It is common for people with ADD to turn to
addictive substances such as alcohol, marijuana, heroin, prescription tranquilizers, pain
medication, nicotine, caffeine, sugar, cocaine and street amphetamines in attempts to
soothe their restless brains and bodies. Using substances to improve our abilities, help
us feel better, or decrease and numb our feelings is called self-medicating.
Putting Out Fires With Gasoline
The problem is that self-medicating works at first. It provides the person with ADD relief
from their restless bodies and brains. For some, drugs such as nicotine, caffeine,
cocaine, diet pills and ÒspeedÓ enable them to focus, think clearly, and follow through
with ideas and tasks. Others chose to soothe their ADD symptoms with alcohol and
marijuana.
People who abuse substances, or have a history of substance abuse are not ÒbadÓ people.
They are people who desperately attempt to self-medicate their feelings, and ADD symptoms.
Self-medicating can feel comforting. The problem is, that self-medicating brings on a host
of addiction related problem that over time makes our lives much more difficult. What
starts out as a "solution", can cause problems including addiction, impulsive
crimes, domestic violence, increased high risk behaviors, lost jobs, relationships,
families, and death. Too many people with untreated ADD, learning, and perceptual
disabilities are incarcerated, or dying from co-related addiction.
Self-medicating ADD with alcohol and other drugs is
like putting out fires with gasoline. You have pain and problems that are burning out of
control, and what you use to put out the fires is gasoline. Your life may explode as you
attempt to douse the flames of ADD.
An article in American Scientists tells us that "In the United States alone there are
18 million alcoholics, 28 million children of alcoholics, 6 million cocaine addicts, 14.9
million who abuse other substances, 25 million addicted to nicotine." (1)
Who Will Become Addicted?
Everyone is vulnerable to abusing any mind altering substance to diminish the gut
wrenching feelings that accompany ADD. There are a variety of reasons why one person
becomes addicted and another does not. No single cause for addictions exists; rather, a
combination of factors is usually involved. Genetic predisposition, neurochemistry, family
history, trauma, life stress, and other physical and emotional problems contribute. Part
of what determines who becomes addicted and who does not is the combination and timing of
these factors. You may have a genetic predisposition for alcohol, but if you choose not to
drink you will not become an alcoholic. The same is true for drug addictions. If you never
smoke pot, snort cocaine, shoot or smoke heroin, you will never become a pot, coke, or
heroin addict.
The bottom line is that people with ADD as a whole are more
likely to medicate themselves with substances than those who do not have ADD.
Dr.s Hallowell and Ratey estimate that 8 to 15 million Americans suffer from ADD, other
researchers estimated that as many as 30-50% of them use drugs and alcohol to
self-medicate their ADD symptoms.(2) This does not include those who use food, and
compulsive behaviors to self-medicate their ADD brains and the many painful feelings
associated with ADD. When we see ADD it is important to look for substance abuse and
addictions. And when we see substance abuse and addictions, it is equally important to
look for ADD.
Prevention and Early Intervention
"Just Say No!" may sound simple, but if it was that simple we would not have
millions of children, adolescents, and adults using drugs every day. For some their
biological and emotional attraction to drugs is so powerful, that they cannot
conceptualize the risks of self-medication.
This is especially true for the person with ADD who may have an affinity for risky,
stimulating experiences. This also applies to the person with ADD who is physically and
emotionally suffering from untreated ADD restlessness, impulsiveness, low energy, shame,
attention and organization problems, and a wide range of social pain.
It is very difficult to say no to drugs when you have
difficulties controlling your impulses, concentrating, and are tormented by a restless
brain or body.
The sooner we treat children, adolescents, and adults with ADD the more likely we are to
help them to minimize or eliminate self-medicating. Many well meaning parents, therapists
and medical doctors are fearful that treating ADD with medication will lead to addiction.
Not all people with ADD need to take medication. For those who do, however, prescribed
medication that is closely monitored can actually prevent and minimize the need to
self-medicate. When medication helps people to concentrate, control their impulses, and
regulate their energy level, they are less likely to self-medicate.
Untreated ADD and Addiction Relapse
Untreated ADD contributes to addictive relapse, and at best can be a huge factor in
recovering people feeling miserable, depressed, unfulfilled, and suicidal. Many
individuals in recovery have spent countless hours in therapy working through childhood
issues, getting to know their inner child, and analyzing why they abuse substances and
behaviors. Much of this soul searching, insight, and release of feelings is absolutely
necessary to maintain recovery. But what if after years of group and individual therapy,
and continued involvement in addiction programs you still impulsively quit jobs and
relationships, canÕt follow through with your goals and dreams, and have a fast chaotic,
or slow energy level. What if, along with your addictions you also have ADD?
Treating Both ADD and Addictions
It is not enough to treat addictions and not treat ADD, nor is it enough to treat ADD and
not treat co-related addictions. Both need to be diagnosed, and treated for the individual
to have a chance at ongoing recovery. Now is the time to share information so that
addiction specialists, and those treating ADD can work together. It is critical that
chemical dependency practitioners understand that ADD is based in onesÕ biology and
responds well to a comprehensive treatment program that sometimes includes medications. It
is also important for practitioners to support the recovering persons involvement in
Twelve Step programs and help them to work with their fear about taking medication.
A COMPREHENSIVE TREATMENT PROGRAM CONSISTS OF:
* A professional evaluation for ADD and co-related addictions.
* Continued involvement in addiction recovery groups or Twelve Step programs.
* Education on how ADD impacts each individualÕs life, and the people who
love them.
* Building social, organization, communication, and work or school skills.
* ADD coaching and support groups.
* Closely monitored medication when medication is indicated.
* Supporting individuals decisions to take medication or not. ( in time they may
realize on their own that medication is an essential part of
their recovery).
Stages of Recovery
It is important to treat people with ADD and addictions according to their stage of
recovery. Recovery is a process that can be divided into four stages, pre-recovery, early
recovery, middle recovery, and long term recovery.
PRE-RECOVERY: Is the period before a person enters treatment for their addictions. It can
be difficult to sort out ADD symptoms from addictive behavior and intoxication. The focus
at this point is to get the person into treatment for their addictions or eating
disorders. This is NOT the time to treat ADD with psycho stimulant medication.
EARLY RECOVERY: During this period it is also difficult, but not impossible to sort out
ADD from the symptoms of abstinence which include, distractibility, restlessness, mood
swings, confusions, and impulsivity. Much of what looks like ADD can disappear with time
in recovery. The key is in the life long history of ADD symptoms dating back to childhood.
In most cases early recovery is NOT the time to use psycho stimulant medication, unless
the individualÕs ADD is hindering their ability to attain sobriety.
MIDDLE RECOVERY: By now addicts, alcoholics, and people with eating disorders are settling
into recovery. This is usually the time when they seek therapy for problems that did not
disappear with recovery. It is much easier to diagnose ADD, and medication can be very
effective.
LONG TERM RECOVERY: This is an excellent time to treat ADD with medications when
warranted. By now most people in recovery have a life that has expanded beyond trying to
stay clean and sober.Their recovery is an important part of their life, and they also have
the flexibility to deal with other problems such as ADD.
Medication and Addiction
Psychostimulant medication when properly prescribed and monitored is effective for
approximately 75-80% of people with ADD. These medications include Ritalin, Dexedrine,
Adderall, and Desoxyn. It is important to note that when these medications are used to
treat ADD the dosage is much less that what addicts use to get high. When people are
properly medicated they should not feel high or "speedy, instead they will report
increases in their abilities to concentrate, control their impulses, and activity level.
The route of delivery is also quite different. Medication to treat ADD is taken orally,
where street amphetamines are frequently injected and smoked.
Non stimulant medications such as Cylert, Wellbutrin,
Prozac, Nortriptyline, Effexor and Zoloft can also be effective in relieving ADD symptoms
for some people. These medications are frequently used in combination with a small dose of
a psychostimulant.
Recovering alcoholics and addicts are not flocking to
doctors to get psychostimulant medication to treat their ADD. The problem is that many are
hesitant for good reasons to use medication, especially psycho stimulants. It has been my
experience that once a recovering person becomes willing to try medication the chance of
abuse is very rare. Again the key is a comprehensive treatment program that involves close
monitoring of medication, behavioral interventions, ADD coaching and support groups, and
continued participation in addiction recovery programs.
There is Hope
For the last few years I have witnessed the transformation of lives that were once ravaged
by untreated ADD and addictions. I have worked with people who had relapsed in and out of
treatment programs for ten to twenty years attain ongoing and fulfilling sobriety once
their ADD was treated. I have seen people with ADD achieve recovery once their addictions
were treated.
"Each day I understand more about how pervasive ADD is in my life. My clients,
friends, family and colleagues are my teachers. I wouldnÕt wish ADD and addictions on
anyone, but if these are the genetic cards that you have been dealt, your life can still
be fascinating and fulfilling." (3)
About the author:
Wendy Richardson, MA., MFCC, the author of The Link Between ADD and Addiction:
Getting The Help You Deserve, is a licensed marriage, family, child therapist and
addiction specialist in private practice. She is also a consultant, trainer, and speaks at
national and international ADD and learning disability conferences.
NOTES
1. Bum, Cull, Braver man, and Comings, ÒReward Deficiency Syndrome,Ó American Scientist,
March-April (1996), p. 143
2. Maureen Martin dale, "A Double-Edged Sword," Student Assistant Journal
(November-December 1995): 1
3. Wendy Richardson, MA.,LMFCC, The Link Between ADD & Addiction: Getting The Help You
Deserve (Colorado Springs, Colorado: Pi–on Press,1997).
(c) 1998, Wendy Richardson, M.A. |
