ADHD and Addiction

Causes of ADHD Exact Cause Unknown

Causes of ADHD Exact Cause Unknown Strong Genetic component has been established.

Causes of ADHD Exact Cause Unknown Strong Genetic component has been established. Can be some common behaviors, i.e. smoking or drinking during pregnancy, other OBN complications.

Other factors Low birth weight Childhood head injuries, particularly to the frontal lobe. Exposure to lead, PCB’s, other environmental toxins.

Onset ADHD always begins in childhood May not be diagnosed until adulthood. Adult diagnosis means enduring symptoms for years.

Progression Research indicates between 30% and 70% of children will continue to display ADHD symptoms as an adult.

Genetics 30% chance an ADHD child has at least one parent with ADHD.

Brain scans

ADHD brains Abnormal functioning of neurotransmitters

ADHD brains Abnormal functioning of neurotransmitters Abnormal functioning of nerve pathways

ADHD brains Abnormal functioning of neurotransmitters Abnormal functioning of nerve pathways Some parts of the brain smaller and less active.

The dopamine connection Some ADHD cases show a particular variation of the DRD4 gene – associated with a dopamine receptor Not all had the variation, those who did generally had higher IQ scores than other ADHD children. Those with the variation more likely to outgrow or show improvement as adults.

ADHD as an adult Sluggish dopamine system. Explains why stimulant ADHD meds are beneficial. Stimulant meds increase dopamine by strengthening the weak dopamine signals in the brain. Drugs of abuse, including nicotine and cocaine, temporarily increase dopamine activity.

The connection Strong connection between ADHD, drug abuse and alcoholism.

The connection Strong connection between ADHD, drug abuse and alcoholism. ADHD 5 to 10 times more common in adult alcoholics than in people without the condition.

The connection Strong connection between ADHD, drug abuse and alcoholism. ADHD 5 to 10 times more common in adult alcoholics than in people without the condition. Among people in treatment, ADHD rate is about 25%.

Why the connection? Self medication.

Why the connection? Self medication. “In our study of young adults, only 30 percent said they used substances to get high. Seventy percent are doing it to improve their mood, to sleep better, or for other reasons” Dr. Timothy Wilens, associate professor of psychiatry, Harvard Medical School.

Self Medication with undiagnosed “When people with ADHD get older, they hyperactive component often diminishes. But inside, they’re just as hyper as ever. They need something to calm their brain enough to be productive.” Dr. William Dodson, ADHD specialist in Denver

Treatment considerations Treat ADHD as other co-occurring disorder Simultaneous treatment for both needed to maximize chances of ongoing recovery.

An example of a treatment program

Profession evaluation for ADHD and co- occurring addiction

An example of a treatment program Profession evaluation for ADHD and co- occurring addiction Continuing involvement in addiction recovery groups

An example of a treatment program Profession evaluation for ADHD and co- occurring addiction Continuing involvement in addiction recovery groups Education on how ADHD impacts the person

An example of a treatment program Profession evaluation for ADHD and co- occurring addiction Continuing involvement in addiction recovery groups Education on how ADHD impacts the person Building social, organization, communication, and work or school kills.

An example of a treatment program Profession evaluation for ADHD and co- occurring addiction Continuing involvement in addiction recovery groups Education on how ADHD impacts the person Building social, organization, communication, and work or school kills. ADHD coaching and support groups.

Closely monitored medication when medication is indicated.

Support for client’s decision to medicate or not.

Stages of recovery Pre-Recovery Early Recovery Middle Recovery Long Term Recovery

Medication and Addiction Psychostimulant medication, when properly prescribed and monitored is effective for % of persons with ADHD. Dosage levels are much lower than intoxication or “high” levels. Relapse rates for those taking meds as prescribed and monitored are significantly lower than those with untreated ADHD

10 problems that could mean adult ADHD 1. Difficulty getting organized 2. Reckless driving and traffic accidents 3. Marital difficulties 4. Extreme distractibility 5. Poor listening skills 6. Restlessness, difficulty relaxing 7. Difficulty starting a task

8. Chronic lateness 9. Angry outbursts 10. Prioritizing issues

Robert Proehl, M.Ed., LADC Therapist Manager, The Referral Center ext. 125