ADHD and Addiction Presentation by   Tom Rue, M.A.,   CASAC, CCMHC, NCC Richard C. Ward Addiction Treatment Center Created...
What is ADHD? <ul><li>Attention Deficit Hyperactivity Disorder is a neurologically-based developmental disorder of both ch...
By any other name… <ul><li>Minimal Brain Damage, or Minimal Brain Dysfunction </li></ul><ul><li>Hyperkinesias: </li></ul><...
DSM-IV (1994)  <ul><li>The fourth edition of the  Diagnostic and Statistical Manual of Mental Disorders  classifies ADHD w...
ADHD Defined <ul><li>Criteria include persistent symptoms of inattention or hyperactive impulsivity that are maladaptive a...
Symptoms of ADHD… <ul><li>Inattentiveness </li></ul><ul><li>Impulsivity </li></ul><ul><li>Deficient rule-following </li></ul>
Inattention <ul><li>Poor sustained attention or effort – particularly to tasks that are relatively tedious and protracted....
Impulsivity <ul><li>Impaired impulse control or delay of gratification. </li></ul><ul><ul><li>Difficulty stopping and thin...
Deficient rule-following… <ul><li>Difficulty following through on instructions or assignments, particularly without superv...
Symptoms <ul><li>People suffering from ADHD may . . .  </li></ul><ul><ul><li>Show a significant difference between verbal ...
Substance abuse Substance abuse is often a secondary outcome if ADD is not identified and treated.  Social and emotional i...
Do these symptoms sound familiar?  <ul><li>Do signs of ADHD resemble common traits or experiences of drug addicts? </li></...
Learned helplessness… <ul><li>Dysfunctional cycles in families can contribute to ADHD-like behavior in children and adults...
Family process in which ADHD worsens <ul><li>Parental pathology (e.g. mood disorders, alcoholism, anti social behavior) le...
Family process in which ADHD worsens <ul><li>Increased negative behavior toward the ADHD child and decreased positive stat...
Who has ADHD? <ul><li>ADHD is 5 to 7 times more common in boys.  </li></ul><ul><li>ADHD occurs in people of every level of...
Some famous people believed  to have had ADHD… <ul><li>Hans Christian Anderson </li></ul><ul><li>F. W. Woolworth </li></ul...
ADHD and recovery… <ul><li>Adaptive behavior strategies can help. </li></ul><ul><li>How can one cope with tendencies to in...
For starters . . . Admit Identify Let Go
<ul><li>Recognize ADHD as a distinct disability. </li></ul><ul><li>Acknowledge that it is possible to live with ADHD and b...
<ul><li>What actions can you take to cope with your natural tendency to forget things, or to be distractible or disorganiz...
<ul><li>. . . of unwillingness to try new approaches. </li></ul><ul><li>. . . of shame, self-blame, and resentments. </li>...
A few strategies for successful living: Deadlines Use a Date-book Prioritize Listen to  Feedback Support  Network Breaking...
Medication treatment.  It is believed that stimulant drugs act on ADHD by affecting the catecholamine neurotransmitters (e...
Medication can help. <ul><li>Under a doctor’s direction  (usually a psychiatrist or neurologist), medications sometimes pr...
How stimulants work <ul><li>ADHD is believed caused by a maturational delay in the development of the nervous system. Drug...
When taken as directed… <ul><li>Stimulants, used under medical supervision, are considered quite safe. Though they can be ...
Medication <ul><li>ADHD is a chemical imbalance, in a similar way that depressive illness or diabetes are chemical imbalan...
Most drugs have side-effects <ul><li>For example, some side-effects of Ritalin may include: </li></ul><ul><li>sleep distur...
You are what you eat. <ul><li>Some believe that sugar or food additives contribute to hyperactivity and other ADHD symptom...
A lifestyle of sobriety will lead to . . . <ul><li>Healthier interpersonal relationships </li></ul><ul><li>More organized,...
Where to Get More Information <ul><li>Talk to your doctor and your counselor </li></ul><ul><li>Advocacy organizations </li...
<ul><ul><li></li></ul></ul>NADDA Guiding Principles for the  Diagnosis and Treatment of ADHD   1.       Evaluate and treat...
<ul><ul><li></li></ul></ul>Guiding Principles ,  continued 7.       Diagnosis should be based primarily upon the DSM-IV AD...
References and Links <ul><li>ADHD Fact Sheet for Parents and Teachers, Guilford Press, 1991.  </li></ul><ul><li>ADDult Sup...
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ADHD And Addiction (Rue, 2001)

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Co-Occurrence of Attention Deficit Hyperactivity Disorder and Addiction

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  • ADHD And Addiction (Rue, 2001)

    1. 1. ADHD and Addiction Presentation by Tom Rue, M.A., CASAC, CCMHC, NCC Richard C. Ward Addiction Treatment Center Created in April 2001 for clients and staff of
    2. 2. What is ADHD? <ul><li>Attention Deficit Hyperactivity Disorder is a neurologically-based developmental disorder of both children and adults. </li></ul>
    3. 3. By any other name… <ul><li>Minimal Brain Damage, or Minimal Brain Dysfunction </li></ul><ul><li>Hyperkinesias: </li></ul><ul><ul><li>Hyperkinetic Reaction in Childhood </li></ul></ul><ul><ul><li>Hyperkinetic Impulse Control </li></ul></ul><ul><ul><li>Hyperactivity </li></ul></ul><ul><ul><li>Hyperactive Child Syndrome </li></ul></ul><ul><li>Attention Deficit Disorder (with or without hyperactivity) </li></ul>Since 1937, ADHD has been known by various names, including:
    4. 4. DSM-IV (1994) <ul><li>The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders classifies ADHD with “ disruptive behavior disorders ” that are observed in childhood. </li></ul><ul><li>ADHD often persists into adulthood. </li></ul>DSM-IV 314
    5. 5. ADHD Defined <ul><li>Criteria include persistent symptoms of inattention or hyperactive impulsivity that are maladaptive and inconsistent with developmental level. </li></ul><ul><li>Between 15 and 50% of ADHD children naturally outgrow their problems as adults. </li></ul><ul><li>The remainder do not. </li></ul>
    6. 6. Symptoms of ADHD… <ul><li>Inattentiveness </li></ul><ul><li>Impulsivity </li></ul><ul><li>Deficient rule-following </li></ul>
    7. 7. Inattention <ul><li>Poor sustained attention or effort – particularly to tasks that are relatively tedious and protracted. </li></ul><ul><ul><li>Easily bored </li></ul></ul><ul><ul><li>Distractible </li></ul></ul><ul><ul><li>Shifts from one incomplete activity to another </li></ul></ul><ul><ul><li>Frequently loses concentration during lengthy tasks </li></ul></ul><ul><ul><li>Fails to complete routine assignments without supervision </li></ul></ul>
    8. 8. Impulsivity <ul><li>Impaired impulse control or delay of gratification. </li></ul><ul><ul><li>Difficulty stopping and thinking before acting </li></ul></ul><ul><ul><li>Difficulty waiting one’s turn, such as in playing or talking </li></ul></ul><ul><ul><li>Difficulty working toward longer-term rewards </li></ul></ul><ul><ul><li>Prefers immediate gratification… </li></ul></ul>
    9. 9. Deficient rule-following… <ul><li>Difficulty following through on instructions or assignments, particularly without supervision. </li></ul><ul><ul><li>Not due to poor language comprehension </li></ul></ul><ul><ul><li>Not due to defiance </li></ul></ul><ul><ul><li>Not due to memory impairment </li></ul></ul>Instructions do not regulate behavior as well in people with ADHD.
    10. 10. Symptoms <ul><li>People suffering from ADHD may . . . </li></ul><ul><ul><li>Show a significant difference between verbal and performance abilities on intelligence testing </li></ul></ul><ul><ul><li>Self-medicate with street drugs ( e.g. marijuana, cocaine, alcohol, etc.) </li></ul></ul><ul><ul><li>Feel emotionally depressed after a success or other high emotional stimuli </li></ul></ul>
    11. 11. Substance abuse Substance abuse is often a secondary outcome if ADD is not identified and treated. Social and emotional immaturity are chronic. Poor peer acceptance and loneliness tend to increase with age and with the obvious display of symptoms. Children with primary inattention tend to have academic problems only.
    12. 12. Do these symptoms sound familiar? <ul><li>Do signs of ADHD resemble common traits or experiences of drug addicts? </li></ul><ul><li>What do you think? </li></ul>erratic results acts out beaks rules does not fit wants it NOW! restless
    13. 13. Learned helplessness… <ul><li>Dysfunctional cycles in families can contribute to ADHD-like behavior in children and adults. </li></ul><ul><li>ADHD traits may be reinforced by learning, as well as being biologically inherited. </li></ul>
    14. 14. Family process in which ADHD worsens <ul><li>Parental pathology (e.g. mood disorders, alcoholism, anti social behavior) lead to… </li></ul><ul><li>Negative mood states in the parents lead to… </li></ul><ul><li>Increased perception of deviant behavior in their ADHD child lead to… </li></ul>Continued…
    15. 15. Family process in which ADHD worsens <ul><li>Increased negative behavior toward the ADHD child and decreased positive statements and social interactions with ADHD child lead to... </li></ul><ul><li>Child’s increased negative behavior and decreased compliance with parental requests and commands lead to… </li></ul><ul><li>Development of oppositional defiant or conduct disordered traits in the child. </li></ul>Continued…
    16. 16. Who has ADHD? <ul><li>ADHD is 5 to 7 times more common in boys. </li></ul><ul><li>ADHD occurs in people of every level of intelligence. </li></ul><ul><li>ADHD tends to run in families. </li></ul><ul><li>There is an association with a family history of alcoholism and/or depression. </li></ul><ul><li>Asthma may be more common in children with ADHD. </li></ul>
    17. 17. Some famous people believed to have had ADHD… <ul><li>Hans Christian Anderson </li></ul><ul><li>F. W. Woolworth </li></ul><ul><li>Beethoven </li></ul><ul><li>George Burns </li></ul><ul><li>Harry Belafonte </li></ul><ul><li>Andrew Carnegie </li></ul><ul><li>Lewis Carroll </li></ul><ul><li>Prince Charles </li></ul><ul><li>Agatha Christie </li></ul><ul><li>Winston Churchill </li></ul><ul><li>Sergei Rachmaninoff </li></ul><ul><li>Mariel Hemingway </li></ul><ul><li>Wright Brothers </li></ul><ul><li>Ernest Hemingway </li></ul><ul><li>Bill Cosby </li></ul><ul><li>Leonardo da Vinci </li></ul><ul><li>Salvador Dali </li></ul><ul><li>Edward Hallowell, MD </li></ul><ul><li>Dwight D. Eisenhower </li></ul><ul><li>F. Scott Fitzgerald </li></ul><ul><li>Henry Ford </li></ul><ul><li>Benjamin Franklin </li></ul><ul><li>Galileo </li></ul><ul><li>Danny Glover </li></ul><ul><li>William Randolph Hearst </li></ul><ul><li>John F. Kennedy </li></ul><ul><li>Zsa Zsa Gabor </li></ul><ul><li>Micheal Jordan </li></ul><ul><li>Robert Kennedy </li></ul><ul><li>John Lennon </li></ul><ul><li>Abraham Lincoln </li></ul><ul><li>Mozart </li></ul><ul><li>Steve McQueen </li></ul><ul><li>Napoleon </li></ul><ul><li>Nasser </li></ul><ul><li>Issac Newton </li></ul><ul><li>Nostradamus </li></ul><ul><li>Louis Pasteur </li></ul><ul><li>Picasso </li></ul><ul><li>Edgar Allan Poe </li></ul><ul><li>Ronald Reagan </li></ul><ul><li>Dan Quayle </li></ul><ul><li>John D. Rockefeller </li></ul><ul><li>Gen. Westmoreland </li></ul><ul><li>Eleanor Roosevelt </li></ul><ul><li>Babe Ruth </li></ul><ul><li>Anwar Sadat </li></ul><ul><li>Pete Rose </li></ul><ul><li>Charles Schwab </li></ul><ul><li>George B. Shaw </li></ul><ul><li>Steven Spielberg </li></ul><ul><li>Sylvester Stallone </li></ul><ul><li>James Stewart </li></ul><ul><li>Henry David Thoreau </li></ul><ul><li>Leo Tolstoy </li></ul><ul><li>Van Gogh </li></ul><ul><li>Thomas Thoreau </li></ul><ul><li>Jules Verne </li></ul><ul><li>William Butler Yeats </li></ul><ul><li>Robin Williams </li></ul><ul><li>Stevie Wonder </li></ul>Source: about.com
    18. 18. ADHD and recovery… <ul><li>Adaptive behavior strategies can help. </li></ul><ul><li>How can one cope with tendencies to inattention and impulsivity? </li></ul>
    19. 19. For starters . . . Admit Identify Let Go
    20. 20. <ul><li>Recognize ADHD as a distinct disability. </li></ul><ul><li>Acknowledge that it is possible to live with ADHD and be in recovery. </li></ul><ul><li>Accept help when needed, including medication if prescribed by a psychiatrist. </li></ul>Admit
    21. 21. <ul><li>What actions can you take to cope with your natural tendency to forget things, or to be distractible or disorganized? </li></ul><ul><li>How have ADHD behaviors contributed to your addictive lifestyle? </li></ul><ul><li>Do you think ADHD can contribute to a relapse of alcohol or drug abuse? </li></ul>Identify
    22. 22. <ul><li>. . . of unwillingness to try new approaches. </li></ul><ul><li>. . . of shame, self-blame, and resentments. </li></ul><ul><li>. . . of the idea that medication is unhealthy. </li></ul>Let Go
    23. 23. A few strategies for successful living: Deadlines Use a Date-book Prioritize Listen to Feedback Support Network Breaking Tasks up Task Lists Prioritize Laugh at Yourself
    24. 24. Medication treatment. It is believed that stimulant drugs act on ADHD by affecting the catecholamine neurotransmitters (especially dopamine) in the brain.
    25. 25. Medication can help. <ul><li>Under a doctor’s direction (usually a psychiatrist or neurologist), medications sometimes prescribed to help improve the functioning of people with ADHD include the following… </li></ul><ul><ul><ul><li>Ritalin </li></ul></ul></ul><ul><ul><ul><li>Dexedrine </li></ul></ul></ul><ul><ul><ul><li>Benzedrine </li></ul></ul></ul><ul><ul><ul><li>Tegretol </li></ul></ul></ul><ul><ul><ul><li>Cylert </li></ul></ul></ul>
    26. 26. How stimulants work <ul><li>ADHD is believed caused by a maturational delay in the development of the nervous system. Drugs can treat the condition by stimulating the mid-brain, balancing it with the outer cerebral cortex. This may be an oversimplification, but it’ s a start. The exact therapeutic mechanism of stimulant action on ADHD is still unknown. </li></ul>
    27. 27. When taken as directed… <ul><li>Stimulants, used under medical supervision, are considered quite safe. Though they can be addictive to teens and adults if misused, these medications are not addictive when taken as directed. </li></ul><ul><li>Stimulents seldom make patients &quot;high&quot; or jittery. Nor are not sedatives. Rather, the stimulants help the ADHD person focus on and control his or her hyperactivity, inattention, and other target behaviors. </li></ul>
    28. 28. Medication <ul><li>ADHD is a chemical imbalance, in a similar way that depressive illness or diabetes are chemical imbalances. </li></ul><ul><li>Prescribed medications, taken as directed, should not be confused with drugs of abuse. </li></ul>
    29. 29. Most drugs have side-effects <ul><li>For example, some side-effects of Ritalin may include: </li></ul><ul><li>sleep disturbances (insomnia) </li></ul><ul><li>depression or sadness </li></ul><ul><li>headache </li></ul><ul><li>stomachache </li></ul><ul><li>appetite suppression </li></ul><ul><li>elevated blood pressure </li></ul><ul><li>appetite suppression </li></ul><ul><li>growth reduction. </li></ul>
    30. 30. You are what you eat. <ul><li>Some believe that sugar or food additives contribute to hyperactivity and other ADHD symptoms. </li></ul><ul><li>There is little research to confirm this hypothesis. However, there is no question that a healthy diet improves physical and mental functioning. </li></ul>
    31. 31. A lifestyle of sobriety will lead to . . . <ul><li>Healthier interpersonal relationships </li></ul><ul><li>More organized, productive functioning </li></ul><ul><li>Fully conscious experience of life </li></ul><ul><li>Less conflict with self and others </li></ul>
    32. 32. Where to Get More Information <ul><li>Talk to your doctor and your counselor </li></ul><ul><li>Advocacy organizations </li></ul><ul><li>Internet searches </li></ul><ul><li>Local public library or school library </li></ul>
    33. 33. <ul><ul><li></li></ul></ul>NADDA Guiding Principles for the Diagnosis and Treatment of ADHD   1.     Evaluate and treat the whole person.   2.     ADHD should be suspected but not presumed. 3.     ADHD may present across the life span.   4.     A comprehensive assessment is necessary for an accurate diagnosis.   5.     Evaluation and treatment of ADHD should be by a qualified professional.   6.     Response to medication should not be used as the basis to diagnose ADHD . continued…
    34. 34. <ul><ul><li></li></ul></ul>Guiding Principles , continued 7.     Diagnosis should be based primarily upon the DSM-IV ADHD criteria.   8.     Diagnosis and treatment of ADHD should involve others familiar with the person undergoing the evaluation.   9.     Treatment should often involve more than one discipline working cooperatively.   10.   Stimulant medications are the benchmark of treatment for most ADHD patients.   11.   Practitioners should become familiar with current research and diagnostic tools. Source: National Attention Deficit Disorder Association
    35. 35. References and Links <ul><li>ADHD Fact Sheet for Parents and Teachers, Guilford Press, 1991. </li></ul><ul><li>ADDult Support of Washington for Adults With Attention Deficit Disorder, on the web at http://www.addult.org/ </li></ul><ul><li>ADDvance: A magazine for girls and women with Attention Deficit Disorder, on the web at http://www. addvance .com/ ADDvance / ADDvanceMag . htm </li></ul><ul><li>Attention Deficit Disorder, on the web at http://add.about.com/health/add/ </li></ul><ul><li>Children & Adults with Attention Deficit/Hyperactive Disorder (ChADD), on the web at http://www.chadd.org </li></ul>
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