3 Why you Should Consider ADHD Alternative Treatments: Abuse of Medication for ADHD is Growing Among High School and College Students for Performance Enhancement aka “Steroids for SATs” & “Study Drugs”

Wow, have things changed in the world of medication for ADHD!  According to Webmd.com a study published in Pediatrics reported that calls from 1998 to 2005 for abuse of ADHD meds among 13 to 19 year olds rose by 76%.¹  They note that this is rate of increase that is “faster than calls for victims for substance abuse generally and teen substance abuse.” ¹ This is cause to pause and reflect.  

I am stunned that the increase of the rate of say, Concerta abuse and other ADHD drug abuse has surpassed alcohol and pot,  and substance abuse generally in the rate of increase, among teens from 13 to 19 at least among calls to poison control centers.  It is really amazing and sad to consider that ADHD drug abuse is now rivaling pot and alcohol abuse among teens.  In later posts I will discuss the reality that the increased use ADHD medications across the world is one of the major contributing factors.  Yet, this is more than sad.  It creates a much more complicated reality when you consider using ADHD medications to treat your child.  I do not have the sense that parents are aware of these facts. 

Today I am writing about how urgent and important it is that parents to consider what some have called “natural remedies for ADHD.”   More broadly I would describe these as alternative treatments of ADD and ADHD. 

Attention Deficit Hyperactivity Disorder (ADHD) commonly called ‘attention deficit’ is typically treated with medications.  This form of treatment is on the rise, but it creates a whole slew of other problems, problems that don’t exist with non-medication ADHD alternative treatment. 

The issue, in my mind, is how do you utilize ADHD treatment medications in the short term while finding better long term solutions?

Today we will consider one of the slew or problems created by using medication for ADHD:  the abuse of ADHD meds by students who don’t have a diagnosis of ADHD.   

One way to answer the question of how to use ADHD medication effectively is to thoughtfully consider the age of the student.  ADD or ADHD medications may be more effectively used in the short term especially with younger kids, but you get into all kinds of thorny issues in adolescence if you continue to treat teens with ADHD medicines.  Many of these problems might be successfully avoided if you prepare and thoroughly investigate other ADHD treatment options earlier while possibly using ADHD treatment drugs as a short-term or stop gap measure.    

In high school and college your children if treated with ADHD medicines will have a controlled substance in their possession or at least accessible to them that their friends and/or classmates will want to abuse.  It puts your child in a precarious position to say the least. 

There is a market in which high school and college kids are buying and selling prescription stimulants illegally.  That’s right, those ADHD treatment Drugs are going to kids without prescriptions and that is dangerous.   What if they get the ADHD medicine from your son?  You really don’t want that to be on your plate if you can avoid it. 

So as your son or daughter turns 10 or 11 years old and you are using an ADHD medicine to treat his ADHD or ADD you need to consider that in 3 or 4 years he will be in school with many other kids that will be abusing that same drug that you give him every day.  In essence he will have a product and a market….  So it would be wise to consider and actually try other options when you child is this age. 

If you continue to use medication to treat ADHD once your child is a teen, he will be tempted to sell it or give it to other kids who use it to study, write a papers, etc.  Yet, this is illegal for him and the kids who abuse these drugs without a prescription.  Your role might be considered as contributing to this crime.  Besides, it is dangerous. 

So, as a short-term solution for children from ages 7 through 10 or 11 medications may fit your child.  However I believe you should also consider other options during this time to find other things that work.  When your child hits his or her teenage years, as you know, everything changes. 

For teenagers the temptation to sell these ADHD drugs to other teens should make you pause and consider this issue.  At minimal you have to seriously contemplate the security of your distribution of ADHD medication to your own child.  This is not something most parents of 7, 8, 9, 10 or 11 year olds consider. 

For example, like nurses at residential facilities,  you have to check your teens’ mouth and have him lift his tongue with his mouth open to make sure the medication has been swallowed, or be as sure as you can be.  The problem with this is that many teens will ‘cheek’ meds.  So they will hide the ADHD meds either in their cheek or under their tongue.  Yes, this really happens. I have worked in residential facilities where this happened.  The meds really have to be placed under lock and key.  I realize that this all sounds intense and possibly overblown, but given that there is a market for these drugs you need to consider it seriously.  So, now you see that this is one of the more serious reasons other treatments for ADHD should be considered and tried before your son or daughter is a teen. 

Realize that I am talking about those teens who abuse it for performance reasons today.  So, the irony here is that if you have a teen that is very competitive and wants to get into the best schools he or she will have friends like that.  Those kids are very tempted to use ADHD medications to give them an edge on tests, papers and standardized tests.  So, the irony is that if you have a “good kid” he still will be tempted by this issue as will his friends.

What other options are there?  I will consider this more thoroughly in later posts. 

However, if you remain unconvinced consider this. 

The core of my own concern with my son in 2005 was where would the medicating of him end, in college, in adulthood? When, ever?  What is the effect of medicating kids from 7 to 17, 7 to 22?  Do we know?  (We still don’t know, by the way.)

Other concerns included:  what will he think about himself if he feels the need to pop a pill to pay attention?  Since the ability to attend wears off with the meds is this really a solution for increasing attention at all?  How effective will this really be?  I was skeptical and the data supports my concerns as you will see in coming posts. 

My other concern in 2005 was that other kids will start abusing these drugs and do I want to put my son in the situation in which other kids want to get this drug from him?  No. 

It was not because I don’t trust my son.  It is because one primary dysfunction of kids with ADHD is that they act impulsively – without thinking.  I used to explain it this way.  Take a kid with ADHD who loves chocolate chip cookies and put a jar of chocolate cookies in front of him.  Then tell him you will leave the room.  If he can manage to not eat any cookies while you are gone you will give him the whole jar.  You leave the room.  He takes a cookie. He doesn’t get the jar.  He can’t stop and think. 

Stopping and thinking, or a lack thereof, is at the core of the problem of ADHD.  By giving them access to a drug which now has a thriving market you place a tremendous temptation in the hands of those who are significantly limited in their ability to resist such temptation, think very big cookie jar, but in a very small pill bottle that is very easy to conceal. 

Not going there.  I’ve seen other kids end up there. I saw it coming.  Don’t even want to get near the entrance.  On this one what the studies say as far as how many admit to selling or giving away the drug doesn’t even matter to me as a father. I am simply not going to put my son in that place, end of story. 

Stanislav Svetlov, et al (2007) use a particularly apt term:  “Steroids for SATs” in their article “Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine.”  Candidly Svetlov et al (2007) note that the “Psychotropic effects and pharmacological pathways evoked by MPH (methylphenidate – Ritalin^TM) are similar, but not identical to those produced by amphetamines and cocaine.” ² 

That is the appeal: “performance enhancing”. 

A comparison with amphetamines and cocaine just sounds disturbing.

Arguably, it is this ‘similarity’ of effect of cocaine to ADHD drugs which creates the appeal of ADHD meds:  the focus, the energy and depending upon the circumstances, the high. 

Additionally ADHD medicines can be addictive (we will consider that in more detail when we consider side effects).  The way that a person ingests ADHD medicines and the dosages matter in terms of creating higher risk for addictiveness and other negative side effects.  When the ADHD meds are prescribed by a  physician he or she provides oversight on these issues.  Not so with kids abusing these drugs. 

Another difference between Ritalin or Adderall or most ADHD medicines in contrast to illegal drugs is that there is the common assumption that since this isn’t cocaine and it is prescribed by doctors, that it cannot be a problem. It must be much safer since doctors prescribe ADHD medications for kids all the time, or so the thinking goes. Well that thinking is not correct.  As a matter of fact it is because there are risks of adverse side effects and addiction that these prescriptions drugs are monitored by physicians. 

One wonders about the relationship of the professional approval of ADHD drugs to what is clearly a trend of increasing ADHD drug abuse on  campuses. 

Many researchers like Stanislav et al have found that (2007) ¹:   “MPH and similar medications have been widely used on College campuses and by students preparing for exams. Nicknamed ‘steroids for SATs,’ MPH and related medications are purchased without prescription and their use may even be encouraged by parents and tutors…. Use by those without any medical or psychiatric diagnosis is increasing.”

This is the key point for parents:  ADHD/ADD medications are “widely used on College campuses” by people without a prescription, without a diagnosis and that abuse is very much on the rise.  There are a series of studies that have found this trend of ADHD medication abuse. 

Then as a parent you are presented with the fact that on college campuses the abuse of ADHD medications is very much on the rise.  Yet your son or daughter who will be away at college will likely be out from under your daily supervision at college.  What to do then?  Well, preferably you sought out other options before your child with ADHD goes off to college.  This issue takes on new importance with adult ADD and adult ADHD, especially if those adults are your college students taking ADHD meds just out of your supervision for the first time. 

Parents: The Unwitting Distributers of Controlled Substances?

How are those on college campuses getting Ritalin without a prescription? 

Two ways: 

1.  Those kids who are diagnosed and prescribed the ADHD drugs are selling it.
2. People are stealing prescriptions and selling them.

Either way, is this a situation you want to be contemplating in high school as you prepare your child to go to college?

As I noted earlier I found what I consider to be a better long term strategy to address the problem of inattention:  Cogmed.  Note that I did not say a solution to the problem of ADHD or ADD.  ADHD also includes hyperactivity and Cogmed has had impact on this area, but it is not as well established and consistent as its impact on attention.  So, Cogmed does not make this claim.  Nor does Cogmed make the claim that it ‘cures’ ADD.  Such claims are easy to assault.  Cogmed makes the claim, supported by placebo controlled, double blind studies that have found 80% of its users have improved significantly in working memory and working memory is related to attention.    So attention is improved as well.  Get the logic?  The key here is that Cogmed is an alternative which may be included with ADHD medicine or not, but it is a viable, reasonable and comparatively financially appealing alternative. 

Cogmed is not a drug. It is not a controlled substance.  Cogmed’s results compel you to complete their program to improve how your working memory functions.  Doing the Cogmed program requires work and effort.  It affects brain functioning.  As such, people who use this program also make the connection that effort and work affect their ability to pay attention instead of simply popping a pill.  However, this work and effort involve doing this very specific set of activities that they discovered through thorough research.  This is very noteworthy.  It is not simply work and effort on anything that will address this issue.  Again, Cogmed is careful not to claim to replace medication for ADHD or to be a cure for ADHD.  However, it is an alternative and you may or may not have a child taking ADHD medications as well doing Cogmed at the same time.  It is an alternative you should seriously consider. 

Go to my website:  www.charlesshinaver.com to learn more about Cogmed. 

The kids who abuse ADHD medicines for performance enhancement is just one group of ADHD medication abusers.  There is another group of kids that abuse these drugs.

To learn more about them see my next blog post……

1 (Aug. 24, 2009) Warner, Jennifer “ADHD Drug Abuse Rising Among Teens” Study Shows Increase in Calls to Poison Control Centers Related to ADHD Drugs. http://www.webmd.com/add-adhd/news/20090824/adhd-drug-abuse-rising-among-teens

2Performance enhancing, non-prescription use of Ritalin: A comparison with amphetamines and cocaine. Svetlov, Stanislav I.; Kobeissy, Firas H.; Gold, Mark S. Journal of Addictive Diseases. Vol 26(4),2007, 1-6.

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