Predisposed Predicament (10/03)

By Mia James

Oct. 28, 2003

"I had smoked pot and drank every day for two years. I was taking Vicodin by the handful. Valium, Xanax, Dilaudid, Lorcet, Lortab, Percocet, you name it," said Jack Osbourne of the hit series The Osbournes, in an interview with MTV. Osbourne, who recently spent some time in a drug rehabilitation center, is still pondering what lead him into his spiraling state of intoxication. Maybe it was his newfound fame; after all, it isnt easy living life under a media microscope. Or maybe he had a genetic predisposition to addiction. However, the findings of recent study may suggest a different answer.

Osbourne suffers from attention deficit/hyper activity disorder, a neurobiological disorder characterized by impulsivity, hyperactivity, and an inability to pay attention. Like many adolescents including 19 Lowell students, according to paraprofessional Edie Borja, Osbourne may fit into a new studys findings that children with this disorder are more likely to use illicit drugs as adolescents.

ADHD and Drug Use
Psychologists Brooke S. G. Molina, Ph.D., and William E. Pelham, Jr., Ph.D. conducted a longitudinal study, a study that documents subjects over a course of time, on 142 teens diagnosed with attention deficit/hyper activity disorder as children and 100 teens without the disorder, all between the ages of 13 and 18. The study concluded that children diagnosed with the disorder, commonly known as ADHD, are more likely to have problems with alcohol, to smoke cigarettes, and to use marijuana during adolescence.

Brandi Valentine, the editor and founder of an ADHD news website (www.adhdnews.com), said the hardships that children with ADHD deal with can lead to drug use.

Children with ADHD have more negative interactions in a day than they do positive ones," Valentine said. "Children shut out of the social circles at school and in neighborhoods often find acceptance with other children who are also socially rejected for other reasons such as behavior, academic failure, drug use, etc. This often finds the child socializing with the wrong crowd, and much like in gangs, the ADHD child begins a path of bad and possibly criminal behavior."

James J. Crist, clinical psychologist and author of ADHD: A Teenagers Guide, agrees that adolescents with ADHD are more likely to use illicit drugs, but points to different reasons.

Some adolescents with ADHD use drugs for the excitement," he said. "A subset of people with ADHD are thrill-seekers and they enjoy the high. Others may use drugs to self-medicate their symptoms. Nicotine can help them calm down and focus. Marijuana and alcohol can help them forget about the stress they experience trying to succeed in school."

Living with ADHD
Gateway senior Max Fink, who was diagnosed with ADHD in the third grade, said the greatest source of stress from the his struggle with inattentiveness. Fink, who stopped taking medication for ADHD in his sophomore year because he felt the drugs werent making much of a difference, said he does notice some changes in his emotional well-being now that he is not treating the disorder.

I get depressed easier, he said. Without the medication it takes more effort to pay attention, and my emotions, which were dulled when I was on the medication, are now heightened.

Treatment
For some, like Kathleen Nadeau, Director of the Chesapeake Psychological Services in Silver Spring, Maryland, Molina and Pelhams conclusions provide yet another reason for children with ADHD to be treated with medication.

"The important fact is that kids treated effectively with medication for ADHD are not more likely to use drugs," she said. "Treatment is the answer ironically, many parents fear that stimulant medication will lead to other drugs when in fact the reverse is true."

Medical treatment may even deter later drug use, according to Crist. "Kids who are more successful, more attentive, and less impulsive due to adequate treatment should have less of a need to abuse drugs," he said.

However, the medicinal approach came under fire in March 2001, when a 14 year-old boy died of long-term use of Methylphenidate, more commonly known as Ritalin, a popular medicine for ADHD patients, according to Oakland County medical examiner Ljubisa Dragovic.

To prevent problems with medication, Crist warns that children taking such medication should have a doctor monitor them regularly to ensure effectiveness and prevent side effects.

"Some doctors give a prescription and don't see their patients for six months," Crist said. "I don't think this is good practice."

Valentine, whose son has successfully taken Ritalin and Concerta for his ADHD for over ten years, supports medicinal treatment, but also stresses the need for counseling.

"Medication is not a magic bullet or cure, and other forms of intervention are necessary to successfully treat and aid the ADD/ADHD child," she said.

Senior Drew Levitt, who was diagnosed with ADHD in the fourth grade and takes medication, said he recently began seeing a homeopathist to treat the disorder and to reduce his reliance on Ritalin. The doctor has helped me lower my dosage, he said.

Misdiagnosis
Though an estimated three to five percent of children under 18 have ADHD, the percentage of misdiagnoses are almost as common the percentage of those diagnosed.

Crist, who has treated ADHD patients for 13 years, admits he still has difficulty distinguishing ADHD from bipolar disorder, depression, or anxiety disorders, which have similar symptoms.

"Inattention or distractibility is common with all four diagnoses, he said. More often, however, I find that people are too quick to diagnose ADHD because they are so familiar with the symptoms. It may take careful observation and testing before we discover that what looks like ADHD is actually a mood or anxiety disorder. A 30-minute doctor's visit is not enough."

Valentine agrees that doctors can be at fault.

"I blame a lot of (the misdiagnoses) on the schools and doctors who only care about the bottom line: his or her pocket book," she said.

A doctor initally misdiagnosed Levitt in the fourth grade and put him on the wrong treatment plan. I saw a specialist who said it was definitely not ADHD and prescribed Prozac, he said.

Co-morbidity, the issue of having more than one disorder, is fairly common in children with ADHD and provides another example of why thorough evaluations are important, according to Crist.

Under-diagnosing is another problem, according to Crist, who said that more intelligent students who get parental help are often able to get by in elementary school, but start to fail once they are expected to perform more independently in middle and high school.

For Crist, keeping kids informed is key. "[Educating children] is why I wrote my book," he said. "The better you understand what the disorder is, the more cooperative the teenager is likely to be with treatment."

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