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Attention Deficient Hyperactivity Disorder, or ADHD, is a condition that affects approximately eight percent of children in the United States. Most commonly identified in childhood, this condition is the most common neurobehavioral disorder diagnosed in today's youth. ADHD is marked by three groups of symptoms. The first group is hyperactivity which can express itself in the child with frequent fidgeting, excessive talking, and/or difficulty playing quietly or staying in one place. The second group of symptoms is impulsivity. This lack of impulse control makes it hard for the child to wait their turn to speak or stand in line. The third group is inattentiveness which shows in a lack of organizational skills and an inability to focus. Most people with ADHD exhibit signs of each of these characteristics to varying degrees. Now ADHD is believed to be an early indicator of a child's potential to abuse illicit substances such as tobacco, alcohol, or drugs later in life. Children with this disorder will frequently have trouble focusing on one topic or activity and will instead move from one unfinished task to next without making much progress. How ADHD affects a person varies greatly depending upon the individual's particular set of symptoms and life circumstances. Diagnosis of the condition can be made in some people before they enter preschool but others may enter adulthood without knowing that they have the disorder. For some people, symptoms appear to fade over time while others will continue to experience signs for the rest of their lives. A number of recent studies have indicated a correlation between ADHD in children and substance abuse issues in their teen years and beyond. One such study in The Journal of the American Academy of Child and Adolescent Psychiatry shows that children with ADHD are more likely to struggle with substance abuse and addiction issues as they get older then their non-ADHD counterparts. According to the study, 35 percent of teens with this disorder have already used at least one substance by an average age of 15 years old, compared with only 20 percent of the general population who have used substances by that age. Not surprisingly, a larger percentage of teens with ADHD, 13 percent, went on to experience substance abuse or dependency as compared to only seven percent of peers without the condition. The website, http://pediatrics.aappublications.org breaks the findings of this study down further into specific substances. It states that children with ADHD are twice as likely to use nicotine in their lifetime and three times more likely to become dependent on nicotine as a teenager or adult when compared to the overall societal norms. They are also twice as likely to meet the criteria for alcohol dependence or cocaine abuse or dependence in their lifetime than the general population. Additionally, the study shows that they are one-and-a-half times more likely to meet the criteria for marijuana use disorder than people who don't have ADHD. The increased chance of substance abuse doesn't necessarily end once the period of adolescence is over, either. According to WebMD.com, roughly one in every four adults in treatment for alcoholism also has ADHD. It is fairly common for sufferers of this disorder to be treated with stimulant medications such as Ritalin or Adderall. These drugs work by raising the levels of dopamine within the brain, improving the individual's ability to focus and pay more attention to what they are doing. These stimulant drugs work in the brain in much the same way that street drugs like cocaine or methamphetamine do and they can become very addictive, especially if taken at higher levels than prescribed. This is because not only do higher levels of dopamine increase focus, they can also cause a pleasurable sensation in the user that generates a drive to keep using regardless of the consequences. There are also reported incidents of people who don't have ADHD abusing stimulant medications for recreational purposes. Because of this known misuse of ADHD medication, an argument has been made that the connection between childhood ADHD and teenage substance abuse is the result of this method of treatment. It has been hypothesized that taking these medications as children may trigger a reliance on mood-altering medications that could explain the increase in substance abuse in children with ADHD. Though the addictive quality of these medications do make them seem like a logical cause of future substance abuse in children with ADHD, additional studies have shown that this is not the case and that, in fact, just the opposite is true. WebMD states that, "Stimulant use might protect against later drug abuse and alcoholism in children with ADHD by relieving ADHD symptoms that often lead to substance abuse problems." Researchers came to this conclusion after discovering that the earlier a child was put on stimulant medication the lower the chances of that child developing substance abuse patterns later on in life. This seems to indicate that the inclination to experiment with drugs comes from the symptoms of the disorder and not the common methods of treatment. The symptoms of ADHD – inattention, impulsivity, and hyperactivity – are behavioral characteristics that predict substance abuse, even in individuals not suffering from ADHD. According to www.help4adhd.org, "Conduct problems such as lying, stealing, and skipping school are more common among children with ADHD and also contribute to the development of substance use." Furthermore, the symptoms of ADHD lend themselves to the development of problems in school, at home, or with their friends and these difficulties often indicate an increased probability of a person abusing substances. Don Kerson, M.D. is a psychiatrist specializing in treatments for adults with ADHD. He says, "Adults with ADHD are impulsive, and when you don't feel good about yourself you're quick to act on the impulse to feel better, even if that impulse is a dangerous one." He believes that the key to avoiding substance abuse issues is modifying the way that the child with ADHD views themselves and thereby avoid the impulse to self- medicate. He states that by learning to be more lenient with themselves when things go wrong and learning to see themselves as capable people instead of people limited by a neurobehavioral disorder, they can raise their level of self-esteem to the point where the urge to use illicit substances disappears. Other esteem-building activities include sharing successes with others and keeping a record of accomplishments made and compliments received to review in moments of self-doubt. Both ADHD and alcoholism run in families, with children of alcoholics who have ADHD even more likely to become alcoholics themselves than children with ADHD whose parents can control their drinking. Another reason why children with ADHD may turn to drug use is that certain street drugs can initially seem to help overcome or mask the symptoms of ADHD. This makes using them more appealing to sufferers of the condition, particularly those who have never been properly treated by a physician and are now trying to medicate themselves with street narcotics. The initial positive effects of taking the drugs will disappear in time but the dependence toward the drugs will remain. A diagnosis of ADHD does not mean that your child will develop a substance abuse problem, just like a child without ADHD is not guaranteed to avoid developing a dependence on alcohol, tobacco, or drugs. For those teens that do develop substance abuse problems, it is possible to overcome dependency issues. Physicians assisting patients with substance abuse problems will typically prescribe antidepressants or non- stimulant medication as a form of treatment. Therapy is frequently recommended as a means of recovery, be it group therapy, such as a 12-step support group, or one-on- one therapy with a counselor or psychologist. accessHealthNews.net PAGE 04 By Regina Creason

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