Dear Alice,

I've recently been evaluated for ADHD. The doctor kept asking about the amount of alcohol that I used and I must admit that it is a lot. I am a college fraternity boy and alcohol is everywhere so I use it quite often. Now, I've taken Adderall before and it helps me tremendously but I'm scared he won't prescribe me the medicine due to this. Are there any other solutions to my ADHD problem even though I have a history of alcohol abuse?

Dear Reader,

You are asking two smart questions. One, about the combination of Adderall and alcohol, and the other concerning alternative treatments for ADHD. To answer them in order: drinking heavily while taking Adderall can lead to some dangerous outcomes. Adderall has a tendency to mask some of the alcohol's effects on the body, but your blood alcohol rises at the same rate it always does. Because of this, you may not realize how much you're drinking. In this situation, alcohol toxicity becomes a threat, as does getting drunk enough to act in ways potentially harmful to yourself or others.

If Adderall works well for you, and you'd like to take it to treat ADHD, you could try to curtail your alcohol intake to make Adderall use possible. But you don't have to go it alone; there sources of support to help you reduce or stop your alcohol use. Most colleges and universities offer similar programs and services which you could check out at Student Services or Student Affairs.

If living in a fraternity is a priority for you but creates an atmosphere where it's unlikely you could limit your alcohol use, there are alternative treatments for ADHD that do not rely on medications. Such treatments can take the form of dietary, behavioral, or cognitive approaches. Just as pharmacological medicines don't work for everyone, these treatments have been effective for some, but not all, of the people studied.

The most common dietary strategy is eliminating foods that can agitate or over-stimulate the nervous system. The well-known Feingold Diet is based on the theory that many children with ADHD have food sensitivities that trigger learning and behavioral problems, ADHD included. Such foods commonly include sugar (in the form of candy, cookies, soda, sugary cereal, etc.), artificially added colors, flavors, and preservatives, and foods commonly associated with allergic reactions like cow's milk, wheat, eggs, soy, corn, chocolate, and yeast. Instead of simple carbohydrates which quickly turn to sugar, a diet consisting mostly of complex carbohydrates (grains and beans), fruits and vegetables, and plenty of protein may improve ADHD symptoms.

Nutritional supplementation is another common dietary approach. It is based on the assumption that something is missing from the diet, and that behavior would be improved by providing it. Popular supplements for ADHD are omega-3 and omega-6 essential fatty acids. Here's the logic: ADHD is a brain-based disorder where neurotransmitters don't function as they're expected to function. Nerve cell membranes are composed largely of fatty acids. Some studies show that supplementing these fatty acids helps improve neurotransmitter functioning. Common sources of these fatty acids are fish and flaxseed oils. Other popular dietary supplements for ADHD are amino acids, basic vitamins, and herbal and homeopathic remedies. All of these things can be bought over the counter at a trusted health food store, but it might be smart to consult with a health care provider, homeopath, registered dietitian, or other expert for some guidance when choosing a supplement.

Behavioral techniques have also proven effective in the management of ADHD. Some find behavioral/cognitive therapy useful to strategize about concrete habits and actions people can practice to decrease their ADHD symptoms. There are also more specialized techniques, such as Interactive Metronome Training (IM). In this treatment a metronome produces a rhythmic beat that individuals attempt to match by tapping a hand or foot. Auditory feedback lets the individual know how well s/he is matching the beat. Some think that this practice, repeated over many sessions, can improve motor planning and timing skills, which could improve ADHD tendencies. Yoga and tai chi can be helpful as well, in addition to getting adequate exercise.  

In the end, each person is unique, and what works for one doesn't always work for another. In a multi-modal approach you holistically treat a complicated condition on its many levels — namely physical, behavioral, and psychological. Additionally, if you try many treatments, you increase your chances of finding something that works for you. If you decide to shun alcohol and take Adderall, you might want to consider also trying some of the remedies described here. Or if you decide Adderall is not for you, it might be a good idea to talk to a doctor about alternatives, now that you're aware of the plethora of treatments available.


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