Drug rehab centers put a number of guidelines in place to ensure the safety of their patients, many of which are challenged by recovering addicts looking for as much normalcy and comfort as possible during the difficult early stages of recovery. One of the most frequently asked questions is: Why no Adderall to treat my ADHD during treatment?
An Addictive Drug for a High-Risk Population
It is well-established that people with ADHD are at increased risk of drug and alcohol problems. While ADHD affects 3 to 5 percent of the population, the rate of substance abuse among those with ADHD is between 10 and 30 percent. Poor impulse control, learning and academic difficulties, social isolation, and low self-esteem – all problems common among people with ADHD – are strongly correlated with substance abuse.
Adderall is one of the most commonly prescribed medications to treat ADHD. It has been classified by the Drug Enforcement Administration as a Schedule II drug, which means that like many of the stimulants used to treat ADHD, it has a high potential for abuse. The drug affects the same areas of the brain as cocaine, methamphetamine and other illicit stimulants. During rehab, there is a significant risk that taking a prescription stimulant like Adderall may trigger drug cravings that lead to relapse.
Alternative ADHD Treatments for Addicts
Although Adderall is not advisable as a first-line treatment of ADHD during drug rehab, there’s no question that ADHD symptoms must be addressed. Many addicts begin abusing cocaine, methamphetamine and other drugs to self-medicate their ADHD. Like other dual diagnoses, someone who struggles with both ADHD and addiction must receive integrated treatment for both conditions simultaneously. Untreated ADHD can trigger relapse, and untreated addiction may worsen ADHD symptoms.
So how do we keep addicts with ADHD as safe as possible? By finding alternatives to addictive stimulants like Adderall.
If we don’t stop the use of Adderall, we cannot accurately assess the severity of the patient’s ADHD or other psychiatric conditions. Many people who think their ADHD can only be managed with Adderall find that when they stop drinking alcohol, smoking pot or abusing other drugs, their ADHD isn’t as unmanageable as they thought.
If a patient is still experiencing ADHD symptoms after coming off medications and other drugs, in many cases there are non-addictive treatments that can effectively manage their condition. Atomoxetine (Strattera), for example, does not have the addiction or diversion potential of medications like Adderall and has been effective for many people with ADHD.
Another way to avoid medications that trigger drug cravings is through the use of alternative medicine. Neurofeedback, for example, helps re-regulate brain waves, improving relaxation and focus so the individual is less hyperactive and more attentive. Addicts with ADHD may also benefit from acupuncture, meditation, massage, nutritional therapy, cognitive-behavioral therapy, self-help support groups and exercise.
Given the close link between ADHD and addiction, treatment of ADHD during drug rehab requires first intervening in ways that will not create more problems than they treat. Very few people with ADHD will get addicted to their medication. But they are more vulnerable to addiction than others, and for those who are receiving treatment for addictions to other drugs, the risks outweigh the benefits.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. Dr. Sack currently serves as CEO of Elements Behavioral Health, a network of addiction treatment centers that includes Promises Treatment Centers, The Ranch, Sexual Recovery Institute, The Recovery Place, Right Step, Promises Austin, Lucida, Journey, Sundance, and Clarity Way.
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Last reviewed: 7 Jul 2014