what is ADHD?

1. ADHD
2. Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).

Attention deficit hyperactivity disorder, more commonly known as ADHD, is a fairly common condition that usually begins in childhood and sometimes continues into adulthood. This condition might seem harmless, but people who suffer from attention deficit disorder often have problems in their careers and relationships. A luxury ADHD center will provide the resources you or your loved one needs to regain control of life. Psychiatric centers help patients learn how to adapt to a normal life after years of struggling. Patients at upscale ADHD centers see improvements in their work performance and their relationships with loved ones.

What Causes Attention Deficit Hyperactivity Disorder?

In order to appreciate why upscale ADHD programs are so helpful for people who suffer from attention deficit hyperactivity disorder, it's important to understand what causes it. Contrary to popular opinion, attention deficit hyperactivity disorder does not occur as a result of poor parenting or a lack of self-control. In fact, studies point to genes playing a large role in whether or not an individual will suffer from this disorder.

According to multiple brain imaging studies, young people who suffer from attention deficit hyperactivity disorder have delayed brain maturity in the regions that involve paying attention, planning and thinking. Recent studies have found that the cortexes of those with ADHD show an overall delayed maturation, and the brain structures that allow the two halves of the brain to communicate display abnormal growth patterns. Because of the nature of this disorder, there are currently no cures available, but treatment can help relieve most of the symptoms. At a high-end treatment and luxury rehab center for ADHD, patients are taught coping mechanisms while the treatment team works to determine which, if any, medications will be effective.

Previously, attention deficit hyperactivity disorder was thought to affect few adults. Approximately 3 to 10 percent of school-aged children suffer from attention deficit hyperactivity disorder. However, symptoms actually continue into adulthood for roughly 60 percent of children who suffer from this disorder. Many adult sufferers have no idea that they still have the symptoms of attention deficit hyperactivity disorder, leading to incredible frustrations as they try to work through the difficulties of daily life.

How Treatment Centers Help Patients

The best upscale psychiatric facilities understand that attention deficit hyperactivity disorder is complicated and that no two patients are exactly the same. For example, a patient who works with numbers in an office might need help due to problems with disorganization, while a truck driver might not have many problems in his or her career. A patient who lives with his or her family or friends might not have the same relationship problems as a patient who lives across the country from loved ones and has trouble keeping track of birthdays and holidays. Each person needs a specialized treatment plan, and an upscale ADHD program will provide just that. Common treatments for ADHD include, but are not limited to, the following:

• Stimulants
• Non-stimulants
• Antidepressants
• Behavioral modification therapy
• Relaxation techniques

When a patient seeks assistance from a high-end treatment center for ADHD, he or she opens the doors to a wealth of resources that will provide the tools necessary to live a normal life in spite of this condition. In some cases, patients require medications such as Adderall and Concerta. Other patients don't need medication at all and will walk away from the treatment center with completely natural coping mechanisms that might even take advantage of some of the positive traits ADHD is known for, including a seemingly endless supply of energy and creativity

Deciding Between a Holistic and Traditional Treatment Facility

Traditional treatment facilities typically rely on a blend of medication and behavioral modification therapy to help people who suffer from attention deficit hyperactivity disorder. In some cases, the treatment team will give a patient a short-term medication while they explore other options. This is usually the most effective form of treatment.

In some cases, medications such as stimulants andantidepressants are not necessary for the treatment of attention deficit hyperactivity disorder. However, many patients do need some type of medical intervention, even if it's temporary, to experience relief from the symptoms associated with this disorder. For the patients who are not comfortable with that, a holistic treatment facility might be a good choice. Unlike traditional treatment facilities, holistic facilities are better prepared to provide treatment to patients who don't want to take medications.

The Link Between ADHD & Addiction

The Link Between ADHD & Addiction

It is common for people with ADHD to turn to addictive substances such as alcohol, marijuana, heroin, prescription tranquilizers, pain medication, nicotine, caffeine, sugar, cocaine and street amphetamines in attempts to soothe their restless brains and bodies. Using substances to improve our abilities, help us feel better, or decrease and numb our feelings is called self-medicating.
Putting Out Fires With Gasoline
The problem is that self-medicating works at first. It provides the person with ADHD relief from their restless bodies and brains. For some, drugs such as nicotine,caffeine, cocaine, diet pills and "speed" enable them to focus, think clearly, and follow through with ideas and tasks. Others chose to soothe their ADHD symptomswith alcohol and marijuana.
People who abuse substances, or have a history ofsubstance abuse are not "bad" people. They are people who desperately attempt to self-medicate their feelings, and ADHD symptoms. Self-medicating can feel comforting. The problem is, that self-medicating brings on a host of addiction related problem which over time make people's lives much more difficult. What starts out as a "solution", can cause problems including addiction, impulsive crimes, domestic violence, increased high risk behaviors, lost jobs, relationships, families, and death. Too many people with untreated ADHD, learning, and perceptual disabilities are incarcerated, or dying from co-occurring addiction.
Self-medicating ADD with alcohol and other drugs is like putting out fires with gasoline. You have pain and problems that are burning out of control, and what you use to put out the fires is gasoline. Your life may explode as you attempt to douse the flames of ADD.
A 1996 article in American Scientists states that "In the United States alone there are 18 million alcoholics, 28 million children of alcoholics, 6 million cocaine addicts, 14.9 million who abuse other substances, 25 millionaddicted to nicotine."¹
Who Will Become Addicted?
Everyone is vulnerable to abusing any mind altering substance to diminish the gut wrenching feelings that accompany ADHD. There are a variety of reasons why one person becomes addicted and another does not. No single cause for addictions exists; rather, a combination of factors is usually involved. Genetic predisposition, neurochemistry, family history, trauma, life stress, and other physical and emotional problems contribute. Part of what determines who becomes addicted and who does not is the combination and timing of these factors. People may have genetic predispositions for alcoholism, but if they choose not to drink they will not become alcoholic. The same is true for drug addictions. If an individual never smokes pot, snorts cocaine, shoots or smokes heroin, he or she will never become a pot, coke, or heroin addict.
The bottom line is that people with ADHD as a whole are more likely to medicate themselves with substances than those who do not have ADHD.  Dr.s Hallowell and Ratey estimate that 8 to 15 million Americans suffer from ADD, other researchers estimated that as many as 30-50% of them use drugs and alcohol to self-medicate their ADHD symptoms.² This does not include those who use food, and compulsive behaviors to self-medicate their ADD brains and the many painful feelings associated with ADHD. When we see ADD it is important to look for substance abuse and addictions. And when we see substance abuse and addictions, it is equally important to look for ADHD.
Prevention and Early Intervention
"Just Say No!" may sound simple, but if it was that simple we would not have millions of children, adolescents, and adults using drugs every day. For some their biological and emotional attraction to drugs is so powerful, that they cannot conceptualize the risks of self-medication.  This is especially true for the person with ADHD who may have an affinity for risky, stimulating experiences. This also applies to the person with ADHD who is physically and emotionally suffering from untreated ADHD restlessness, impulsiveness, low energy, shame, attention and organization problems, and a wide range of social pain.³ It is very difficult to say no to drugs when you have difficulties controlling your impulses, concentrating, and are tormented by a restless brain or body.
The sooner we treat children, adolescents, and adults with ADHD the more likely we are to help them to minimize or eliminate self-medicating. Many well meaning parents, therapists and medical doctors are fearful that treating ADHD with medication will lead to addiction. Not all people with ADHD need to take medication. For those who do, however, prescribed medication that is closely monitored can actually prevent and minimize the need to self-medicate. When medication helps people to concentrate, control their impulses, and regulate their energy level, they are less likely to self-medicate.
Untreated ADHD and Addiction Relapse
Untreated ADHD contributes to addictive relapse, and at best can be a huge factor in recovering people feeling miserable, depressed, unfulfilled, and suicidal. Many individuals in recovery have spent countless hours in therapy working through childhood issues, getting to know their inner child, and analyzing why they abuse substances and engage in addictive behaviors. Much of this soul searching, insight, and release of feelings is absolutely necessary to maintain recovery. But what if after years of group and individual therapy, and continued involvement in addiction programs your client still impulsively quit jobs and relationships, can't follow through with their goals, and has a fast chaotic, or slow energy level. What if, along with addiction your client also has ADHD?
Treating Both ADHD and Addictions
It is not enough to treat addictions and not treat ADHD, nor is it enough to treat ADHD and not treat co-occurring addiction. Both need to be diagnosed, and treated for the individual to have a chance at ongoing recovery. Now is the time to share information so that addiction specialists, and those treating ADHD can work together. It is critical that chemical dependency practitioners understand that ADHD is based in one's biology and responds well to a comprehensive treatment programthat sometimes includes medications. It is also important for practitioners to support the recovering persons involvement in Twelve Step programs and help them to work with their fear about taking medication.

A COMPREHENSIVE TREATMENT PROGRAM CONSISTS OF:

• A professional evaluation for ADHD and co-occurring addiction.
• Continued involvement in addiction recovery groups or Twelve Step programs.
• Education on how ADHD impacts each individual's life, and the lives of those who love them.
• Building social, organization, communication, and work or school skills.
• ADHD coaching and support groups.
• Closely monitored medication when medication is indicated.
• Supporting individuals decisions to take medication or not ( in time they may realize on their own that medication is an essential part of their recovery).

Stages of Recovery
It is important to treat people with ADHD and addiction according to their stage of recovery. Recovery is a process that can be divided into four stages, pre-recovery, early recovery, middle recovery, and long term recovery.
PRE-RECOVERY: Is the period before a person enters treatment for their addictions. It can be difficult to sort out ADHD symptoms from addictive behavior and intoxication. The focus at this point is to get the person into treatment for their chemical and/or behavioral addiction. This is NOT the time to treat ADHD with psycho stimulant medication.
EARLY RECOVERY: During this period it is also difficult, but not impossible to sort out ADHD from the symptoms of abstinence which include, distractibility, restlessness, mood swings, confusions, and impulsivity. Much of what looks like ADHD can disappear with time in recovery. The key is in the life long history of ADHD symptoms dating back to childhood. In most cases early recovery is NOT the time to use psycho stimulant medication, unless the individual's ADHD is impacting his or her ability to attain sobriety.
MIDDLE RECOVERY: By now addicts, and alcoholics, are settling into recovery. This is usually the time when they seek therapy for problems that did not disappear with recovery. It is much easier to diagnose ADHD at this stage; and medication can be very effective when indicated.
LONG TERM RECOVERY: This is an excellent time to treat ADHD with medications when warranted. By now most people in recovery have lives that have expanded beyond intense focus on staying clean and sober. Their recovery is an important part of their life, and they also have the flexibility to deal with other problems such as ADHD.
Medication and Addiction
Psychostimulant medication when properly prescribed and monitored is effective for approximately 75-80% of people with ADHD. These medications include Ritalin, Dexedrine, Adderall, and Desoxyn. It is important to note that when these medications are used to treat ADHD the dosage is much less that what addicts use to get high. When people are properly medicated they should not feel high or "speedy, instead they will report increases in their abilities to concentrate, control their impulses, and moderate their activity level. The route of delivery is also quite different. Medication to treat ADHD is taken orally, where street amphetamines are frequently injected and smoked.
Non stimulant medications such as Wellbutrin, Prozac, Nortriptyline, Effexor and Zoloft can also be effective in relieving ADHD symptoms for some people. These medications are frequently used in combination with a small dose of a psychostimulant. 
Recovering alcoholics and addicts are not flocking todoctors to get psychostimulant medication to treat their ADHD. The problem is that many are hesitant for good reasons to use medication, especially psycho stimulants. It has been my experience that once a recovering person becomes willing to try medication the chance of abuse is very rare. Again the key is a comprehensive treatment program that involves close monitoring of medication, behavioral interventions, ADHD coaching and support groups, and continued participation in addiction recovery programs.

ADHD and stimulant medication Abuse

ADHD and stimulant medication Abuse

(The following article has been adapted from my book, The Link Between ADD & Addiction, Getting the Help You Deserve, (1997) Piñon Press, and my new book When Too Much Isn't Enough, Ending The Destructive Cycle of AD/HD and Addictive Behavior, to be released in January (2005) Piñon Press.)

Treating adults and children with medication has been, and continues to be the subject of great controversy. Even in the face of years of scientific research, advances in understanding how these medications work, and significant improvement in the quality of life for millions around the world, there are still those who question, doubt, and attack the role that medication provides in the treatment of AD/HD.

Even more controversial is treating recovering alcoholics and addicts with stimulant medication. The "evils" of Ritalin have been the target of the media for years. Fear, which is often caused by the lack of accurate information, fuels anti-Ritalin and anti-medication groups. The media, which thrive on controversy, have recently been providing more accurate and scientific information when covering medications to treat AD/HD. Non-biased information that is based on sound research with proven results diminishes fear of the unknown, and squelches myths about the effective use of medication to treat AD/HD.

Stimulant Abuse and Addiction

There has been a flurry of high profile media about the abuse of stimulant medications. Many of these articles or shows focus on young people abusing Ritalin, Adderall, and Dexedrine. The truth is; these medications can be abused and the abuser can become addicted. Unfortunately the media tends to draw erroneous conclusions, such as, the use of stimulant medication to treat AD/HD causes drug addiction.

Most cases of stimulant abuse are among adolescents and adults who are not being treated for AD/HD. These are people that will abuse almost any drug if given the chance. Adderall and Dexedrine, are abused by people who are trying to get a high similar to speed. Ritalin, however, is often abused as a last resort because it doesn't give the user the euphoria they crave.

Although rare, drug addicts and alcoholics abuse stimulant medication by taking more than prescribed, or by grinding it up to inhale or to mix with water and inject. Some of these people learned how to present as though they had AD/HD in order to obtain stimulants. In most cases, these people had been given large prescriptions with little or no ongoing treatment for AD/HD or addiction.

Facts About Stimulant Medication

Unfortunately, many still hold the inaccurate belief that treating AD/HD with stimulant medication leads tosubstance abuse later in life, when in fact the opposite appears to be true.

• Untreated AD/HD is a risk factor for developing a substance use disorder later in life. (Biederman et al. 1997, Wilens et al. 1997, Hechtman and Weiss. 1985, Wilens et al. 2003)
• Treating AD/HD with stimulant medication appears to reduces risk of later substance use disorders by half. (Wilens et al. 2003)
• Concurrent treatment for coexisting conditions if they are present (bipolar, anxiety disorders, obsessive thought patterns)

Comprehensive Treatment for Those with Addiction

A comprehensive treatment plan is the most effective way to avoid medication abuse or addiction relapse. Medication should not be used as the sole treatment for AD/HD. Taking pills to rebalance your neurotransmitters is not enough. This means that your AD/HD, eating disorders, other co-occurring conditions and/or addictions are treated at the same time. If you stray away from your addiction recovery, you will be at greater risk to relapse. If you don't receive adequate treatment for your AD/HD, you're at greater risk for relapse. A comprehensive treatment plan is one that contains the following components:

• AD/HD treatment in the form of education, coaching, and support groups
• Regular visits with your doctor and close medication management
• Therapy or counseling regarding AD/HD and recovery issues
• Involvement in addiction recovery programs
• Family and relationship counseling when needed

Taking Medication Versus Street Drugs

Here are some important differences between taking prescribed medication and using street drugs.

• Stimulant medication is taken orally, at specific times, in dosages that do not create a "high" or euphoria.
• Due to the low dosage and lack of euphoria, most people do not develop a tolerance to stimulant medication.
• The dosage and quality of medication will not vary. Street drugs can be diluted or cut with baby powder, ephedrine, and who knows what.
• Street amphetamines produce a "high" as a result of much higher doses (several hundred times higher), and the route of administration (smoking, snorting, injecting).
• The intense euphoria produced by high doses of street amphetamines can cause cravings for more and quickly lead to addiction.
• Unlike street drugs, your intake of stimulant medication will be closely monitored by your doctor and other members of your support system.

Conclusion

Many substances including sugar have the potential to be abused by certain individuals. A genetic predisposition for addiction is not the only cause of addiction. Who becomes addicted and who doesn't is determined by a variety of factors. Environment, stress, trauma, life circumstances, and coexisting conditions such as depression, anxiety, post traumatic stress disorder (PTSD), and AD/HD are important contributing factors.

Stimulant medication such as Adderall, Dexedrine, and Ritalin are abused by those who are drug seeking, or addicted. Most people who take stimulant medication to treat their AD/HD do not abuse it. As a matter of fact, the greater problem is that they forget to take it.

Research indicates that those with untreated AD/HD are at greater risk to self-medicated with substances. Stimulant medication has a protective effect for some with AD/HD and decreases self-medicating. Medication should not be used as the sole treatment for AD/HD. A comprehensive treatment plan is the most effective way to avoid medication abuse or addiction.

References

Biederman, J., Wilens, T., Mick, E., Faraone, S.V., Weber, W., Curtis, S., Thornell, A., Pfister, K., Jetton, J.G., & Soriano, J. (1997). Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study. Journal of the American Academy of Child and AdolescentPsychiatry, 36, 21-29.

Blum, K., Cull, J., Braverman, E., Comings, D. (1996). Reward deficiency syndrome. American Scientist,84, 132-145.

Bonci, A., Bernardi, G., Grillner, P., Mercuri, N.B. (2003). The dopamine-containing neuron:maestro or simple musician in the orchestra of addiction. Trends Pharmacological Science, 24, 4, 172 April.

Hechtman, L. (1985). Adolescent outcome of hyperactive children treated with stimulants in Childhood: a review, Psychopharmacol Bul, 21:178-191.

Hechtman, L, Weiss, G. (1986). Controlled prospective fifteen year follow-up of hyperactives as adults: non medical drug and alcohol use and anti-social behaviour. Can J Psychiatry, 31:557.

Richardson, W. (1997). The link between ADD and addiction: Getting the help you deserve. Colorado Springs: Piñon Press.

Thompson, L.L., Riggs, P.D., Mikulich, S.K. & Crowley, T.J. (1996). Contribution of ADHD symptoms to substance abuse problems and delinquency in conduct-disordered adolescent. Journal of Abnormal Child Psychology, 24, 325-347.

Whitman, B. (2000). Adult outcomes for persons with attention deficit/hyperactivity disorder. In Accardo, P., Blondis, T., Whitman, B., & Stein, M. (Eds.) Attention Deficits and Hyperactivity in Children and Adults: Diagnosis, treatment, management. 2nd ed., Revised and expanded. New York: Marcel Dekker, Inc.

Wilens, T. E., Faraone, S. V., Biederman, J., & Gunawardene, S. (2003). Does Stimulant Therapy Of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-Analytic Review Of The Literature. Pediatrics, 111(1), 179-185.

Wilens TE, Biederman J, Bredin E, Hahesy AL, Abrantes A, Neft D, Millstein R, Spencer TJ. (2002). A Family Study Of The High-Risk Children Of Opioid- And Alcohol-Dependent Parents. The American Journal On Addictions. Winter, 11(1):41-51.

About the Author: Wendy Richardson, M.A., MFT, CAS is a Licensed Marriage, Family Therapist, and Certified Addiction Specialist in private practice in Soquel, California. Wendy is the author of The Link Between ADD & Addiction, 1997, Piñon Press. She has contributed chapters on AD/HD to books focusing on criminology and on women with AD/HD. She has also authored numerous articles on AD/HD and co-occurring conditions. She is a consultant, trainer, and is a frequent presenter at national AD/HD, addiction.

Addiction and ADHD Adults

Why ADHD adults who seek treatment are much less likely to abuse drugs and alcohol

Intoxicants are risky business if you have attention deficit disorder (ADD ADHD). A recent survey found that more than 15 percent of adults with the disorder had abused or were dependent upon alcohol or drugs during the previous year. That's nearly triple the rate for adults without ADHD. Alcohol and marijuana were the substances most commonly abused.

“Abuse isn't about how much you're doing or how often it happens. It's about how your use affects your relationships, health, work, school, and your standing with the law,” says Wendy Richardson, a marriage and familytherapist and certified addiction specialist in Soquel, California. “If you have difficulties in these areas and you keep on using, you definitely have a problem.”

Why is substance abuse such an issue for adults with ADD?

“In our study of young adults, only 30 percent said they used substances to get high,” says Timothy Wilens, M.D., associate professor of psychiatry at Harvard MedicalSchool in Boston. “Seventy percent are doing it to improve their mood, to sleep better, or for other reasons.” This kind of “self-medication” seems especially common among individuals whose ADHD remains undiagnosed, or who have been diagnosed but have never gotten treatment. “When people with ADHD get older, the hyperactive component often diminishes,” says William Dodson, M.D., an ADHD specialist in Denver. “But inside, they’re just as hyper as ever. They need something to calm their brain enough to be productive.”

That was the case for Beth, 27, a 

special education teacher

 in Ft. Wayne, Indiana. In college, she recalls, “My mind was so out of control, and drinking would make that go away. I didn’t drink to get smashed, but to concentrate and get my homework done.” Drink eased other ADHD miseries, too. Says Beth, “The boredom was impossible. I could be sitting in an interesting lecture and be totally bored. When I drank, I didn’t care that I was bored.”

The impulsivity, poor judgment, and social awkwardness that often come with ADHD pave the way to overindulgence, regardless of the consequences. Jennifer, 29, of Fayetteville, Arkansas, felt that having ADHD made it hard for her to fit in — except with the crowd that smoked marijuana. “They accepted me,” she says. “I used to think, ‘They don’t care if I’m a little crazy, if I don’t finish sentences, and walk out of the room while they’re talking.’”

There are other ADHD-related factors that can raise the risk for substance-abuse problems. Compared to people without the disorder, those with ADD are often less successful academically. Fewer graduate from high school and college, and they earn less money.

Biology is another factor. “There’s an increased rate of substance-use disorders in close relatives of people with ADHD,” says Dr. Wilens. Genes associated with risk-taking and novelty-seeking behavior may predispose an individual to both ADHD and substance abuse.

Whatever the explanation, trouble usually starts in adolescence; until age 15, ADDers are generally no more likely than non-ADDers to experiment with drugs. From this age on, rates of abuse and dependency skyrocket. Half of all adults with untreated ADHD will develop a substance use disorder at some point in their lives.

In adulthood, any major life change can mean increased risk. “Starting a new job, or having a child may activate a genetic vulnerability,” says Richardson.

Preventing the problem

The medications most widely prescribed for ADHD, methylphenidate and amphetamine, are controlled substances — meaning they have the potential to lead to abuse and addiction. Because of this, some people assume that it’s risky to take these drugs. In truth, it’s the opposite: ADDers who take these medications as prescribed are less likely than untreated ADDers to drink or abuse drugs. Put another way, treating ADHD effectively is powerful protection against substance abuse.