The safety of stimulant medications for ADHD has long been debated. Are these medications safe to use? Will giving children medication at a young age result in later substance abuse? Are these medications addictive? Are these medications too easily available that they pose a risk of abuse to those that don't have ADHD? As parents carefully and deliberately decide whether to have their child take medication to treat symptoms of ADHD, all these questions come into play.
Are Stimulant Medications Safe?
Most modern literature about ADHD medications indicate that, when stimulant medication is used as prescribed, and under the supervision of a medical doctor, they are both safe and effective. These medications have been shown to significantly reduce symptoms of ADHD, such as inattention, hyperactivity and impulsiveness. They can help a child, or adult, think through situations before jumping in, plan and follow through tasks. But these medications are not "magic pills." They don't cure ADHD or take away all the symptoms. Medications are meant to be used as one part of a treatment plan. Behavioral strategies, such as creating "to-do" lists or using technology to remind yourself of appointments, should be used as well. In addition, each person reacts differently to medication. Some people find symptoms almost disappear with medication, some find medication barely helps. Some people find it hard to tolerate the side effects, for example, increased heart rate and blood pressure, loss of appetite or headaches, and others feel very little side effects. Because of these differences, it is important to consistently speak with a medical professional about your, or your child's, experiences on the medication. With close monitoring, these medications have been found to be very safe. Research has shown that a treatment plan combining medication and behavioral strategies is the most effective treatment for ADHD.
Will Giving Children Medication at a Young Age Result in Later Substance Abuse?
If a child becomes accustomed to taking medication to control behavior, will he later turn to abusing other drugs or alcohol later in life? Surprisingly, most studies show the opposite is true. According to the article, Addiction Issues with ADHD Medications, "...individuals with ADHD who use stimulant medication to control their symptoms are less likely to become addicts than are individuals with ADHD who are not on medication. In addition, research shows that treating ADHD with stimulant medication appears to reduce the risk of later substance abuse problems by half."
Treating ADHD seems to cut many of the behavioral risks that can develop in teens and adults. Larua Pickford Ramirez [ADHD Medications: Are ADHD Drugs Addictive and Should You Give Them to Your Child?] offers the following statistics for untreated ADHD:
- 55 percent abuse drugs and alcohol
- 35 percent drop out of high school
- 19 percent smoke cigarettes
- 42 percent of hyperactive boys are arrested for a felony charge by the age of 16
Treatment for ADHD significantly reduces these statistics, and according to the previous information the statistic for substance abuse is cut in half when treatment for ADHD is used.
Are These Medications Addictive?
Stimulant medications are classified by the U.S. Food and Drug Administration (FDA) as Schedule II medications. These means they are seen as having a high abuse potential. These medications must have a written prescription handed in to the pharmacy each time they are refilled. Usually, when someone takes these medications as prescribed, they do not become addicted to the medications.
The medical community is still trying to understand the science behind addiction. Why do some people become addicted to substances and activities while others don't?
Addiction occurs when the pleasure senses of our brain light up after taking a medication or engaging in an activity, such as gambling or shopping. First, this behavior becomes a habit, something that makes you feel good. But as time goes on, you crave this substance or activity and need it to feel good. An article in Time Magazine, "How We Get Addicted" hypothesizes that addiction occurs when the reasoning part of the brain fails to compensate for the intense pleasure we feel. In other words, we don't balance out reason and pleasure. We continue to participate in addictive behaviors even though we know they are not good for us. If this is true, addiction is as much a deficit in logic and reasoning as it is in the pleasure of the addiction.
Even so, some people are more at risk for becoming addicted to substances and behaviors than others. The National Institutes of Health state that "vunerability to addiction differs from person to person." Genetics are the biggest risk factor, accounting for between 40 and 60 percent of a person's vunerability to addiction. Other risk factors include:
- Developmental stage
- Social environment
Individuals with mental disorders have a greater risk of substance abuse than the general population.
Even though stimulant medications have the potential to be addictive, when used as prescribed and monitored by a medical professional, the risk of addiction is small and the benefits, for many, outweigh the risks. In addition, addiction often occurs because of a rapid "hit" to the pleasure center in the brain, for example, when someone snorts cocaine, they feel euphoric within seconds. ADHD medications don't do this, for example, Ritalin, a common medication for ADHD, metabolizes slowly and never gives that "rush" or feeling of euphoria.
Are These Medications too Easily Available that They Pose a Risk of Abuse to Those that Don't Have ADHD?** Join our discussion: Faking ADHD for the Medication**
We have talked about the low risk of addiction when stimulant medications are used as prescribed and under the supervision of a doctor, but what happens when someone who doesn't have ADHD takes these medications? This happens all too often in high schools and colleges. Students find these medications help them focus, stay alert and stay up all night to finish a paper or study for a final. The New York Times [The Adderall Advantage, 2005] states that 20 percent of college students have used Ritalin or Adderall to help them study. College students get these medications by buying them from a student with ADHD and a legitimate prescription or have learned to exaggerate ADHD traits to be diagnosed with ADHD and prescribed medication. In these cases, the risk of addiction is higher and there are a number of health and addiction risks:
- When prescribed, dosage is based on the individual, when taking someone else's medication, the dose can be higher than what would have been recommended
- High doses can cause elevated heart rates, increased blood pressure, tremors, mood swings, paranoia, seizures, hallucinations and delusions
- High doses can increase the risk of addiction
- Snorting ADHD medications increases the risk of addiction
Stimulant medication is seen by many college students as the "steroid" for the brain. It increases focus and ability. In today's culture of having to be the best, students turn to these medications to give them a competitive edge. In these cases, stimulant medications carry a high risk of addiction.
See also: Stimulant Medication Abuse
"Adderall: College Students' Best Friend-Or Worse Enemy?" 2007, Kristin Jenkins (student), BrynMawr College
"Addiction Issues with ADHD Medications," 2007, Nov 5, Margaret Austin, Ph.D., Natalie Staats Reiss, Ph.D., and Laura Burgdorf, Ph.D., MentalHelp.net
"ADHD Medications: Are ADHD Drugs Addictive and Should You Give Them to Your Child?" 2004, Laura Ramirez, International Center for Disabilities on the Internet
"Drug Abuse and Addiction," Date Unknown, Staff Writer, National Institute on Drug Abuse
"How We Get Addicted," 2007, July 5, Michael D. Lemonick, Time Magazine
"Managing ADHD With Medication," Reviewed 2007, Oct, Reviewed by Richard S. Kingsley, MD, KidsHealth.org
"The Adderall Advantage," 2005, July 31, Andrew Jacobs, The New York Times