Should People with ADHD Use Stimulants?

If the title of this post looks familiar, it’s because I posted nearly the exact same title under the “articles” section. 

At Mindful Phoenix, the articles have a more academic tone, while the blog posts take a more casual approach. And this topic is just important enough that I decided it belongs in both places. 

So, should those of us with ADHD use stimulant medication? 

Well, I’m not your doctor. I’m not anybody’s doctor. I did wear scrubs on TV one time, but that doesn’t mean I have a medical degree. So I can’t say whether stimulants are right for you. That’s for you and your own doctor to decide together.

What I can say is that, broadly speaking, when people with ADHD have access to our medication, it’s a good thing. In fact, it’s necessary. 

And yet, people keep arguing that we shouldn’t have it. They usually bring up side effects and the potential for addiction. And to be fair, those are valid concerns. But these arguments are missing some key pieces of information. 

I Keep Forgetting to Take My Highly Addictive Medication 

I keep my stimulants in a special bottle with a timer on the cap. That timer tells me exactly how long it’s been since I last opened it. 

Before I had this timer, I would regularly find myself saying “Wait…Did I remember to take my medication?” And because I’d rather err on the side of caution, I would decide not to take it. This protected me from accidentally doubling my dose, but it also meant that there were some days when I was writing articles powered only by spite and anxiety. 

But Aren’t Stimulants Addictive?

Yup! They are indeed addictive, and I will never argue that they’re not. They are specifically designed to boost dopamine, and dopamine is the main chemical behind addiction. 

And yet, we keep seeing ADHD-ers who need reminders to take their medication. Why? 

Well, picture a bathtub if you’re able. The bath represents the brain. Imagine that the bathwater is dopamine. A neurotypical brain is like a full bathtub. It already has all the water it needs. So if you turn the faucet on, that tub is eventually going to overflow. For a neurotypical, taking a stimulant is like turning on the faucet in a full bathtub. It’ll flood the brain with too much dopamine. At this level, that quick dopamine boost could lead to addiction. 

Now, imagine a bathtub that’s only half full. You can’t enjoy a bath that way. Not unless you enjoy having cold knees. An ADHD brain is like a half-filled bathtub. If you turn on the faucet, then the bathtub will fill, just like the neurotypical bathtub did. But the difference is that the ADHD bathtub goes from “too little” to “just enough,” while the neurotypical bathtub goes from “just enough” to “the floors in here will never be the same.” 

When people complain about ADHD-ers taking stimulants, they talk as if we all have full bathtubs. They don’t want to risk us getting water on the floor, even if there was a low risk of that happening. They’d rather have us shut up and deal with having cold knees.

Stimulants Can Prevent Addiction in Many People with ADHD 

Wait, how does an addictive medication prevent addiction? 

Well, if you have a normal dopamine level, and you crank it up to 11, you can get addicted to that feeling. But if you have low dopamine levels, and you bring them up to normal, then, well, you can finish writing an article. You’re not getting high, you’re checking your emails. And I’m going to go ahead and assume that you’re not addicted to that. 

Now, it doesn’t work that way for everybody, and there are some nuances here. 

To be clear, stimulants are not always the right option. If you have a history of substance abuse, or if one of your family members experiences addiction, let your doctor know before you pursue treatment. Your doctor may decide that a non-stimulant option would work best for your situation. 

Still, many people with ADHD can indeed avoid substance abuse by taking stimulants as prescribed by a doctor. 

Gateway Drug or Security Fence?

Why would a substance that harms neurotypical people protect people with ADHD? There may be several reasons. Off the top of my head, I can think of two. 

First, impulsivity is one of the most common symptoms of ADHD. It’s also a risk factor for substance abuse. Because stimulants reduce impulsivity, they may help people with ADHD slow down and weigh their options before trying illicit drugs. 

Second, some ADHD-ers may turn to illicit drugs for symptom relief. Without access to medication, they may turn to unregulated and unpredictable drugs, and those drugs are far more likely to cause a high than properly-used prescription stimulants. 

Who Are We Protecting? 

I remember reading one of the many hand-wringing articles about prescription stimulants. They quoted a guy who said something like “We really need to ask ourselves if the benefits of stimulants outweigh the risks.”

Translation: “We really need to ask ourselves if the benefits of stimulants for people with ADHD outweigh the risks for neurotypical people.” 

Because that’s what they really mean, isn’t it? 

If people really, truly wanted to prevent addiction, then they wouldn’t just make it more difficult for neurotypicals to abuse stimulants. They’d also make sure that those of us who need stimulants are able to access them. 

But that’s not what they’ve done. Instead, they’ve made it more difficult for those of us who need medication to get it. And when some ADHD-ers can’t access medication, they may experience a higher risk of substance abuse. In other words, they’re protecting neurotypicals from addiction by making ADHD-ers even more vulnerable to it. 

They’ve sent a very clear message about who matters most.