As a psychiatrist working with a lot of teenagers, many of them use marijuana regularly. There is a group of patients that I see who smoke marijuana daily. They tell me that marijuana works very well for their ADD/ADHD, and that it is “god’s natural medicine”. I have also had teenagers ask me for a prescription for “medical marijuana”. There are also some teens who become ‘advocates’ for the cause. They bring in printouts from the internet to share with me why marijuana should be legalized, and how I am part of the system to keep it down.

After hearing about this for so long, I went to the scientific literature to read about the actual impact of marijuana on ADHD. Here are some of my thoughts – some supported by my clinical experience, some supported by the scientific literature:

• Patients with ADHD who smoke marijuana regularly are generally self medicating. Marijuana decreases their hyperactivity, and to some extent may help with their anxiety symptoms (clinical observation).
• Marijuana does not improve focus and concentration (scientific literature).
• Regular Marijuana use impairs memory and word finding tasks – i.e. it worsens brain functioning. (scientific literature)
• Smoking Marijuana is a health risk – for lunch cancer, etc. (scientific literature).

I do not, nor will I ever prescribe marijuana for ADHD. I do not believe that it is allowed in Canada’s medical marijuana legislation anyway. I will admit, that on occasion, I have joked about what my office would be like if I were the doctor who prescribed medical marijuana for ADHD. I would be very popular with many ADHD teens – and my waiting room would be a party every day… We’d have to have some good music, some snacks (for the munchies), etc. But I digress. OK to joke about – but not a real treatment option.

So – what do I recommend for patients who are using marijuana regularly, thinking that it helps them?

I recommend going to a substance abuse treatment program (i.e. outpatient counseling), which uses a ‘harm reduction model’. This usually involves education about the risks and side effects of the drug, as well as encouraging less use. For example, if a teen is smoking daily, one of the first goals would be to not smoke during the school days. Once that was achieved, the goal would be to not smoke during weekdays at all, etc.

Also, I recommend getting good treatment in place for ADHD – including therapy options, as well as medication, and developing skills and strategies. If the ADHD or co-existing conditions are treated effectively, there may be less of a drive for the patient to use marijuana to self medicate.

What are your thoughts? Please share your thoughts and experiences in the comments section below.

Best,

Dr. Kenny

©2012 ADD ADHD Blog.com. All Rights Reserved.

Technorati Tags: ADD, ADHD, Marijuana, Substance Abuse, Substance Dependence

That’s why the results of a recent study are encouraging. It shows that the prescription drug, Strattera®, is particularly effective in helping those teens who not only have ADD/ADHD but who are also being treated for some type of drug problem.

About 40 percent of the teenagers who are being treated for drug abuse also have some degree of ADD/ADHD, according to Dr. Christian Thurstone, of the Denver Health and Hospital Authority, University of Colorado.

Strattera® is most effective, in fact when it’s used in combination with cognitive behavior therapy, he says. These findings were recently presented to the American Academy of Child and Adolescent Psychiatry (AACAP) 55th annual meeting held Tuesday, Nov. 4, 2008 in Chicago.

Clinicians, however, seem reluctant to actually provide these individuals with integrated treatment, Dr. Thurstone continued. While not actually sure why, he suggests that the lack of research in this area may be one reason for this. In fact, only one drug trial involving teens with ADD/ADHD and substance abuse has shown a positive response. That particular study revealed that the use of Cylert® for adolescents with both of these problems appeared to help.

The trial took 70 teens, aged 13 through 19, who not only were diagnosed with ADD/ADHD, but had at least one non-tobacco substance use disorder as well. These adolescents were divided into two groups, one receive Strattera®, the other receiving a placebo. All of the participants received cognitive behavior therapy.

Results revealed that the ADD/ADHD symptoms decreased significantly for those who were administered the Strattera®. But the real surprise came when the group receiving the placebo as well as the cognitive behavioral therapy showed improvement similar to findings from several other trials studying adults with ADD/ADHD and substance abuse.

Dr. Thurstone said that a more extensive study may be needed to detail the difference between the results received from Strattera and those of the placebo.

To view the entire article, you can click here.

Dr. Kenny

Technorati Tags: Strattera, ADHD, Substance Abuse, ADD

©2012 ADD ADHD Blog.com. All Rights Reserved.