New to ADHD - share your lessons learned

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Citation?

I'm not the PP who wrote that but I know from experience-- from seeing family members who destroyed their own lives from self medication with drugs and alcohol.
Since then, I've found many articles that confirm that. It's not just one source.
We decided to medicate because we wanted our kid to understand that there are productive and regulated ways of helping yourself. Bottom line is that you are going to seek what will help your brain.

The FDA censured several drug companies for claiming that their ADHD drug prevented substance abuse. I don't think the science is there. It is fine to talk about how the meds seem to work for your kid, but pretty execrable to claim that not using meds is going to turn your kid into a drug addict.

Right, and that's why the statement says:

Kids who don't take meds are more likely to self-medicate with drugs and alcohol.

"More likely" does not mean that not using meds is going to turn your kid into a drug addict

Having a high cholesterol diet will put you at greater risk of having a heart attack. It does not mean that eating red meat will make you have a heart attack.

Show me the evidence on that. The FdA doesn't appear to believe that is true.

And I mean show me studies where the authors do not get paid by the pharmaceutical industry ...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Citation?

I'm not the PP who wrote that but I know from experience-- from seeing family members who destroyed their own lives from self medication with drugs and alcohol.
Since then, I've found many articles that confirm that. It's not just one source.
We decided to medicate because we wanted our kid to understand that there are productive and regulated ways of helping yourself. Bottom line is that you are going to seek what will help your brain.

The FDA censured several drug companies for claiming that their ADHD drug prevented substance abuse. I don't think the science is there. It is fine to talk about how the meds seem to work for your kid, but pretty execrable to claim that not using meds is going to turn your kid into a drug addict.

Right, and that's why the statement says:

Kids who don't take meds are more likely to self-medicate with drugs and alcohol.

"More likely" does not mean that not using meds is going to turn your kid into a drug addict

Having a high cholesterol diet will put you at greater risk of having a heart attack. It does not mean that eating red meat will make you have a heart attack.

Show me the evidence on that. The FdA doesn't appear to believe that is true.

And I mean show me studies where the authors do not get paid by the pharmaceutical industry ...

Katusic SK, Barbaresi WJ, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Psychomotor stimulant treatment and risk for substance abuse among young adults with a history of attention-deficit/hyperactivity disorder: a population-based, birth cohort study. J Child Adolesc Psychopharmacol (2005) 15:764–76. doi:10.1089/cap.2005.15.764


Wilens TE, Faraone SV, Biederman J, Gunawardene S. Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics (2003) 111:179–85. doi:10.1542/peds.111.1.179

Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood – a naturalistic long-term follow-up study. Addict Behav (2014) 39:325–8. doi:10.1016/j.addbeh.2013.09.002


These are a few after a brief 2 minute search on pubmed. I'm sure a more extensive search would provide more.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Citation?

I'm not the PP who wrote that but I know from experience-- from seeing family members who destroyed their own lives from self medication with drugs and alcohol.
Since then, I've found many articles that confirm that. It's not just one source.
We decided to medicate because we wanted our kid to understand that there are productive and regulated ways of helping yourself. Bottom line is that you are going to seek what will help your brain.

The FDA censured several drug companies for claiming that their ADHD drug prevented substance abuse. I don't think the science is there. It is fine to talk about how the meds seem to work for your kid, but pretty execrable to claim that not using meds is going to turn your kid into a drug addict.

Right, and that's why the statement says:

Kids who don't take meds are more likely to self-medicate with drugs and alcohol.

"More likely" does not mean that not using meds is going to turn your kid into a drug addict

Having a high cholesterol diet will put you at greater risk of having a heart attack. It does not mean that eating red meat will make you have a heart attack.

Show me the evidence on that. The FdA doesn't appear to believe that is true.

And I mean show me studies where the authors do not get paid by the pharmaceutical industry ...

Katusic SK, Barbaresi WJ, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Psychomotor stimulant treatment and risk for substance abuse among young adults with a history of attention-deficit/hyperactivity disorder: a population-based, birth cohort study. J Child Adolesc Psychopharmacol (2005) 15:764–76. doi:10.1089/cap.2005.15.764


Wilens TE, Faraone SV, Biederman J, Gunawardene S. Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics (2003) 111:179–85. doi:10.1542/peds.111.1.179

Dalsgaard S, Mortensen PB, Frydenberg M, Thomsen PH. ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood – a naturalistic long-term follow-up study. Addict Behav (2014) 39:325–8. doi:10.1016/j.addbeh.2013.09.002


These are a few after a brief 2 minute search on pubmed. I'm sure a more extensive search would provide more.

You have at least one there who was paid to promote ADHD drugs (wilens). What about the rest?

[Anonymous]

Ok, here is some recent research debunking the claim that ADHD meds reduce the risk of drug abusehttp://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2013.4a6

And as far as I know, there are no studies that compare the outcomes of non-drug and drug treatment in terms of later illegal drug use. Also, apparently a lot of the earlier studies counted nicotine use as drug abuse - which, while concerning, is not exactly the same as being an alcoholic.

Anyway, my point here is that the decision to medicate or not should not be guided by scare tactics about a kid becoming a heroin addict if not medicated. There are many other much more important factors at play - and the evidence is thin for the claim, and tainted by conflicts of interest.

[Anonymous]

Does anyone have a good recommendation for psychiatrists in NOVA?

[Anonymous]

Anonymous wrote:Ok, here is some recent research debunking the claim that ADHD meds reduce the risk of drug abusehttp://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2013.4a6

And as far as I know, there are no studies that compare the outcomes of non-drug and drug treatment in terms of later illegal drug use. Also, apparently a lot of the earlier studies counted nicotine use as drug abuse - which, while concerning, is not exactly the same as being an alcoholic.

Anyway, my point here is that the decision to medicate or not should not be guided by scare tactics about a kid becoming a heroin addict if not medicated. There are many other much more important factors at play - and the evidence is thin for the claim, and tainted by conflicts of interest.

OP, this is definitely a lesson learned for you- there will always be people who are pro and anti medication.
Make your decision based on your child and your family.
Ask yourself these questions:
1) What are the immediate, near term, and long term effects of medicating?
2) What are the immediate, near term, and long term effects of NOT medicating?
3) If your child had any other medical condition, say for example, a heart condition that may benefit from medication (but you won't know until you try), would you give them that medication?
4) What is your overall stance on mental health? Since you are asking about ADHD on this thread, then you see its existence. Do you believe that medication can help with something a lot more abstract than a heart condition, such as mental health?

I did not read a lot of scientific articles because as PP stated, you don't want to be scared or guided by statistics.
To me, stats don't matter as much when I've got my own family issues I'm dealing with. What guided me was family genetics - I've seen the effects of ADHD in my family and I needed to give my child a chance to understand how her brain chemistry affects her behavior and her actions . This article has been very helpful in understanding how serotonin and dopamine works:

http://www.withoutagym.net/dopamine-and-serotonin/

[Anonymous]

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

Also, take a look at the FDA's view on these claims by the drug industry that ADHD drugs reduce the risk of poor school performance and drug addiction. They are false and misleading and unsupported by evidence:

"[the claims that the ADHD drug reduces risk of drug abuse, poor academic performance] are misleading
nonetheless because the only sensible interpretation of placing the consequences of
untreated ADHD in pieces promoting the use of Focalin XR for ADHD is to imply that
Focalin XR may reduce the likelihood or severity of the consequences of untreated
ADHD listed above (i.e., poor social–emotional development and job success, poor
academic performance, impaired driving, smoking and substance abuse) and induce
the desired treatment outcomes when this has not been demonstrated by substantial
evidence or substantial clinical experience. While Focalin XR has been shown to
improve the DSM-IV total subscale score of the Conners ADHD/DSM-IV Scales for
teachers (CADS-T), which measures ADHD symptoms such as fidgeting, restlessness,
and failure to complete tasks started, this scale does not measure the effect of
treatment on the multiple outcomes listed above (i.e., social–emotional development
and job success, academic performance, driving ability, smoking and substance abuse),
and it does not necessarily follow that improvement in the DSM-IV total subscale score
of the CADS-T is correlated with a positive effect on these outcomes.
None of the references cited2,3,4,5,6,7 in support of the presentations above from the
slide deck present data on the effect of treatment with Focalin XR on the outcomes
presented on the slides. While Focalin XR is indicated for the treatment of ADHD, F DA
is not aware of substantial evidence or substantial clinical experience demonstrating
that Focalin XR can help patients avoid these consequences."

http://www.fda.gov/downloads/Drugs/ucm054000.pdf

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

Nice blanket statement and you are wrong. No, not every study was by drug companies... Most weren't. Don't read one of three; read a bunch. FDA can only base their assessments on very specific drug trials that are hard to conduct with kids. Many drugs aren't approved for cfertain outcomes by FDA for a myriad reasons. I work with rare diseases and patients are always stuck with insurance companies not acknowledging the only drugs that work clinically because they haven't "met their trial standard", standards that are often impossible to meet. FDA only recently started recognizing the need to allow quality of life measures ( a standardized assessment of ones quality of life) as a viable outcome measure. They have yet to implement.

Of venture to guess that my kid and my family's QOL is significantly higher on medication.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

Nice blanket statement and you are wrong. No, not every study was by drug companies... Most weren't. Don't read one of three; read a bunch. FDA can only base their assessments on very specific drug trials that are hard to conduct with kids. Many drugs aren't approved for cfertain outcomes by FDA for a myriad reasons. I work with rare diseases and patients are always stuck with insurance companies not acknowledging the only drugs that work clinically because they haven't "met their trial standard", standards that are often impossible to meet. FDA only recently started recognizing the need to allow quality of life measures ( a standardized assessment of ones quality of life) as a viable outcome measure. They have yet to implement.

Of venture to guess that my kid and my family's QOL is significantly higher on medication.

We're talking here about the specific claim that ADHD meds reduce the risk of drug addition and school failure as compared to other, non-drug approaches. Please provide the study that demonstrates that - which is 1) NOT co-authored by someone with demonstrable financial ties to the pharmaceutical industry (so that knocks out Biederman and many others) and 2) compares stimulant treatment of ADHD with other non-pharmaceutical treatment methods, instead of meds v nothing. Maybe that exists?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

Nice blanket statement and you are wrong. No, not every study was by drug companies... Most weren't. Don't read one of three; read a bunch. FDA can only base their assessments on very specific drug trials that are hard to conduct with kids. Many drugs aren't approved for cfertain outcomes by FDA for a myriad reasons. I work with rare diseases and patients are always stuck with insurance companies not acknowledging the only drugs that work clinically because they haven't "met their trial standard", standards that are often impossible to meet. FDA only recently started recognizing the need to allow quality of life measures ( a standardized assessment of ones quality of life) as a viable outcome measure. They have yet to implement.

Of venture to guess that my kid and my family's QOL is significantly higher on medication.

We're talking here about the specific claim that ADHD meds reduce the risk of drug addition and school failure as compared to other, non-drug approaches. Please provide the study that demonstrates that - which is 1) NOT co-authored by someone with demonstrable financial ties to the pharmaceutical industry (so that knocks out Biederman and many others) and 2) compares stimulant treatment of ADHD with other non-pharmaceutical treatment methods, instead of meds v nothing. Maybe that exists?

You also have to exclude Barkley, since he gets $$ from the ADHD drug companies.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Kids who don't take meds are more likely to self-medicate with drugs and alcohol. Also, they tend to suffer social isolation and low self-esteem Stay open to meds and go to a good psychiatrist who has experience in medication combos and dosage levels beyond what a pediatrician will manage.

Source/reference?

Just go to www.pubmed.com and search ADHD and substance abuse of some other drug/term. There are hundreds that discuss the increased risk.

We've been over this. There is no good evidence that not medicating ADHD leads to increase risk of drug abuse - the studies don't appear to compare treatments other than medical; they include cigarette smoking as drug abuse; and/or were conducted by researchers with long-standing ties to the pharmaceutical industry and a resultant huge conflict of interest. There is *so much* conflict of interest with medical research in this area being funded by drug companies that you can't just go on pubmed - you need to look at a lot of different sources.

Nice blanket statement and you are wrong. No, not every study was by drug companies... Most weren't. Don't read one of three; read a bunch. FDA can only base their assessments on very specific drug trials that are hard to conduct with kids. Many drugs aren't approved for cfertain outcomes by FDA for a myriad reasons. I work with rare diseases and patients are always stuck with insurance companies not acknowledging the only drugs that work clinically because they haven't "met their trial standard", standards that are often impossible to meet. FDA only recently started recognizing the need to allow quality of life measures ( a standardized assessment of ones quality of life) as a viable outcome measure. They have yet to implement.

Of venture to guess that my kid and my family's QOL is significantly higher on medication.

We're talking here about the specific claim that ADHD meds reduce the risk of drug addition and school failure as compared to other, non-drug approaches. Please provide the study that demonstrates that - which is 1) NOT co-authored by someone with demonstrable financial ties to the pharmaceutical industry (so that knocks out Biederman and many others) and 2) compares stimulant treatment of ADHD with other non-pharmaceutical treatment methods, instead of meds v nothing. Maybe that exists?

You also have to exclude Barkley, since he gets $$ from the ADHD drug companies.

(btw same PP, not trying to sock puppet)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Don't settle for 504, get the iep

How would one qualify for an IEP with ADHD - Inattentive + executive function?

Can someone address this question? We're in the same situation too.


Thank you!

In FCPS it's unlikely unless you hire an advocate. We got an IEP only because DS was Aspergers/ADHD/Anxiety. If you have other comorbidities you can argue more effectively. How extreme is the ADHD? Our psychiatrist went to the meeting with us (we paid her of course) and she embarrassed the Langley personnel who had come to (routinely) fight the IEP. We also had our tutor and letters from our doctor. It is well worth it if you can get an IEP because at least in FCPS the 504 will be ignored.