Drugs Abuse and ADHD

[miguelangel]

A few days ago I was surfing internet, my goal was to find a ADHD forum to share a thesis on dopaminergic drugs addiction that is included in an essay I recently sent to Reina Sofia Award (Spain).
The truth is I did not search too much, forums and communities I found were too formal. I do not know how but I fell in one youtube  Rick funny video and then I went into the web. I like this site, so I would like share my thesis and have your opinion:

Inside the document (it is written in spanish but if anyone wants to read it I will gladly send ) I argued that the genetic susceptibility factor in addictions to drugs abuse is a dopamine deficit. Among other things I have written:

“PET imaging studies from NIDA, define the existence of  similarity between brains of addicts to any dopaminergic drug  (heroin, cocaine, alcohol, methamphetamine) and  brains of ADHD people, with  reduction in D2 receptors and affected areas in the frontal cortex.

There is a try to blame homeostasis on this similarity, however to be true homeostasis responsibility  we should accept this mimetic homeostasis independent from the metabolic process that acts on each particular drug, even drugs in which it is  known a different homeostatic process we should add the mimetic homeostasis with ADHD brains . Also we have to accept that the process defined as homeostasis it is not homeostatic, since time after cessation of consumption it does not recover the initial equilibrium (D2 receptors) and it becomes a permanent damage”

“The official version” is not inclined to accept genetic susceptibility, even less if this susceptibility derives from a deficit of dopamine, in such a case the addict simply would be “self medicating” by using drugs that substitutes the ones prescribed by medicine to patients with the same disorder (sometimes the treatment would be very similar, the brain cannot tell the differentiate between cocaine and methylphenidate or amphetamine and methamphetamine)

I understand that genetic susceptibility derived from a hereditary deficit of dopamine, is largely the explanation of addictions and NIDA ´s recent research point in that direction. However, the interpretations are forced to be consistent with a moral which criminalizes drugs and addicts behavior. Homeostasis is consistent with that blame, it is not a morally neutral process, it is a self-induced process derived from the irresponsibility of having started consumption. It will cost to change the outlook, but it will have to be assumed. “

“By failing to take into account the existence of a susceptible population, prevention campaigns turn into a death trap for ADHD youth.

Over 80% of people who use drugs do not generate an addiction (are figures from Columbia University Professor Carl Hart). When a young observes reality, he sees that there are many people who consume drugs and do so just occasionally, on weekends, when they party, reasonably that young believes campaigns exaggerate the consequences of using drugs and drugs effects. Prevention loses its credibility.

In case of a “normal” young, these campaigns will impact positively, although he will consume, fears that his life will be destroyed will make him want to control his intake and he will get it. His brain does not care so much about dopamine, he has enough, and by controlling his intake he will prevent homeostatic processes

The problem will be if this young has ADHD, to him it will be true the fast and strong addictiveness which can be seen in campaigns against drugs. His brain will prompt him to continue to consume that substance that improves his dopamine levels, he cannot do what their friends do, and by trying to control the use of that drug he will cause a limbic system reaction that in order to overcome his scruples, will induce him a compulsive addiction. “

I belive that the knowledge of this susceptibility is important to the ADHD community, I want to share it and also have your opinion

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[wanderquest]

So are you suggesting that in order to develop an addiction you probably have a dopamine receptor problem to start with?

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[miguelangel]

Yes, I am saying that you have to have a dopamine deficit in order to become addicted to any dopaminergic drug (alcohol, cocaine, heroine, metamphetamine) and that deficit has in the brain the same physiological expression that has ADHD:  reduction of dopaminergic receptors D2 and affected areas in the frontal cortex. In other words only ADHD brains or similar brains generate compulsive addiction to drugs

I prefer to talk about dopamine deficit instead of ADHD because whether it is true that all ADHD people have that condition, not all dopamine deficit imply a symptomatic ADHD, also such a deficits may be associated with other disorders, not necessarily defined as ADHD

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[jojosephine]

I agree with you 100% that ADHD should be called Dopamine Deficit Disorder.

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[miguelangel]

Great, I like it, the acronym DDD is funny and sounds funny in any language. We should create a forum proposing the change: no more ADHD or ADD, just DDD

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[wanderquest]

Do you think this is true even for super-fastly addictive drugs like heroin and meth? I could see this as a real possibility for most drugs like alcohol and cocaine but those two seem particularly scary and able to affect anybody who tries them.

I  agree about the drug-campaigns losing almost all credibility once you get to a certain age and see “normal” people using them freely with no issues.

When I was growing up our schools participated in the D.A.R.E. programs. I bought in fully and was completely anti-drug. Then when I got into highschool and college and realized that they don’t make people lose their minds, I started trying all kinds of stuff.

Never heroin and never meth though, because I knew of how fast you could get addicted and that scared me. Seeing pictures of those addicts is what drove home that message for me as something I didn’t want to chance.

My own personal experience told me I didn’t have a problem with marijuana, I need to be careful with alcohol, and that after only one experience I knew I needed to never ever do cocaine again. The one time I did it I could feel myself immediately wanting more right away. I had a friend (thank God) stop me and I knew it was something I could never do again or I would probably keep going until it killed me.

I have a family history of alcoholism, so I kinda knew I needed to be careful of that even after I had decided to ignore any anti-drug crap I heard from the government or school authorities. But I honestly believed this hereditary inclination only applied to alcohol.

It is pretty well established that drug use is higher amongst those with ADHD, I don’t think I’ve ever heard the postulation that it’s a pre-requisite in the other direction though.

Dopamine deficit sounds more accurate and something less likely to be a stigmatic “label” for those that have it,  but by calling it Attention Deficit, more people are likely to realize they may have it in the first place.

And as another anecdotal bit from my own experience, I have barely had any interest in drinking since I’ve been taking Vyvanse. Not that I was drinking heavily beforehand, but I can just tell I have less desire to have a beer after work.

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[jojosephine]

@wanderquest I could write word for word your experiences and feelings towards drugs and alcohol…right down to the fact that I could care less if I ever drink alcohol again since taking Vyvanse.

And I truly believe that if ADD was called what it really is at the biological level (Dopamine Deficit Disorder), there would be no stigma attached at all and it would be welcome as a medical condition like diabetes. People who need to get treated will get treated and there would be a lot less cases of alcoholism and drug addictions and all of the social and economical problems.

And my new motto is:

“Dopamine, where have you been all my life”

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[miguelangel]

It is known since decades the high comorbidity between Drug Abuse and ADHD, there are many studies that correlate diferents addictions and ADHD but remains “just another ADHD co-morbidity”. The thesis I stand for is that having a dopamine déficit is necessary to become addicted to any dopaminergic drug, it is a prerequisite. People without this deficit can play with drugs, but those who have a dopamine deficit we cannot . Drugs are extremely dangerous to us and although we realize that anti-drug advertising is fake, that there are many people who use drugs without geting addicted, we cannot do it, we have to know that to us, will be true  that exaggerated propaganda

Two dais ago I post in “Marijuana and ADHD”( I was trying to attract attention over that dangerous comorbility)

I propose a new research to find the prevalence between addiction to drugs and ADHD:
1-Search on goole celebrities with any drug addiction: alcohol, cocaine, heroin …

2-Choose the drug you want, also the criteria to introduce the person in your study population (alphabetical, included in more than one list …)..

3- Then search again in google if these celebrities have been diagnosed with ADHD,

4- You will notice that the prevalence is much higher than researchers  define and also you will realize that all those celebrities with drugs abuse but without diagnosis of ADHD are from an age at which this disorder was not considered among adults, , If not, the prevalence would be around 100%  ”

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[miguelangel]

Yes I stand that it is true for any dopaminergic drug including heroin and metamphetamin. We also have to understand that advertising about certain drugs are very misleading: cocaine is similar to methylphenidate (Ritalin, Concerta) and methamphetamine to amphetamine (Adderall) and I quote:
“The brain cannot distinguish between amphetamine and methamphetamine” (Carl Hart Pofesor Columbia University)
“In our studies with cocaine abusers we substitute cocaine by methylphenidate because the brain cannot tell the difference between these two drugs” (Dr. Nora Volkow, Director of National Institute of Drug Abuse)

I understand that when you take a stimulant medication, it reduces the need or attraction to other dopamine sources, it is natural. The knowledge about the relation between dopamine deficiency and addictions is important not only on prevention purposes. To treat and cure addictions we should keep in mind that patients are persons with a dopamine deficit, a deficit that has been worsened by drug abuse. That fact, today medicine usually does not take in account.

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[wanderquest]

How would this apply in the case of cigarettes? At one point nearly half the population smoked. Surely not that many people have a dopamine deficit.

 

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[blackdog]

An interesting theory. It needs to be kept in mind that the effect of drugs on neurotransmitters has not really been proven, it is only theoretical. But it is something worth studying.

If all people with ADHD or addiction have it because of dopamine deficiency….then all people with ADHD would be drug addicts, and all drug addicts would have ADHD. Since that is not the case, then there must be some other factors involved. I have never tried anything  highly addictive like cocaine, but I have never become addicted to anything I did try. And the one thing the doctors I have seen seem to agree on is that I most likely have a dopamine deficiency.

I agree that the anti-drug programs aimed at young adults are completely useless. It was nothing but a big joke when I was in high school. And my nephew, who is in grade 9 now, says he has seen kids snorting coke right in the classroom.(though I believe he may be exaggerating)

What did it for me was seeing people who had fried their brains completely. I looked at them and just decided I did not want to be like that. I am now fairly confident I would not end up like that even if I did use drugs recreationally. But I don’t get out much so I have no way of testing that theory.

I was just thinking about this while washing the dishes ( ’cause I have to think about something other than washing dishes) and I was thinking that it may be a matter of degrees, like with ADHD. Everyone who has ADHD is different and some have more severe symptoms than others. Same with drug addiction. Some addicts are able to quit easily and some struggle for years. So maybe it depends on the level of dopamine deficiency.

Also, there are the environmental factors. I grew up in a house where there was very rarely even any alcohol and no drugs, except for cigarettes.  And I hung out with the nerds in school so our parties mostly consisted of watching movies and  playing board games, or just sitting and talking. Which was actually really, really boring for me.

My point is that someone who grows up around drugs or has friends who are into drugs is more likely to develop an addiction than someone who doesn’t have that exposure.

 

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[sdwa]

I think Gabor Mate says something similar about dopamine and addictions in his book “Scattered.”

I don’t think addiction is automatic for people with ADHD, because I have tried a few things in my life that I didn’t become addicted to. I didn’t like cocaine or marijuana. There are some things I used to use (alcohol and nicotine one) because I got into a habit, a routine, despite being aware that I felt worse, not better. If I was “self-medicating” I didn’t experience it that way consciously – and was not helped in any way by substance abuse. My mood did not improve. My state of mind did not improve. There was no advantage. I do like caffeine – but so does everyone else.

Making impulsive decisions to try something stupid might be automatic, but I’m not convinced addiction is. There could be higher rates of addiction among ADHDers because we are impulsive and suggestible – which I think has more to do with the social environment that the effect of the drugs.

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[miguelangel]

Good point. It is true that the percentage of smokers is higher (I think 20-30%) than that of ADHD.

I remember in Spain in my generation more than 60%  people consumed alcohol daily at each meal, lunch, dinner and even breakfast (I started at 4 years old), and almost did not exist alcoholics. In orther to generate a compulsive addiction  it is needed two conditions: genetic susceptibility and be afraid to get addicted, try to control intake.

What percentage of smokers have developed a compulsive addiction? I do not know.
Neither do I know what percentage of the population has a dopamine deficit. ADHD people comes to be those which the deficit is important enough to be clearly symptomatic.

In Europe it is been made the tests PET (Positron Emissions Tomographies) on nicotine addicts, the same carried out by the NIDA on addicted to methamphetamine, heroin, cocaine and alcohol, and the result was similar, also nicotine addicts have a brain with the same characteristics as ADHD people. However I personally believe that nicotine and heroin can hook  people without dopamine deficit. Both drugs have a great homeostasis (fast physiological changes in order to keep initial balance)

Although it does not have to mean anything, epidemiological figures are curious. Around the 6-16% of children and teenagers in the U.S. are diagnosed with ADHD and only between 10 and 15% of drug users generate a compulsive addiction.

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[blackdog]

I knew a smoker who definitely had a compulsive addiction. We would be walking down the street and he’d suddenly stop, drop his brief case, and take out his cigarettes. Like as if someone just pushed a button on a remote control. He was also an alcoholic.

My father smoked heavily, about 4 packs a day, when I was growing up. It actually helped to keep me from smoking because I learned early by listening to other people telling him why he should quit. And because one day he left one burning in the ashtray and I decided to try smoking. I think I was maybe 5 or 6 years old. Needless to say, it was not an enjoyable experience.

Medications that increase dopamine are used for smoking cessation so it makes sense that if that works then smokers may have dopamine deficiency. And I can totally see how a smokers brain would be like a brain with ADHD. That would explain my husband.

There are many people who believe that allowing children to drink alcohol at a young age helps to prevent them from over indulging when they get older. The lower rate of alcoholism in countries like Spain is one of the reasons.

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[miguelangel]

Of course a person has to have contact with drugs to become addicted, what I advocate is that a casual and party contact that many people have with drugs without  getting addicted, in the case of a person who has a dopamine deficit, that person will be in a serious risk of developing a compulsive addiction

To me it is not very clear that  education and environment around you has much to do with addiction to drugs abuse. I will try to make me understand

I never believed that education given to  children had much to do with the results you get from them, I have never met a better parents than my own parents and uncles of Madrid, good people, intelligent and devoted to the education and care of their children, each couple had four children and from eight we were three have died as a result of drugs and someone more had serious problems. It made no sense, the only explanation I found was that basically everything is random. The believe that through education we can influence the future of our children should be little more than illusion.

When I found out that I have ADHD, I realized that my brothers and my cousins also had it. Everything got sense: ADHD was the cause that drugs had played such a crime in our family.

The relation of ADHD with drugs was one of the first things I understood, I think that even it was inside one of the first tests I did: is there any member of your family who has had problems with alcohol or drugs?

It is true that most addicts are related with marginal areas of aur society but it is also true that the old belief that ADHD was a disease just in children which disappear with adulthood was because the vast majority of adult people with ADHD would disappear from our world, end up in jail, dead, addicted to drugs or at other marginal areas of our society. Marginality and ADHD have always been related although we are not so much aware. On this site will be difficult to find the ADHD in jail, the ADHD drug addict or any marginal ADHD ,  we will talk and discuss only the ADHD that have been able to combine our disorder with living inside this society, and apparently we are  minority within the ADHD adult population.

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