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ADHD medications: Things you should know as a parent

March 31, 2014

Attention deficit/hyperactivity disorder (ADHD) is one of the most common conditions among school-aged children, affecting roughly one in 25 kids. Children with this disorder often have trouble controlling their behavior, which can have wide-ranging effects on their home and academic lives.

One of the mainstays of treatment is the use of prescription stimulant medications (Adderall, Ritalin, Concerta are some common brand names) often used for long periods of time throughout the child’s developmental years. Many parents worry about the long-term use of such medications, especially whether the use of these medications makes it more likely that a child will be susceptible to substance abuse later on in life.

Here are a few things you should know if you’re considering medication for ADHD:

Stimulant medications aren’t linked with substance abuse later in life

Once a child has been diagnosed with ADHD, parents are faced with a tough decision: to medicate or not. On one hand, there is solid medical evidence that stimulant medications are very effective and bring a wide range of benefits to children. On the other, parents worry about the potential long-term effects. One of the common concerns parents have is whether the use of stimulant medications in childhood could increase a child’s vulnerability to substance abuse disorders, whether that is addiction to prescription or illicit drugs, cigarettes or alcohol.

However, studies that have addressed this concern do not show any difference in the likelihood of substance abuse for children who have been treated with stimulant medications versus those who haven’t been treated with stimulant medications. In other words, the best information that we have to date says that these medications do not make kids any more or less likely to experience substance abuse problems.

Although the use of stimulant medications isn’t the cause of substance abuse problems, substance abuse is still a huge problem in our society. There are many factors that affect the likelihood that someone experiences substance abuse (for example mental health problems or trauma), but treatment for ADHD with stimulant medications isn’t one of them.

Stimulant medications can (and are) being abused

While stimulant medications, when used appropriately under the care of a physician, are safe and effective for those with ADHD, they do have the potential to be used inappropriately.

When used in the treatment of ADHD, stimulant medications are prescribed at low doses to be taken every day. They work to slowly and steadily increase the dopamine levels in the brain, which allows a person with ADHD to focus better and maintain attentiveness. However, dopamine in the brain affects sensations of pleasure and euphoria as well. In order to get those euphoric effects, one has to have fast and high levels of dopamine surges in the brain, and that’s where the potential for addiction comes in.

When stimulant medications are used in higher doses than prescribed, different routes than intended (crushing the pills and snorting them or mixing them with water and injecting them, for example) or by people who haven’t been diagnosed with ADHD, the potential for addiction increases. While the slow and steady dopamine increases produced by an appropriate dose of medication is beneficial and therapeutic, the rapid surges of dopamine caused by inappropriately high doses of stimulants interrupt the normal brain functioning and can be very harmful.

What does all of this mean? It means that stimulants can be wonderful for those who are under the care of a doctor and who take the medication as it is intended. However, it’s important for parents (especially as their children reach adolescence) to understand the potential pitfalls of this medication in order to prevent misuse from occurring.

Know how to use medication properly

To gain the maximum benefit, use stimulant medications exactly as your doctor has prescribed. Some children, as they reach adolescence begin to understand more about the effects of their medication, and can manipulate accordingly.

As an example, one side effect of stimulants is that it decreases appetite. A young girl who perhaps is struggling with body image and wants to prevent weight gain might decide that instead of taking her medication before school in order to gain the intended benefit, she takes her medication after school to curb her appetite during the time of day when she struggles with overeating. This misuse not only deprives her of the benefit of the medication in the learning environment, but is allowing unhealthy behaviors to take hold.

Teens might also choose to take their medication at certain times to promote wakefulness or they may take several doses at a time to experience the euphoria that high doses can bring. Each of these represents a misuse of the medication, and parents must be vigilant in detecting these behaviors if they begin.

It’s important to remember that stimulant medications are very effective and safe when used as they are intended and under the supervision of a physician. However, recognizing the potential dangers that exist also allows parents the opportunity to prevent misuse that can have detrimental effects on their child.

As the old saying goes, don’t throw the baby out with the bath water. If your child has ADHD, don’t forgo a potentially helpful treatment out of fear. Work with your doctor to weigh all of the potential risks and benefits to decide whether a treatment is right for your child and then learn to use the medication well in order to get the best results.