ADHD, Conduct Disorder, Drugs, & Alcohol

ADHD, Conduct Disorder, Drugs, & Alcohol
New study sheds light on this alarming link

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It’s not difficult to find ADHD teens who participate in risky behavior that includes excessive alcohol, drug, and tobacco use. Throw in conduct disorder and lives can spin even further out of control.

Conduct disorder is an emotional/behavioral disorder that ( involves specific repetitive behaviors. “These behaviors fall into four main groupings: aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules time and time again.”

A new study by The Cincinnati Children’s Hospital Medical Center and published in the journal Drug and Alcohol Dependence links ADHD with conduct disorder, drugs, and alcohol.

They study examined data on more than 2,500 teens between the ages of 12 and 15. The scientists found that a teen with both ADHD and conduct disorder was 3 to 5 times more likely to use drugs and alcohol, and begin use at an earlier age than a teen without either disorder.

If the teen had ADHD alone, they had an increased likelihood of tobacco use, but not alcohol use.

“Early onset of substance abuse is a significant public health concern,” says William Brinkman, MD, a pediatrician at Cincinnati Children’s Hospital Medical Center and the study’s lead author. “Adolescents who use substances before the mid-teen years are more likely to develop dependence on them than those who start later. This is why prevention is so important.”

Chemical Imbalance Is Probably Not Behind ADHD

Scientists question dopamine’s involvement

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PsychCentral reports of a study performed by Cambridge University that challenges the popular idea that dopamine is the culprit behind ADHD. Dopamine serves as a key neurotransmitter (carries signals between brain cells) that helps regulate cognitive function including the ability to pay attention.

The researchers suggest that ADHD is more likely due to structural brain differences, including reduced brain size. To determine this, the scientists gave Ritalin to some participants while others got a placebo. They were then required to test their ability to pay attention over a period of time.

“While the results show that Ritalin has a ‘therapeutic’ effect to improve performance, it does not appear to be related to fundamental underlying impairments in the dopamine system in ADHD,” said co-author Trevor Robbins, Ph.D., director of the MRC Centre for Behavioural and Clinical Neuroscience Institute.

PsychCentral reports that, “The researchers discovered that both the ADHD patients and the controls who were given Ritalin showed similar increases of dopamine in their brain, as well as similar levels of improvement in attention and concentration.”

These results are similar to previous studies which report that the ability to increase attention is attained by almost anyone taking Ritalin. This might account for its vast increase in illicit use among high-school and college students. It also implies that it is used as a shot-gun approach to ADHD therapy rather than a specific drug targeting brain function. The most important finding is that the study suggests there may not be a dysfunction in dopamine regulation in ADHD patients.

Unfortunately, Ritalin is often used to diagnose ADHD. A 20 minute evaluation by a family doctor results in a prescription with an, “If this helps, then it’s ADHD,” approach. We now know that Ritalin likely will have the same effect for most of the people taking it; it will improve their ability to pay attention. Therefore, it is not an effective method to diagnose ADHD.

“These new findings demonstrate that poor performers, including healthy volunteers, were helped by the treatment, and this improvement was related to increases in dopamine in the brain,” said Barbara Sahakian, Ph.D, study lead author.