Improving care of attention deficit hyperactivity disorder (ADHD) in people who use drugs

INTERVENTION: The subjects will be divided randomly on enrolment into tow groups. Group A will be immediately be provided with additional services including case management, counselling, access to ADHD coaching, and a mental health review with a psychiatrist. A research nurse will provide case management. All contacts and reviews (including telehealth review) will be recorded. Group B will be offered all the additional services after 6 months of treatment as usual. Treatment as usual consists of assessment by an addiction medicine specialist, psychiatric registrar or psychiatrist who prescribes medication, provides psychoeducation and reviews the patients as required. The additional services include: (a) case management by a nurse or alcohol and other drug case worker includes monitoring adherence and issuing reminders to ensure partiipation (b) access to coaching by a qualified ADHD coach (typically 10 weekly one hour sessions) (c) formal review of comorbid mental health issues by an independent psychiatrist (d) regular review (at least monthly) by the research nurse or an addiction medicine or addiction psychiatry consultant CONDITION: Attention Deficit Hyperactivity Disorder (ADHD);substance use disorder (SUD) ; ; Attention Deficit Hyperactivity Disorder (ADHD) ; substance use disorder (SUD) Mental Health ‐ Addiction Mental Health ‐ Other mental health disorders PRIMARY OUTCOME: Change in ADHD related impairment; [Weiss Impairment Scale; Baseline and three monthly for 6 months Group A and 12 months Group B] Change in ADHD symptoms[Adult ADHD Self Report Scale (ASRS) ; Baseline and three monthly for 6 months Group A and 12 months Group B] Change in substance use[Change in Australian Treatment Outcome Profile; Baseline and three monthly for 6 months Group A and 12 months Group B] SECONDARY OUTCOME: Change in compensatory behaviours[Compensatory ADHD Behaviours Scale (CABS) Baseline and three‐monthly Group A and at 12 months Group B] Change in depression, anxiety and stress[DASS‐21 Baseline and three monthly for 6 months Group A and 12 months Group B] Change in psychological functioning ‐ as assessed by the Loffty inventory[Loffty inventory Baseline and three monthly for 6 months Group A and 12 months Group B] Change in reported Quality of Life[WHO Quality of Life Scale ‐ Brief Baseline and end of intervention (6 months for Group A and 12 months for Group B)] INCLUSION CRITERIA: Aged 18 year or over Score >= 14 on ASRS part A Have the diagnosis confirmed on interview (DIVA) Live within the Goulburn Valley Health catchment area