With an increasing number of ADHD diagnoses in recent years, many sufferers have found themselves struggling to find a suitable medication to help mitigate their symptoms and allow them to lead more balanced lives. Whether due to inefficacy, unwanted side effects, or difficulties with addiction, the search for a better alternative has increasingly become a priority. Could cannabis be the solution we're after?
What Is ADHD?
Formerly known simply as Attention-Deficit Disorder (ADD), Attention-Deficit/Hyperactivity Disorder is an incredibly common neurological disorder that affects the brain's ability to focus. This disorder affects around 11% of school-aged children and between 4-6% of adults. These numbers are difficult to nail down due to the fact that many people go undiagnosed for much or all of their lives.
Despite its ubiquity, ADHD and its effects on a person's daily life are often misunderstood by the general public. Too frequently, ADHD is derided as merely a nuisance or inconvenience to those that experience it. In reality, this disorder is far more than an occasional difficulty focusing or a hyper, jittery feeling.
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The main symptoms of ADHD fall into two sides: inattentive type and hyperactive type. For the inattentive type, sufferers often have difficulty focusing during conversation, trouble paying careful attention to details, are easily distracted, and are forgetful. These often translate to poor performance at school or work, where those with ADHD often make small mistakes, forget crucial details, avoid tasks that require extended mental effort, get distracted from the task at hand, and may frequently lose important items. It is for these reasons that ADHD is recognized as a disability by the Americans With Disabilities Act and Rehabilitation Act, meaning those who are meaningfully impaired by their symptoms may qualify for reasonable work accommodations.
The other main subset of symptoms, the hyperactive type, is often characterized by an inability to stay seated for extended periods of time, constant fidgeting and tapping of the hands and feet, obnoxious or intrusive behavior in personal interactions, extreme impulsivity, and being excessively talkative. While a constant boost of energy seems like it would be beneficial, hyperactive ADHD sufferers face a number of challenges from their symptoms. Their impatience and impulsivity often lead to erratic behavior and questionable decision-making, especially when under stress. Their need to stay moving and inject themselves into social interactions can make them come off as abrasive and impudent, meaning they have more difficulty than others in making and maintaining friendships.
These symptoms vary from person to person. Some diagnosed may only experience a handful of those listed here, while others report dealing with all of them from both types of ADHD. How can they find relief?
Treatment
As is the case with most neurological disorders, the exact causes of ADHD are unknown; this makes treating the disorder incredibly tricky and finding an outright cure almost impossible. The primary treatments today consist of rigorous therapy, especially with young children who are still developing, and intervention with medication to manage symptoms. The most common medications employed to suppress symptoms are stimulants, specifically amphetamines, such as Adderall and Ritalin.
While prescribing stimulating drugs to someone who has difficulty focusing and sitting still may seem like throwing gasoline on a fire, it has proven surprisingly effective. The brain of someone with ADHD has a reward center that works improperly, meaning that they do not get appropriate boosts of serotonin and dopamine the way a neurotypical person might. This is the assumed culprit behind their inability to follow through on tasks, form cursory memories to keep track of their belongings, and focus for long periods of time. The prescribed medication activates and stimulates these neurotransmitters and makes the brain far more effective at feeling rewarded for these behaviors.
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Unfortunately, despite their efficacy, amphetamines aren't a risk-free wonder cure. Some diagnosed with ADHD that are prescribed one or more of these stimulants find them entirely ineffective. Even worse, some report that their symptoms are greatly exacerbated with the use of these drugs, making their symptoms incredibly debilitating. Many of those who do find some relief from their ADHD symptoms are plagued with various side effects. In addition to the mild side effects caused by many medications, such as headaches and irritability, ADHD medications have been known to cause far more severe reactions. There are numerous reports of users experiencing a racing heart, palpitations, severe anxiety, spiking blood pressure, rapid mood swings, dizziness, persistent insomnia, skin rashes, and, in rare cases, seizures and strokes. These negative effects can push some to abandon the treatment entirely, or it may necessitate further medication to treat these newly onset symptoms.
In addition to their potential for negative reactions, amphetamines and stimulants themselves are known to be incredibly addictive. Even among those who are prescribed the drugs, the potential for abuse is inherent. The Journal for Clinical Psychiatry conducted a study and noted that, from 2006 to 2016, the number of cases of abuse of dextroamphetamine-amphetamine (Adderall) rose sharply by 67%. The number of emergency room visits associated with the drug in turn rose by 157%. Most alarming is the number of young adolescent users who are either prescribed the drug or procure it from elsewhere. It's worth noting, the DEA, while hardly always a trustworthy judge of a drug's true impact, has long listed dextroamphetamine-amphetamine as a Schedule II drug, indicating strong potential for addiction and abuse.
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Can Cannabis Help?
Cannabis is well-documented for its numerous medicinal uses, from managing pain to quelling PTSD symptoms. On paper, a drug that makes you feel relaxed and euphoric feels like a good idea for someone who needs to feel calm and focused, but just how effective is it when it comes to ADHD? As with all cannabis-related research, the science is still young and poorly funded. However, we do have a few studies to look at.
In 2020, the Rambam Maimonides Medical Journal released the results of a small study conducted on 112 adults with ADHD. They found that, over time, a majority of participants who consistently used cannabis and CBD were able to gradually reduce or altogether cease their stimulant medication. In 2019, the Sage Journal conducted a study of over 1,700 students with ADHD. Their findings, based on data self-reported by the students, found that more than half of them self-medicated with cannabis in one form or another. A portion of them specifically indicated that they did so to mitigate the negative side effects of their medication prescribed for their ADHD. A further study specifically of posts online discussing ADHD in conjunction with cannabis found that more than 35% reported improvement in their symptoms with its use, while 7% reported negative interactions.
Not all studies have come to the same conclusion. A massive study done by the Lancet pored over 83 separate studies conducted about cannabis and compiled the data. They concluded that, "There is scarce evidence to suggest that cannabinoids improve depressive disorders and symptoms, anxiety disorders, and attention-deficit hyperactivity disorder." While this may seem concrete, they also stated that there were plenty of positive results found throughout the studies examined, but that these may be outliers or incidental.
The overall effectiveness of cannabis and cannabinoids on ADHD remains to be seen. Some have certainly found it to be invaluable when it comes to managing their symptoms and helping them focus. Ultimately, as was the conclusion of all of the aforementioned studies, more rigorous testing and studying need to be done. Time will tell if cannabis will become the new, more reliable, safer go-to drug to keep those with ADHD living happy, healthy lives.