Which Motivations Impact the Relation Between ADHD Symptoms and Simultaneous Use of Alcohol and Marijuana?

Attention-deficit/hyperactivity disorder (ADHD) symptoms are associated with greater risk for substance use and abuse. About one in four adults with ADHD has a comorbid substance use disorder. Polysubstance use, or mixing multiple drugs, is becoming increasingly prevalent on college campuses. The simultaneous use of alcohol and marijuana (SAM) is a particular polysubstance use pattern that is significantly correlated with more risky behaviors (e.g., reckless driving, unprotected sex) and adverse consequences (e.g., blackouts, physical injury) than using one substance alone. An estimated 15% of 18- to 29-year-olds engage in SAM each year, while recorded rates of SAM in college students are closer to 25%. As polysubstance use behaviors increase, it is important to understand how undergraduates with ADHD engage in SAM considering they are already at a higher risk of developing substance abuse disorders. Moreover, this investigation has clinical importance as the prevalence of college students with ADHD is rising with an estimated prevalence rate of 2-8%. The current study explores the relation between ADHD symptoms and SAM and the moderating role of motives for SAM in this relation. Data were drawn from the Undergraduate Learning, Emotion, and Attention Research Network (ULEARN) study, an online survey-based study examining attention, learning, and psychological functioning in college students. Among students who reported using alcohol or marijuana in the past month, 22.6% (n=487) reported this use included engaging in SAM. Using binary logistic regression, the total number of ADHD symptoms reported was significantly associated with SAM. Despite this association, none of the four motive subscales examined (i.e., calm/coping, conformity, positive effects, or social) served as significant moderators in the relation. Inattentive symptoms were more strongly associated with SAM than hyperactive/impulsive symptoms. Implications of the results for future research and clinical practice will be discussed