ADHD Treatment Prevents Drug Abuse

[Heretic.Ape.]

ADHD Treatment Prevents Drug Abuse

(Ivanhoe Newswire) -- Adolescent girls with ADHD are at a significantly higher risk for cigarette smoking and substance abuse than girls without -- but new research shows that risk can be lessened by treatment with stimulant drugs.

The new study confirms similar findings in boys and shoots down concerns that stimulant drug treatment increases the risk of drug or alcohol abuse.

“Girls with ADHD actually tend to get into trouble with substance abuse earlier than do boys with the disorder, so confirming those results was not simply academic,” lead study author Timothy Wilens, M.D., director of the Substance Abuse Program in the Massachusetts Pediatric Psychopharmacology Department and an associate professor of psychiatry at Harvard Medical School, was quoted as saying.

Researchers assessed girls with ADHD for use, abuse and dependence on tobacco, alcohol, marijuana or other drugs five years after they joined a larger study. Results show treatment with stimulant drugs halved the risk of smoking or substance abuse.

“We can confidently say that stimulant treatment does not increase the risk of future substance abuse or smoking in girls with ADHD and at least delays the onset of cigarette smoking and substance abuse,” Dr. Wilens said.

SOURCE: Archives of Pediatrics and Adolescent Medicine, 2008;162:916-921

Originally Posted by Heretic.Ape

Or: Feed your kids our pills and they won't take those evil ones.

[runitsthepolice]

Interesting. Swim assumes this study was done on teens that had never tried smoking. Adderall always makes him smoke a lot.

[FuBai]

Would love to know the selection criteria for the sample population. Is it not possible that those who are diagnosed with ADHD at an early age and prescribed legal amphetamine have more overbearing parents that made it more difficult to use drugs or made them less likley to admitt to it? What was the duration of the study and the age of the population - i.e. was this long term enough to assess potential for drug use after adulthood had been reached? Did they ask questions about over using/abusing thier prescription speed? Perhaps if you have a large amount of a potent drug that is provided for you, as a child, at no cost to yourself you would say "Why bother with illegal drugs when I can tweak my tits off on legal meds?" I've certainly seen a lot of reports of abuse/over use of ADHD meds by "ADHD sufferers".

[MrG]

Yet another report that so conveniently fails to address the alarming numbers of children being diagnosed with ADHD or its variations when the simple fact is they need to be getting some decent sleep.

Leaving kids to sit all night at the tv, computer or games console and then expecting them to sleep well would be laughable if it weren't so damn fucking ridiculous.

America, on the whole, your children do not have ADHD, they simply have parents who have failed to give them a proper routine which promotes a healthy sleep cycle followed by a non-sedentary lifestyle and healthy diet.

Stop pouring fistfuls of pills down their necks simply because you can't be bothered to think about raising them properly.

[Taren]

Swim theorizes that many of ones who aren't getting treated with stimulants may be turning less legal alternatives as a way to self-medicate.

[~lostgurl~]

ADHD drugs cut risk of drug abuse

Reuters | Wednesday, 08 October 2008

Girls who take stimulants to treat attention deficit hyperactivity disorder are less likely than others with the condition to start smoking or to abuse alcohol or drugs.

They said girls with ADHD who took stimulant drugs had half the risk of substance abuse and nearly half the risk of smoking cigarettes as those who were not treated with drugs. "It shows a greater than 50 percent reduction for developing a substance use," said Dr. Timothy Wilens, director of a pediatric substance abuse programme at Massachusetts General Hospital, whose study appears in the Archives of Pediatrics and Adolescent Medicine.

Several studies have found that people with ADHD are far more likely to smoke and abuse drugs, and treatment with stimulants such as Ritalin, known generically as methylphenidate, can lower this risk in boys. But at least one study suggested this benefit did not extend to adolescent girls with ADHD.

Millions of children with ADHD are treated with drugs such as Novartis AG's Ritalin and Shire Plc's Adderall. Wilens disclosed financial ties to both of those companies and several others, including Eli Lilly and Co.

Wilens and colleagues studied 140 girls with ADHD aged 6 to 18 -- 94 percent of whom were taking stimulant medication -- and 120 girls without ADHD. The girls periodically had psychiatric evaluations over five years. The researchers wanted to see if treating girls with ADHD might increase the risk of smoking and substance abuse. Instead, it lowered the risk. Because the average age of the girls studied was 16, it is not yet clear whether this decreased risk will continue through young adulthood, when people have a higher risk for smoking and substance abuse.

Wilens said any finding that a medication reduces the odds of smoking is important. "If you smoke and have ADHD, over half of those kids ultimately go on to have a substance abuse problem," he said in a telephone interview.

The research team also included Dr. Joseph Biederman, a Harvard psychiatrist who has been accused by Iowa Republican US Sen. Charles Grassley of not fully disclosing payments from drug companies. Biederman in this study disclosed ties to Novartis, Shire and other companies.

The study was funded by the National Institutes of Health and by the Lilly Foundation.

http://www.stuff.co.nz/stuff/4719214a7144.html

[MrG]

That is a completely baseless theory.

Juvenile stimulant abuse does not come from a desire to self-medicate, it comes from a desire to take drugs and get high.

[FuBai]

Originally Posted by MrG

That is a completely baseless theory.

Juvenile stimulant abuse does not come from a desire to self-medicate, it comes from a desire to take drugs and get high.

With all due respect, that's a little hippocritical. Prove to me that no Juvenile stimulant abuse stems from a desire to self-medicate.

[Taren]

Originally Posted by MrG

That is a completely baseless theory.

Juvenile stimulant abuse does not come from a desire to self-medicate, it comes from a desire to take drugs and get high.

Swim takes illegally obtained adderall to self-medicate for disthymia. Swim also belongs in the age group typically classified as "juvenile". Thus there is at least one counterexample to your rather sweeping statement. Swim also knows many other people his age who are taking drugs, either illegal or not prescribed to them, because the alleviate the symptoms mental disorders they have been diagnosed with and cannot afford or access treatment for, or because they make long lasting mental or emotional problems, which have not been diagnosed, better. So the theory is not baseless. There is also evidence, although Swim couldn't point to a specific study just at present, suggesting that the majority of drug abuse is some form of self medication, and swim doesn't see why that should be any different for young people.

[MrG]

Originally Posted by Taren

Swim takes illegally obtained adderall to self-medicate for disthymia.

Dysthymia (chronic depression) is not treated with Adderall so SWIY might want to rethink that idea, if he is actually doing that of course. You know that pesky internet, people claiming all sorts of things that aren't actually true.

Originally Posted by Taren

So the theory is not baseless.

Unfortunately, until evidence is provided, it is.

Originally Posted by Taren

There is also evidence, although Swim couldn't point to a specific study just at present, suggesting that the majority of drug abuse is some form of self medication, and swim doesn't see why that should be any different for young people.

Again, if it were true then yes, it shouldn't be viewed as being any different for young people. But until you actually *can* point to a specific study, your claim for its existence is exactly the same as your claim to know people who purely self-medicate with their illegally obtained drugs - baseless.

[El Calico Loco]

Originally Posted by MrG

Dysthymia (chronic depression) is not treated with Adderall so SWIY might want to rethink that idea, if he is actually doing that of course. You know that pesky internet, people claiming all sorts of things that aren't actually true.

Perhaps it should be, if it works for some. Perhaps some depression relates to dopamine rather than serotonin? Swim's mother has suffered from emotional disturbances her entire life, and her drugs of choice have always been coke, amps, and other dopamine-affecting compounds. Prozac did nothing for her.

Again, if it were true then yes, it shouldn't be viewed as being any different for young people. But until you actually *can* point to a specific study, your claim for its existence is exactly the same as your claim to know people who purely self-medicate with their illegally obtained drugs - baseless.

I don't think he means self-medicate in the sense of "I know I have an officially recognized condition, and I take drugs that I have heard are useful for it". I think he means "taking this drug makes me feel better." That could be due to physical or mental pain, and is self-medication, in a sense.

You don't need a double-blind study with a large random sample to disprove a generalization like none use in order to to medicate. One counterexample is sufficient.


ECL

[MrG]

How is this desire supposed to manifest itself?

A juvenile feels an urge, apropos of nothing, to find a drug dealer who can sell him some stimulant powder?

Or said juvenile, having heard that he might be able to buy some illegal stimulants, decides that he needs to take it because he knows he has ADHD and its the right thing to do?

With all due respect, are you high?!!!

[FuBai]

Originally Posted by MrG

How is this desire supposed to manifest itself?

A juvenile feels an urge, apropos of nothing, to find a drug dealer who can sell him some stimulant powder?

Or said juvenile, having heard that he might be able to buy some illegal stimulants, decides that he needs to take it because he knows he has ADHD and its the right thing to do?

With all due respect, are you high?!!!

With all due respect that was not what I asked. You have defined an argument that has several obvious flaws - I would accept that theory nonetheless if there was evidence presented to me of its fact, but you have not given me any.

Now to the flaws - one off recreational use of amphetamines could lead to the juvenile in question discovering that they allay anti-social tendancies. Moreover, the post which we are discussing was not specifically talking about the abuse of illicit amphetamines, but recreational drugs as a whole. This confusion over amphetmaines probably stems from the fact that the medication in question is an amphetamine, but in reality the study assessed all recreational drug use, not simply illicit amphetamine use. Therefore it is just as easy to discuss juvenile Marijuana, opiate, tobacco or alcohol use in this context. CNS depressant drugs could, in the short term at least, allay some of the symptoms of ADHD, and it would not be difficult for a child who had heard of those drugs or come into contact with them to recognise them as being something which makes people "more chilled out". The step from recognising them as relaxing to using them to relax (the symptoms of ADHD being an inability to relax or be calm) is a small one.

It is important to note that I am not arguing for this theory, I am simply asking for evidence to discredit it.

[100mg Methylphenidate]

Swim has ADHD. His brother had ADHD too. Even after avoiding marijuana, alcohol, tobacco, and all other drugs for months, he still lacks the ability and motivation to stay organized and focused throughout multiple aspects of his life. He doesn't have medical insurance either, so he is forced to illegally aquire adderall and other stimulants, which do fix his problem. Healthy? Probably not. A good idea? No. But he feels compulsed to and feels like it's worth it for now. So there's one case I guess...although, I really doubt most people who do coke/meth do so to fix their ADHD.

[MrG]

Originally Posted by FuBai

It is important to note that I am not arguing for this theory, I am simply asking for evidence to discredit it.

Well that's no different to the type of stance used by god-botherers to defend their delusional beliefs. They also like to come up with bizarre claims that cannot be proven nor disproven and, just as in their case, I state that if you want to claim something ludicrous as fact then it is you as the claimant that must provide the proof. (Or, in this case, Tarin who proposed this juvenile-self-medicating-with-narcotics theory)

The reality is that stimulants taken for ADHD are dosed a fraction of what the recreational amount is. So some juvenile who has ADHD and just happens to find himself taking speed for the first time is not going to experience a cessation of his symptoms which then can act as a sign for him to continue "self-medicating". He's going to take a rec dose and get tweaked.

Originally Posted by 100mg Methylphenidate

He doesn't have medical insurance either, so he is forced to illegally aquire adderall and other stimulants, which do fix his problem.

Yeah right, that might be his excuse in court but it doesn't wash with me.

[100mg Methylphenidate]

It is rather expensive to pay for medicine and a doctors visit without insurance...swim can't even afford to get sick anymore.

[100mg Methylphenidate]

Actually adderall is used as a last line sorta thing for treating depression. Mostly because of rebound depression and it's abusiveness. But think about it. What are some of the symptoms of clinical depression? Lethargy, not caring about anything, feeling unmotivated? What does adderall do to most people? Make them compulsed to do stuff and work, while giving a sense of well being and euphoria.

[Bajeda]

Theres a fairly thorough document in the archive centering around ADHD and its relation substance abuse disorders. ---> ADHD and Co-Occurring Substance Use Disorders: New Clinical Insights and Emerging Therapies

The article echoes other research (would have to dig to find it) postulating that nicotine consumption via tobacco is a form of self-medication for those with ADHD (or schizophrenia). It goes off the mark - I feel - when it tries to tie tobacco use into the gateway theory, where starting to smoke cigarettes makes you much more likely to use other drugs in the future.

However, it also mentions that persons diagnosed with ADHD take a much longer time to rid themselves of their addiction (whatever it may be). This is echoed in another older article -----> Alcohol, Drugs and Attention Deficit Disorder: A Model for the Study of Addictions in Youth --plus others I could pull up if necessary. The heightened chronicity (and overall incidence) of substance abuse problems in the ADHD population is definitely significant and calls for further research. I find it hard to deny this without providing some more specific evidence *cough*MrG*cough*, but agree with the argument that attempted self-medication is the primary impetus for SUD in ADHD diagnosed persons is a bit tenuous at this point.

As the previously linked article mentions, poor judgement and impulsivity shown in subtypes of ADHD could contribute to substance abuse problems. More importantly though, people with ADHD don't seem to abuse any one specific type of drug. It makes sense for them to consume nicotine or stimulant drugs, but that doesn't seem to be the case. The high level of co-morbidity shared between ADHD and other psychological disorders could help explain this, but I don't know of any research definitively showing this. Attention impairments found in those with SUD are also present in ADHD, so perhaps part of the reason for higher incidence of SUD in those with ADHD is due to persons abusing drugs at a young age and then later being diagnosed with ADHD after exhibiting symptoms resulting from a SUD. If that is the case though, I wouldn't want to be prescribing powerful stimulant medications to children until we are sure that we aren't creating cases of ADHD by influencing neurological development.


Ironically, I wasn't paying enough attention while writing this (kept leaving the comp to do other things) and lost my train of thought, so I apologize for the rambling mess above. Basically I think that a desire to self-medicate symptoms could contribute to substance abuse, but boredom paired with impulsivity is a more likely reason. Also, the study cited by the news article only followed the participants until the age of 16. The age at which one begins to use illicit substances does seem to be important with regard to likelihood of have a SUD later on in life, but once you get to college age mental disorders are much more likely to manifest and environmental factors also make substance abuse more likely. I guess thats why the researcher said that stimulant medication treatment "at least delays the onset of substance abuse".

This is why I generally try to avoid ADHD threads. I just wonder why I bothered with it after I'm done writing something

Reputation Comments on this post:

Don't do yourself an injustice, you bother with it because we value and cherish your words Baj.

[MrG]

You're quite right ECL, but simply stating that he believes that some people he knows are self-medicating does not prove his theory although it does, at least, give a reason why he has that theory. It doesn't carry enough weight to support the original claim of "many" juveniles self-medicating though.

Look, this is less about whether or not juveniles are self-medicating and more about how a theory, when not supported by sufficient information can be misconstrued and misinterpreted.

Who knows whether he meant one thing or the other? In fact, a quick look at the responses will show you that people read the theory to mean very different things purely because it had no supporting statements in order to clarify it.

I'll be the first to say that I have no idea whether juveniles are self-medicating but, if you want to propose it as a theory, it has to be presented in a manner that will immediately provide me with enough information that I can at least acknowledge its potential validity, as a theory.

I don't mind being wrong but I sure as hell hate being misinformed.

Over on this thread at post 5 is a solid example of what happens to unsubstantiated theory when it has grown a little hair on its balls and starts to demand unquestioning acceptance.

[El Calico Loco]

Originally Posted by MrG

I'll be the first to say that I have no idea whether juveniles are self-medicating but, if you want to propose it as a theory, it has to be presented in a manner that will immediately provide me with enough information that I can at least acknowledge its potential validity, as a theory.

You say you have no idea, but your statement above was categorical.

I propose nothing, save that it's not as ridiculous an idea as you indicated. There are reasons why some people become drug addicts while others who try the same drug(s) do not, and I don't think they're all that complicated. I'm sure some addicts are just thrill-seekers who went to far, but I doubt they are the majority; I don't have a study on-hand linking serious drug addiction to serious emotional problems, but I would be willing to bet real money on a strong positive correlation.

As far as this study goes...all it seems to say is that those who already have drugs that make them happy don't seek out other drugs to make them happy as often as those who lack happy drugs. Not exactly rocket surgery.


ECL

[MrG]

Yes, it was categorical in the sense that the idea sounded absurd to me and I required, at the very least, either a reasonable explanation as to how it would manifest itself in a juvenile or, even though I may not believe everything I read, some anecdotal evidence to explain why the user came to that theory.

[Taren]

Swim isn't going to bother with quoting because it's 2:30 in the morning. Resources rather more reliable than the internet (like casual conversation with psychiatric professionals and hanging out in the local university's health science's library) indicate that disthymia often doesn't respond well to anti-depressants, leading many, at least of the doctors that Swim talks to, to believe that it may be more of a dopamine issue, and thus would have a generally poor response to drugs that mostly affect serotonin.
Swim thinks he can pretty well assume that someone is self-medicating when they ask him what they should be taking based on their mental issues, and then keep taking it because it makes said issues better. (Swim is the resident "druggeek" and psychology geek of his school, and thus gets a lot of these questions).

[100mg Methylphenidate]

Guys....it's late...and I haven't slept in a couple days...but I think I have the real answer....

People with ADHD probably didn't pay attention to DARE. Therefore, they didn't learn how bad drugs were! Brilliant? XD