The New York Times recently called out a new epidemic that I see all too frequently — prescription stimulant addiction.
Drugs like Adderall and Vyvanse are being prescribed in droves to teens, college students and often young children for Attention Deficit Hyperactivity Disorder (ADHD, commonly known as ADD), despite the fact that they are known to be habit forming. These habits then persist on through many people’s adult years leading to abuse and dependence.
Before I went to med school I worked at the NYU School of Medicine’s Mental Health and Addictive Disorders Research program as a research coordinator for pharmaceutical trials for adult ADHD medications. Our center boasted some of the top psychiatrists in the field.
I even co-authored a book chapter on ADHD with the doctor I was working with at the time called “Diagnosing ADHD in Adults.” The book reviewed the criteria that should be used to say an adult has the disorder. Then and now, a simple few minute verbal questionnaire, administered by a civilian and not a doctor, was all it took to figure out if someone should be on a drug for ADHD.
That experience sparked my interest in a more comprehensive approach to medicine that included exercise, nutrition and meditation practices for mental health. Many of the people participating in our center’s research studies really just needed a lifestyle change—to stop eating so much sugar, or to stop working night shifts that disrupted sleep patterns for instance—more than they needed a drug.
At Parsley Health our doctors spend meaningful time getting to know a patient’s life story. Then use cutting-edge testing to get to the root cause of your problems. From there we create comprehensive nutrition, fitness, mental health and medication based treatment plans. One of our goals is to get you off of unnecessary medications like the kinds overprescribed for ADHD.
Stimulants, like Adderall, Ritalin and Vyvanse, are difficult to wean people off of. Even with diet, exercise, supplements and relaxation practices that help rebalance the nervous system and increase parasympathetic tone in the body, the side effects and withdrawal from coming off of these drugs can be too much for people to take.
Even worse is that these drugs appear to cause tolerance formation, meaning people need higher and higher doses for the drugs to keep working. Sometimes a patient’s dose simply stops being effective overnight and they crash.
The side effects of these drugs are also interesting in that they go far beyond the brain. Anxiety, poor sleep, heart palpitations, headaches, and even acne, are all common side effects. But the side effects I think are most interesting are digestive related ones. Many of the people I see on these drugs also have symptoms like gas, bloating, reflux and chronic constipation.
This makes sense. Our GI tracts have a complex nervous system called the enteric nervous system that regulates movement, digestion and even immune responses. These amphetamine-based drugs are not just active in our brains, they also stimulate receptors in every cell in our digestive tracts and have been shown to slow down the movement of our intestines and the emptying of our stomachs.
We also know that if slow transit times and impaired movement happen for a long time, the bacterial balance in the gut, known as the microbiome also changes. This can lead to SIBO—small intestinal bacterial overgrowth—a common cause of symptoms like brain fog, bloating and acid reflux.
It starts with these 3 steps:
Cut out sugar
Refined sugar and carbs like bread crackers and pasta work like cocaine in the brain, leaving most people on a crash and burn energy roller coaster.
Take magnesium glycinate to sleep better
Instead of tossing and turning, or taking a powerful drug for sleep, try a little magnesium. Sleep is when our brains detoxify and restore so we feel good the next day. If your sleep is poor quality you are more likely to feel anxious and exhausted, and to look for stimulants like caffeine sugar and even medications to get through the day.
Develop a meditation practice
We all learn to tie our shoes as kids but we don’t learn healthy coping strategies for stress. Instead people turn to alcohol, drugs, overworking, or overeating to relieve uncomfortable emotions. Just a few minutes of meditation a day can resolve symptoms of anxiety.