WASHINGTON -- Children with attention deficit/hyperactivity disorders are at a high risk of developing substance abuse problems later. And the American Academy of Pediatrics is out with additional guidance for doctors designed to help reverse that troubling trend.
The guidance is found in a clinical report by the Academy's Committee on Substance Abuse, published in the July issue of the journal Pediatrics.
The committee looked at all kinds of studies and data and determined the stimulant medication prescribed for ADHD is not to blame, and may actually reduce the risk of a substance abuse disorder.
The report notes that these medications have the potential for misuse and that up to 23 percent of the school-aged children who take these drugs are approached by people who want to buy them. Yet, when used properly under strict monitoring, they can be very effective.
Dr. Adelaide Robb, chief of the Division of Psychology and Behavioral Health at the Children's National Health System, says treatment should begin as early as possible, noting it is the symptoms of ADHD that put a child at risk.
"One of the hallmarks of ADHD is impulsivity," she says, "and so these kids are more likely to do something without thinking."
Adding to that behavioral issue is a matter of biology. ADHD patients have an increased number of dopamine receptors, which are part of the pleasure and reward centers of the brain.
Because of those extra receptors, "Kids with ADHD may be craving, if you will, reward-providing chemicals," Robb says.
Robb, a pediatric psychiatrist who has done extensive research into drug therapies for mental disorders, says medications for ADHD can actually reduce those cravings, and she notes untreated ADHD kids are those at highest risk.
In its clinical report, the academy urges all doctors to monitor ADHD patients carefully to make sure they have been following their treatment and no one has tried to buy or steal their medications.
Another big recommendation is for physicians to educate patients and their parents about the potential for substance abuse, and make sure they are aware that these children are at higher risk of trouble.
Robb says there are great resources available for parents who have concerns about medications and other therapies for ADHD. One of the best places to go is parentsmedguide.org, a project of the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry.
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