05/14/06

For These Kids, Medication Reduces Risk of Alcohol, Drug Use Later
By: Rachel Bryan

A concern some parents have about medicating their child for attention deficit hyperactivity disorder (ADHD) is that their child might get used to using drugs to solve problems, thereby increasing their chances of illegal drug use in the future. Furthermore, if there is a history of drug abuse in the family, parents are understandably concerned about starting their child on drugs at a young age.

Fortunately, this is not the case. When medications for ADHD are used correctly, they can actually reduce the risk of alcohol and drug use down the road. Nobody wants to see kids on medicine needlessly. And medication should not be the first thing that is tried when attention issues are raised. But when all of the interventions have been tried and met with only minimal success, it may be time to consider medication.

When a child is suspected of having ADHD, providers should try to treat it with behavioral interventions first, both at home and school. This often includes preferential seating in the classroom, rewards for increased on-task behavior, homework breaks at home, and increased communication between the school and home. However, all of the interventions in the world won't help a child sufficiently if he needs the addition of medication to help him control what he and his environment simply cannot. This does not mean that you stop providing all of the other support; it does mean that you recognize when a behavioral plan is not enough.

When ADHD goes unsuccessfully treated, kids are at risk for more serious problems down the road for three reasons.

•First, a child who cannot attend to lectures because his thoughts or fingers can't slow down long enough to absorb the necessary information will not reach his potential. The energy spent trying to control himself is not spent on learning.

•Second, as a child continues to fail to meet his potential, his teachers and peers may form judgments about his behavior: Johnny never pays attention; Johnny can't do the work; Johnny is always the one who fidgets in line; Johnny is always getting in trouble; Johnny's work is messy, etc.

•Third, Johnny begins to make negative self-judgments because he sees the red marks on his paper, hears the teacher's annoyance after she's spoken to him for the 10th time and sees his peers roll their eyes as he gets yelled at, again. Research has repeatedly demonstrated that children with ADHD get significantly more negative attention than their peers.

Imagine that Johnny, now 11, has heard this kind of feedback for two years. People close to him know of his wonderful strengths, but too many others know that he is the kid who struggles and gets in trouble. Rejected by many peers, he begins to find comfort in the company of others who, like him, are less successful and maybe a little bit more rambunctious. Johnny has to find other ways to build his self-esteem because the usual ways are being closed out to him. He may find friends who find it easier to act out and have more scars to numb with alcohol or a hit off a joint.

This is not meant to imply that ADHD kids are headed for drugs. But it is not uncommon, and it is even easy to understand, that when a child who struggles with ADHD, depression, anxiety or any kind of emotional turmoil is not treated effectively, he may learn to self-medicate years of pain with alcohol or drugs as an adolescent or adult.

ADHD meds can level the playing field for a kid like Johnny, helping him to focus and pay attention like every other child. And good providers listen to Johnny to see if it is helping. If the medication does not help or has negative side effects, then it is the wrong medication and Johnny shouldn't be taking it. But when Johnny says, “My mind doesn't go all over the place any more,” and his teacher says, “He is much more part of the class now,” then we know we have an appropriate agent.

Medication is not a magic bullet. But a youngster's identity, sense of worth, academic success, involvement in extracurricular activities and family support help to insulate him from future drug use. Appropriate medication is one of the tools that give a child with ADHD that fighting chance.

Dr. Rachel Bryant is a licensed psychologist in private practice in the Southern Tier. The Star-Gazette will forward comments and questions. Send them to: Star-Gazette, Attn: Features Department, 201 Baldwin St., P.O. Box 285, Elmira, NY 14902.