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Managing ADHD, Common Co-Occurring Disorder

According to an article in the American Journal of Addiction, 10-24% of adults with substance use disorders also have ADHD, and the incidence among adolescents is even higher. Symptoms include having trouble focusing or concentrating on tasks, being forgetful about completing tasks, being easily distracted, having difficulty sitting still. interrupting people while they’re talking, and more.

"Drug-seeking behavior may be used as a means of self-medication in order to compensate for this lack of balance and to avoid feelings of unpleasantness,” explains Sarah Johnson, MD, medical director for a treatment provider with locations throughout the Eastern US.

Medication has been used to successfully treat ADHD, but it is not without risks. Common side effects of Ritalin and Adderal include loss of appetite, weight loss, dry mouth, stomach upset/pain, nausea/vomiting, dizziness, headache, diarrhea, fever, nervousness, and trouble sleeping. It can also interfere with other medications. The biggest argument in favor ot medication, aside from the results, is that taking pills is very easy. Stimulants such as Adderal and Ritalin work by increasing the availability of the neurotransmitters dopamine and norepinephrine in the brain. Regular exercise also produces these neurochemical changes. Both work in similar ways and have similar results, but exercising regularly can be difficult.

The rewards for this extra effort are numerous for people with and without ADHD. These benefits of regular exericse include decreased stress and anxiety; improved impulse control; enhanced working memory; improved ability to plan, organize, and remember details; and increased levels of brain-derived neurotrophic factor, a protein involved in learning and memory, which is typically low in people with ADHD.

Medication or exercise for ADHD? Both reduce the symptoms of ADHD. One encourages a person with an SUD to solve their problems with pills. The other promotes self-efficacy. Which one do you think should be tried first?

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