Managing Treatment

Finding the Limits: My Meds’ and My Own

“I’m not so worried about developing an abusive reliance on medication — as long as I acknowledge that treating my attention deficit is no substitute for working my program.” An alcoholic in recovery discusses ADHD treatment.

There are some in the recovery community who view medication for things such as ADHD or a mood disorder with skepticism. The idea, I suppose, is that it is dangerous for someone with a history of substance abuse to rely on yet another a substance. I understand the concern. I have felt the out-of-control desire for a substance. I have done stupid, hurtful and irresponsible things in order to use. I understand what it means to be powerless. That gives me a healthy fear of taking any substance or engaging in behavior that I know from my history can get out of my control. It makes sense to be cautious.

I started medication for ADHD after careful consideration and discussion with my counselor and an ADHD specialist psychiatrist who knew my history with substance abuse. I started out with a small dosage and am in the process of trying to determine what is the best medication and dosage to help. I’m not in a hurry and appreciate the opportunity to start slow and increase dosage or change medication as needed. I am not taking a stimulant-based medication and I have not taken any amounts that have given me any sort of “high.” I am comfortable that I am proceeding prudently and with appropriate professional support.

I didn’t really think that treating my ADHD would get rid of the impulses that drove me toward substance dependence. I admit, though, that I kind of hoped. I admit that I wish my ADHD medication would make it so that I didn’t have to work my program. The program consists of taking responsibility for my actions, being honest, being aware of what I am feeling, taking care of myself in healthy, grown-up ways — all stuff that I am not good at. Taking ADHD medications, so far, has helped me to feel less pressure, fewer random, scattered thoughts, and less of a push to be seeking out new, thrilling behavior. As far as I can tell, it doesn’t help me take responsibility for myself. It doesn’t make me be more honest and forthright. It doesn’t help me make amends for my bad behavior. It’s not a magic bullet.

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Through working a twelve-step recovery program though, I also realize that there are aspects of my character that are not helped by ADHD medication. The program calls them “character defects” and they are the things that really impair my ability to stay present with myself, avoid selfishness and maintain a connection with my higher power. I am sure I’m not the only alcoholic who wishes there was a pill that would get rid of my character defects. Unfortunately, there is not.

ADHD is a part of who I am. It is how my brain is wired. It has its good points and bad. It helps me make some creative connections that I might not otherwise make. It is a condition, rather than a disease. My substance abuses have no redeeming value; it is much more useful to think of them as diseases. They are things over which I have no control. They will ruin my life and kill me. There is nothing good about the disease itself.

There is, however, value in recovery. The process of realizing my limitations and reaching outside myself is good. Maybe its how people without a history of substance abuse, “normies,” can be naturally. For me, I need the threat of dependence to motivate me to do the work to stay sober. It is work and it’s work that I sometimes would rather not do. If I could take a pill, I would.

Whether alcohol, drugs, sex, food, shopping, gambling or whatever the trigger that I am drawn to because of my ADHD, taking medication for ADHD helps relieve some symptoms, but it doesn’t mean I couldn’t go there again. There’s a paradox in substance abuse, of being both powerless and responsible for my behavior. So, treating that abuse, I have to do what I can both from a brain chemistry angle and a recovery standpoint.

[Do I Have ADHD? Take This Test To Find Out]