- Inability to sit still
- Difficulty managing impulse control
- Difficulty being quiet when necessary
- Difficulty getting along with other people
Whatever the combination of symptoms, the end result is that it is difficult to function optimally at school, work, and home. For many, this difficulty can translate into uncomfortable feelings, including social anxiety, low self-esteem, and others, which in turn can trigger an increased risk for drug and alcohol abuse.
Other issues related to ADHD and substance abuse concern the types of medications used to treat the disorder. Because most of the medications prescribed to patients living with ADHD are addictive, this can further increase the risk of the development of a substance use disorder.
Social Stigma and ADHD
An estimated 11 percent of kids between the ages of 4 and 17 had an ADHD diagnosis at some point in their lives as of 2013, up from 7.8 percent in 2003. Boys are about three times as likely to be diagnosed with ADHD compared to girls; that is about 13.2 percent of boys have been diagnosed with ADHD at some point and only 5.6 percent of girls have had the diagnosis.
Despite the widespread prevalence of the disorder, there is still a great lack of understanding and awareness of how best to address the problem and stigma is rampant. Young people especially can struggle with a feeling that they are “bad kids” or otherwise less likeable than their peers. The disorder can be extremely isolating to individuals who are frustrated by a genuine desire to “fit in” and follow directions without the coping skills to make it happen on a regular basis. This struggle, especially if it continues unaddressed or is addressed harshly, can lead to feelings of inadequacy, depression, anger, and more – feelings that can lead to the desire to “self-medicate” the problem and escape through heavy use of drugs or alcohol.
Additionally, because ADHD commonly manifests in childhood, the disorder can contribute to early age of first use of drugs and alcohol, another risk factor that may increase the chance that a substance use disorder may develop.
Medication and Addiction
There are a number of different medications that are commonly prescribed to treat ADHD. Some of these are stimulant medications that are controlled substances and addictive, and some are nonstimulant medications that are not controlled substances and not addictive. Depending on the severity of a patient’s symptoms, medications may be used alone or in combination, and should they prove ineffective or if there are other co-occurring disorders present, other types of medications may be used as well.
- Strattera: Also sold under the generic name atomoxetine, Strattera was the first nonstimulant medication available for use in children for the treatment of ADHD.
- Intuniv: Also known as guanfacine, this drug is prescribed specifically to lessen compulsive behaviors.
- Kapvay: Also known as clonidine, this medication is usually prescribed in combination with stimulant drugs to increase their ability to manage aggressive behavior and inattention.
- Evekeo and Adzenys XR ODT (amphetamine)
- Adderall and Adderall XR (amphetamine/dextroamphetamine)
- Dexedrine, Zenzedi, and ProCentra (dextroamphetamine)
- Focalin and Focalin XR (dexmethylphenidate)
- Vyvanse (lisdexamfetamine)
- Ritalin, Ritalin SR, Ritalin LA, Concerta, Metadate CD, Metadate ER, Daytrana, Methylin, Methylin ER, and Quillivant XR (methylphenidate)li>
- Lexapro (escitalopram)
- Wellbutrin (bupropion)
- Effexor (venlafaxine)
- Zoloft (sertraline)
For many families, the use of these medications is a game changer. They genuinely help the individual to focus, sit still, accomplish tasks, and otherwise avoid engaging in compulsive behaviors that can make it difficult for them to make friends and progress academically or at work. In some cases, they work when nothing else does to create a more balanced and harmonious life for all involved. But these medications are not without their risks, especially when used by children and/or for years on end. Many have not been studied extensively to determine what the long-term effects of use will be, and the result is that many families have unexpectedly found their use to be detrimental, if not devastating.
Medication-Seeking Behavior and False ADHD Diagnosis
In general, stimulant drugs cause a “high” in the user, increasing their energy level and sociability, and negating the need for sleeping or eating. In those who are living with ADHD, the drugs have the opposite effect; they serve to calm the person down, to increase their ability to focus on a task and see it through to completion, and to improve their ability to think before they speak or act.
When a child takes these medications, a parent is on standby to make sure they work correctly. Should the response to the medication be the opposite of what is intended, parents can immediately contact the doctor and stop use of the drugs. For this reason, abuse of the drugs during childhood is rare.
However, over time, a child’s body chemistry will change with growth. The medications and dosages that were effective for an 8-year-old child, for example, will not necessarily still be effective when the child is 15 or 16. Additionally, the nature of the disorder can shift and change as a child grows. Many find that symptoms fade over time, but if medication continues without periodic “medication vacations” to determine whether or not they are still necessary, the individual may continue taking the drug unnecessarily, and it may begin to have a different effect in the user. That is, over time, the child who needs the drugs to function healthfully can grow into a young adult who experiences a “high” from use of the meds. If parents and doctors do not regularly check in, this inadvertent “abuse” of these addictive medications can turn into an addiction.
In other cases, young adults who no longer need their medications may find it more useful as a commodity, selling the pills to classmates who take the drugs with the goal of improving their ability to study or manage heavy course loads as well as a thriving social life. In this way, many young people who may never have otherwise used addictive drugs find their way into a substance use disorder, feeling dependent on the pills to manage their responsibilities and then seeking out the medication on their own – even falsely presenting with symptoms of ADHD to a doctor in order to get a prescription for the drug. Without a parent’s supervision, many young people with this issue begin drug seeking in college in hopes of getting regular access to pills that they believe will help them improve their performance and succeed.
Holistic Healing for ADHD
Some options include:
- Cognitive Behavioral Therapy: CBT helps clients to identify the perspectives and assumptions they hold that inform their experience, often to the negative, and helps them to identify more positive frameworks to improve quality of life.
- Behavior modification: Behavior modification often focuses on one behavior at a time that causes the client problems and helps them to either eradicate it completely or replace it with a more benign behavior.
- Mindfulness: Practicing living in the present moment can help people living with ADHD to increase their ability to focus and decrease daydreaming.
- Neurofeedback: A form of biofeedback, neurofeedback can help to manage neurological issues commonly associated with ADHD, like sleep disorders, anxiety, involuntary movements, and others.
- Memory training: Memory training can help clients with ADHD to increase their ability to retain information, organize, and follow through on multistep tasks.
- Parent training: Parents and caregivers can help to improve chances of success for children living with ADHD. In fact, if parents do not learn how to provide structured support to kids as they learn how to manage executive function and behavioral choices, medication will do little good in the long run.
- Vitamins and supplements: Some vitamins and supplements have been shown to be helpful in managing issues related to ADHD, and some have detrimental effects. Specific supplements and dosages will vary based on symptoms and other factors, including weight and age.
- Dietary changes: In some cases, the symptoms of ADHD are really negative reactions to certain foods in the diet. Doing an elimination diet to pull out potentially hazardous foods and then adding them back in one by one over the course of months can help to determine whether or not diet is contributing to symptoms.
- Exercise: Regular exercise is beneficial for a number of reasons. For people who are living with ADHD, it can provide a positive outlet for hyperactive energy, balance out moods, and improve sleep.
- Stress management: Dealing with ADHD symptoms can be stressful on its own, and for many, a co-occurring anxiety disorder is an issue. Learning how to manage stress can be helpful in the moment as well as over the long-term.