Dr. Jon Grant, Director of the Addictive, Compulsive and Impulsive Disorders Lab and Clinic and Professor at the University of Chicago gave 2 talks at Addiction Medicine Conference 2020: “Cognitive Traits that Predispose to Addictive Behaviors” and “Behavioral Addictions”. We caught up with him later to pass on audience questions. A few of them asked about ADHD diagnosis and treatment.
Q: I see a relative prohibition to treating ADHD with stimulants in patients with SUDs. What are your thoughts on this?
A: I think you have to really know the patient well. Then perhaps treating with atomoxetine first and then if not successful, a stimulant, would be fine.
Q: How do we parse out ADHD in someone with SUD and when should we treat the ADHD component in these people? It seems that identifying and treating underlying ADHD would be of GREAT benefit to patients who suffer with SUD but I know there are a lot of concerns for abuse and diversion with ADHD meds.
A: I often get formal psychological testing on people to examine their attentional issues.
Q: Do these people (with BH addictions) mostly come from certain socioeconomic groups?
A: It spans all social/economic levels.
Q: Please explain delayed discounting.
A: It is a tendency to place less value on rewards that are delayed in time. It is an aspect of impulsivity.
Q: What was the dosage of n acetylcysteine?
A: 1200mg twice a day
Q: Any new data on naltrexone for pathological gambling? It looked promising a few years ago but haven’t heard much the past year or 2.
A: It is an old generic drug and there has been no funding for gambling from the NIH and so nothing is really happening.
We’ll answer more questions from the virtual Addiction Medicine Conference in upcoming newsletters. Be on the lookout!