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ADHD treatment discourages children from drug abuse later

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TORONTO -- Treatment with stimulants such as Ritalin halves the chances that a child with attention deficit hyperactivity disorder (ADHD) will become a drug or alcohol abuser later, according to several studies reported here over the weekend.

Although some animal research suggests that stimulants can ''prime'' the brain for addiction, the medications ''help protect kids, reducing their risk for later substance use. . . . But they do not immunize them'' against drug or alcohol problems, says psychiatrist Timothy Wilens of Massachusetts General Hospital in Boston. He spoke on a panel at the American Psychological Association meeting.

Wilens' review of recent studies on 1,195 children who were followed through their teens or into adulthood found that children treated with stimulants were no more likely than their peers in the general population to have drug or alcohol problems. But kids with ADHD who weren't given stimulants were twice as likely to become abusers.

The research on animals has been misleading, Wilens says, because injecting very high doses of stimulants induced the brain changes that could signal addiction. Children with ADHD take much lower doses than the animals received, and they get the medicine orally, which is unlikely to foster addiction, he says.

Wilens says he believes the attention problem in ADHD ''is a stealth risk factor for substance abuse. . . . People can't concentrate enough to get things done.'' Their feelings of frustration and failure could promote escape through drugs or alcohol.

But poor impulse control, often a part of untreated ADHD, also might encourage addictions. ''You've got an impulsive teenager at a party, and he's vulnerable,'' says psychologist Stephen Faraone of Harvard Medical School in Boston. Parents may carefully structure their kids' lives, ''but when you grow up, one of your tasks is to structure your own life,'' and an adult with untreated ADHD symptoms can have a lot of trouble doing that, Faraone says.

Still, the stimulants ''are not a panacea,'' he cautions. About 30% of children can't tolerate the side effects, which can include insomnia, headaches, stomachaches, irritability and poor appetite.

An estimated 3% to 5% of U.S. children have ADHD.

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