I CANT SEEM TO PAY ATTENTION AND FORGET DETAILS?
Attention Deficit disorder in Naples and South Florida has been increasing due to diagnostic accuracy. The condition I am referring to is Adult Attention Deficit Disorder. There is a great deal of information on the internet with excellent references and so I will not go into detail. This diagnosis continues to be the focus of attention (no pun intended) over the past few years. The explanation usually given is that clinicians and investigators have become more clinically vigilant of its symptoms and therefore the incidence of ADHD has risen. More important, ADHD and addiction disorders seem to coexist with a higher frequency. This co-existance also called Dual Diagnosis. This existance of two illness makes it a challenge to treat for example Cocaine Addiction and ADHD since the treatment of choice is a stimulant derrived from Amphetamine. ADHD is also confused with Anxiety Disorders and Bipolar disorder. Thus, the treatment of ADHD requires years of experience and training to avoid misdiagnosis.
However, I always caution my patients on this issue since Attention problems are associated with almost all diseases such Anxiety, Depression, Insomnia, Bipolar Disorders and especially certain forms of substance abuse This illustration below demonstrates how it can co exist with other illness:
The illustration above comes Joseph Biederman and Stephen Faraone, Harvard Mahoney Neuroscience Institute Letter, Winter 1996 Volume 5 Number 1.
Therefore, I always caution my patients not to come to the conclusion that ADHD is only what they have. I have noticed that ADHD is an easier diagnosis for the public to accept due to the stigma of mental illness. The initial evaluation, however, offers an incredible opportunity to uncover other painful symptoms that my patients harbor. I do have the clinical opinion that sometimes this diagnosis is added on top the list of treatment without considering other diagnosis such as anxiety or mood disorders.
Parents are bombarded with conflicting information about attention-deficit/hyperactivity disorder (ADHD) and its treatment. Increased use of stimulant medications has sparked debates about whether more people are being appropriately recognized and treated or whether people are being overmedicated. Three questions often arise in discussions of this issue:
(1) Are people with ADHD more like to develop substance abuse?
Question 1 is the least controversial and is answered in the affirmative by volumes of epidemiologic data indicating that the diagnoses of ADHD and substance abuse occur together more frequently than expected by chance alone. Comorbidity of ADHD with bipolar or conduct disorder has a greater than additive effect on the risk of developing substance abuse. Furthermore, those with ADHD are at greater risk for earlier onset substance abuse, and even a family history of ADHD is a risk factor for developing substance abuse
(2) Does using stimulant medication to treat ADHD lead to substance abuse?
On March 8, 2008, a new study led by Joseph Biederman, MD, director of Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital finds that the use of stimulant drugs to treat children with ADHD has no effect on their future risk of substance abuse. What makes this study unique is what not funded by pharmaceutical companies but by a grant from the National Institutes of Health, including the National Institute for Drug Abuse.
Earlier studies examining whether stimulant treatment could increase substance abuse risk have had conflicting results, but they had several limitations, the authors note. Some only looked at adolescents, although young adults are at the highest risk of substance abuse. Others did not control for conditions such as conduct disorder that are know to be associated with substance abuse or may have looked at the impact on use of only a particular substance. The current study, designed to address those shortcomings, analyzed patterns of substance use in a group of young men 10 years after their original diagnosis with ADHD. This is truly ground breaking news for mothers concerned about stimulants and their children.
(3) Are the stimulant medicines themselves addictive? I can answer this in two parts.
Short acting drugs with rapid absorption and has a euphoric will no doubt lead to addiction. The faster the rate of uptake, the greater the abuse potential. This is why METH AND CRACK COCAINE is highly addictive. The neuroimaging work of Nora Volkow, MD research shows that the faster the rate of uptake, the greater the potential -- methylphenidate takes an hour to raise dopamine levels whereas cocaine takes seconds.However, people who suffer from ADHD do not seem to become addicted themselves. This was answered in the study above. The other observation is that people who suffer from ADHD do not have euphoria but rather a calming effect in their brain.
Strattera is a new treatment without using amphetamine. However, the stimulants such as CONCERTA® and Vyvanse are other effective treatment options. One concern that periodically appears is that getting addicted to the stimulants. A person with a primary diagnosis of ADHD will unlikely become addicted to the stimulants since the medications offer relief and not Euphoria. The euphoria is the components of addictive drugs that people seek. However, I never encourage the use of stimulants of sober patients that have ADHD since it can trigger another relapse in their addiction. Drug addictions and ADHD appear to coexist more often than not.
Call for an evaluation for ADHD in Naples. We will treat and evaluate patients with ADHD (Attention Deficit Hyperactivity Disorder) from Fort Myers, Marco Island, Bonita Beach, Estero and all of Southwest Florida . Dual Diagnosis with ADHD is a treatable disease in Naples Florida by Dr Leonard Lado. Addiction Recovery and ADHD can be treated at the Lado Healing Institute.