Pic3The chances of developing an addiction goes way up for people with ADD and “untreated ADD, is one of the leading causes of substance abuse in America today”. Studies of adults with ADD have found: a) co-occurring alcohol abuse disorders at rates ranging from 17% to 45%, b) drug abuse or dependence at rates ranging from 9% to 30%. As surprising as this may seem, studies have shown that people with ADD are: a) “more likely to develop a substance abuse problem at a younger age, b) more likely to require lifetime substance abuse treatment and c) more likely to develop prolonged substance abuse problems throughout life.” However, the good news is, “medication treatment of ADD reduces the risks of substance abuse by 85% amongst teen patients with ADD.” ( John Lee, Editor. “Why ADD/ADHD Increases the Odds of Addiction – And How to Get Better”, June 21, 2011: web page: http://www.choosehelp.com/mental-health/why-add-adhd-increases-the-odds-of-addiction-and-what-to-do.html )

I am no longer surprised at the number of alcoholic/addicts that I see in therapy who have an underlying undiagnosed, untreated, ADD. It is so sad to imagine all of the years they have suffered not only from their addiction, but from the frustration of having something else wrong that caused them to feel different, worthless, anxious, or depressed. Just imagine how many of the adult alcoholics and addicts actively using, or walking into a 12-step program, or into therapy, are part of that 85% of undiagnosed teens with ADD!! Think about that!

Brain function impaired

Frontal lobe impairment: There has been a great deal of research done revealing that brain function of persons with ADD is impaired, particularly in the frontal lobe. Many of their symptoms are very similar to people with closed head brain injury. The frontal lobe is responsible for a) “sequencing” handle information in a sequential step by step manner, b) “drive” ability to accomplish tasks, c) “executive control” or social appropriateness; a loss of this leads to blurting out comments, impulsivity, and distractibility. The ability to logically organize and plan behavior, which enables you to set and achieve goals is impaired. Considering the possible consequence of one’s behavior and preventing “runaway” emotional responses is a function of the frontal lobe. Basically, frontal lobe impairment affects attention, impulse, time management, task completion, and thinking capacity.

Dopamine deficiency: There is very strong evidence which links dopamine receptor deficiency (receptor D2) to many behavioral abnormalities including addiction (alcohol/drugs/sex/pathological gambling), food binging, and attention deficit. What a double whammy! Growing up with attention deficit and then developing addictions all because of the same dopamine deficiency in the brain!! One research study revealed that “52% of cocaine addicts” and “49% of children with Attention Deficit” had the abnormal dopamine receptor D2 present. (Sudderth, David & Kandel, Joseph. (1997) Adult ADD: The Complete Handbook. New York, NY. Three Rivers Press. pg 31)

Dopamine is the neuro-chemical responsible for reward or “feel good” sensory response in the brain. Therefore, if dopamine is released in lesser amounts in the brains of those with ADD/ADHD, causing them a lessened ability to feel “normal pleasure”, then it is completely understandable and even expected that they would seek out normal pleasure levels through intoxication or thrill seeking behaviors, which increase the amount of dopamine released in the brain.

Increased Norepinephrine: There is also research supporting the idea that another part of the brain called the “locus coeruleus”, a group of neurons located in the brainstem responsible for norepinephrine release, may be firing at an increased rate. This causes sensory overload; too many thoughts at once and the inability to sort or filter them and focus.

Self-medicate

It is no surprise that undiagnosed and therefore untreated individuals with attention deficit would turn to cocaine and marijuana to self-medicate. The cocaine is a stimulant, which causes increased dopamine release and the marijuana slows down the rapid firing of thoughts and helps concentration.

It is no wonder that most of the current treatment for ADD is stimulant-type medications like “Ritalin”, “Adderall”, and “Concerta”, which increase the dopamine levels. Needless to say, these are much more effective and safer than cocaine.

“Clonidine” (sustained release) is used to specifically treat the rapid firing of norepinephrine, achieving a much safer and effective result than marijuana. It is often used in combination with the stimulants mentioned above because it has a calming effect enabling the person to control their thoughts, impulses, and sleep disorders.

One man with severe ADD says that the constant stimuli is so distracting that if he didn’t smoke marijuana before he started his day, he wouldn’t be able to drive because he’d be so distracted that he’d have an accident for sure. He not only has justified his chronic long-term marijuana use, he knows that it helps.

NOTE: Of course, absolutely do NOT advocate the use of marijuana or other illicit drugs to self-medicate attention deficit (or depression and other mental health issues). There are too many unknown and uncontrolled factors causing major health risks, and unsafe mixtures and dosing, and therefore inconstant effects on the brain. (http://psychcentral.com/lib/2010/adhd-and-marijuana/) This is extremely dangerous!! Please seek proper medication treatment.

Written by: Giselle Belanger, RN, LCSW  (psychotherapist) Available for appointments in person, by phone, or by skype webcam. Contact info: [email protected], Mex cell: (322) 138-9552 or US cell: (312) 914-5203.