ADD/ADHD Medications: Handle With Care
It’s not only people diagnosed with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder who function better after taking ADD/ADHD drugs. These powerful stimulants will have the same effect on all of us, ADD/ADHD or not. So why shouldn’t all of us pop in a pill everyday to help us feel more cheerful and focused and energetic?
Because though ADD/ADHD drugs are effective for a variety of conditions, they have a history of abuse, addiction and deadly side effects.
Before you take these medicines or give them to your child, you need to know the benefits, and weigh them against the side-effects and the risks of abuse and addiction. Here are some things you should know:
The benefits
Amphetamines (the class of drugs to which most ADD/ADHD medications like Adderall and Vyvanse belong) and methylphenidate (Ritalin, Concerta, Daytrana) have been around since the end of the nineteenth century. In the 1930s they first began to be used medically - as decongestants and inhalers for people suffering from asthma and colds. Up to the 1950s, they were even available over the counter as ‘pep’ pills to help increase energy and concentration (one marketing slogan was that two pills were better than a month’s vacation), and to treat obesity, chronic fatigue, depression, and daytime sleepiness, and to counter overdoses of sleeping pills.
From the 1960s, they have been widely prescribed for overactive and distractible children who are not able to cope in normal classrooms - those with ‘minimal brain dysfunction’, as it was then called, or what is now known as Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder. The drug has a calming and ‘focusing’ effect on these children, and helps them sit in their place, listen and get better grades (at least a short while!).
Dangerous side-effects
But amphetamines (Adderall and Vyvanse) and the milder methylphenidate (Ritalin, Concerta, Daytrana) have always been problem drugs.
Some minor side-effects from these drugs are reduced appetite, nausea, increase in blood pressure and heartbeat and sometimes skin rashes. If you or your child is taking this medicine for ADD/ADHD or anything else, your doctor may help you to manage these side-effects.
There are more serious problems when the drug is taken over a long time. In animal studies, rats treated with Ritalin in the period corresponding to childhood in humans were more likely to be depressed as adults. Long-term abuse of this drug can lead to psychosis, malnutrition, slowing growth (for children), severe itching, dyskinesia (excessive repetition of movements and meaningless tasks), and heart trouble.
A high risk of abuse
You need to be especially careful with ADD/ADHD drugs because they are addictive. When taken in large doses, orally or through injection or smoking, they can produce a feeling of euphoria, and once you have this experience you are likely to go the same way as addicts with worse substances like cocaine - do anything to get high again.
It’s not so safe in smaller doses either. If you take them for over months or years for staying awake or for loosing weight, you might become dependent on the drug, and have withdrawal symptoms if you try to stop them. Those taking the drugs without a doctor’s prescription and supervision are more likely to get addicted, and this will not just be depraved losers looking for a ‘high’. Those likely to abuse Ritalin, Adderall, and other drugs for ADD/ADHD are likely to be people just like us - overburdened with family and work responsibilities, who feel they need just a little bit more energy and concentration to get by.
Even in the 1930s, when the drug first came into the market, it was abused by people who pulled out the strip containing the drug from the inhaler Benzedrine and either chewed it or put it into their coffee.
By the 1960s, all over the world, the problems with amphetamine and methylphenidate misuse became well-known. The police noticed an increase in crime due to drug abuse, and doctors noticed more people coming for emergency treatment for drug overdoses. There were also celebrity cases like the death of British cyclist Tim Simpson due to an overdose of amphetamines and the British Prime Minister Eden’s dependence on amphetamine during the Suez Crisis (which was said to have affected his judgment).
Most governments tried to increase control over the drug: in the United States, the drug was placed in Schedule 2 of Controlled Substances Act of 1971 - the category of drugs which have acknowledged medical uses but are addictive and likely to be abused. Sweden experimented with loose controls for a while during the late 1960s, on the ground that most people would be responsible enough not to abuse the drugs. But as the number of addicts and crimes and deaths connected with drug abuse increased, Sweden quickly returned to stricter controls.
Recently, what is new is that from 1990, prescriptions for methylphenidate (Ritalin, Concerta, Daytrana) and various forms of amphetamines (Adderall, Vyvanse) alone have risen more than five-fold - mainly for what is called Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. While the abuse profile of amphetamines and methylphenidate is similar to other Schedule 2 drugs, what is different is that these drugs are now being prescribed mainly for children.
A few children will definitely benefit from these drugs, but these medicines have become so widely available, and there is so much ignorance about their potential for abuse and addiction, that there is danger of an epidemic of abuse. We need to make sure that medicines are given only to children who really need them - not use them as a shortcut to controlling children who are bored, or unhappy, or simply too playful for the modern classroom. We also need to make sure that there is awareness of the dangers of self-medicating with these drugs to study, party, lose weight, or get a high.
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