005 Do Stimulants Cause Addiction?

Because the medication used to treat ADHD is a controlled substance, it's natural for parents to have fears about giving it to their kid. In this episode, Kelly and Teresa discuss the most common concerns they hear from parents, explain how stimulants work as a treatment option, and what the science says about the risk for addiction. For more information check out this interview with Dr. Dodson. Here at the Parenting Balance Podcast, you'll find simple, science-based tools and tricks for parenting kids with ADHD or anxiety. Although we are both family therapists, this podcast is for informational purposes only and should not replace the guidance of a qualified professional. Join us as we debate and discuss our own experiences as parents of kids diagnosed with ADHD and anxiety and breakdown the latest research into easily digestible portions. We created this podcast to educate, inspire hope, explore new ideas and discover together what we know to be true: you are not alone, and finding a community of support can make all the difference. Please join our Parenting Balance Podcast Community here and sign up here to be the first in line for our new Modern Guide to Understanding Kids With ADHD mini-course.

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Transcript

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Hi Everyone, welcome to the parenting balance podcast. My name is Kelly Williams. I'm a licensed clinical social worker and an ADHD parenting expert by experience. I'm here with my partner Hi, I'm Teresa Van Pelt I'm a licensed mental health counselor and anxiety parenting expert by experience. And for the past 10 years, Kelly and I have had a family practice in Florida. This podcast is for parents who want to really understand what's going on with ADHD and anxiety so you can ditch the chaos and feel confident and happy again. Hi, this is Teresa. I'm here with Kelly. This episode is full of useful information about treating ADHD with medication, including a concern I hear often about stimulants being addictive. The information and this episode should not be considered. Medical advice we're not prescribers. This information is based on our personal and professional experiences. So look, Kelly. This is a question I get often or concern I get often when it comes to medication medicating kids for ADHD a lot of families say, Listen, I don't want my kids on a stimulant. We have a history of addiction in my family, and I don't want my kid to be addicted. Yes, I know. I hear that a lot, too. And it's, um it's hard to understand, right? It's hard to like, just give a simple explanation. But, you know, early on in this podcast, we talked about how ADHD is not a deficit of attention. What it really is, is a deficit of regulation, okay, And addiction is what happens when people are dis regulated. So when I, um when I'm working with families and they tell me they have this history of addiction, you know, I say well, what you really have is a history of ADHD, right? You have a history of red flag for me of untreated ADHD, and I dig deeper cause of a lot of times people who in the family who have addictions it's there are a lot of times untreated ADHD, or it is years to be there. That's how they're coping with, right? The ups and downs, the strong intensity, these emotional symptoms that we've already talked about that are not in the current diagnostic criteria, but not only that, you know. It's also how, remember the article about the 500 times more corrective feedback, right? What happens to your sense of self when you've lived an entire life of not ever feeling good enough? You know, um, so you know, yes, addiction is an outcome of untreated ADHD, and thereby taking a stimulant medication is actually a protection from becoming addicted. There's actually research, Oh, the surface. Because it's something that I think is not known. I don't think it's mainstream. Yeah, and I think it is like, counterintuitive, right? You know, because we've got It's a controlled substance. It's a stimulant. Hey, there's that word, right? So let's talk for a minute about what is a stimulant stimulating in a non-neurotypical pickle brain. So in one of the episodes, we kind of talked. We touched on this idea of the neural transmitters, okay, and that the neurotransmitter dopamine is weak in an non-neurotypical brain. Now, this is important because dopamine is our reward Neural transmitter and in general, for humans, our bodies are designed to kind of always be sort of seeking out Homeo Stasis, you know, So that's like equilibrium, and your brain wants to be engaged. It wants to be interested. It wants to be thinking about right. That's what it does. It's like thinking it's our brains are what makes meaning of everything that's going on for us humans. And so the brain is always seeking out like optimal stimulation. I'm not sure if this is coming across, you know if this makes sense to you. But when there isn't when things don't feel interesting to us, we're gonna find something that is correct. There's something that I need to say also. And that's kind of an aside that one of the questions that a prescriber will ask is probably not the six year old but other people. Have you ever tried cocaine? And what was your reaction? OK, a lot of times, people who have non-neurotypical brains have the opposite. Oh, well, action, that is, actually you know, the Only actual way to confirm this diagnosis is to see what the reaction to a stimulant nous right that is the only 100% says that we have Well, I'm going to say it's 80% because only 80% of people will respond to a stimulant. But um, that is actually our most accurate assessment. Um, way to know is what happens when you take a stimulant and you are correct. Um, taking this stimulant has a calming effect when there isn't enough dopamine in the synapse. Okay, When there is enough dopamine in the synapse, then it has an activating effect, and that's the difference. So lots of people do cocaine because it makes them, um, activated. I can. Motivated, activated. It makes him feel good, like energized all that stuff, All three with things. But if you are normalizing your dopamine function, okay, if if your dopamine is below the threshold and it's brought up to normal, it's not an activating feeling. It's like, Oh, normal feeling. Oh, this is what everybody is talking about, right? So, um, that's a really good question. Yeah, there's something I know we talked about. We were talking about the addictive tendency or whatever, but something that I see often with teenagers is if they're untreated, they tend to gravitate more towards marijuana, and they really enjoy it because it calms them. It kind of makes them feel normal. Yeah, So I'm not I'm not educated enough on this from a practice, You know, like I can't explain why that is. I can Absolutely I don't think there's enough research right now. Right? At least that I know of. I know that marijuana slows down beta waves. Remember early on. And we were saying like, it wouldn't it be great if you had a deficit of attention? Right. Um, I think marijuana, like, slows down. How you think? Maybe And so, But yet I'll absolutely say that in the in practice, every adult I've ever met, mostly males, great are untreated adults. They are using marijuana on a regular basis as a treatment mechanism, either to induce sleep or to get going in the morning or, you know, right, like so we see these kind of classic patterns. And so, um, so how does all this? Right? So we wanted to kind of talk about today stimulants, addiction, and other medication-related topics. So let me just do a quick little overview about, um, stimulant medications. Um, there are two classes of stimulant medications. One is amphetamine One is methylphenidate. In general, humans with ADHD will respond better to one class or the other. There is no way to know which one will suit you better unless you try them both to find out. Okay. And stimulants are not like other medicines in that they aren't based on body size and weight, but rather they are based on sort of metabolism. Okay. And when we're talking about ADHD. One of the symptoms, of course, is hyper cognition. So that's a brain that is thinking very, very fast. And that's ah, high brain metabolism. And so even though, like, let's take my own son, for example, he's six years old at the time that we go to see the neurologist. And mind you, I had to wait all these months for this appointment. I did all this research, but it may be crazy. Oh, yeah. Um, and the neurologist takes one look at him and says, My God, he's the most hyper child I've seen in six months. How have you been dealing with this? You know, So I couldn't decide if I was just kind. No, in my mind, I'm like, I don't know whether you're happy about that. Like nothing wrong with me or devastated. Yeah, I was devastated. And, you know, it was it was a mix. It was like relief. And, you know, I could, you know, like, laid the guy out right in the teacher and everyone else. Yeah, you know, But again, you don't know what you don't know, right? He's my 1st 1 Where do you hear the story About how my daughter got a medicine? That one's even funnier, but we're talking about stimulus here, okay? And so, um, so even though he's a little boy and, um, you know, it doesn't like the number of milligrams right of the stimulant. Has To match the hyperness? Not his weight, Not his way, Not his size. You know, I think it's scary for parents are for people. Sometimes when they look at the dosage and they're like, my uncle only takes exactly 10 milligrams admiral or whatever. Exactly a totally big source of, like, misunderstanding about the medicine. All right. And lots of parents come to me and they go, Oh, he's on a stimulant. But it's just a tiny little bit, right. Like, because that's gonna work better. I mean, that's sort of like going to the eye doctor and being like, okay, don't need the full prescription. A little bit because I just I wanted to be blurry still, but not as blurry as it was. Yeah, I don't want you exactly. I mean, there's just no other way to say it. And I'm not laughing at parents of No, but I'm not. And to see it in this way, yeah, ableto look through and there's a thin for many of doctors, there's plenty of pediatricians. There's plenty of people who don't specialize in this, who I personally have consulted with on behalf of my family's and the prescriber thinks these same things. Okay, so here's why. Um so that's kind of why I'm chuckling is because we've really got to understand. And you know who is my favorite person who writes about this and who teaches about this, Um, William Dodson, this wonderful man who used to be He was a pediatrician, And then I think he went back and did psychiatry. And then he started this clinic in Colorado only for a THC. Um, he is wonderful in talking about what medications mean how to adjust. Ah, he calls it optimizing medications. He invented a term that he calls rejection sensitive dysphoria, which kind of addresses some of these mood symptoms that we've talked about that are not even yet in our ah, diagnostic and statistical manual. So, um, if you want more information from her prescriber, look up William Dodson on the Internet and he's a frequent contributor to Attitude magazine. Dr Carnell magazine, by the way, a d d i t u D e e cute. Love it? Yeah. Attitude bank attitude. Magas Like a, um, clearing house. I think of a lot of information about a lot of up, up to date information about 80 HD for our practice. That's the only magazine that we subscribe to. Yeah. I mean, no one reads magazines anyway, but that one's super helpful. It is super helpful, and it disappears from the lobby. All that it does. And that shows how could it is a great resource. It's a great resource. All right, So, um, here's your take away for today. Okay? Um, even though it feels counterintuitive to give your child a controlled substance, that is it called a stimulant. Um, the effect of the medicine is too. Ah, normalized dopamine function and thereby actually calm behavior. Um, so stimulants are actually activating. Ah, back part of the brain. When I talk to kids about this, I just call it the back in the front. Okay, so the stimulant medications, they activate the back part of the brain And because that part of the brain is activated, then the brain can reach kind of that home. You Stasis and it isn't seeking out additional stimulation. So the results is, you know, the back park gets activated and all of a sudden the teacher becomes interesting enough toe listen to. So the kids not like what I did when I was a kid talking to the person next to me. Oh, yeah, and any through Italy, Nature. Alright. Exact Adri mean? So when we activate that back part of the brain, it levels out everything in the brain, so that then the then it's then the teachers. Okay, When we don't activate the back part, the brain is out of home a Stasis, and it starts seeking out more interesting things, right? Because remember, all the brain isn't prioritizing the stimulation. Well, when the dopamine isn't normalized, so it doesn't it's like it doesn't know what's important to attend to. And so then it starts going around, you know, looking for other things anyway. So that's how I explain that. Now, Um, that's how stimulant medicines work. There are also non stimulant medicines, and what they do is they activate the front part of the brain. And this is especially important as kids get older because the front part of the brain is where our executive functions Air house. And we sort of talked about how those air the, you know, the connecting the dots, sort of a skills that kids need. And they absolutely need more independence with those as they get older. So as our kids get older, we wanna usually combine a stimulant with a non stimulant as they get older. All right, so you're take away for today. Did I already say that part you did was heard to say it again? Is that if your child has a THC? Treating their symptoms with stimulants is a protective factor against future addiction, Period. That's a wrap for today. I hope you doing this next time when we talk about what balance looks like when you live with a d. H d. Thank you for listening to the parenting balance podcast to doing our mailing list, Go to parenting balance dot com slash podcast. When you join, you will be notified of upcoming live Q and A's. You could help us plan future episodes. We'd love to hear comments and questions. You can reach us by email. Hello at parenting balance dot com. 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