Staying sober with a medication I was told to avoid
What's true for one person in recovery is rarely true for everyone in recovery.
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One of my clearest memories from my freshman year of high school is being at our mid-morning assembly, looking around at the hundreds of kids surrounding me, and knowing with absolute certainty that every single one of them was smarter than me. I am too dumb for this school, I remember thinking. I don’t belong here.
My insecurity wasn’t (solely) teenage angst; I had evidence: a giant pile of failed math tests with a teacher’s foreboding SEE ME scrawled across the bottom.
I attended an elite prep school—let’s call it Ivy League Academy—which was known for being academically intense and, as a result, getting kids into top-tier colleges. I was at the school largely because my sister had attended it. She graduated the year before I started, excelling as school president and captain of the debate team, ultimately garnering an acceptance at a college so academically rigorous that it was commonly referred to as “where fun goes to die.”
I’d come to Ivy League Academy from a delightful, Montessori-esque school I’ll call Willow Park. At Willow Park, teachers were interested in reading literature, writing, ideas, discussions, and creativity. I loved it. Then, I went to the fancy prep school and I didn’t understand why my genuine attempts to learn the material kept getting such crappy results. In fact, except for English Literature, I was barely passing my classes and in legitimate danger of failing math.
And then, I found something at which I truly excelled. My proficiency was not in algebra or Spanish but in finding and consuming alcohol. This was a win-win: 1) drinking made the feelings of being an idiot failure disappear, and 2) I’d finally found something that I was great at.
.
Eventually, I figured out various methods for studying more effectively and generally worked my ass off. But I always felt like I had to work twice as hard as everyone else to get the same result. I developed a dedicated work hard/play hard ethos that would last through college.
After I got sober and started working as a public librarian, my boss noticed I would regularly do things like...start emails and not send them. I got tested for ADHD, initially sure there was no way I would be diagnosed with the disorder. I still thought of ADHD as exemplified by the kids in grade school who couldn’t sit still in class and disrupted my favorite part of school: silent reading time.
I had always been able to lose myself in books; when I was reprimanded in school, it was usually because I was staring out the window (probably making up stories) or reading under my desk. In the 90s, these were not symptoms most people associated with ADHD. It was as though being an advanced reader at a young age meant that I couldn’t have ADHD, and thus, my problems were simply a deliberate lack of attention. Perhaps the most repeated line on my report cards in grade school had to do with “not living up to my potential.”
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There were other signs. I had a habit of losing papers I’d sworn I’d put in my backpack; every organizational system my mom helped me devise for homework, permission slips, and time management seemed to disappear from my brain the moment she left the room.
She was as baffled as I was. There was a lot of “I saw you put it in your backpack—what happened between here and school?” I didn’t have a good answer. Things just...got lost. I felt ashamed and like an idiot. “What is so complicated about just handing it in when you get to school?” She was right, there was nothing complicated about it! So what did it mean that I found it so difficult?
Turns out, I have ADHD. It’s exceedingly common for women to be diagnosed as adults for the same reason I was—we don’t always exhibit the symptoms people associate with ADHD.
I am convinced that I would have ended up addicted to alcohol regardless of whether I had ADHD or not. I tick almost all of the boxes that clinicians use to determine if someone has an increased risk of developing alcohol use disorder. I just didn’t realize how significant the ADHD box was.
A 2017 study found that ADHD is associated with a more than twofold increased odds of alcohol-use disorders; a 2021 study found that as many as two in five people with ADHD will develop a substance use disorder. Researchers have lots of ideas about why this might be (there can be a genetic component, stress hormones, social isolation as a result of ADHD, the list goes on), but—like addiction—there are many different factors at play.
One study suggests that alcohol use disorders start around 8 years earlier in patients with ADHD. The same study found that the severity of alcohol use disorder is worse in people with ADHD compared to those who don’t have the disorder.
The risk is especially pronounced for women. A clinical study of ADHD youth found that, compared to boys with the disorder, girls with ADHD have a larger relative risk for substance use disorder.
After my diagnosis, I was immediately put on Adderall. It took some time to figure out the correct dosage, but once I did, the change was profound. It was like my brain went from having books strewn across the floor to being alphabetically organized on shelves. Mentally, I could go from point A to point B without falling down some unrelated rabbit hole. I still struggle with many ADHD symptoms (please never ask my partner how many times a day I freak out over “losing” my phone), but things would be a thousand times worse without medication.
Plenty of people in recovery (who were not doctors) warned me against taking the prescribed stimulants, calling them “legal meth” and heavily implying that I would jeopardize my sobriety by doing so. Indeed, some people misuse prescription stimulants like Adderall and Ritalin—I’m not discounting the harms that can result. But the same drugs can be life-saving for people with ADHD. Despite what some uninformed people suggested, taking Adderall helps me stay sober.
When I got sober in 2008, the prevailing wisdom was simple: people with a history of addiction should not take controlled substances. I am so glad that my doctor didn’t adhere to that belief. Clinicians who study ADHD now agree that treating the disorder with stimulants doesn’t increase the risk for later SUD or AUD. Instead, the evidence suggests that “stimulant treatment during childhood might reduce the risk for developing a SUD, especially when the treatment is initiated early and intense.”
It’s hard not to wonder how things might have been different if I had known all of this and started medication earlier. I think it’s fair to say that, at the very least, I wouldn’t have spent so much time feeling like the dumbest kid in school.
Thankfully, I didn’t listen to the people who discouraged me from taking ADHD meds. It wasn’t that their words had no effect—I was worried about my sobriety. But their warnings didn’t track with my experience being on the medication. I used alcohol to numb my emotions, mentally escape, and feel more comfortable in my skin. Those were seductive, almost magical feelings. Instead of being a means to escape reality, Adderall grounds me, keeping the paths in my brain brightly lit and easier to navigate.
One other big difference between my relationship with Adderall and alcohol? If I don’t set an alarm, I’ll forget to take the pill. I never once needed to be reminded to drink.
Addiction doesn’t look the same for everyone, and neither does recovery.
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I’m not a doctor or mental health professional, so my advice shouldn’t be construed as medical or therapeutic. You are free to take or leave it.
It still blows my mind how many people in recovery will "play doctor" with others' recovery. Recovery is different for every single person who attempts it. I've been doing this for over 3 decades and I absolutely avoid people who say things like "you aren't really sober if you do that". Someone else's soberiety is none of my business. Period.
Oddly enough, in the midst of mania (Bipolar 1, here), my doctor prescribed adderall (sp). I simply did not see how this could help my raging mind, but it did. It was life saving, and proved to lessen the severity of the mania.
Thank you for posting your journey.