Anesthesia Safe for Kids, Doctors’ Group Says

FRIDAY, July 15, 2016 (HealthDay News) — Anesthesia eases the pain of millions of children who must have surgery every year, but parents who are worried about the safety of these medications should talk to their anesthesiologist about their fears, experts advise.

“Particularly in infants and toddlers, surgery is only recommended when necessary for the child’s health, so parents should not avoid an important procedure out of fear,” said Dr. Randall Flick. He is chair of the Committee on Pediatric Anesthesia at the American Society of Anesthesiologists (ASA).

“Physician anesthesiologists have completed years of special training to ensure safe, high-quality care, which should set parents’ minds at ease,” said Flick, who is also associate professor of pediatrics and anesthesiology at the Mayo Clinic in Rochester, Minn.

There are many important details about children’s health that anesthesiologists should know before surgery, the ASA added in a news release. The group recommends that parents ask the following seven questions before any type of surgery:

• How can I ensure my child’s surgery is successful?
  Parents should always provide the anesthesiologist with their child’s detailed medical history. The doctor should know if children have any allergies or asthma. Anesthesiologists should also know if children have ever had a bad reaction to anesthesia.
• Should my child’s medications be stopped before surgery?
  Before surgery, the anesthesiologist must receive a detailed list of children’s medications. This list should include over-the-counter pain medications and vitamins. It’s important to ask the doctor if these medications should be stopped before surgery and for how long. The answers to these questions will depend on each child’s health and the specific procedure being done.
• Can my child eat or drink before surgery?
  Children usually need to stop eating solid foods six to eight hours before surgery. In some cases, sipping clear liquids, such as water, may be allowed up to two hours before surgery, and breast milk may be given up to four hours before surgery.
• How can I help prepare my child for surgery?
  Parents can help children feel better by explaining that their surgery will help fix a problem and help them get better. They should also know that it won’t hurt and they won’t even remember what happened. Children should also understand that their parents will be nearby, but their doctors and nurses are also there to take care of them.
• Is anesthesia safe for my child?
  Overall, anesthesia is very safe. The risks associated with these medications depend on a number of variables, such as the complexity of children’s health issues, their age and how urgent their surgery is. The long-term effects of anesthesia on infants and toddlers are still under investigation.
• Will my child be in pain after surgery?
  Children will be prescribed medication to ease pain after surgery. They are safe if they are taken as directed. An anesthesiologist can also help ease children’s nausea following surgery.
• What type of anesthesia will my child receive?
  There are many different types of anesthesia. Some are given through an IV and others are inhaled through a mask. The type of anesthesia children receive will be determined by their anesthesiologist based on their health and the type of surgery they are having.

More information

The American Academy of Pediatrics has more about children and anesthesia.

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1st Case of Female-to-Male Sexual Transmission of Zika Reported

By Steven Reinberg
HealthDay Reporter

FRIDAY, July 15, 2016 (HealthDay News) — A New York City woman who became infected with the Zika virus on a trip outside the United States passed the infection to her boyfriend during sex, city health officials reported.

It’s the first reported case of female-to-male sexual transmission of Zika — before this case, sexual transmission had only been reported as spreading from men to women.

The woman, in her 20s, said she had traveled to a Zika-endemic area and developed headache, cramps, fever, fatigue, rash and other symptoms during the day she flew home and after returning to New York City.

She had unprotected vaginal sex with her partner on the day of her return, and about a week later her male partner came down with symptoms of what also turned out to be Zika infection.

Both individuals recovered from Zika illness, which is usually transient.

Zika is typically transmitted via the bite of the Aedes aegypti mosquito, and the greatest danger is when infection occurs in pregnancy.

These infections have been tied to thousands of cases in Latin America of a devastating birth defect known as microcephaly, in which babies are born with abnormally small heads and neurological issues.

The New York City woman was not pregnant, city health officials said.

Infectious disease experts noted that while mosquitoes are by far the most common means of Zika transmission, sexual transmission can sometimes occur.

The case documented in New York City isn’t surprising, said Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City.

“Anytime you see male-to-female transmission, there’s always the risk of female-to-male transmission — we found that with HIV,” said Siegel, who was not part of the research.

He believes that the New York City case is probably not the first female-to-male transmission — just the first such case reported.

However, “if our concern about Zika is the risk of birth defects, female-to-male transmission isn’t going to increase that risk, unless the male has multiple partners,” Siegel explained.

He also believes that sexual transmission of the virus should not keep people from protecting themselves from mosquitoes — the main source of infection — whenever they travel to Zika-endemic areas.

The report was published July 15 in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

In the face of the growing reality of sexual transmission of Zika, U.N. health officials issued updated guidelines earlier this year aimed at helping prevent infection. The advisory urges that women planning to become pregnant wait at least eight weeks before trying to conceive if they or their partner live in — or are returning from — areas where the Zika virus is active. The guidelines had previously recommended a four-week waiting period.

And if the male partner has had symptoms of Zika infection, couples should wait six months before trying to have a baby, the World Health Organization officials added.

The virus may also transmit, in rare cases, through oral sex. In a report issued last month, doctors said a 24-year-old Parisian woman came down with Zika symptoms after having sex seven times with a 46-year-old man. The man had developed Zika symptoms just before leaving Brazil and arriving in Paris last February.

Each time, the couple had vaginal sex without ejaculation and oral sex with ejaculation, according to the report.

The report was published June 2 in the New England Journal of Medicine.

The vast majority of Zika infections have occurred in Latin America, with Brazil the hot zone with an estimated 7,000 cases of microcephaly. There have been no reports of Zika-induced microcephaly contracted in the United States. But two babies have been born in the United States with the birth defect after their mothers contracted the virus while traveling during pregnancy in countries where Zika is active.

And U.S. health officials have said they expect to see Zika infections in Gulf Coast states such as Florida, Louisiana and Texas as the summer mosquito season picks up.

To limit any potential spread of Zika virus via mosquitoes, health officials on the federal, state and local level are deploying a three-pronged strategy: improving mosquito control; expanding their ability to test for Zika; and urging the public to protect themselves against mosquitoes.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquito bites by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Making Sense of Senseless Violence

By Margaret Farley Steele
HealthDay Reporter

FRIDAY, July 15, 2016 (HealthDay News) — Shockwaves are reverberating around the world yet again as a scene of once-unimaginable terror played out Thursday night in the midst of a national celebration in Nice, France.

This time, a large truck mowed down hundreds of revelers following a fireworks demonstration on Bastille Day, the holiday commemorating the French Revolution. So far, 84 people have been confirmed dead.

As the world mourns once more with France, mental health professionals say it’s important to monitor your reactions to this massacre, one in a seemingly endless stream of horrors.

“We’re just inundated,” said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, who worked with survivors of the 9/11 terrorist attacks and Hurricane Katrina in 2005. Even with a tragedy occurring thousands of miles away, he said, “because of 24-hour media coverage you can feel threatened . . . feel that the wolf is at the door.”

The list of recent tragedies seems endless:

• Mass killings in Dallas, Orlando, Brussels, Istanbul and Paris, to name a few.
• Police shootings across the United States, including one in Minnesota where a routine traffic stop a week ago turned deadly for a 32-year-old black man who was with his girlfriend and her 4-year-old daughter.
• Babies born with abnormally small heads and brains because of a newly emerging mosquito-borne virus circulating in Latin American and the Caribbean.

Manevitz said it’s normal to feel sadness, confusion or anger in the face of catastrophes. “Anyone can feel a sense of helplessness that the world is a dark and dangerous place,” he said.

But because today’s 24/7 news cycle can trigger what he calls “acute stress reactions,” Manevitz said adults need to put these events in perspective.

How? By distinguishing between the possibility of something occurring and the actual probability.

Zika virus, he said, is a concern for anyone attending the Olympics this summer in Brazil. But in reality, what are the odds of a Zika-carrying mosquito infecting someone in New York City or Chicago or Seattle?

Some people cope with unsettling news by shutting themselves off from the media. For others, getting as much information as they can helps them put the odds of a threat in context, said Manevitz.

“But people with a susceptibility to PTSD (post-traumatic stress disorder), anxiety or depression may have a more amplified reaction,” he said.

For young children, he recommends restricting media coverage. Kids 7 and younger don’t understand what they’re seeing and can become anxious or sleepless, Manevitz said.

For older kids, “it’s best to be involved with what they see so you can explain what’s happening and put disasters in context,” he explained. “Tell them, ‘We have police and firemen to keep us safe.’ “

Also, share your feelings with children, tell them the truth and reassure them, he added.

As difficult as these topics may be to discuss, parents shouldn’t avoid them, says the American Psychological Association.

“Children often learn or know when something sad or scary happens. If adults don’t talk to them about it, a child may overestimate what is wrong or misunderstand adults’ silence,” according to the association.

Sharing troubling news can also have long-term benefits. “When parents tackle difficult conversations, they let their children know that they are available and supportive,” the psychologists’ group notes.

Manevitz added that parents must keep their own emotions in check. “Parents are role models of coping skills for their children,” he pointed out.

He offers other coping mechanisms for parents to share with their children. For instance, you and your child can write a letter to a victims’ organization or make a donation to a relief agency. Also, discuss your own family disaster plan — what to do if a lockdown occurs at school, for instance.

For young and old, it’s important that you “don’t allow the small possibility of something happening impact your life,” Manevitz stressed.

The U.S. Department of Homeland Security offers this advice to parents of children:

• You are their biggest influence. When you can manage your own feelings, you can make disasters less traumatic for your kids.
• Encourage dialogue. Listen to your kids. Ask them about their feelings. Validate their concerns.
• Answer questions. Give just the amount of information you feel your child needs. Clarify misunderstandings about risk and danger.
• Be calm, be reassuring. Discuss concrete plans for safety. Have children and teens contribute to the family’s recovery plan.
• Shut off the TV! News coverage of disasters creates confusion and anxiety. Repeated images may lead younger kids to believe the event is recurring. If your children do watch TV or use the Internet, be with them to talk and answer questions.
• Find support. Whether you turn to friends, family, community organizations or faith-based institutions, building support networks can help you cope, which will in turn help your children cope.

More information

Visit the American Psychological Association for more tips on discussing tough subjects with your kids.

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Cancer Patients, Doctors Often Disagree About Prognosis

FRIDAY, July 15, 2016 (HealthDay News) — Cancer patients and their doctors often hold different opinions about the patient’s chances for survival and how long he or she might live, according to a new study.

And, in many cases, patients are unaware there’s any misunderstanding.

“First, some patients might know the doctor’s prognosis estimate but the patient chooses to disagree, often because they believe other sources. And second, some patients think that their doctor agrees with their opinion about prognosis but, in fact, the doctor doesn’t,” said study co-author Dr. Ronald Epstein. He is a professor of family medicine, psychiatry and oncology at the University of Rochester Medical Center in New York.

For the study, researchers asked 236 patients with advanced cancer about their prognosis. The 38 doctors who treated them independently said they would “not have been surprised” if their patients died within a year.

Researchers also asked whether patients knew their opinions about their prognosis differed from those of their doctors and the extent to which life expectancy influenced treatment options.

“When people think they’ll live a very long time with cancer despite evidence to the contrary, they may end up taking more aggressive chemotherapy and agreeing to be placed on ventilators or dialysis, paradoxically reducing their quality of life, keeping them from enjoying time with family and sometimes even shortening their lives,” Epstein said. “So it’s very important for doctors and patients to be on the same page.”

The study, published July 14 in the journal JAMA Oncology, found that 68 percent of patients rated their odds for survival differently from their doctors. Almost all patients were more optimistic than their doctor. Of the 68 percent, only 10 percent understood that their views and their doctor’s differed.

“Of course, it’s only possible for doctors to provide a ballpark estimate about life expectancy and some people do beat the odds,” Epstein said in a journal news release.

“Positive thinking by patients can improve quality of life,” Epstein noted. “But when a patient with very advanced cancer says that he has a 90 to 100 percent chance of being alive in two years and his oncologist believes that chance is more like 10 percent, there’s a problem.”

Talking about a cancer prognosis often involves not one, but several, conversations between doctors and patients about personal priorities and treatment goals amid feelings of fear, confusion and uncertainty, the authors said.

Seven out of 10 patients surveyed said they would opt for supportive care rather than aggressive treatment as the end of their lives neared. To make an informed decision, however, patients need to know when death is imminent, the researchers said.

They added that better communication between doctors and their cancer patients is urgently needed.

More information

The U.S. National Cancer Institute provides more information on understanding cancer prognosis.

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Play ‘Pokemon Go’ Without Landing in the ER

FRIDAY, July 15, 2016 (HealthDay News) — Here a Pokemon, there a Pokemon, everywhere a Pokemon!

Just about every millennial seems to be out and about with a smartphone in pursuit of digital monsters via the “Pokemon Go” game. But players distracted by their smartphones risk injury from mishaps like walking into traffic or tripping over a curb.

How can you be safe and still get a burst of activity by playing “Pokemon Go” in public places? The American Academy of Orthopaedic Surgeons is offering advice through its “Digital Deadwalker” campaign.

“We love that these games are bringing children and adults outdoors and encouraging exercise,” Dr. Alan Hilibrand, a Philadelphia orthopedic surgeon, said in an academy news release. “But we also want everyone to be mindful of their surroundings as they enjoy this activity. Walking while looking at your phone or electronic device can result in sprains, broken bones and other serious, even fatal, injuries.”

Almost 40 percent of Americans have seen an incident caused by distracted walking, according to a recent academy study. About one in four have been in one themselves. Seventy-eight percent of adults call distracted walking a “serious” issue, but less than a third say they usually or always walk while distracted themselves.

The academy offers these tips to avoid a mishap when you’re on the “Pokemon Go” — on foot:

• Focus on everything around you: People, objects, obstacles.
• Keep your eyes on your surroundings instead of your phone when you cross into traffic or enter an intersection.
• Be careful when you cross streets and wait for a traffic light if possible. Watch for pedestrians, cars and bikes.
• When you reach a curb, look up. Don’t look down. Use the same level of caution when you’re in the middle of intersections.
• Stop and get out of the way of other pedestrians if you need to use your cellphone or talk to the person next to you.
• If you’re wearing headphones, set the volume low enough so you can still hear traffic and things around you.

“Pokemon Go” is a free “augmented reality” game that lets players use their phone’s camera to capture, train and trade virtual Pokemon characters that can appear without warning in a real-world setting.

But the wildly popular game — the top grossing app on iTunes, less than a week after its release — is so enthralling that players are unintentionally placing themselves in harm’s way. Unanticipated consequences include sprained ankles, bruises from walking into traffic, trees and lamp posts, risky driving and even some robberies, according to reports from across the United States.

More information

For more on pedestrian safety, visit the National Highway Traffic Safety Administration.

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Heavy Moms Likelier to Pile Food on Kids’ Plates: Study

FRIDAY, July 15, 2016 (HealthDay News) — Obese and overweight moms seem to serve their kids more food at meals, potentially boosting their risk for childhood obesity.

University of Florida researchers asked mothers to describe their level of hunger and that of their 3- to 6-year-olds before meals. Twenty-nine children took part in the study.

Women who were overweight or obese reported feeling hungrier and thought their kids were hungrier, too. Then, they gave them bigger portions.

“Because young children have difficulty recognizing when they are full, the more food they are presented at mealtime, the more they are likely to eat,” lead investigator Sarah Stromberg said in a university news release. Stromberg is a doctoral student in the Department of Clinical and Health Psychology.

Study senior author David Janicke, a professor of clinical and health psychology, said, “If we can start to identify those factors, we might be able to intervene to help parents develop more appropriate portion sizes for younger kids, which hopefully can lead to a longer life of healthy eating habits.”

The researchers noted that the findings are preliminary, because the study was small.

“This study was a good starting point, and ultimately if we’re able to see these findings replicated we can intervene with knowledge, awareness and strategies to help parents and kids work together to limit how much kids are being served,” Janicke said.

Meanwhile, how can parents make sure their kids don’t eat to excess?

“Parents decide what to serve their kids and when, but kids still should have a reasonable amount of control over how much they eat,” Janicke said. “If kids eat an appropriate serving size and are still hungry, they can ask for more.”

The study appeared in the June issue of the Journal of Human Nutrition and Dietetics.

More information

For more about kids and diet, visit nutrition.gov.

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Doctors Should Bone Up on CT Scan Cancer Risks

FRIDAY, July 15, 2016 (HealthDay News) — Doctors routinely order CT scans as diagnostic tools. But many are ill-informed about the cancer risks associated with this imaging technology, a new study suggests.

Patients who undergo CT scans are exposed to harmful ionizing radiation, which could affect their lifetime risk for developing cancer, Canadian researchers said.

“Underestimating radiation dose from a CT scan … may lead to minimization of the risk estimate when considering a test,” said the study’s lead investigator, Dr. David Leswick, of the medical imaging department at the University of Saskatchewan College of Medicine.

For the study, the researchers surveyed doctors, radiologists and imaging technologists about radiation exposure from CT scans.

They found the vast majority knew that one abdominal-pelvic CT increases patients’ risk for cancer. But many didn’t know how the dose compared to radiation from a standard chest X-ray.

The average radiation dose from an abdominal-pelvic CT scan is roughly the equivalent of 100 to 250 chest X-rays, the researchers said.

But only about one in five doctors and technologists and just 28 percent of radiologists were able to correctly identify the CT scan dose in relation to X-rays, the study found.

Nearly half of the doctors, four out of five radiologists and 63 percent of technologists accurately estimated or overestimated the dose, the study found.

Many others underestimated the dose level, which was more concerning, the researchers said.

The findings were published recently in the Journal of Medical Imaging and Radiation Sciences.

As doctors order CT scans with increasing frequency, accurately understanding the risks of radiation exposure is significant, Leswick and his colleagues said in a journal news release.

More information

The U.S. Food and Drug Administration provides more on radiation risks from CT scans.

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Cornea Transplants Riskier for Women When They Come From Men?

FRIDAY, July 15, 2016 (HealthDay News) — Women who undergo a cornea transplant may have a worse outcome if their donor is a man, a new study suggests.

Subtle differences between men and women may increase the risk of failure or rejection for up to five years, the British researchers found. They noted that matching the gender of cornea donors and recipients could help improve transplant outcomes.

The study involved more than 18,100 cornea transplant patients. More than 80 percent still had a working cornea after five years. Of those who had a failed transplant or tissue rejection, more were women who had received a cornea from a male donor.

On average, 180 transplants fail for every 1,000 gender-matched procedures, compared with 220 failures among every 1,000 male-to-female transplants, according to the researchers. They said these results were especially evident among patients with Fuchs endothelial dystrophy — a condition affecting a thin layer of cells that line the back of the cornea.

The findings were published July 14 in the American Journal of Transplantation..

The findings are most likely associated with the male Y chromosome, study leader Dr. Stephen Kaye, an opthalmologist at The Royal Liverpool University Hospital, said in a journal news release.

The authors said more research is needed to confirm their findings and to potentially justify allocating corneas from male donors only to other men. Corneas from female donors may be given to either men or women, the researchers said.

“If confirmed, this would be relatively straightforward to put into place without delay in donor tissue allocation to patients or any significant added cost,” Kaye said. “The long-term impact this could have on patient care may be substantial.”

More information

The U.S. National Eye Institute provides more information on diseases of the cornea.

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Gut Bacteria May Hold Clues to Chronic Fatigue Syndrome

By Kathleen Doheny
HealthDay Reporter

FRIDAY, July 15, 2016 (HealthDay News) — Chronic fatigue syndrome — a condition that continues to baffle doctors — may be influenced by a person’s intestinal bacteria — sometimes called gut microbiome, new research finds.

“Patients with chronic fatigue syndrome have a different profile of bacterial species in their gut microbiome than healthy individuals,” said the study’s senior author, Maureen Hanson. She’s a professor of molecular biology and genetics at Cornell University, in Ithaca, N.Y.

In the small study, she and her colleagues found that people with chronic fatigue syndrome had less diversity or different types of bacteria, compared to healthy people without chronic fatigue syndrome. People with chronic fatigue syndrome also had more species of bacteria that promote inflammation and fewer bacteria that dampen inflammation, the researchers found.

The new findings provide evidence to refute what Hanson calls “the ridiculous concept that the disease is psychological in origin.” For years, she said, some have suggested that chronic fatigue syndrome is simply psychological and can be helped by therapy. Not so, she said.

Even so, “I would not say we found the cause,” Hanson said. Rather, her team has found “another biological abnormality.”

Not everyone with chronic fatigue syndrome has the skewed microbiome, she said. Some of the study volunteers had fairly normal microbiomes.

Between 1 million and 4 million Americans have chronic fatigue syndrome, also known as myalgic encephalomyelitis, according to the U.S. Centers for Disease Control and Prevention. But only about 20 percent of people with the condition have been diagnosed. Symptoms may include overwhelming fatigue not helped by rest, sleep that is not restorative, malaise, joint and muscle pain, headaches and gastrointestinal problems such as irritable bowel syndrome.

In the study, the Cornell researchers evaluated 48 people diagnosed with chronic fatigue syndrome and 39 healthy controls. All provided stool and blood samples. The researchers tested stool samples for bacterial DNA. In chronic fatigue syndrome patients they found bacterial profiles with less diversity. This is similar to those seen in people with two bowel diseases: Crohn’s disease and ulcerative colitis, the researchers said.

“A lot of bacteria in our gut are beneficial,” Hanson said.

If patients with chronic fatigue syndrome don’t have as diverse a population of bacteria, she said, that could cause problems. The researchers also found markers of inflammation in the blood samples of chronic fatigue syndrome patients, likely due to a “leaky gut” from intestinal problems that let bacteria enter the blood. Bacteria in the blood could trigger an immune response and worsen symptoms, the researchers said.

Using the microbiome findings, the researchers said they were able to correctly classify whether 83 percent of the study volunteers had chronic fatigue syndrome or didn’t. If these findings are confirmed in a larger study, the authors suggested that the gut microbiome could be used as an additional test to determine if it’s likely that someone has chronic fatigue syndrome.

The new research “is yet another study that proves this is not a psychological disease,” said Zaher Nahle, vice president for research and scientific programs at the Solve ME/CFS Initiative, a nonprofit organization focusing on myalgic encephalomyelitis/chronic fatigue syndrome.

More and more research on various health conditions has focused on what experts call the gut-brain axis, Nahle said. Other research has suggested the gut microbiome might be linked with anxiety, depression, autism and other conditions. “It’s a promising avenue of research,” he said.

If the research progresses and bears out for chronic fatigue syndrome, Nahle said, adjusting the diet might be one way to help symptoms.

Remedies such as probiotics are often suggested to patients, Hanson said. Probiotics are foods or supplements with live “good” bacteria that may alter and improve the gut environment. But it’s too soon to know if it would have an effect.

“Really, we don’t know whether probiotics will help or not,” Hanson said. There is not enough research currently, and more research on probiotics would be helpful, she said.

The study was published recently in the journal Microbiome.

More information

To learn more about chronic fatigue syndrome, visit the U.S. Centers for Disease Control and Prevention.

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Do ADHD Medicines Boost Substance Abuse Risk?

By Kathleen Doheny
HealthDay Reporter

FRIDAY, July 15, 2016 (HealthDay News) — Parents often worry that their children who take stimulants to treat attention deficit hyperactivity disorder (ADHD) may be at higher risk for substance abuse later.

Now, a surprising new study finds that risk was actually lower when medicines such as Ritalin and Adderall were started earlier and taken longer.

“Most notably, the risk of substance use in adolescents who had been treated at an earlier age and for a longer duration with stimulant ADHD medications was the same as for the general population of children,” said study leader Sean Esteban McCabe. He is research faculty chair at the University of Michigan Institute for Research on Women and Gender.

“The study found that the odds of reporting any substance use were over two times more likely among individuals who reported later onset [age 15 or older] and shorter duration [two years or less] of prescription stimulant medication therapy for ADHD as compared to those who initiated early [age 9 or younger] and for longer duration [six years or more],” McCabe said.

The researchers evaluated more than 40,000 high school seniors, including more than 3,500 who were prescribed stimulant medication for ADHD and 1,300 who were prescribed non-stimulant medicine.

The researchers gathered information on medication use and whether or not the teens had engaged in binge drinking, cigarette smoking, marijuana or cocaine use.

“Later initiation of stimulant medication for ADHD, shorter duration of use, and the use of non-stimulant medication for ADHD were all associated with increased substance use during adolescence,” McCabe said.

But the study can’t prove cause and effect, the researchers said.

According to background information in the study, nearly one in eight high school seniors in the United States has used stimulant or non-stimulant medication for ADHD. Medication can help with the symptoms of ADHD, a brain disorder marked by hyperactivity, impulsivity and lack of attention.

While the new findings might seem counterintuitive, McCabe said the results actually reinforce the importance of early detection of ADHD and continuous treatment.

“Some experts have asserted that early detection and appropriate medication management may decrease core ADHD symptoms, such as impulsivity, and may promote adaptive behavior that could reduce substance use and substance use disorders later in life,” he said.

Another pediatrics expert agreed.

“This study provides parents and physicians with further reassuring evidence that prescribing stimulant medications to grade-school children with ADHD is not associated with an increased risk of later substance use at age 18,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York, in New Hyde Park.

“Although some parents have expressed the fear that Ritalin and other stimulant medications could be ‘gateway drugs’ that put children with ADHD at even greater risk for later substance abuse problems, this well-designed analysis of a large national sample clearly shows that this is not the case,” Adesman added.

While it could be possible that some of the children using the stimulant drugs later were experimenting and did not actually have ADHD, McCabe said that information was beyond the scope of the study. The findings do suggest that precautions are needed when prescribing ADHD medicines for older teens, including an assessment of substance use history and ongoing monitoring, he said.

Parents can do much to reduce the risk of substance abuse by their kids, McCabe said. If they suspect ADHD, getting their child checked out early can help get them the treatment they need. Parents can also be good role models in the use of their medicines, he said.

The study was published in the June issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

More information

To learn more about ADHD, visit the U.S. Centers for Disease Control and Prevention.

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