Transcript ADHD and Addiction

ADHD and Addiction
Causes of ADHD
• Exact Cause Unknown
Causes of ADHD
• Exact Cause Unknown
• Strong Genetic component has been
established.
Causes of ADHD
• Exact Cause Unknown
• Strong Genetic component has been
established.
• Can be some common behaviors, i.e. smoking
or drinking during pregnancy, other OBN
complications.
Other factors
• Low birth weight
• Childhood head injuries, particularly to the
frontal lobe.
• Exposure to lead, PCB’s, other environmental
toxins.
Onset
• ADHD always begins in childhood
• May not be diagnosed until adulthood.
• Adult diagnosis means enduring symptoms for
years.
Progression
• Research indicates between 30% and 70% of
children will continue to display ADHD
symptoms as an adult.
Genetics
• 30% chance an ADHD child has at least one
parent with ADHD.
Brain scans
ADHD brains
• Abnormal functioning of neurotransmitters
ADHD brains
• Abnormal functioning of neurotransmitters
• Abnormal functioning of nerve pathways
ADHD brains
• Abnormal functioning of neurotransmitters
• Abnormal functioning of nerve pathways
• Some parts of the brain smaller and less
active.
The dopamine connection
• Some ADHD cases show a particular variation
of the DRD4 gene – associated with a
dopamine receptor
• Not all had the variation, those who did
generally had higher IQ scores than other
ADHD children.
• Those with the variation more likely to
outgrow or show improvement as adults.
ADHD as an adult
• Sluggish dopamine system.
• Explains why stimulant ADHD meds are
beneficial.
• Stimulant meds increase dopamine by
strengthening the weak dopamine signals in
the brain.
• Drugs of abuse, including nicotine and
cocaine, temporarily increase dopamine
activity.
The connection
• Strong connection between ADHD, drug abuse
and alcoholism.
The connection
• Strong connection between ADHD, drug abuse
and alcoholism.
• ADHD 5 to 10 times more common in adult
alcoholics than in people without the
condition.
The connection
• Strong connection between ADHD, drug abuse
and alcoholism.
• ADHD 5 to 10 times more common in adult
alcoholics than in people without the
condition.
• Among people in treatment, ADHD rate is
about 25%.
Why the connection?
• Self medication.
Why the connection?
• Self medication.
• “In our study of young adults, only 30 percent
said they used substances to get high. Seventy
percent are doing it to improve their mood, to
sleep better, or for other reasons” Dr. Timothy
Wilens, associate professor of psychiatry,
Harvard Medical School.
Self Medication with undiagnosed
• “When people with ADHD get older, they
hyperactive component often diminishes. But
inside, they’re just as hyper as ever. They need
something to calm their brain enough to be
productive.” Dr. William Dodson, ADHD
specialist in Denver
Treatment considerations
• Treat ADHD as other co-occurring disorder
• Simultaneous treatment for both needed to
maximize chances of ongoing recovery.
An example of a treatment program
An example of a treatment program
• Profession evaluation for ADHD and cooccurring addiction
An example of a treatment program
• Profession evaluation for ADHD and cooccurring addiction
• Continuing involvement in addiction recovery
groups
An example of a treatment program
• Profession evaluation for ADHD and cooccurring addiction
• Continuing involvement in addiction recovery
groups
• Education on how ADHD impacts the person
An example of a treatment program
• Profession evaluation for ADHD and cooccurring addiction
• Continuing involvement in addiction recovery
groups
• Education on how ADHD impacts the person
• Building social, organization, communication,
and work or school kills.
An example of a treatment program
• Profession evaluation for ADHD and cooccurring addiction
• Continuing involvement in addiction recovery
groups
• Education on how ADHD impacts the person
• Building social, organization, communication,
and work or school kills.
• ADHD coaching and support groups.
• Closely monitored medication when
medication is indicated.
• Closely monitored medication when
medication is indicated.
• Support for client’s decision to medicate or
not.
Stages of recovery
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Pre-Recovery
Early Recovery
Middle Recovery
Long Term Recovery
Medication and Addiction
• Psychostimulant medication, when properly
prescribed and monitored is effective for 7580% of persons with ADHD.
• Dosage levels are much lower than
intoxication or “high” levels.
• Relapse rates for those taking meds as
prescribed and monitored are significantly
lower than those with untreated ADHD
10 problems that could mean adult
ADHD
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1. Difficulty getting organized
2. Reckless driving and traffic accidents
3. Marital difficulties
4. Extreme distractibility
5. Poor listening skills
6. Restlessness, difficulty relaxing
7. Difficulty starting a task
• 8. Chronic lateness
• 9. Angry outbursts
• 10. Prioritizing issues
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Robert Proehl, M.Ed., LADC
Therapist Manager, The Referral Center
[email protected]
405-525-2525 ext. 125