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Medication Could Help Lower the Risk of Substance Abuse



Are you concerned about the increased risks for substance abuse among young people with ADHD? There is good news: A new study in the American Journal of Psychiatry found that ADHD medications significantly lower the risk of substance abuse.

One of the largest studies to date focusing on ADHD medications, researchers drew from anonymous medical records of 146 million people to identify almost 3 million people affected by ADHD. The results show for those employing medication as part of treatment, the men in the study had a 35 percent reduction and women had a 31 percent reduction in risk of developing substance abuse problems.

What does ADHD have to do with substance abuse risk?

Although the reasons why people affected by ADHD often have a higher risk of substance abuse are not completely understood, studies point to several factors

We know executive functions, behaviors and emotions are governed by neurotransmissions, which are signals sent between brain cells. Dopamine is a key neurotransmitter, heavily involved in the reward center of the brain. Low levels of dopamine are associated with inattention, mood instability, and reward and motivation deficits—common symptoms of ADHD. 

Illegal drugs, including cocaine, methamphetamine, marijuana, and some legal ones, such as nicotine  and alcohol, increase dopamine levels, especially in the reward center. Some people affected by ADHD may “self-medicate” with these drugs to increase their dopamine levels to treat their symptoms. 

Treating ADHD with stimulant medications 

A recent review of studies focusing on the long-term outcomes of stimulants to treat ADHD symptoms found they are a safe and effective treatment when used optimally. Optimal treatment means following a careful dosage for the patient and consistent follow-up and dose adjustment, when needed. 

"While concerns about prescribing medications to treat ADHD that have the potential for abuse are understandable, this study provides further evidence that the use of these medications is not associated with increased risk of substance use problems in adolescence or adulthood,” says lead researcher Patrick D. Quinn, PhD. “Rather, this and other recent studies find that the risk of such problems is lower during and after periods of use of these medications."

Parents do need to work closely with their child’s health care provider for the proper use of stimulant medications for ADHD, and to avoid potential problems, including the risks for later substance use. 

Picking the right ADHD treatment for your child

There are many factors that can affect attention and behavior. A careful and thorough assessment is necessary to make an ADHD diagnosis. A complete history, including medical and school records, parent- and teacher-completed ADHD rating scales, and parent interviews are all needed for diagnosis

It’s important to understand your child’s specific circumstances:
  • your child’s age
  • the symptoms your child is experiencing and symptom severity
  • potential active substance abuse issues
  • the health care professionals’ advice for your child
While medication can be effective part of managing ADHD symptoms and help reduce the risk of substance abuse, keep in mind that the most effective treatment plans include a variety of tools, including parent training, behavioral therapy, counseling and education supports. For more information about diagnosis and treatment, see Diagnosing ADHD and Treatment of ADHD.

Prevention is taking a proactive approach

There is increasing evidence that stimulant medications for ADHD are helpful in reducing the risk of more serious problems over time. Early intervention holds the key to positive outcomes for your child. Developing and nurturing a healthy relationship with your child is also an important part of preventing substance abuse.

“The most important thing is probably to be vigilant about risk factors that we know affect drug use,” Brooke Molina, PhD, tells Ask the Expert column readers in Attention magazine. “These include good parental monitoring, involvement, and helping performance in school.”

Dr. Molina has three suggestions for parents looking for ways to decrease the risk of substance abuse in their children with ADHD:

  1. Establish clear expectations for behavior and follow-through.
  2. Remember to work on maintaining the supportive, warm part of the relationship in between those tough times. Do fun things together, even if you’re just listening without lecturing, and a little joking around here and there.
  3. Keep your child involved in healthy activities and stay involved, even if you find it tiring. It will pay off in the long run.

Additional resources:

This article appeared in ADHD Weekly on August 24, 2017.
     


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