Study Finds Telehealth Does Not Increase Substance Use Disorder Risk in ADHD Patients

The recent study conducted by researchers at Massachusetts General Brigham has revealed that telehealth does not increase the risk of substance use disorder among patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) who are prescribed stimulant medications. This research, published in the *American Journal of Psychiatry* on June 12, 2025, addresses concerns among healthcare professionals regarding the potential for increased substance use disorders when ADHD patients receive care through virtual consultations.

Telehealth has emerged as a critical mode of healthcare delivery since the onset of the COVID-19 pandemic, allowing patients to access medical services remotely. According to Dr. Vinod Rao, MD, PhD, lead author of the study and medical director of Adult Ambulatory Psychiatry at Massachusetts General Hospital, “Our study suggests that generally, telehealth-based relationships—which make healthcare more accessible—can be safe and don’t increase the risk of substance use disorder.”

The study involved an analysis of electronic health records from 7,944 ADHD patients between March 2020 and August 2023, a period when many healthcare providers transitioned to online care. Researchers found that while 91% of patients had at least one in-person visit with their prescriber around the time they received a stimulant prescription, 9% maintained a telehealth-only relationship.

Despite initial concerns, the findings indicated that patients who exclusively used telehealth to manage their ADHD medication were not at a higher risk of developing a substance use disorder compared to those who had face-to-face appointments. However, it was noted that patients aged 26 years and older who received their initial stimulant prescription via telehealth were at a greater risk for developing stimulant use disorders, suggesting that older patients may be more vulnerable to such risks in a telehealth context.

The researchers emphasized the need for comprehensive diagnostics and routine follow-ups, especially among patients initiating treatment through telehealth. Dr. Timothy Wilens, MD, chief of the Division of Child and Adolescent Psychiatry at MGH and corresponding author of the paper, remarked, “While we think the findings should be replicated, the vast majority of the data shows no increase in substance use disorder developing when patients exclusively use telehealth.” He stressed that these findings support the continued use of telehealth in ADHD stimulant therapy within clinical settings.

As telehealth continues to be a vital component of healthcare, understanding its implications on patient outcomes remains crucial. This study provides reassurance to healthcare providers and patients alike, indicating that virtual care for ADHD management can be conducted safely without exacerbating the risks of substance use disorders. Future research may further illuminate the dynamics between telehealth and substance use, particularly among different age groups and demographics, fostering a more comprehensive understanding of how virtual care impacts patient health across varying contexts.