Giving your child any new medication can be nerve-wracking, but when doctors refer to it as a stimulant and it’s classified as a controlled substance, it’s particularly understandable to feel uneasy.
Further compounding these fears is the general stigma around mental health conditions and the belief that if a problem is “in your head,” then you should be able to control it by force of will – or, in the case of your children, through better parenting.
But ADHD is a real neurological condition, and medication helps many people manage their symptoms and lead less fraught, more productive lives. Unfortunately, there are a number of common misconceptions about ADHD medications that can cause parents to worry unnecessarily.
If your child takes medication for ADHD or you are considering having them try it, here are a few concerns that you can put to rest.
Myth 1) All ADHD medications are stimulants
“When people talk about ADHD medications, they typically think of stimulants,” Andrew Kahn, associate director of behaviour change and expertise at
Understood.org, told HuffPost.
In fact, there are two categories of ADHD medications: stimulants and non-stimulants.
Stimulants work by targeting dopamine, a neurotransmitter. They have been prescribed to patients with ADHD since the 1960s. Some stimulants prescribed today include Focalin, Ritalin, Adderall, Concerta, and Vyvanse (as well as their less-expensive generic counterparts.)
Non-stimulant medications target a different neurotransmitter, norepinephrine. Some brand names of non-stimulants are: Strattera, Intuniv and Tenex.
There are different pros and cons to stimulant and non-stimulant medications, and a common refrain among parents of kids with ADHD is that you don’t choose your child’s medication — you see which medication works best for your child.
Myth 2) ADHD medications are a dangerous substance
Stimulant medications are a controlled substance, meaning their use is regulated under federal law.
“A medication may be classified as a controlled substance if there’s a potential for abuse or dependency, or if it poses potential health risks and needs to be carefully monitored,” Kahn said.
“Controlled refers to the way that a medicine is stored, produced, handled, and distributed,” Dr Larry Mitnaul, a board-certified adult and child psychiatrist, told HuffPost. “Those controlled substances with medical indications are allowed to be prescribed by licensed medical professionals.”
It’s important to note that a potential for misuse doesn’t necessarily indicate a high probability for it.
“The great majority of people prescribed stimulant medications for ADHD do not abuse or misuse their medications,” Kahn said.
However, because stimulant medications increase dopamine production in the brain, in addition to increased focus and attention, they can also bring about “a feeling of improved mood or a sensation of wellness”. In large enough doses, a person might experience this as a kind of “high.”
If stimulant medications are used in amounts higher than intended, or by someone who doesn’t have ADHD, the risks include “heart attack, stroke, manic-like behaviour, paranoia, and dependence (if used frequently),” Kahn explained.
Non-stimulant medications do not carry the same risks, but stimulant medications continue to be widely prescribed. “Stimulants ... are the most commonly prescribed and are most effective for reducing the symptoms of ADHD,” explained Brooke Molina, a professor pf psychology, psychiatry and paediatrics at the University of Pittsburgh.
Myth 3) Taking ADHD medications will lead to drug addiction and dependence
Because there is a potential for misuse with stimulant medications, some parents worry that their child will become addicted to ADHD medication, or that the medication will serve as a “gateway drug” that leads them to use other dangerous substances.
Research does not support this theory. On July 5, Molina published a study on this topic in JAMA Psychiatry that found “no evidence of an association between stimulant medication use for ADHD and adolescent and young adult substance use or substance use disorder in a sample of individuals rigorously and comprehensively studied from childhood to early adulthood,” she told HuffPost.
“Individuals with ADHD do indeed have, as a group, elevated risk for harmful substance use and substance use disorder, just like children whose parents have substance use disorder also have elevated risk for substance use disorder,” explained Molina.
But the results of her study shows that “stimulant medications prescribed to children and perhaps continued through adolescence are not contributing to this risk.”
These findings echo a 2017 study that found that not only was there no link between the use of ADHD medications and substance use problems, but that patients taking medication for their ADHD were less likely to have an issue with substance abuse than those who weren’t.
“Current research indicates that the longer someone with ADHD is undiagnosed or untreated, the more likely they are to struggle with mental health challenges.”
- Brooke Molina, professor pf psychology, psychiatry and pediatrics at the University of Pittsburgh
Kahn said this finding could reflect that medicated individuals are “less likely to ‘self-medicate’ to navigate their differences. And they’re more likely to benefit from the supportive care they receive.”
He noted further that “current research indicates that the longer someone with ADHD is undiagnosed or untreated, the more likely they are to struggle with mental health challenges.”
At the same time, Molina noted there is still a need for vigilance, particularly as children reach adolescence: “Sharing, trading, and selling stimulants is relatively common and families should be prepared for this possibility.”
She recommended storing the medication in a protected location, being selective with who you tell about the prescription and preparing a response in case someone asks for the medication.
Myth 4) It takes a while for ADHD medications to kick in
While other medications that impact neurotransmitters, such as antidepressants, often take a number of weeks before users notice an effect, “in general, the stimulant medication effects are more immediate,” said Mitnaul.
In comparison, it can take four to six weeks to notice the impact of a non-stimulant medication.
Frustratingly, even with the quick results of stimulant medications, it can take some trial and error to find the right dose and formula for your child.
There are both short- and long-acting versions of these medications, and dosing depends on your child’s individual sensitivity to the medication, not simply their age or weight.
For example, you might find that it works well for your child to take a long-acting stimulant medication in the morning before school, but that they need a booster dose in the afternoon in order to manage symptoms so that they can finish homework.
Your doctor can also work with you to adjust medications to deal with side effects such as loss of appetite or trouble sleeping.
Myth 5) ADHD medications are only necessary when children are in school
While trouble with schoolwork is often what triggers an evaluation for ADHD, the condition affects kids at all hours of the day and in every component of their lives.
“Taking medication can help to address the many areas where ADHD affects thinking, attention, learning, and daily functioning,” Kahn said.
Some children take “breaks” from their medications on weekends and vacations, whereas others take them every day regardless of planned activities.
It’s important to discuss your medication use with your doctor, who will best be able to advise you given your particular medication and circumstances.
Myth 6) Children will outgrow their need for ADHD medication
“ADHD is a lifelong difference in how the brain works,” Kahn said. It is not a condition that children will grow out of, though they can learn to manage it effectively.
“Treating ADHD isn’t a medication versus ‘something else’ endeavour,” Kahn continued. “Medications alone can be very helpful in managing some of the core symptoms of ADHD. But even people who are well-supported with medication need a variety of other interventions to thrive in their daily lives.”
While treatment often includes medication, other treatments – such as therapy, accommodations at school, assistance with executive functioning skills and adjustments to diet and exercise – are frequently part of an overall treatment plan that will change as children grow, mature and figure out how to best manage their ADHD.