A patient of mine said today “Marijuana isn’t a gate way drug Adderall is!” This client was diagnosed adhd as a child and started on Adderall which made him by his words “tweak.” He lost his appetite became irritable and agitated but his Doctors continued the medications as his grades did improve. By the time he was 14 he started self-treating with marijuana to according to him get rid of these side effects. He continued on Adderall for 7 years until I stopped it. The next difficult task will be getting him off the marijuana.
My favorite saying, I heard at work ,was when one therapist in describing a local practice that does testing for ADHD said, “if they tested a horse it would be diagnosed with ADHD.”
That is the problem. All ADHD has a lack of attention but not all lack of attention is ADHD. Most “Neuropsy testing” done these days is superficial as it is expensive with poor insurance coverage to get thorough testing. A lot of insurances no longer cover Neuropsy testing at all and it can cost $3000.00 for an exam that really means anything. Most people just get school testing for their IEP and this testing is extremely superfluous. It is not real Neuropsy testing.
This client had processing delays, Learning disorders and, low average IQ . All of which will test as ADHD on superficial testing but giving him stimulants is like overdriving a computer. Sure, it works but at a cost. The computer heats up when overdriven and, in a way, so does the brain. You can get aggression, agitation, anxiety, mood lability and secondary self-treatment all as can be seen in this client.
There are many more effective interventions that could have helped him in school but Medication is the default intervention in this country. Other countries that do not believe in adhd create effective individual education plans for each child using behavioral interventions. I have seen some creative schools use service animals, aerobic exercise, standing desks, bouncy bands, kinetic learning, and other interventions that successfully manage kids without medications.
In this client Adderall wasn’t a gateway drug, it was a drug in itself. If you don’t have ADHD Adderall is just cocaine. Another area of concern in medicine is in eating disorders. Back in the 1950’s many housewives got addicted to amphetamines as Dr’s were giving them out like candy for weight loss. Although this never really entirely went away it had receded a bit (mainly because many of the diet pills were killing women by causing heart attacks.) Now returning to the past Vyvanse (long acting Adderall) got the indication for binging. Once again, we are addicting a large portion of women to amphetamines. But now they have medical marijuana to take with it to help them stop them from Tweaking or with their subsequent Anxiety diagnosis. Sound familiar!