It is a chemical disorder of the brain. We have
approximately 140 different chemicals in our brain and it is believed that ADD
is caused by inheriting faulty genes, which result in faulty regulation of the
supply of four of the most important brain chemicals. They are Dopamine,
Adrenalin, Noradrenaline and Serotonin.
These abnormalities give rise
to a vicious cycle of poor functioning, discomfort and distress and the use of
drugs to try to boost performance and relieve distress. Those drugs usually
cause more problems than they solve, thus putting the ADD sufferer into ever
increasing distress and trouble.
Although the different aspects of ADD
vary in degree from person to person, the common pattern is as
follows.
There is poor attention, focusing or concentration. This leads
to learning difficulties and a poor education.
There is a disturbance
of activity, usually overactivity and hurrying (Attention Deficit
Hyperactivity Disorder, or Attention Deficit Hurry Disorder, or ADHD); but
sometimes resulting in underactivity, boredom, daydreaming, slowness, dawdling
and lack of motivation, with difficulty in getting started and a tendency to
procrastinate (Attention Deficit Daydreaming Disorder or ADDD). This activity
disorder may result in problems in the classroom. The child cannot stop
talking, fidgeting or moving around, distracting his classmates, aggravating
his teachers and perhaps becoming the class clown; or he/she may sit quietly
in the corner of the class daydreaming, be neglected and fall behind. The
family may be driven mad, and relationships be strained or damaged, because of
the hyperactivity and impatience, or because of failure to achieve and to
contribute. Employment is very difficult, with poor performance, friction with
employers and workmates and frequent dismissals, resignations and periods of
unemployment.
There may be a strong tendency to impulsivity, with knee
jerk reactions and snap decisions, some of which are too quick to be the best.
There may be a strong tendency to impulsivity, with knee jerk
reactions and snap decisions the norm, often resulting in mistakes, regrets
& overuse of credit cards or even shoplifting.
There are often
problems with time. ADD people are often very impatient and 5 minutes may seem
or be an impossible length of time for them to wait. On the other hand they
may get so involved in things that they don't notice the hours going by, miss
meals, neglect other duties and forget appointments. Appointments are very
hard for ADD sufferers to make and to keep. They often can't come to grips
with making an appointment with a psychiatrist who has a six week waiting
list. They often have difficulty with things that require planning
ahead.
The net result of all this is that education and performance is
poor, relationships are strained, there may be difficulty in getting or
keeping a job and certainly in developing a satisfactory career, and the
suffering and distress involved may mean that the person seeks relief in
various types of social, prescribed or illegal drugs. This tendency to
substance abuse is so common that ADD sufferers are sometimes said to have an
"addictive brain". Research recently showed that treatment of primary school
ADD children with Dexamphetamine or Ritalin, reduces their chances of
substance abuse in adolescence by 85%.
It is our finding, confirmed by
independent psychiatric assessment in most cases, that at least 60% of the
heroin addicts I see in my clinic are ADD sufferers, mostly ADHD sufferers,
but also a significant number of ADD sufferers.
1. Reducing the
chemical abnormalities by the use of Dexamphetamine or Ritalin, which have a
normalising effect rather than a stimulating effect on ADD sufferers.
Dexamphetamine and Ritalin are difficult to obtain because both the public and
the authorities have tended to lump them together with other dangerous black
market amphetamines such as Speed and Methamphetamine and to overlook the fact
that ADD sufferers have unusual chemistry. One man's poison is literally
another man's medicine with ADD. In most developed countries the baby has been
thrown out with the bath water. Much damage is being done to innocent people
by regulations which were introduced to protect the population against
addiction, but which are based on faulty generalisations that cause a very
vulnerable section of the population, who don't have the resources or the
capabilities to get proper medical attention and pharmaceuticals, to use
dangerous and unsatisfactory alternatives from drug dealers.
2. E.E.G.
Biofeedback if available and affordable.
3. Any other concurrent
substance abuse must be effectively diagnosed and treated.
4. Any other
disturbances such as depression, anxiety, social phobia or relationship or
family breakdowns, that coexist with or have been brought on by the ADD, must
be dealt with.
5. Assessments should be done to define the gaps in the
sufferer's education, caused by their inattention and inability to
focus/concentrate and their behaviour problems and strained classroom
relationships, during their school years. Supplementary education should be
used to fill in the gaps and complete their education.
6. Training will
be needed to make use of their new ability to focus/concentrate, read and
study and their normalized energy/activity, in preparing for employment and a
career.
7. If legal Dexamphetamine or Ritalin is not available (which
is the scandalous situation that exists in Perth for any adult who cannot
afford to consult a private psychiatrist) then Epilim (Sodium Valproate),
serotonin boosters and tricyclics will usually have some beneficial effect.
The alternative is black market Dexamphetamine or Ritalin, taken in the
morning by mouth, regularly and in small amounts. Black market Dexamphetamine
or Ritalin is a far safer and better choice than intravenous street
amphetamines, heroin or cocaine, if a sufferer has to make do with self
medication for a period.
In Western Australia the only free public
clinic that diagnoses and treats ADD is the children's hospital. Family
doctors, even if they are experts in drug and alcohol medicine, cannot
prescribe stimulant therapy. This means that penniless addicts have to go
without proper treatment and usually self medicate dangerously, using
cannabis, intravenous street amphetamines, heroin, morphine, or cocaine, at a
cost that causes poverty and crime and brings the risks of Hepatitis B and C
and HIV.
Because of some of the genes many of us carry, a proportion of
our babies are born with genes that inevitably lead to unusual chemistry,
which almost inevitably leads to conditions (ADD, depression, anxiety etc.)
that in turn almost inevitably lead to distress, poor performance, social
problems, substance abuse and dependence and great social cost. Fortunately
today we have the capability to correctly diagnose & treat those
conditions, although unfortunately it often doesn't happen.
Until the
healthcare professionals, the public generally and the authorities in this
field, understand and act on ADD, this whole sequence will continue to occur
and drug addiction, the drug world and the drug lords will grow and
prosper.
We must provide reasonable availability of chemicals that
relieve these chemically unusual and afflicted people of their distress and
disability, without giving rise to the side effects and dangers of the drugs
and methods pushed by the criminal world.
We already have the chemicals
we need - buprenorphine, valproate, serotonin boosters, naltrexone,
dexamphetamine, ritalin, and occasionally lithium, but so far we lack the
wisdom and systems to make them reasonably available. Available in ways that
are accessible even to people who suffer from the disabilities, dysfunctions
and lack of resources of ADD sufferers.
Despite anything anyone may
tell you, none of these types of medicine is any more dangerous than dozens of
other chemicals your family doctor writes prescriptions for every week. If
they were reasonably available, in a way that was accessible to people with
the disabilities and dysfunctions ADD sufferers have, there would be very
little street trade in any of them. The criminal market for speed,
methamphetamine, ecstasy, heroin, morphine, cocaine and cannabis would
contract sharply. The pushers and the Mr. Bigs would have to find something
else to do. The Criminal Justice, Education and Public Hospital systems would
have the pressure taken off them. We would be able to get on with building up
the people we are presently causing untold misery and chopping to
pieces.
