Each year it seems that more and more children are showing symptoms of an attentional disorder (ie: ADHD) and/or impulse control issues. As a result, over the past decade we have witnessed a sharp increase in the prescription of medications by physicians to children who present with these problems. Sadly, there are still even more children who go untreated.
A number of red flags should be raised whenever a physician suggests medications be prescribed to children experiencing these difficulties. Questions include: ‘Was the diagnosis complete and proper?’ and ‘Does my child really need medication(s)?’ What are the benefits of taking the medication? What are the potential side effects? What is the treatment plan and is it realistic? Is there an increased risk of future substance abuse?
Generally, when prescription psychostimulant medication is taken properly there is little indication that it will lead to future substance abuse. However, in the past 15 years, there has been a nationwide concern over the misuse of prescription psychostimulant medications and the rates of substance abuse among those suffering from an attentional disorder. Those suffering from attentional and impulse control problems are more at risk for adolescent substance abuse.
Developmentally, adolescents and young adults tend to exhibit increases in their risk-taking behaviors at the same time that parental supervision begins to decline (as your child ages your involvement in their daily lives continually diminishes). Those who have less control of their impulses are more vulnerable to developing a substance abuse problem. Some studies indicate that elementary school age children who are prescribed psychostimulant medication have a much lower rate of future substance abuse than those who are first prescribed medication in high school or college.
Surveys indicate that most college students who use and misuse psychostimulants do so for the increased attentional effects rather than for “getting high.” However, those students who are “at-risk” because of underlying attentional or impulse difficulties are also more vulnerable for developing a substance abuse problem.
Those who suffer from ADHD and never receive proper treatment are much more likely to also be diagnosed with substance use disorder than those who were diagnosed with ADHD and received proper treatment and those with no diagnosis of ADHD. It was found that alcohol was the biggest problem drug followed by marijuana, tobacco (cigarette smoking) and cocaine.
Children who exhibit signs of attentional or impulse problems need to be properly evaluated as early as possible. Not only is it more effective to treat children earlier rather than later, as the studies show, there is also less of a chance that the “at-risk” child will develop a substance abuse problem.
Glass, K.; Flory, K. (2011) Are symptoms of ADHD related to substance use among college students? Psychology of Addictive Behaviors, Jun 6, 2011.
Kevin M. King, K., Fleming, C.B., Monahan, K.C, & Catalano, R.F. (2011) Changes in Self-Control Problems and Attention Problems During Middle School Predict Alcohol, Tobacco, and Marijuana Use During High School Psychology of Addictive Behaviors, Vol. 25, No. 1, 69-79
Kollins, S.H. (2008) A qualitative review of issues arising in the use of psychostimulant medications in patients with ADHD and co-morbid substance use disorders. Current Medical Research and Opinion, Vol 24(5), 2008. pp. 1345-1357.
Kollins, S.H (2008) ADHD, Substance Use Disorders, andPsychostimulant Treatment Current Literature and Treatment Guidelines, Journal of Attention Disorders, Volume 12 Number 2, pp 115-125
Peterkin, A.L.; Crone, C.C.; Sheridan, M.J.; Wise, T.N.(2001) Cognitive performance enhancement. Misuse or self treatment? Journal of Attention Disorders, Vol 15(4), May, 2011. pp. 263-268