Medications for ADHD and Future Substance Abuse
ADHD MEDICATIONS AND FUTURE SUBSTANCE ABUSE
I am frequently asked by parents of children taking stimulant medications for ADHD if they are at an increased risk for future substance abuse. Research suggests that children with ADHD do have a tendency towards future abuse problems at a rate 2 to 3 times that of children without ADHD, but the research does not indicate that it is the medication that causes this increased risk.
Research recently published out of UCLA that analyzed 15 long term studies and followed 1000’s of children from age 8 to 20 found that stimulant medication use did not increase or decrease the risk of substance abuse. Steven Lee (Ph.D.) says the increased risk is a result of the symptoms of ADHD, not the medication treatment.
The 3 classic symptoms of ADHD are:
1. inattention
2. impulsivity
3. hyperactivity
but they also frequently exhibit:
a) poor self control
b) poor recall of the past
c) poor future planning
Steven Lee contends that it is the combination of these 5 symptoms that can lead to poor choice making and subsequent abuse problems. It is worthy to note that the active ingredients of stimulant medications (Ritalin, Biphenton, Concerta, Dexedrine, Adderall, Vyvanse) are either methyphenidate or amphetamine. These 2 classes of drugs clearly do have an abuse potential if used in improper ways as they will cause a cocaine-like high. Government health authorities recognize this potential and have placed strict controls on the number of pills that can be dispensed to a patient at one time.
The evidence is clear that stimulant medications can be of great help to individuals living with ADHD as they assist with the control of many of the troublesome symptoms. It is also clear that these medications have an abuse potential because of the euphoric reaction that can occur with improper use.
My recommendations to parents are:
1) consult with your pediatrician and pharmacist
2) closely supervise the administration of the meds
3) continually monitor and evaluate their effectiveness
4) educate your child about the need to use medications wisely
There are benefits and risks with all medications including the stimulant forms for ADHD. It all comes down to finding the right balance to maximize the benefits and minimize the risks.