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ADHD, stimulants, and substance abuse

For those of you who follow the controversy surrounding the treatment of ADHD with stimulants, there is a new study out that claims treating ADHD with stimulants does not increase the risk of future substance abuse. Go figure.

A new study finds that the use of stimulant drugs to treat children with ADHD has no effect on their future risk of substance abuse. The report, which will appear in the American Journal of Psychiatry and has been issued online, assessed more than 100 young men 10 years after they had been diagnosed with ADHD and is the most methologically rigorous analysis of any potential relationship between stimulant treatment and drug abuse.

“Because stimulants are controlled drugs, there has been a concern that using them to treat children would promote future drug-seeking behavior,” says Joseph Biederman, MD, director of Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital (MGH), the study's lead author. “But our study found no evidence that prior treatment with stimulants was associated with either increased or decreased risk for subsequent drug or alcohol abuse.”

I find this study interesting because I know so many kids who were treated with stimulants as kids who either then either abused or sold them as teens or wound up experimenting with other drugs throughout life. However, I have also noticed that people who are given stimulants as kids do not find them so interesting as adults (been there, done that, diminishing returns) but this does not rule out the natural curiosity for trying other drugs later in life.

Earlier studies from the MGH Psychopharmacology group had suggested that stimulant treatment might actually reduce the risk of substance abuse in ADHD patients, who are at elevated risk to begin with, but that result did not hold up in the current analysis, which included some of the same participants. The researchers note that those shorter-term studies only followed participants into adolescence and that treatment may delay rather than totally prevent future substance use, something that should be investigated in the future.

I agree that short-term studies may not tell the whole story. When quitting forced medication as a child there is a natural tendency for to backlash against all drug use in general as teens. However, those feelings may fade over time and circumstance. Life is long.

Posted By jamesk at 2008-03-02 15:29:01 permalink | comments
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zupakomputer. : 2008-03-06 09:12:19
Well it is a modern thing - most disorders and the like that have been identified in recent times can be traced to artificial things being introduced into everyday life.

Certainly there were hyper folks and problem causers that existed back when life was more natural - but also back then, people knew they were possessed and so forth, because there was a proper understanding of the soul moreso.

It's certainly obvious to me, that everyone I've ever known or known of, that is labelled some kind of problem child - it's as if they're all exactly the same person. They all talk and behave exactly the same, generations apart. It's because the same entity, or whatever you want to call it, is controlling them all, or maybe is them all.
All human issues and problems all boil down to there being any confusion over what life is all about, and the exact nature of the thing that leaves the body when it dies.
Cultures that know about reincarantion are better at recognising the deeper causes of what leads to any imbalances in the first place - take India for example, they've had a system that integrates health and medicine with food for thousands of years. Ayurvedic. Traditional Chinese and Japanese and Thai cultures also understand the nature of spirit and ghosts, and have means of ensuring these are not disturbing to the living should something have gone wrong in those areas.

What a lot of western culture has done, since the likes of the witch-hunts, is eradicate an understanding of existence in its entirity. Then somehow expects to find answers to problems, without wanting to properly look into all the relevant areas of life. As many say, our type of medicine only treats symptoms, by supressing them. It doesn't want to look at root causes, because the sad truth is that most of those root causes are the things that very system has introduced into our everyday lives - even if you yourself do not, for example, eat dodgy foodstuffs - chances are you'll live right next to others that do.
This kind of thing in broader terms has the effect that if you are wanting to keep your space uninterrupted and clear, you tend to move away from the kind of places that have become swamped with the noise and confusion; so over time all the intelligent people are moving away from these centers of stupidity and illness-causing, making them all the worse;

people are like tuning forks - the lowest vibrating energies will pull the others in the vicinity down to their level. One bad apple really does ruin the box. Then the box ruins the boxes around it, and they ruin the boxes around them, and so on.

So, I do agree there's no way the cause of the rise of troublesome kids is just because they always have mobiles glued to their heads and hands and because they eat total shit - the actual cause is the type of society that floods the marketplace with that kind of pointless garbage lifestyle in the first place.
That damaging economy requires consumers to keep it going; it needs to cultivate a world where people are going to be dumb enough to buy its wares unthinkingly and use them unthinkingly.

Hence why it's the very same system that tells so many lies about drugs, and also relies upon drugs being misused by stupid people - then it can use them as examples to further make life worse for the intelligent folks, by taking away their access to things like sacramental plants and the right environments to use them in, which in turn means there's less 'magical' ceremonies and the like taking place that would redress the balance of power back into the intelligent way of running things.

jamesk : 2008-03-06 00:25:28
Nowhere Girl: ADHD is clinically a syndrome usually associated with poor dopamine uptake, which is why stimulants seem to help fidgety and distracted children maintain focus for longer periods of time. It worked for me, certainly. It is a paradox, but think of stimulants as helping to "focus" the hyperactive energy into something more productive than cartoon-level nuttiness. The old-fashioned cure for hyperactivity was to let the kids run wild outdoors until they were too tired to fidget, but modern society frowns on letting kids just run wild unsupervised and all. All kids these days need to be supervised, indoors, complacent, and consuming popular snacks/media/meds. Happy childhood.
Nowhere Girl. : 2008-03-05 10:45:18
Well, for me it's a bit hard to believe that these are just additives and mobile phones which are responsible for hyperactivity disorders. While I certainly do think that we should perceive these disorders in a different way and most importantly - for the good of the children - treat them with psychotherapy, I also think it has a deeper background. If it was just a matter of sweets and telephones, there would have been no hyperactive children earlier. And I'm pretty sure there have been some, only they were called "naughty" and not "hyperactive".
However, I agree with you about that astonishment: why should stimulants help in such a condition? Hyperactive children are already hyper-stimulated... Anyway, this whole matter is incredibly curious from a cultural point of view: isn't it the same substance which is fought against as "speed" and forced on schoolchildren as "Ritalin"? The war on consciousness has a lot of pecularity and hypocrisy about it.
zupakomputer. : 2008-03-05 10:33:41
What part don't you agree with then? And am I to take it that because you mentioned me specifically, for some reason, that you agree precisely with what everyone else here wrote?!
I'm not making it up - when this 'disorder' was originally identified it was considered something the same as being hyperactive - the attention wasn't held because the mind wandered too fast and flighty onto many different topics and thoughts other than the one(s) at hand.

It was only later on that newspaper reports began talking about people diagnosed with AD related problems being prescribed stimulants. Now it's being treated more like instead of the problem being hyperactivity, it's a type of short-term memory loss issue, as if they've been using strong pot of some type.

Nowhere Girl. : 2008-03-05 02:56:00
I cannot fully agree with zupakomputer, however, it's quite obvious that ADD/ADHD are a invention of recent times. One could still argue if medicalization isn't better than "You are a bad child, you will drive your parents into grave"... But anyway medicalization of everything that deviates from 100% normal is a larger phenomenon. For example, lately I've read a book about how our bodies are in a very real sense a cultural coonstruct (bodies do exist, but their functions can really be altered through sociocultural pressure - for example 19th century upper class women were really very weak because of wearing corsets, thus proving the belief that women are not capable of any independence) and it for example describes how menopause is no longer perceived as a natural process, but rather as something closer to a condition that could and even should be treated.
Where it comes to "abnormal" behavior, we have always only had the choice of perceiving it as a moral versus medical problem, the time for acceptance has yet to come.
As I wrote, I'm not sure if medicalization isn't the better solution, one that doesn't make those children feel guilty for something they can't fully control. However, I think it's urgent to stop forced medication and develop alternatives to pharmacological treatment. It's curious that the question whether those kids won't be prone to that Horrible Threat of Substance Abuse seems to be the biggest problem. Isn't it perhaps a means to forget that stimulants can be directly harmful, especially to young, developing body-minds - a means to forget that certain segments of the society are responsible for forcing those children to be treated with Ritalin? I believe some psychotherapeutic alternativ has to be developed. Maybe it wouldn't work instantly, but I'm pretty sure it would. But still it requires a good psychotherapist who wouldn't make the child feel guilty and wouldn't present perfect self-control as a holy, eternal standard.
zupakomputer. : 2008-03-04 07:37:24
Always seemed odd to me that any of the attention-deficit labels were treated with stimulants; I'm not sure if what happened was that 'hyper-active' and 'attention deficit' used to refer to the same issues, wheras now the ADs mean something else.
Cause obviously for any hyper condition, stimulants are the worst thing to use.

Certainly, before it became something that got prescribed any kind of medication, kids that didn't or couldn't focus in class were usually found to have been eating sweets that had specific additives in them - when the confectionary was no longer eaten they went back to being non-hyper.

This'll probably be something that gets worse overall, given that using mobile phones too much, or at all in some cases, causes things like inability to focus.

Michael. : 2008-03-03 11:53:06
Today The Issue ([link] is featuring a piece on ADHD medications called "Academic Steroids." The piece examines a first hand account of ones use of Adderall, as well as an analytical view and an experts opinion on heart risk and ADHD medication. Definitely something you and your readers would be interested in.

Cheers,

Mike McGregor
Editor
The Issue

faaa. : 2008-03-02 23:57:22
Great post! ADHD medications can aid in improving one's condition. I seeked help from [link] as they provide a variety of solutions to the attention deficit disorder. I've tried them and it really works. I highly recommend this to all of you.
omgoleus : 2008-03-02 19:22:19
This study is missing the obvious point that prescribing stimulants to schoolchildren increases the risk of stimulant abuse by their classmates... duh.

Brandon : 2008-03-02 18:59:13
The take home message of this study for me is that controlling for 'conduct disorder' and similar social variables should be done with all these drug abuse studies. You will find in the literature that these types of controls are often lacking in studies where they are trying to prove a drug's danger or show a gate-way drug effect. I suspect the authors of this study were more optimistic, and therefore more careful in designing their controls.

I think many studies showing dangers of drug use are actually showing the dangers of being someone who among other things uses drugs. For example are older studies which claim that smoking marijuana confers risk for developing cancer, but when they controlled for other factors, namely cigarette smoking and education/income, this risk disappeared.

What is even worse is that the government has been (let's hope unintentionally) marketing drugs directly to those at risk for poverty, mental illness, and criminality. In an attempt to discredit drug use, they claim (amongst other things beyond the scope of this rant) that drugs are extremely dangerous, and can be used to ignore your problems. We might ask, what is the demographic that listens to this message, believes it, and still decides to use drugs?

I'm gonna go chug a 'Full Throttle' (blue demon flavor baby)

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