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Column originally published Feb 22, 2022

Ritalin Can Be Abused, But It Doesn’t Cause Addiction, Untreated ADHD Can Lead To Addiction

Question: Our twelve-year-old son is quite an athlete; he excels in every sport that he plays. However, he is not doing well in school. His teacher said that he cannot pay attention. When I tell him to do homework, it is always a huge struggle. My husband said he was like that when he was young. He was diagnosed with ADHD, and treated with Ritalin pills. They helped him to pay attention, but he became too quiet. His parents stopped the medicine when he was in high school. He did manage to graduate, even got a scholarship to play hockey at university. Unfortunately, he got involved in alcohol and drugs, and dropped out after one year. His parents blamed Ritalin for his addiction. Last year, my sister’s daughter was diagnosed with ADHD. The paediatrician started her on medicine, and she is doing very well. I am reluctant to see a paediatrician. I am scared that our son will need medicine, and get into drugs like his father.

Answer:

I believe your husband’s addiction was not because of Ritalin. There are people who abuse Ritalin, but it doesn’t cause addiction. Let me explain this to you.

Attention Deficit Hyperactivity Disorder (ADHD) has been recognized for over a century. The most obvious symptom is physical hyperactivity, more in boys than in girls. They get into trouble in school and at home. This hyperactivity is less obvious when they become teenagers. As a result, many thought ADHD is a childhood condition that they outgrow.

In the last few decades, it is evident that some boys, and most girls, with ADHD are not physically hyperactive. They are hyperactive in their brain that no one can see. They can sit quietly in class, but their mind is somewhere else. Some can still do well in school, but many don’t, and they lose their self-esteem.

Trying to fit in, they may hang out with “the wrong crowd,” and experiment with cigarettes (or vape nicotine), weed (cannabis), and alcohol. These may calm their brain; they feel accepted by others, not knowing that they are getting into addiction. It is the untreated ADHD that leads to addiction, not Ritalin pills.

Your husband remembered that Ritalin pills helped him to pay attention, likely improved his marks also. Unfortunately, at that time, short-acting Ritalin and Dexedrine pills were the only medications available for treatment of ADHD. Each pill worked for few hours. As a result, many children needed to take medicine two to three times a day. Some children became more quiet, this scared parents who were used to their hyperactivity. That was why many children didn’t stay on medicine.

Since early 2000, we have several long-acting ADHD medications that can work 10 to twelve hours. Many children and adults with ADHD only need to take one dose every morning; it can be effective until close to bedtime. They can pay attention in school, do homework, and study. They can participate better in team sports like soccer and baseball, where they have to pay attention to other team members. These medications don’t change their personality or creativity.

It is good to know that your son is active in sports. The physical activity is very important for his brain’s function. Many teenagers spend a lot of time on social media and videogame; this is very harmful for their developing brain. You should limit his time on these activities, and make sure he has a good sleep schedule.

Although your son can become an elite athlete, it is still very important for him to succeed in school. Long-acting ADHD medications can help him to pay attention and learn. He can do well in sports and in academics. When his athletic career ends, he will have his education to pursue other professions. If he doesn’t get help with ADHD, he may get frustrated, and drop out of school.

I suggest that you contact your primary care provider, and discuss your concern. He may need an assessment with a psychologist who can determine whether he has ADHD or not. Most paediatricians have training in ADHD, and can advise you about long-acting medications. Watch and see how he responds. You may be surprised to find his academic potential in addition to his athletic ability.