/or substance use disorder (SUD). Individuals with concurrent ADHD and SU/SUD can have complex presentations that may complicate diagnosis and treatment. This can be further complicated by the context in which services are delivered. Also, when working with young people and adults with co-existing ADHD and SU/SUD, there is uncertainty among healthcare practitioners on how best to meet their needs. In February 2022, the United Kingdom ADHD Partnership hosted a meeting attended by multidisciplinary experts to address these issues. Following presentations providing attendees with an overview of the literature, group discussions were held synthesizing research evidence and clinical experience. Topics included: (1) A review of substances and reasons for use/misuse; (2) identification, assessment and treatment of illicit SU/SUD in young people and adults with ADHD presenting in community services; and (3) identification, assessment and treatment of ADHD in adults presenting in SU/SUD community and inpatient services. Dis-cussions highlighted inter-service barriers and fragmentation of care. It was concluded that a multimodal and multi-agency approach is needed. The consensus group generated a table of practice recommendations providing guidance on: identification and assessment; pharmacological and psychological treatment; and multi-agency interventions.
摘要：
注意缺陷/多动障碍（ADHD）通常与物质使用（SU）和/或物质使用障碍（SUD）同时发生。患有并发ADHD和SU/SUD的个体可能具有复杂的表现，可能使诊断和治疗复杂化。这可能因交付服务的上下文而进一步复杂化。此外，与患有ADHD和SU/SUD的年轻人和成年人一起工作时，有不确定的医疗保健从业人员如何最好地满足他们的需求。2022年2月，英国多动症伙伴关系主办了一次由多学科专家参加的会议，以解决这些问题。在向与会者提供文献概述的演讲之后，结合研究证据和临床经验进行小组讨论。主题包括：（1）对物质和使用/滥用原因的审查；（2）识别，评估和治疗在社区服务中出现的患有ADHD的年轻人和成年人中的非法SU/SUD；和（3）识别，在SU/SUD社区和住院服务中出现的成人ADHD的评估和治疗。震荡强调了服务间的障碍和护理的分散。结论是，需要采取多式联运和多机构的方法。共识小组生成了一份实践建议表，提供以下方面的指导：识别和评估；药物和心理治疗；和多机构干预措施。
