Should People with ADHD Use Stimulant Medication?
Stimulant medication is a valid, effective and even necessary treatment for many people with attention deficit hyperactivity disorder (ADHD).
People often misunderstand how stimulants help the ADHD brain, and as a result, many have argued against its use, citing its potential as a “gateway drug.” Such rhetoric has impeded access to treatment for people with ADHD.
The ADHD Stimulant Paradox
When people oppose stimulant treatment for ADHD, they often use two arguments. First, stimulants such as Adderall and Ritalin are inherently addictive medications. Second, people with ADHD appear to be more vulnerable to addiction than the general population. Various studies show a link between substance abuse and ADHD.
It is understandable, therefore, why so many people would believe that those with ADHD could easily become addicted to their medication.
However, an interesting paradox occurs when it comes to stimulants and people with ADHD. Although stimulant medication is addictive, and ADHD increases addiction risk, when people with ADHD are prescribed this medication, they may have a lower risk of abusing substances than they would have experienced had their ADHD remained untreated.
Stimulants and the ADHD Brain
According to several experts, ADHD is caused by a lack of dopamine access in the brain. While there is insufficient evidence to conclude that this theory is correct, it has been proven that for people with ADHD, increasing dopamine helps alleviate symptoms.
Dopamine has several roles. For example, it contributes to focus and motivation, both of which are difficult for those who have ADHD.
Dopamine is also a reward chemical, or a “feel good” chemical, designed to help us repeat behaviors that are good for our survival. Sex, exercise, eating, and many other healthy activities trigger dopamine release. As a result, we are more likely to repeat these behaviors.
When a person has low levels of dopamine, it can be difficult to find enough focus and motivation to start a task.
Stimulants temporarily boost the brain’s dopamine levels. When somebody with ADHD takes a prescribed stimulant, the medication helps that person accomplish their tasks, stay present, and avoid debilitating overwhelm.
Stimulants in the Non-ADHD Brain
Stimulants also boost dopamine when somebody without ADHD consumes them. However, when a person with ADHD takes a stimulant, their dopamine moves from a low level to a level that aligns with a neurotypical baseline.
When somebody without ADHD takes the same stimulant, their dopamine will rise from this typical baseline to a much higher, and dangerous, level. Because dopamine is designed to cause repeat behaviors, this drastic increase creates a high risk of further drug abuse and addiction.
Lack of Access May Increase Risk of Addiction for Those With ADHD
According to multiple studies on the the subject, stimulants often serve as a protective factor against addiction for many people with ADHD, especially when treatment begins early.
When individuals with ADHD consume illicit substances, they often do so as a form of self-medication. Proper, doctor-supervised treatment, however, prevents many individuals from seeking relief via illicit means.
Therefore, a lack of access to stimulant medication may yield the opposite result, increasing the individual’s risk of substance abuse.
Are Stimulants the Right Choice for Everyone with ADHD?
Stimulants certainly are not the right choice for every person who has ADHD. Each person has unique traits, circumstances, and brain chemistry that determine the best treatment for their needs.
For example, if a person has experienced substance abuse and addiction, their doctor may recommend non-stimulant treatment options. Likewise, somebody who experiences high blood pressure may need to avoid stimulants.
However, when a person with ADHD appropriately uses a doctor-prescribed stimulant, adequate access to that medication may drastically improve their quality of life.
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Sources:
Dove Medical Press — Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome
Harvard Health Publishing — Dopamine: The Pathway to Pleasure
Pharmacology and Therapeutics — Evidence-Based Pharmacological Treatment Options for ADHD in Children and Adolescents