Addiction, Part 2
The implication is clear: If you or your child has ADHD, make sure to arrange for appropriate treatment (including, if necessary, ADHD medication).
Experts urge parents to start talking to their kids about the matter at an early age. If you wait until fifth or sixth grade, it may be too late. Let your child know that having ADHD raises his risk for trouble, that he is more vulnerable to addiction than are his non-ADHD peers. Make sure your child understands that the best way to avoid trouble is to avoid illicit drugs altogether, and to wait until adulthood to use alcohol (if at all).
The good news? According to the National Institute on Drug Abuse, an individual who hasn’t started abusing a substance by age 21 is unlikely to start later. This seems to be true for ADDers as well as non-ADDers.
What’s more, regular exercise seems to help people avoid the lure of self-medication. “It’s important for people with ADHD to exercise, and keep the brain stimulated,” says Richardson. “Boredom puts you at risk. You need to be moving, to challenge yourself physically.”
Double trouble, double treatment
In her effort to break her dependency on marijuana and other drugs, Jennifer had been to countless 12-step meetings. She even attended a 28-day residential rehab program. But all was in vain, because her ADHD hadn’t yet been diagnosed or treated.
“I couldn’t stay focused on recovery,” Jennifer recalls. “In meetings, my mind was on anything but what they were talking about. How ugly the walls were. How annoying the speaker’s voice was. I’d think, ‘How long are they going to talk? The coffee is getting cold. I have to meet so-and-so at the mall.’”
The unfortunate truth is that ADHD makes substance abuse harder to treat — and vice versa. “I couldn’t deal with my ADHD until I got sober,” says 36-year-old David, a salesman in San Jose, California. “But it was hard to stay sober before my ADHD was under control.”
What’s the right way to get help? Recent studies suggest that it’s best to optimize the treatment for ADHD only after the individual has been sober for six weeks to a few months. “The results won’t be very dependable if you just try to blast through ADHD without waiting for abstinence,” explains Dr. Wilens. Adds Dr. Dodson, “You can’t really tell whether ADHD medication is working if someone is intoxicated on something else.”
From 12-step programs to psychotherapy, the same treatments that are effective for ending substance abuse in non-ADDers are also effective when ADHD is part of the picture. Be aware, however, that some 12-step programs continue to promote a mistrust of “mind-affecting” medication, and may advise participants against taking stimulants. The best defense against this misguided advice is education—for yourself, your sponsor, and other group members. “I sometimes have a sponsor come into a therapy session, to explain what ADHD is and how the medications work,” says Richardson.
Sometimes an ADHD diagnosis preempts treatment for substance abuse. Jim, of Greeley, Colorado, smoked marijuana for years without ever realizing he had a problem — until he was treated for ADHD.
“I could function and get by when I was high, but the drug blunted my curiosity and affected who I hung out with,” says the 41-year-old. “It stunted my emotional growth. Getting the right medication to treat my ADHD was an awakening. As I became familiar with what it was like to have a clear, stable mind, I came to value myself and my ability to interact with others intelligently. Pot wasn’t fun anymore.”
This article comes from the February/March 2007 issue of ADDitude.