MAMa FAQ's #4

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More information can be found in Crystal Meth: They Call it Ice.

My child had ADHD as a child. Did the Ritalin he took cause him to be addicted to methamphetamine?

Around 30% of addicts seeking treatment have Attention Deficit Hyperactivity Disorder, and addicts with concurrent ADHD have much higher risk of severe addiction. ADHD addicts have high rates of violent crime and incarceration, family disintegration and abandonment. The association between meth addiction and ADHD is very complex.

ADHD involves a defect in the dopamine receptors in the brain. The receptors are less responsive to natural normal levels of dopamine in the brain. The result is a distracted fidgety inability to concentrate that is first symptomatic in the early school years, but persists into adulthood in a large majority of patients. It's like somebody is always tapping on your shoulder to interrupt you.

Treatment for ADHD usually involves medications like Ritalin, Concerta, and Adderal, all of which are stimulants. These drugs are chemically different from methamphetamine but they stimulate the same receptor system, the dopamine receptors in the brain. When these receptors are stimulated at low levels, they improve concentration by allowing the brain to tune out unnecessary impulses that would be a distraction.

Stimulant drugs can be abused. They can be diverted for the manufacture of methamphetamine, or simply used in high enough doses to get a meth like high. Newer drugs like Strattera operate on a different receptor system, the epinephrine system in the brain, and so they are not stimulants and cannot be abused.

People with untreated ADHD are extremely susceptible to methamphetamine addiction. They stumble onto a drug that instantly makes them feel intensely focused, energetic, powerful, and competent. They regard it as a treatment for their problem and get defensive if their drug use is questioned or challenged.

The ADHD addict will gravitate to methamphetamine. It solves all his problems. He doesn't know how he ever got by without it. When the methamphetamine wears off, all the ADHD symptoms come flooding back in, along with the withdrawal and toxic effects of the methamphetamine, and he is miserable until he gets another hit.

As the methamphetamine induced brain damage sets in with symptoms of anxiety, scattered thought processes, and loss of mental focus, he uses even more. He thinks his problem must be getting worse and he needs more methamphetamine to be able to cope. Addiction is much more rapid and severe in the ADHD adult than in the normal healthy person trying methamphetamine. He's using it therapeutically, and it 'works.'

Of course, the combination of ADHD and methamphetamine addiction is going to result in some very significant brain dysfunction. Methamphetamine addicts with concurrent ADHD have severe problems with memory, learning, abstract thinking, attention, focus, and verbal fluency. The thought disorders associated with ADHD are characterized by impulsiveness and poor decision making that contribute to the severity of the addiction.

Effective treatment is important for the rehabilitation of the ADHD addict. Treatment of ADHD with Strattera or long acting low abuse potential stimulants improves success rate of substance abuse treatment dramatically. Educational therapy and psychotherapy are helpful for developing skills to cope with the challenges of ADHD, but pharmacologic therapy is still essential in some cases for long term success and prevention of relapse

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