To the Editor:
I would like to thank the Gloucester Daily Times and the Gloucester Police Department for bringing to our attention a problem that is near and dear to both my personal and professional heart.
That's the use, misuse, abuse, and overprescribing practices of the stimulant drug Adderall (the Times, Page 1 news story, March 26; editorial, March 28).
As a behavioral health provider in two area family medical practices, I see many patients who are reporting the symptoms of attention deficit hyperactivity disorder and are specifically requesting Adderall.
It is my subjective experience that the abuse of Adderall is rampant, particularly in the young adult population. It is very easy to obtain and may actually be more abused or diverted than many other widely prescribed medications such Xanax, Klonipin, Vicodan and Percocet.
I think the Gloucester Police Department's assertion that this medication is being misused and abused is right on target.
While Adderall and many other stimulant and non-stimulant medications assist in managing the behavioral and cognitive symptoms of ADHD, it is highly unlikely that so many people, especially young adults, are actually in need of this medication.
In fact, a thorough diagnostic assessment may not even reveal that ADHD symptoms are present. Depression, anxiety, bipolar disorder and, or substance abuse are more likely culprits and often have symptoms which overlap with ADHD.
In our practices, Adderall is often being requested for anything other than ADHD symptoms. It is requested for depression, as a diet aid, as a pick-me-up stimulant, to stay awake on the job, and last but not least, for self-reported ADHD symptoms ranging from poor focus and concentration to hyperactivity.
Many patients are requesting this medication through self-diagnosis rather than formalized neuropsychological testing. Patients will often come in requesting this medication in particular without any supporting treatment records indicating that it has been prescribed previously, nor do they have testing documents that confirm ADHD has contributed to poor school performance.
If alternative medications are recommended, patients will frequently say that "...only Adderall works."
I have seen patients get extremely angry and belligerent when they have been told this medication was not indicated for their particular symptoms and is better managed by psychiatry. And when this medication is abused, I have seen it result in family problems, job loss, and the abuse of other illicitly used drugs.
In our society where we have difficulty tolerating psychological discomfort, it is so easy to take a pill that provides relief from whatever ails us.
What is more helpful in many more circumstances than not is a comprehensive diagnostic assessment and good behavioral health support alone, or in combination with psychotropic medications.
True symptoms of ADHD can often be minimized with the implementation of good coping tools, recognizing one's strengths, holistic forms of treatment including diet and exercise, organizational strategies and of course, family support, consistency and structure.
Mostly, however, the abuse and misuse of this medication may make it difficult to obtain for those who truly need it.
Thank you again for bringing this important issue to the front page.
LISA SCHOTT, LICSW
Primary Care/Behavioral Health Integration Program
Gloucester Family Health Center