BEING MORE CREATIVE IN TREATING ADDICTION

Re: Alternative treatments give addicts a chance, Jan. 24

Your editorial on treating stimulant addiction seems to confuse
methylphenidate with methamphetamine. They aren't the same.
Physicians like Dr. John Grabowski and Dr. Fran Levin have been
treating patients with co-occurring attention deficit hyperactivity
disorder (ADHD) and substance abuse safely with stimulants for years.

Although ADHD has a prevalence of four to five per cent in the
general adult population, it affects 25-35 per cent of
"substance-abusing" adults.

While methamphetamine blasts the brain with more than 1,000 times the
baseline amount of dopamine, within the first hour, long-acting
stimulants trickle dopamine into the brain, at one-tenth the rate,
over the whole day. The goal is not to treat the substance abuse, but
rather to treat the underlying ADHD so that its symptoms (boredom,
impulsivity and poor planning) do not trigger relapse into substance abuse.

Long-acting amphetamines such as Concerta do not create a high, are
not addictive and are not easily abused. If we want to decrease the
homelessness, crime, and prostitution linked to addiction we may have
to be more creative with our treatments. The social and economic cost
of doing nothing is in the billions. Sam Sullivan's plan may not be
as far fetched as it sounds.

Dr. Anthony Ocana

Bowen Island