The Construction of the First Validated (Evidence Based) Guideline for Dual Diagnosis of ADHD and SUD; Data from Focus Groups

This study aims to obtain more information about the expectations and experiences of patients with attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) and about the opinions of addiction care professionals. This information has been used to develop the first multidisciplinary guideline for identification and treatment of ADHD in addicted patients. Focus group interviews were performed with two groups of professionals and a group of patients of one of them. The interviews were transcribed and analyzed using QSR NVivo 9 software. The analysis revealed a great difference between addicted inpatients and outpatients as to the possibilities of diagnosing and treating ADHD. It is difficult to make a proper diagnosis in patients who are not fully abstinent, as there are no validated diagnostic instruments for this target group. Observation is seen as more important than questionnaires but there have been no studies on the utility of observation. Patients often ask for non-pharmacological treatment. Underdiagnosing of ADHD in addicted patients is a persistent problem. Additional research is required into diagnostic tools for making a proper diagnosis in patients not fully abstinent as well as into pharmacological interactions. Observation, degree of distress and cognitive examination should form part of the diagnostic process. The positive experiences in the residential addiction services with non-pharmacological well-grounded, structured treatment methods for addiction offer a perspective to develop specific methodologies adapted to patients with comorbid ADHD.