Allgemein Gesellschaft in English

Substance Abuse and AD(H)D

Eine Kokslinie und jemand, der einen zusammengerollten Geldschein hält

I am watching the trial of Johnny Depp vs Amber Heard via Legal Bytes on youtube right at the moment, and during lunchbreak there is a bit of a discussion about how things are going in this trial at the moment. One topic that is being discussed a lot is Johnny Depp’s substance abuse and how that might affect (or not) his credibility and subsequently the outcome of the trial. It seems to be the strategy of Amber Heard’s team to paint him as a highly aggressive person because of  his substance abuse, mainly alcohol and cocaine. So, I’ll write down my two cents here, in case anybody is interested. Here goes:

As far as I am informed, Johnny Depp suffers from ADHD. Back in the day (I’m about two years younger than him), this disorder did not exist. Kids with ADD or ADHD were just a pain in the neck, got scolded a lot and were always told to behave. The hyperactive ones would be told to sit still, to be silent, to look where they were going. The non-hyperactive ones would hear things about paying attention, stop dreaming all the time, do their homework, do their chores, and PLEASE keep up and stop to dawdle.  There was no disorder. There was no medication. And the kids grew up thinking there was something wrong with them, because they were told so. This is the perfect breeding ground for substance abuse – especially for stimulants. Why that?

AD(H)D is sort of a malfunction of the brain metabolism, especially two substances get scarce: dopamine and noradreanaline. The usual medication to treat that is a so-called uptake inibitor, mostly methylphenidate; most people know that by the trade name Ritalin. What this substance does is to prevent dopamine and noradrenaline from being transported too fast out of the brain, so that an even level is preserved. That is what we do nowadays.

Of course, when you have such a disorder and it is undiagnosed you will be tempted to try things to see if they help. Cocaine does, as it has basically the same effect on dopamine and noradrenaline[1]. So, imagine someone who really does suffer from AD(H)D trying cocaine and realizing that this helps – with concentration, with social interaction etc. etc. The problem is that cocaine is highly addictive and has various other effects, whereas methylphenidate is not addictive in the doses that are given to patients with AD(H)D.

Alcohol is suspected to cause changes to the gray brain mass which might influence the concentration and diffusion of – you will have guessed it – dopamine. According to researchers[2], „an increased diffusion in the extracellular space might seem to be a very unspecific mode of action for a drug. But a wide range of communication processes in the brain are being influenced“.

I will not translate the whole article about this, because this hint is enough for my purpose here: Alcohol is a way of self-medication for patients with ADHD, obviously.

And there we are. That is how you might come to addictions and substance abuse because of your undiagnosed disorder.

I would like to add that I have a son who has ADD and has been medicated with methylphenidate ever since he went to secondary school. The effect of this drug which is, in fact, a stimulant, is vastly different from the one it has on people without AD(H)D. My son got more focused, calmer, more determined. Someone without AD(H)D would get nervous and agitated, perhaps even aggressive under this medication.

So, I would not assume that alcohol and/or cocaine will make the user aggressive under these circumstances. Hence, I recommend talking to an expert who knows far more than a concierge doctor or a concierge nurse about what might happen when those drugs are used.

That’s my 2ct on this topic. If you would like to know more about this: Search engines are your friend! ;o)

[1] http://www.thema-drogen.net/drogen/coca-und-kokain/kokain/kokain-wirkung/

[2] https://www.wissenschaft.de/gesundheit-medizin/alkohol-veraendert-zellzwischenraeume-im-gehirn/

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