My 16 year old daughter was diagnosed as Attention Deficit Disorder and then, at the age of 57, so was I. A lifetime of struggle was placed into a context that made sense of a lot of failure and frustration. This blog documents and celebrates what has happened to me since.

Sunday, October 29, 2006

does medication for ADD/ADHD lead to adult substance abuse?

some studies re use of medication for ADD/ADHD and future substance abuse and addiction

http://pediatrics.aappublications.org/cgi/content/abstract/111/1/179

(Conclusion.Our results suggest that stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.)




http://

(Conclusion. This study concurs with 11 previous studies in finding no compelling evidence that stimulant treatment of children with attention-deficit/hyperactivity disorder leads to an increased risk for substance experimentation, use, dependence, or abuse by adulthood.)



It does seem to be well established that ADD/ADHD, themselves, untreated, do have a high correlation to adult substance abuse. a study representative of this is found at

http://

Saturday, October 28, 2006

A legislative fix...

At a Joint House and Senate Judiciary Committee hearing earlier this week I heard a presentation on methamphetamine. Members of the Oregon Legislature are very interested in the problems posed by methamphetamine, as well they should be and what they were hearing from a panel of scientists was background information to aid them in making policy on law enforcement and substance abuse treatment.

At one point in the hearing one of the Senators asked whether giving "all those amphetamines" to children wasn't setting them up to become meth addicts. This was a question off of the topic that the scientists who were testifying were there to address but after saying that there was great disagreement about that in the scientific community it was also likely that pharmacological treatment of neurological disorders like ADD and ADHD prevented some who undergo it from becoming addicts later.

True.

I know from my work co ordinating policy for the drug and alcohol treatment courts in Oregon, as well as from person experience as one with ADD, that this latter "likelihood" is far more likely true than the former. (In fact, although I do not claim a comprehensive knowledge of the scientific literature I don't think I have ever heard anyone say that prescribing appropriate medication for ADD and ADHD made one more prone to meth addiction than children who were not. Perhaps someone has some data...)

But I know that people with conditions within this cluster of neurological disorders do self medicate and some of them use methamphetamine (as well as dexies, bennies, and cocaine. And alcohol. And caffeine). I once heard a judge ask a woman, a drug court client in court who was a recovering meth addict, how we would know if she had relapsed and was back on meth. The woman said, "I'd be sitting here calmly." The woman, I believe, suffers ADD and was self treating herself with meth.

My own life--including alcohol and substance abuse as a young person--is a testimony to this kind of self medicating strategy by people who have this disorder. One of the many benefits of my beginning to take Concerta is that it has cut my drinking of alcohol down to below what is considered an "acceptable" level. I drank alcohol more before beginning medication.

I talked to the Senator later in the hallway and explained that the "amphetamine" that ADD and ADHD children are presecribed is not meth, while it is a related substance. The scientists who were on the panel, also involved in this later conversation, validated my explanation that related drugs are do not have the same effect on people--that good, healthy results can come from a medication that is very closely related to an unhealthy drug (and that a medication that has a good effect on one person can have negative effects on another).

She explained that she was relating what they said to a negative experience she had as a young woman when a doctor, thinking she was overweight, prescribed "amphetamines" for her. She said it was a negative experience and that she couldn't take them very long.

I hope that the Senator heard what we were telling her. I hope she understands that her reaction to whatever she was prescribed was very different than that of children who are appropriately prescribed things like Concerta to regularize neurological functioning. I hope she understands that, while, in a way, her wondering about drug addiction and the use of pharmacological treatment of children with ADD and ADHD "made sense," she also understands the actual complexity of that about which she was wondering aloud.

There is a lot of bunk being promulgated about ADD and ADHD (I heard someone on a local radio station who wrote a book saying that ADD and ADHD are the result of bad parenting--that it comes from indulging children prior to the age of three). Some people are reluctant to believe these conditions exist because it cannot be "seen."

But it can be seen. The results of the clinical evaluations undergone by my daughter clearly show the manifestations of the disorder--as clearly as looking at a thermometer shows the manifestation of a fever, or the digital readout (used to be the reading of a dial) shows the manifestation of high blood pressure. And, of course, my life clearly shows that it exists.

I am realizing, as I openly talk about my own condition, and that of my daughter, how important it is for people who have experience with ADD and ADHD to speak out and to make it known what's going on and how it has to be dealt with.

Taking a "drug" is only part of the picture. A pharmacological regimen also has to be bolstered by developing behavioral strategies to overcome the limitations on functioning. Oddly, I developed the strategies before the medication, while my daughter is using the medication and then developing the strategies. She was diagnosed at 16, I was diagnosed at 57.

Here's a book that gives general, introductory information about treatment of ADD and ADHD, as well as other aspects of the disorder. It's probably not of much value to someone on the well versed but, for beginners, it can be a good start.

Attention Deficit Dosorder and Learning Disabilities.
Barbara D. Ingersoll and Sam Goldstein

It makesa the point, by the way, that learning disabilities are very frequently co-occurent with ADD and ADHD.

Thursday, October 12, 2006

tell them the truth...

I was presiding in a delinquency case recently and the young man was entering a plea on a probation violation. His counselor told me that he had stopped taking his meds and that this was a major part of the problem. I asked what meds he was taking and the counselor said "Concerta."

"Really," I asked. "ADD?"

"ADDHD"

"Ah," I said, "with the hyperactivity component."

"Yes," said the counselor and the young man nodded his head

"What's the dosage?" I asked.

"Fifty four miligrams," the young man said.

"you don't like to take your meds?" I asked.

He shrugged. "i don't think I need them," he answered and then he looked down at the floor for a moment. Looking up he said, "but everyone says I'm better when I take them so...so...so, I'll take them."

"Good," I said. "You know, I took 54 miligars of Concerta this morning."

He, and several other people in the court room looked at me.

I nodded. "Yes," I said. "I don't have the H component, but I sure have the A, the D and the D."

He just looked amazed.

"You wouldn't want me to be your judge," I said, "if I wasn't taking my meds."

The room was completely silent.

"Take your meds," I said.

He nodded.

I went on to pronounce the sentence for his probation violation.

it is important for the world to know that there are some of us who have grown up with ADD and have not ended up in prison or a mental institution. It's very important to struggle agains the myths.

About Me

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I am a convinced Beanite Friend, a member of Bridge City Friends Meeting, Willamette Quarterly Meeting and North Pacific Yearly Meeting of the Religious Society of Friends. Notwithstanding the doubts of some who claim the name, I am a Christian who does a Buddhist practice and believes that God talks to everyone, all the time. I have worked in the judicial branch of government, as well as being a trial lawyer, a public school teacher (counselor and coach), a kite merchant, and a Marine Corp Sergeant. I am currently working as a consultant to public and private agencies on issues of child welfare, juvenile justice, and substance abuse treatment courts.