ADHD

ADHD is the acronym for a medical condition - Attention Deficit Hyperactivity Disorder. A variation on this disease is ADD which is Attention Deficit Disorder without the corresponding hyperactivity. Other similar diseases in this class are Bipolar, Tourette’s, Migraines, Autism, and Anxiety/Depression. It is estimated that about 6-9% of children may have some form of ADHD, and 5% of adults. It is twice as common in boys, and it is usually diagnosed between the ages of 6 and 8.

 

This ailment was first diagnosed in 1902, and is characterized by Inattention and/or Hyperactivity and sometimes Impulsivity.

Younger patients in preschool more commonly suffer from the hyperactivity issues, while older adolescents may experience more of the inattention and impulsivity. This can lead to decrease in academic performance, struggle with relationships, and other social behaviors. Symptoms can change over time and remission often occurs with aging, with or without treatment.

 

Hyperactivity issues involve squirming while seated, running, climbing, constant motion or talking, restlessness, and excessive movement. Often there is impulsive behavior such as inability to wait for their turn, interruption of games or activities, and speaking out of turn.

 

Inattention may often cause overlooking or missing details, difficulty in test taking, inability to organize tasks or activities, and failing to complete school work or projects. These individuals also tend to avoid tasks that require mental focus, have difficulty in daily activities, tend to lose things and are easily distracted and unable to focus on sustained tasks. A combination of these symptoms are often common, and other conditions such as learning disabilities, anxiety, depression, and anti-social behavior can occur. The disease is formally diagnosed by a licensed clinician or doctor, and the symptoms must be chronic or long lasting, impair functioning, and may cause delayed developmental problems. Often, there is a requirement for having at least 6 of the common signs of the disease, most of which are outlined above.

 

Treatment is generally in three different classes: medication, psychotherapy, and counselling and behavioral therapy. Current medical pharmacology includes the use of the following drugs – Concerta, Ritalin, Metadate, Amphetamine, Adderall, Clonidine and others… Some adverse side effects (ie. high blood pressure, seizures, heart disease, glaucoma, liver or kidney disease, or anxiety disorder) may need to be addressed or counter-acted with the use of other prescriptions. These standard drugs can be helpful as long as they are prescribed properly by an experienced practitioner, who monitors the patient closely and frequently. Often, it takes time and experimentation to arrive at the proper dosage and drug type. Even so, one objection  to current therapy is that the medications used to treat ADHD may frequently have unwanted negative side effects such as decreased appetite, sleep issues, stomach problems, headaches, and irritability or moodiness. These side effects are rarely if ever experienced with cannabis, as long as it is prescribed properly by an experienced provider.

 

In fact, the use of medical cannabis has proven anecdotally to provide some relief and improvement of symptoms in those with ADHD. This has been seen in clinical practice, as well as reported in the literature.

In fact, some older patients have used it unknowingly to treat their symptoms without having an M.D. diagnose their condition.

 

Younger patients with ADHD may also benefit from cannabis, however it becomes a tricky situation because medical cannabis not legally be recommended for adolescents or those under the age of 18 without special approval. As cannabis has been shown to be somewhat detrimental to the developing brain in adolescents, the use of cannabis should only be considered if traditional methods and drugs have failed, or the negative side effects of these drugs are preventing their use. The question of age and legality of using cannabis is of concern, so this topic must be addressed and we do not recommend underage use of cannabis in this state.

 

It has been found that low Dopamine levels (a neurotransmitter) are common in the disease. This specific neurotransmitter is beneficial in maintaining attention, memory, cognition, and concentration. Prescription medications often increase dopamine levels, often by decreasing its degradation and preventing metabolic breakdown. It is well documented that cannabis can also increase dopamine levels by increasing dopamine and norepinephrine production, and possibly prolong its effect.

Cannabis can slow neural impulses by causing retrograde inhibition (which inhibits nearal conduction between neurons, and also can bind to dopamine receptor sites, which allows more dopamine in circulation. There are some 40 studies on the use of cannabis for ADHD that were conducted before the year 2000, so some scientific evidence already exists to indicate a mechanism for action in ADHD. More clinical studies needed… as is quite often the case with cannabis research.

 

Cannabis can help achieve some of the goals of treatment which include reducing impulsivity, decreasing movement issues, improving sleep, and allowing better performance and focus on task.  Many with ADHD who use medical cannabis report improvement. The ingestion technique and strain may depend upon each individual situation and their treatment objectives. Medical supervision is a must, and careful monitoring is necessary. Tinctures, sublingual sprays, edibles, and pills may be most beneficial. Smoking and vaping are also acceptable in adults who have this condition, as some individuals have persistence of disease into adulthood. For those interested, there are clinical trials available at NIMH/NIH in Bethesda Maryland to enroll candidates who are interested.

 

In conclusion, it is quite obvious that cannabis is a valid alternative for treatment of this disease, but must be carefully prescribed and used in proper dosage and form to be most effective… particularly useful when traditional methods have failed, or side effects of traditional therapy require mitigation.