Addiction & ADHD Medication: Fighting Fire with Fire

ADHD Medication

If you come to a 4th of July party with my extended family, you’ll see a fun loving group! We’ll be laughing, singing, dancing and having a loud and fabulously great time. But there’s one thing you won’t see at our party: alcohol. Why? Because I come from a long line of proud, successful, intelligent and recovering alcoholics. Almost no one in my family drinks any more – it’s just too risky.

If you or a loved one has ever struggled with alcoholism and/or addiction, you know the emotional, financial and physical toll substance abuse can take on a family. Those who do recover know they have only a daily reprieve. Less than 10% stay clean and sober for over a year.

Connection Between ADHD and Addiction

Back to my family. It may not surprise you to know that in recent years, many of us have been diagnosed with adult ADHD. Addiction, alcoholism & ADHD are closely related. Not only is there a genetic link, but how the reward pathways work in the brain is similar, as well. It’s truly fascinating (& frightening) stuff.

So, based on all that, my kids are genetically pre-disposed to become addicts, alcoholics, and have ADHD, depression, anxiety and bi-polar disorder. Not so fun, right?

And yet, when our then 4-year old son was diagnosed with ADHD I hesitated only briefly when the doctor recommended stimulant medication.

“WHY TAKE THAT RISK?!” I can hear you yelling that as I write this. “Why expose your child to a medication that he could later become addicted to?”

Proper Treatment of ADHD Reduces Risk of Addiction

Because the best minds in neuroscience have shown, again and again, that treating ADHD with stimulant medication and behavior therapy (parent training and support) can actually reduce the risk of addiction and alcoholism later in life.

Let me say that again: Recommended treatment of ADHD in children reduces the risk of addiction and alcoholism later in life.

There are multiple studies to support this, but here’s what convinced me. I read in a CHADD Fact Sheet, “What You Need to Know About Substance Abuse and ADHD Treatment,” that An American Academy of Pediatrics report “describes an 85 % drop in the risk of later developing a substance abuse disorder for individuals with ADHD who received medication treatment, when compared to those who did not have medication management. Children who were treated with stimulant medication at an earlier age were the least likely to develop a substance abuse disorder. (emphasis mine).”

It went on to add that Behavior Therapy “also conveyed some protective influence against later substance abuse. Behavior Therapy through parent training is the recommended treatment for young children under the age of five; behavior therapy and medication management are recommended for elementary-aged children and older.”

For more information (or a little light reading, depending on your style), check out the original American Academy of Pediatrics’ clinical report.

Now, if you’re a science geek like me, another CHADD fact sheet on “Substance Abuse and ADHD” provides more detail. Specifically, it says that “stimulant treatment may protect against later substance abuse or dependence for boys (Biederman et al. 1999) and for girls ( Wilens, Adamson et al., 2008 ). No studies have yet shown that stimulant treatment is associated with worsening of substance use in adolescence (or for that matter, among adults being treated for both substance dependence and ADHD; for review, see Wilens, 2008 ) (emphasis theirs).”

What If Addiction Is a Result of Undiagnosed, Untreated ADHD?

Armed with this knowledge, I’ve wondered again and again: What if all the happy, recovering alcoholics in my family had been diagnosed with ADHD as children instead of as adults? What if we’d all been treated for ADHD when we were kids? Could we have bypassed the pain and gut-wrenching destruction of alcoholism and addiction?

I will never know.

But I do know this. I have the opportunity to spare my children (or at least greatly reduce their risk) of substance abuse by providing them with behavior therapy (in the form of really well-informed parents) and appropriate medication. And you better believe I’m doing everything I can to decrease their risks, and increase their odds of reaching adulthood without addiction.

No Guarantees in this Parenting Gamble

To be clear, in spite of all my knowledge, research and education, it’s possible that my kids may still cross that line into addiction. They are not unique in this. In fact, ALL teenagers, ADHD or not, are at risk for alcoholism & addiction — because they are TEENAGERS! Their brains are hard wired to take crazy risks because they don’t see the connection between actions and consequences. So, what can we do?

Three Steps to Improve the Odds

There are three things all parents can do to improve the odds for your kids, whether they have genetic predispositions, or not: communicate, educate & demonstrate:

1. Keep the lines of communication open with your kids. Start having conversations about drugs and alcohol very early on. If your teen also has ADHD, this graphic from Harvard University may help explain the risks.

2. Share with your kids how alcohol impacts the developing brain. The National Institutes of Health has some great resources.

3. Demonstrate & verbalize what your family’s expectations are regarding underage drinking. According to the U.S. Department of Health & Human Services, the number one reason teens abstain from drinking is fear of parental disapproval . Let them know what’s important to you.

However you choose to manage your children’s ADHD, it’s important for you to know that they are at risk for all kinds of scary consequences. It’s hard information, we know. But it’s so important.

You can beat the odds, however. Parents who get the education & the behavior training needed to effectively support their ADHD children watch their kids grow up to be successful, resilient adults. And remember, if you’re reading this article, you are on the path to becoming one of those parents!

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