< Back to previous page

Publication

Barriers to the implementation of a guideline for recognizing and treating adult ADHD in patients with a substance use disorder

Journal Contribution - Journal Article

Background: This is a qualitative study to explore the implementation
barriers of the guideline for the recognition and treatment of adult ADHD in
patients with a substance use disorder (SUD). Methods: Focus-group
interviews were performed with addiction professionals (physicians,
psychiatrists and psychologists) who had tried the guideline and
psychiatrists specialised in addiction but without specific experience with
ADHD. The interviews were transcribed and analyzed using QSR NVivo 9
software. Results: In addition to the common problems with the
introduction of evidence-based clinical guidelines into daily practice, our
analysis revealed a number of specific barriers: lack of information from
the family, pressure from the patients and those close to them to make an
ADHD diagnosis, and the potential for abuse of the medication.
Furthermore, diagnostic instruments for ADHD have not been validated in
an addicted population. Although patients with ADHD usually are treated in
an outpatient setting, patients with ADHD and a comorbid substance use
disorder are hard to deal with in an outpatient center for various reasons.
Finally, there is a lack of specific ADHD expertise in substance abuse
treatment organizations. Conclusion: Despite the availability of an
approved guideline for recognizing and treating adult ADHD in patients with
a substance use disorder, underdiagnosis and inadequate treatment still
persist. As in general addiction treatment, medication only plays a
supportive role in the treatment of SUD with comorbid ADHD. An
integrated approach and further improvements in the competence of the
practitioners may help to reduce the resistance to diagnose ADHD in
addiction treatment centers. Specific interventions need to be developed to
keep these patients in treatment.
Journal: Journal of Dual Diagnosis
ISSN: 1550-4263
Issue: 10
Volume: 3
Pages: 130-138
Publication year:2014
Keywords:guideline, barriers to implementing, ADHD, substance use disorder, qualitative research, attention deficit hyperactivity disorder, addiction
Accessibility:Closed