October 10, 2008

Harvard Study: ADHD Drugs Keep Girls With ADHD From Smoking, Drug Abuse

There's a reason for the Harvard bit in the headline: the Harvard ADHD/Bipolar Child--that would be child psychiatrists Tim Wilens and Joe Biederman, both objects of a Senate investigation into not properly disclosing their Big Pharma funding--are out with a new bit of covering-their-asses research. Most of you likely know that some studies have shown that kids on ADHD drugs have an increased risk of drug abuse and that just hasn't sat well with some forces in child psychiatry (mostly the true believers at Mass. General) who continue to ask the question: "Do ADHD meds lead to drug abuse in kids with ADHD?"

Certainly, the street would answer "Yes." Scratch a teen with ADHD and you'll find a smoker, a joker and a midnight toker.

Recently, Biederman had a paper out in the American Journal of Psychiatry, claiming that 10 years of stimulant therapy didn't up the risk for substance use disorder in male adults with ADHD. Now, his colleague Wilens has a study--114 teen girls--out in the Archives of Pediatrics & Adolescent Medicine wherein he and co-author Biederman found:

"There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; {chi}2113 = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; {chi}2111 = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD.

"Conclusion: Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD."

I've not seen the full paper, so I cannot speak to what substance use was found, but I've got my guesses. Literally every single teen or 20-something I've run into over the last decade who takes stimulants smokes cigarettes, drinks more than the docs would likely approve of, and smokes weed, too. And of course the 20-somethings had been on the ADHD meds for years. As for the "protective effects" claim, whenever a psychiatrist uses that term, I've learned it's best to run for the hills.

Wilens told Reuters:

"Wilens said any finding that a medication reduces the odds of smoking is important. If you smoke and have ADHD, over half of those kids ultimately go on to have a substance abuse problem,' he said in a telephone interview."

Yes, cigarettes are gateway drugs. What's interesting about the study is that cigarette smoking has gone so much over the last 10 years or so that I'm not surprised by his finding on smoking at all. It's much harder for teens to lay hands on cigarettes than in, say, 1995 and the indoctrination--oops, I mean public health education--of teens on smoking is far more aggressive than it was in earlier research environment on the stimulant-smoking question.

All the same, I'm sure their findings apply to some people and not to others. But it sure is fun to watch how hard these guys will fight to protect their medicate the rowdy, inattentive kids paradigm. So hard that you wonder if they had more than an academic interest in the question they are asking. The current study was funded by Eli Lilly, makers of Strattera, and NIMH.

Didn't Sen. Charles Grassley find that the Harvard crew was pulling down millions from Big Pharma? Oh, yes.

"Biederman: $1.6 million from 2000 to 2007

"Wilens: $1.6 million from 2000 to 2007"

At the same time, these researchers were not fully disclosing these Big Pharma payoffs--oh wait, that's research funding to do objective science--which makes life really tricky for researchers who are also getting federal research funding concurrently.

That's some serious coin and if ADHD drugs were deeply-connected to drug abuse, you can bet the whole paradigm would take a hit and so would Wilens and Biederman's objective science.

And that almost makes me want to send the pair a box of Cubans. Except I'm sure they can afford to buy their own and have them shipped in from Switzerland.

Posted by Philip Dawdy at October 10, 2008 12:03 AM
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Comments

If I had a child I would rather see him/her smoking than on any of these drugs.

The indoctrination--oops, I mean public health education--of teens on smoking shows how people rely on these campaigns no matter what is the contempt.
I'm sure that when they find out a way to profit from cigarettes an indroct... a public health education will be reporting how nicotine is good to calm down the stress and many other benefits.
Does anybody knows when cigarettes stop being profitable or who profit with cigarettes sales?
I always ask myself why this campaign was so successful since these people have no concern with HEALTH whatsoever.


Posted by: Ana at October 10, 2008 06:42 AM

Ha!! The Harvard crowd is sort of caught in a Catch-22 here. The Papolos' book "The Bipolar Child" 2nd edition, in the preface, gives a warning on ADHD drugs and antidepressants. Seems those drugs are making children "Bipolar" according to their statement.

So where does the Harvard group draw the line between who is ADHD and who is "Bipolar"?

This study really seems to be Junk Science. Heaven forbid, too, that a teen should ever smoke a cigarette rather than take an antidepressant, an ADHD drug or an antipsychotic and/or mood stabilizer. Do you realize what this would do to Pharma!

Posted by: Rosie at October 10, 2008 08:30 AM

Hi Ana,

The stop smoking campaign actually started out as a health campaign back in 1964 with the Surgeon General's report. Then, there were some who realized how much money could be made by forcing people to quit smoking. Different foundations were payings lots of money to those who contributed to the stop smoking groups.

Lawyers, states collecting big bucks off the extra taxes on cigs, the "anti" groups, etc. - all were making a fortune. One state even raised cigs a dollar a pack with the idea it would go to fund education but it turned out, in a big scandal, that actually three people had received all of this extra tax money.

Of course, Big Tobacco fought back. They even worked on developing a cigarette with less tar but same amount of nicotine. It would have cut deaths rates from cigs in half [two and three-fourths years off one's life vs. five and one-half years.] But the "anti's" would have none of it.

Still, smoking was considered a private choice. Unlike the prescription drugs, people weren't smoking because their docs had given them a pack of cigarettes.

It was when Pharma realized that they could make billions off stop smoking products that things began to change. This was in the early 1990's. Pharma figured that people would only stop smoking if smoking was stigmatized so they cooked up a bunch of studies to show the dangers of second hand smoke. All of these studies were padded. Suddenly, the Government did not allow smoking on planes, buses, trains, in the workplace, etc.

The "anti's" even started a hate campaign against smokers. This is why one-fifth of the population is in hiding. They hate being hated.

The unfortunate side effect of the stop smoking campign, though, was that almost everyone quit smoking and started taking pescription drugs instead. Their weight increased and their quality of life went down. So even after the massive campaigns of the early 1990's, the death rate has not decreased because people are so fat and nervous.

What is the situation in Brazil with regard to smoking?

Posted by: Rosie at October 10, 2008 11:06 AM

Self-medication is a common theme with ADHD. Smoking seems to be the central focus of self-medication regimens.

The fact that nicotine allays common distraction and other scatter-brain problems comes as no surprise to me. I just wonder if the negative physical ramifications are worth the cleansing of my brain's closet.

Don

Posted by: Don at October 10, 2008 10:06 PM

in my experience people in clinics and hospitals tend to smoke like my car on the freeway in the middle of a heat wave. part drugs, part disorder, part da company. i'm an ex smoker and, personally, i much prefer speed over cigaretts. lol.
p.s. Amen on the "protective effects", Philip

Posted by: jenna at October 11, 2008 12:04 AM

Honest to God these guys just don't stop, hell they've taken over the world worse than Walmart and Starbucks. But no one seems to notice the pharmaceutical industry and it's corruption. We seem as a society to care about coffee beans hand picked by children more, and no one gets how Walmart is the new status quo for American Welfare--pay ppl cheap wages, run the little shops out of town, and no one ever moves up the ladder, keeping the workers at poverty level.

Wilens and Biederman are getting away with SO much, just like Nemeroff, Yale University, all of them that are being investigated. The APA, I mean Grassley won't be able to keep up, then of course the Government isn't all that clean either.

Posted by: Stephany at October 11, 2008 11:15 AM

While I despise they payoffs and the wink wink nudge nudge that goes on by some of these people I also don't assume everyone is doing the same. I look at neuroscience and see this article http://www.sciencedaily.com/releases/2008/07/080708171545.htm

I then look at article like this next link where they actually made a program that reduced that amount of people being diagnosed and reduced the amount of people being prescribed medications.

http://www.sciencedaily.com/releases/2008/07/080707081830.htm


Personally I think they need to take huge steps in stopping the payoffs, ghost writing, and my pet peeve direct to consumer marketing.

Posted by: JD at October 12, 2008 08:04 AM

Rosie,
I only saw your explanations today.
Thank you for the explanations. Just as I supposed.
Same here.
Smoking= out Champix/Wellbutrin= in

Posted by: Ana at December 19, 2008 03:59 PM
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