We have now docked in Marina Del Rey, a little bubble of calm in the mad sea that is Los Angeles. I'm still waiting to get the green light to practice, but all the paperwork has been submitted, so we wait. Despite it's reputation, LA is populated by wonderful, kind, generous people. I haven't met a sour face since we moved here. Well, how could you be if it's 24 and sunny every day?
In the meantime, we are hard at work addressing your prescriptions and chart transfers. Thank you for your patience. Again, as mentioned these services are not covered by MSP, so please order and pay for them through the website.
Also, please be sure your doctor's name and fax number are up-to-date, so that we are sending the right documents to the right people.
It's been our pleasure getting to know you.
Sincerely, NorthShore ADHD and Addiction Clinic, October 2019
The Overlapping Neurobiology of ADHD and Addiction
Attention Deficit Disorder
ADHD is the most common neuro-developmental disorder in children. It is more heritable than hair or eye colour and more common than anxiety and bipolar combined. At least 50% of those kids grow up to be adults with ADHD.
People who have ADHD are more likely to drop out of school, become parents in their teens, have their electricity cut off, get fired, go bankrupt, fail in relationships and get injured in car accidents. But the greatest injury of all, is the steady decline in self esteem that accompanies repeated failure, despite their best effort.
ADHD is not a religion that you have to "believe" in. A physician saying they don't believe in ADHD is like a cardiologist saying they don't believe in diabetes.
ADHD and Addiction
PERFUSION in ADHD
Addiction, like ADHD is marked by decreased Dopamine neurotransmission, particularly in the circuits that govern impulsivity and reward. Not only is dopamine low to begin with, but when stimulated by drugs or alcohol, dopamine, rises higher and faster and falls lower than in non-addicted people. It is this instability in Dopamine transmission that remains, even in recovery. That is why people with addiction often trade on e addiction for another.
ADHD, like Addiction, manifests as impulsivity, but also by under-stimulation of the dopamine circuits that govern cognition, execution, and motor control.
Therefore, if a person with Addiction also has ADHD, those symptoms of impulsivity, poor concentration, disorganization, hyperactivity will persist even after the person is in recovery. It's not persistent post withdrawal syndrome. It's ADHD.
Addiction and Compulsion
Addiction to substances like cocaine and heroin, are governed by the same neurobiology as compulsive gaming, shopping or sex. Behind all these is the quest for dopamine.
The feelings and emotions associated with Dopamine became, through natural selection, the signal that a behaviour was associated with survival. And as we mentioned, in people with addiction those dopamine circuits and by extension, their emotions and behaviours are dysregulated and unstable
That's why people with the most severe addictions would do anything, even kill themselves for dopamine.
Therefore you can't treat ADHD or Addiction or Compulsive behaviours until you stabilize their circuits, helping craving and withdrawal recede, and allowing them to better regulate their emotions and themselves.
That is why treating people to regulate themselves works. Whether it's meditation therapy, hugs, group support or medication. Whatever it takes.