There has long been thought to be a link between child and adolescent bipolar disorder and an increased risk of substance abuse but it is not clear whether this is due to bipolar disorder itself or co-existing conditions such as attention-deficit hyperactivity disorder (ADHD), conduct disorder or anxiety disorders. A U.S. study of 203 children compared those with bipolar disorder to an unaffected control group. The incidence of alchohol abuse, drug abuse and smoking was significantly higher in the children with bipolar disorder and overall the rate of substance abuse was much higher (34% vs 4%) among those with bipolar disorder. The onset of bipolar disorder preceded the onset of substance abuse and those who developed bipolar disorder in adolescence were more likely to develop drug problems than those who developed the condition in childhood. When adjusted to account for co-occuring behavioural and psychiatric conditions the results still indicated significantly higher risk in the bipolar group.
You can find out more about this research at