"Helping you to help your ADD ADHD child"by Anthony Kane, MD
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These theories were first proposed by physicians. The ideas were later picked up and expanded upon by distributors of natural treatments for ADHD and are used to play upon the fears of parent in order to sell their ‘drug free’ alternatives.
This research project was a combined effort of researchers at Massachusetts General Hospital, Harvard School of Public Health, and Harvard Medical School. The scientists divided 212 boys into three groups and followed them for several years. The first group consisted of 56 boys with ADHD who received on the average four years of drug treatment for their ADHD. The second group was made up of 19 boys also with ADHD, but who received no drug treatment for their condition. The third group consisted of 137 boys who did not have ADHD.
When the boys were 15 or older, they were evaluated for substance abuse disorders involving alcohol, marijuana, hallucinogens, stimulants, or cocaine.
(I want to point out that there is a difference between substance abuse and a substance abuse disorder. Substance abuse is recreational use of medications. This may include inappropriate use of alcohol or other drugs. This is fairly common in our society and does not always indicate a significant problem. Our real concern is when recreational use of medication becomes a disorder. A substance abuse disorder is where the person continues to use a mood- or behavior-altering substance despite the fact that this substance causes significant problems in the person's life.)
Results of the study were fairly dramatic. 18 percent of children without ADHD had at least one substance abuse disorder, when surveyed in their mid teens. The group of ADHD children who received medical treatment faired almost as well. Only 25 percent of that group had at least one substance abuse disorder.
However, among the ADHD children that did not receive medical treatment, 75 percent of that group had at least one substance use disorder during the follow up study.
This study suggests that if your child has ADHD and does not take medication, he is three times as likely to get seriously involved with drugs, than if he does receive medication.
Other researchers have found that the younger age that medical treatment began, the lower the risk of a future drug abuse problem.
Other Risk FactorsOther factors have been identified that predict a higher risk of future drug abuse.
Wilens found that the two biggest indicators of future substance abuse disorder in ADHD children were coexistent conduct disorder and coexistent bipolar disorder. Other researchers found that with regard to conduct disorder, IQ played a factor. Children with conduct disorder and high IQ scores were more likely to later develop a drug problem. In contrast, in children who did not have a conduct disorder, those with a lower IQ were more likely to develop a substance abuse disorder.
ConclusionMost parents are concerned about starting their ADHD children on stimulant medications. This is for a variety of reasons and many of these reasons are valid. However, what many of these well meaning parents fail to consider is that there are concrete risks involved with not starting their children on drug treatment. One very measurable risk is the risk of future drug involvement.
Parents must consider that the risk of future drug abuse gets larger the longer they withhold medical treatment from their children. The risk becomes three times as great when they withhold medical treatment completely from their ADHD children. If ADHD is complicated by conduct disorder or bipolar disorder there is even a greater chance of future drug abuse developing.
So if your child has ADHD it could be that giving medication may not be the best approach. But you should know that not giving medication also carries with it some danger. Be sure you or whoever is managing the treatment of your child considers all the risks before you make your decision.
Anthony Kane, MD
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