Every day we speak to families in crisis because a loved one, usually their child (18-30 years old) has a raging substance abuse problem and co-occurring mental health disorder. One startling fact we’ve noticed, is that in nearly every case, the child has been prescribed medication for ADHD, usually Ritalin or Adderall, in addition to a medication for anxiety or depression, such as Xanax. It seems that once a medication has been prescribed, and there is an endless list of them because no one size fits all and their effectiveness appears to dissipate over time, the slippery slope of addiction and substance abuse becomes much more prevalent.
It appears that genetics also play a part in the likelihood of a substance abuse disorder developing in an individual who also has ADHD. People with ADHD tend to be more impulsive and likely to have behavioral problems, both of which can contribute to drug and alcohol abuse. Also, both ADHD and alcoholism tend to run in families. A child with ADHD who has a parent with alcoholism is more likely to also develop an alcohol abuse problem than one without.
Statistics suggest that our experience may not be unusual. The number of children prescribed medication for ADHD soured from 600,000 in 1990 to 3.5 million by 2013, and that number continues to climb. Moreover, it seems that the increase in the number of prescriptions written by doctors has coincided with four (4) factors: 1) drug company marketing, which has expanded the definition of ADHD to include things such as carelessness and impatience, 2) drug companies overstating the benefit of the medications, 3) a twenty (20) year campaign by the drug companies to publicize the syndrome and promote the pills to doctors, educators and parents, and 4) false and misleading advertising by the drug companies as to the true benefits and dangers of their drugs. (http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html?pagewanted=all)
Studies have shown a strong connection between ADHD, alcoholism and drug abuse (http://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link#1). Moreover, ADHD is five (5) to ten (10) times more common among adult alcoholics than it is in people without ADHD. It is also more common for children with ADHD to start abusing alcohol during their teenage years. In one study, 14% of children ages 15-17 with ADHD had problems with alcohol abuse or dependence as adults, compared to children without ADHD. Another study found that at a mean age of 14.9 years, 40% of children with ADHD began using alcohol, compared to 22% of children without ADHD.
According to Dr. Nora Volkow, the director of the National Institute on Drug Abuse, the brain’s likelihood of becoming addicted to a drug is related to how a drug increases levels of the naturally-occurring neurotransmitter dopamine, which modulates the brain’s ability to perceive reward reinforcement. The pleasure sensation the brain gets when dopamine levels are elevated creates the motivation for individuals to perform actions that are indispensable to our survival (like eating or procreation). Dopamine is what conditions us to do the things we need to do (http://bigthink.com/going-mental/your-brain-on-drugs-dopamine-and-addiction). The reason that dopamine-producing drugs are so addictive is that they have the ability to constantly fill a need for more dopamine. “A person may take a hit of cocaine, snort it, it increases dopamine, takes a second, it increases dopamine, third, fourth, fifth, sixth. So there’s never that decrease that ultimately leads to the satiety,” she says. This is why individuals dealing with addiction often relapse or have to go through treatment multiple times. Based on what I have observed, to some individuals, the need for a “high” is as strong as the need to breathe.
While every client’s case is different, the common thread is the diagnosis of ADHD and the use of medication which nearly always seems to make matters worse. One client, who was facing the prospect of a lengthy prison sentence, had been misdiagnosed and mistreated for his condition for close to twenty (20) years, beginning when he was ten (10) years old. He testified at his sentencing hearing that after he was diagnosed with ADHD and anxiety, as he got older and his need for a “high” increased, he progressed from abusing the medications to abusing cocaine, heroin, caffeine, and basically anything that would make him “feel better”.
There are a limited number of treatment centers that are really great at dealing with the dual diagnosis patient, regardless of whether the client is in criminal or Marchman Court. To observe a client who has been stabilized and is in recovery is a thing to behold, it’s like saying goodbye to Mr. Hyde and hello to Dr. Jeckyll. Parents often tell us that they finally have their child back after countless years of despair.
We are proud to work with an incredible team of professionals who are ready, willing and able to help with these issues. We do not charge for a consultation or for access to my resources. So, if you know a family in crisis, encourage them to reach out for help.