ADHD or attention deficit hyperactivity syndrome is a condition characterized by hyperactivity and attention problems that can start when children are quite young. About 3-5% of children are affected worldwide. For more than 30%-50% of these children, the symptoms persist into adulthood resulting in a range of emotional and mental problems. According to the latest estimates, more than 4.7% Americans live with ADHD and the condition is more common in males than females. Research has shown that the condition can be managed with effective medication, behavioral management, lifestyle changes and counseling. Most researchers believe that a properly calibrated regimen of counseling and medication can control ADHD.
The most common medications for ADHD include stimulant medications like Ritalin and Adderall and non-stimulant medications like atomoxetine. Both groups of medications are relatively safe but they do have side effects. Ritalin increases the amount of dopamine in the brain soothing the symptoms of ADHD. Adderall contains a mix of amphetamine salts like dextroamphetamine saccharide, and dextroamphetamine sulfate and it is also used to control ADHD but it is considered to be Schedule 2 Drug( only provided on prescription.) Atomoxetine is a non-stimulant medication that is used for ADHD but it does cause a range of side effects like increased heart rate, high blood pressure, abdominal pain and nausea. However, many children and adults are able to control problematical behaviors and concentration issues through the use of medications that are monitored carefully.
In recent years, a few very confusing cases of increased substance abuse in ADHD patients have come up. According to research, most ADHD patients (adult and children) are well controlled on stimulant medications. However, adult ADHD patients seem to have an increased risk for substance abuse behavior through three potential routes.
1. Self-medication for ADHD as stimulant or controlling medication was discontinued
2. Increased levels of reward-seeking behavior
3. Defiant disorder and conduct disorder in childhood continuing on to adulthood resulting in psychosocial impairments.
The research about the condition is not clear. Abuse patterns seem to begin when treatment for ADHD is stopped. Adults with ADHD are more likely to be impulsive and they are likely to engage in risky and dangerous habits that result in addiction and substance abuse. However, most doctors have noted that patients who are properly monitored and controlled on ADHD medication are less likely to abuse the drug or develop an addiction. Another factor to consider is that ADHD has a genetic component. Patients who develop ADHD may also have a family history of alcohol or substance abuse.
Drug Abuse History And ADHD
The ADHD medications generally do not cause problems when used as prescribed. However, it is mandatory for a patient to disclose any previous addiction history to the doctor. Most doctors recommend controlling all substance abuse behavior before ADHD treatment is started. A very strict mode of treatment is required.
• Patients are counseled about the addiction potential of the stimulants like Ritalin and Adderall. At the patient’s home, the stimulants are kept in a safe place with a family member who dispenses the drugs.
• Weekly prescriptions are provided to ensure that the drug is not overused. Any behavior where the patient actively asks for more medications is to be noted.
• A written therapeutic contract with consequences for a relapse should be written down and signed with the patient. The contract should be reviewed regularly with patients.
Counseling is often very beneficial as efforts can be made to reduce stress which results in better concentration and less impulsivity. Many times we can’t focus or concentrate due to reviewing situations over and over again in our minds. Finding ways to cope with difficult situations through tools such as breathing and stopping negative thought patterns will improve daily functioning and reduce distractions.