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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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  #1  
Old 10-16-05, 04:08 PM
onemoreyear onemoreyear is offline
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My Take on ADHD Medication Addiction

Hi all...so one of the most frequent posts I've seen in this forum, the medication forum, and others is concern over ADD meds being addictive...

Well, my answer is YES with an if and NO with a but:

I don't believe that ADD meds are chemically addictive. I have taken Ritalin, Adderall, Dexedrine, and Strattera. I have also taken Paxil (which has terrible withdrawal symptoms!)

Here's the NO part: Paxil is what you would class as "chemically addictive" because it creates a physical dependency and you build up a tolerance. If you try to stop it abruptly, there are horrible withdrawal symptoms.

I think that most people who take ADD meds would agree that they take them as LITTLE as possible, and when they stop taking them, they feel better! No muscle aches, no tremors, no insomnia. Most ADD students I know take every possible opportunity to avoid taking their meds--over summer and on the weekends, they will avoid them like the plague! And never once have I felt that if I didn't have my Adderall, I would die...

On the other hand (here's the YES) they are addicitive in the sense that the anxiety someone can feel before they are diagnosed and medicated for ADD can be so intense that they can't imagine school, work, intimacy, long conversations, etc. without them! (This is me.) I wouldn't say I'm addicted to Adderall, but if I have to sit through a class without it, I freak out!
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Old 10-16-05, 04:14 PM
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scuro scuro is offline
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Seems like addiction and tolerance are current issues on the board again. Time to post a link to a past thread where this was hashed out.

http://www.addforums.com/forums/showthread.php?t=17742
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Old 10-16-05, 06:20 PM
mctavish23 mctavish23 is offline
 

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Please read the 3 studies covering 13 years that show the use of ANY stimulant can reduce the risk of Substance Use Disorder by up to 85%.

It's contained within the link posted by scuro or at the now closed Adderall omg thread.
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Old 10-16-05, 06:57 PM
Hyperion Hyperion is offline
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Part of the problem is that there is no universal definition of "addiction," or any universal means of distinguishing between physical addiction or psychological dependence. And of course, one must add to this the fact that the "addictive" effects of every drug are different...for instance, benzodiazepines cause less compulsion towards continuous use than, say, cocaine, but have the most physically extreme withdrawal symptoms of any commonly used class of drugs. Ditto with SSRIs, which have no recreational value but similarly extreme withdrawal effects. On the other hand, cocaine has little physical withdrawal effects, yet produces almost immediate compulsion towards continuous use.

And, of course, individual neurology comes into play, such as the fact that many people with ADD are physically incapable of getting "high" off of amphetamines, or the fact that some people are genetically incapable of using alcohol without becoming addicted.

In short, addiction, like all issues in neuropharmacology, really is as complicated as brain surgery. This really shouldn't come as any surprise if you sit down and think about it for a second, but many people, including most politicians, seem completely ignorant of this fact, and treat the subject as if anyone with a high school diploma ought to be able to figure it out.
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Old 10-16-05, 08:56 PM
mctavish23 mctavish23 is offline
 

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My point is that using (any) stimulant to treat ADHD, reduces the likelihood of SUD (which is operationally defined in those studies).

The medications in and of themselves are not the problem.

It's whether they're misused or not.
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Old 10-16-05, 09:19 PM
Ann74 Ann74 is offline
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Due to medical problems, I'm not taking any meds right now. When the Dr. told me to stop, I thought I was going to cry. I was wondering how I was going to get anything accomplished. I had no physcial side effects, but I walk around feeling like I'm useless. Psychological I guess?
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Old 10-16-05, 10:12 PM
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Excellent post, Hyperion. When you look in the DSM many disorders are addiction disorders to a whole host of substances. I guess there are some people in this world who are genetically inclined to easily become addicted to certain substances. A lot of people don't know that.
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Old 10-16-05, 11:45 PM
Hyperion Hyperion is offline
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Quote:
My point is that using (any) stimulant to treat ADHD, reduces the likelihood of SUD (which is operationally defined in those studies).
Oh, no, I was responding the original poster, regarding the difficulty in defining the addictiveness of ADD medications compared to other drugs. Substance abuse is obviously a completely separate issue from addiction, and I definitely agree that treating ADD with stims will reduce substance abuse.

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I guess there are some people in this world who are genetically inclined to easily become addicted to certain substances.
Yup, but this raises an important philosophical question: Is it morally and legally acceptable to jail people based on an addiction if that addiction is due to genetic factors, and more importantly, does having different penalties for different types of addiction constitute genetic discrimination, in that a person who is genetically susceptible to alcohol addiction is punished far more lightly than someone genetically predisposed to a marijuana or cocaine addiction?

And of course, there's the far bigger and more politically touchy question of whether dealing with addiction as a criminal problem makes any sense whatsoever from a medical perspective, since we no longer treat other psychiatric disorders with imprisonment, although we did at one point.
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Old 10-17-05, 08:18 AM
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UnleashTheHound UnleashTheHound is offline
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Yup, but this raises an important philosophical question: Is it morally and legally acceptable to jail people based on an addiction if that addiction is due to genetic factors, and more importantly, does having different penalties for different types of addiction constitute genetic discrimination, in that a person who is genetically susceptible to alcohol addiction is punished far more lightly than someone genetically predisposed to a marijuana or cocaine addiction?
I guess you'd have to prove the genetic part first. I know the laws in this area aren't always exactly fair or logical, but generally the addict is a problem for society. Often they resort to theft to support their addiction. They can be a drain on social services. They support underground drug trafficking which brings all kinds of problems. I'm speaking generally, because I know you can always point to some weekend user who was in the wrong place at the wrong time.

So anyway it seems clear to me that something needs to be done more than just excusing the problem. But that brings me to the next part...

Quote:
And of course, there's the far bigger and more politically touchy question of whether dealing with addiction as a criminal problem makes any sense whatsoever from a medical perspective, since we no longer treat other psychiatric disorders with imprisonment, although we did at one point.
I would look at the desired end result. That would be fewer addicts on the street. If you can successfully rehabilite them, then that seems to be infinately preferable to jail. Incarceration is expensive. If you could turn these people into productive citizens then that's one more person paying taxes instead of draining the treasury. However, if they continually relapse then jail might be the only option. My two cents.
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Old 10-17-05, 01:41 PM
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I don't think you could become addicted if you take the right med and the right dose of it... That just my opinion.
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Old 10-18-05, 09:48 AM
dbr2 dbr2 is offline
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What do y'all think about what this doc says :

http://www.adders.org/info28.htm

Thanks.

DBR

Last edited by dbr2; 10-18-05 at 09:49 AM.. Reason: to corect spelling
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Old 10-19-05, 01:57 PM
Hyperion Hyperion is offline
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It's good information. Very simplified, of course, but the simplification is well done. One shouldn't use it as a textbook, of course, but as a simplified description that might help a layperson get a better idea of how ADD and meds work, it's very well done.
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Old 10-21-05, 11:17 AM
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Quote:
Originally Posted by Hyperion
Part of the problem is that there is no universal definition of "addiction," or any universal means of distinguishing between physical addiction or psychological dependence.
Addiction and dependence are two very different conditions and can clearly be distinguished from eachother universally. We know the function of addiction as well as the avenue of development. Addiction necessitates abuse, not the other way around. The use of any substance, whether natural or synthesized, that evokes change in the chemical balance of the body can be considered an addiction risk in anyone. The moment that a person abuses a substance, that person is admitting dependence. When the priority of the dependence supplants rational thought and logic the person has developed an addiction. An "addicted" person will continue to use even though the person knows they are doing harm to themselves. This is an action of the reward center in the brain. The most primitive area, also the most vital; the reward center operates on the ultimate 50/50. The center sends a signal of 'If you dont use, you will die' to the cognitive area of the brain where the decision (to live or die) is made.

Dependence does not always involve abuse and often times will affect the most morally respected individuals the greatest. Dependence is also very relative to the individual; The discrimination between the two personalities (before/after) can be subtle or very profound. The condition arises when a noticeable shift in perspective occurs and the shift can be attributed to a specific positive event. The fact that the event must remain positive is the most definitive separation between addiction and dependence. This raises the question, is dependence an early form of addiction? It is true that addicts are dependent on being addicted, but not every dependency becomes addiction. Likewise, a person pre-disposed to addiction will not necessarily be dependent before being addicted.

The variable is the cause of the condition which, given the diversity of mankind, is selectively unique. This applied to society has revealed that persons with ADD/ADHD tend to be more prone to develop dependence and/or addiction at some point in their life. Simply put, the message of reasoning in an impaired mind runs out of momentum and the mind defaults to the active thought of use. This is essentially impulse; all too common a symptom of many mental disorders including ADD/ADHD.

The application of a substance designed to potentiate thought and reason is a common and often effective treatment option. Because the intended results of the treatment often include behavioral changes, the positive effects on mood and focus become necessary for normal operation. As long as the ADHD patient, taking prescription medication, stays within the limits established by the prescribing doctor; The person will not develop addiction. Though dependency is far more probable as the benefits manifest themselves, the risk of addiction still exists as the choice to abuse remains.

Addiction also has symptoms akin to ADHD like depression and low self-esteem. Thus an improper inference is often made; Assumptions about the addictive qualities of most medications cause confusion and cloud better understanding of treatment. In theory, ADHD medication should help prevent and cure addiction in ADHD individuals, where the opposite would be true of non-ADHD individuals taking the same medication. Only your doctor can decide what medication is best for you.

Withdrawl is a result or consequence of addiction and conditional to the presence of addiction. It can never be the cause of addiction. The brain creates an antidote for every chemical ingested in an attempt to maintain its balance. As the prolonged use of a substance continues the body becomes tolerant and more of the substance is needed to produce the same effect. As the dose rises, over time the brain will change production of the affected natural substances. If the external supply stops the brain not only has a deficit but also attempts to balance the supply. Since changing production rates takes time the symptoms of the withdrawl surface for that time and vary based on the action of the original medication. Withdrawl is temporary, but can be very dangerous or life threatening depending on the severity of symptoms.

Relapse is a natural, often necessary process of addiction. It can be potentiated by withdrawl but will never be the cause of addiction. Because relapse and withdrawl are more commonly associated with recovery, discussion of these topics would be appropriate on a different thread.
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