Letters to the Editor

Medication provides benefits for adolescents | Letter to the Editor

A comment recently made during a community discussion of methamphetamines must be addressed. It was stated that children with Attention Deficit Hyperactivity Disorder are prescribed Ritalin (methylphenidate), “a close cousin to amphetamines: Statistically, this puts them at risk for amphetamine addiction.” That view is not supported by scientific research. As an addictions professional,  I fear this will become the next Vashon “urban legend,” with parents discontinuing  medications that are profoundly helpful.

Imaging studies show differences among ADHD subjects in brain areas that control movement, reasoning, logic, behavioral control and sensory reward that are also involved in substance use disorders (SUD). ADHD is associated with problems thinking, learning, controlling behaviors, maintaining interpersonal relationships and developing psychiatric disorders and SUD. Adults with untreated ADHD may suffer occupational impairment due to poor education, performance and reasoning. Perceiving themselves as failures, many with untreated ADHD attempt to self-medicate poor attention, restlessness, difficulty learning and processing information.

Every published study indicates that individuals with untreated ADHD have a significantly higher risk of developing SUD. However, substance abuse is a hugely complex process involving many factors. The belief that stimulants become the drug of choice is erroneous: ADHD individuals treated with stimulant medications feel “normal” not high.

A 2003 meta-analysis of  ADHD research concluded stimulant treatment of ADHD reduced the risk for substance disorders.  The latest study demonstrates that ADHD adolescents treated with stimulants had a decreased risk for SUD and those not treated with stimulants were twice as likely to develop SUD. In fact, the sooner stimulant treatment was started, the less likely adolescents were to develop SUD. However, when stimulant treatment was not started until age 18, the rates of SUD were higher.  Medication is one component of treatment. Decisions require collaboration with professionals expert in diagnosing  and managing  ADHD.

— Nodie Sullivan MSN, ARNP, CNS

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