DOMINATIONassociated with ADHD. When control dopamine is weak, people go
after things they want with little thought about the long-term con-
sequences. Kids with ADHD grab toys and cut in line. Adults with
ADHD make impulse purchases and interrupt people.
The most common treatments for ADHD are Ritalin and amphet-
amine, stimulants that boost dopamine in the brain. When these drugs
are used to treat people with ADHD, tolerance usually doesn’t develop
as it does for those who take these drugs to lose weight, get high, or
enhance their performance. Nevertheless, stimulants are addictive
drugs. The FDA puts them in the same class as opioids, such as mor-
phine and OxyContin. These are considered the highest risk in terms
of abuse, and they have the most stringent restrictions on how doctors
can prescribe them.
People who live with ADHD are at high risk of addiction, especially
adolescents, because of their poorly functioning frontal lobes. Years
ago, when the illness was less well understood, doctors and parents
were reluctant to give these vulnerable children addictive drugs such as
Ritalin and amphetamine. It sounded reasonable: don’t give addictive
substances to people at risk for addiction. But rigorous testing showed
unambiguously that adolescents who were treated with stimulant drugs
were less likely to develop addictions. In fact, those who started the
drug at the youngest age and took the highest doses were the least likely
to develop problems with illicit drugs. Here’s why: if you strengthen
the dopamine control circuit, it’s a lot easier to make wise decisions.
On the other hand, if effective treatment is withheld, the weakness of
the control circuit is not corrected. The desire circuit acts unopposed,
increasing the likelihood of high-risk, pleasure-seeking behavior.
A SURPRISING RISK AMONG ADHD PATIENTSDrug addiction isn’t the only risk these children face. It’s hard for a
child with ADHD to extract valuable resources from his environment—
typically in the form of good grades—when he can’t focus or control
his impulses. But poor grades are only the beginning. Young people