Why Treating ADHD With Medication Is Not the Same As Treating Diabetes With Insulin

Our pediatrician is a lovely, competent individual, but she looked us in the face today and said, "I am for using medication to treat ADHD.  If your child had diabetes, you'd treat it with insulin, wouldn't you?"  For those of us who have heard these words from well meaning friends, family, or medical professionals, they are the pinnacle of oversimplification.  The decision to treat your child's ADHD (or your own) with medication is definitely not the same as deciding to treat diabetes with insulin, and this is why:

ADHD does not directly cause death if not treated with medication.  A person with diabetes (of the kind that needs insulin for treatment) will die within a short period of time if they do not get insulin.  A person with ADHD will not die without medication.  They may be very miserable and be so impulsive that they make a fatal mistake, but it is not nearly as reliable a death as a diabetic going without insulin.

 There are several research proven treatments for ADHD that do not involve medication.  Now, diabetes type II can be treated with diet and exercise.  But the type of diabetes that requires insulin (type I)  cannot be treated with diet alone.  It definitely cannot be treated with counseling.    ADHD, on the other hand, can be treated fairly successfully in some patients with behavioral techniques (especially in preschoolers, where such treatments are the treatment of choice) and with counseling and coaching (especially in adults and motivated teens).  Researchers are also beginning to see possible benefits for nondrug treatments such as  fish oil/omega3 fatty acids, dye restriction, and neurofeedback.  These treatments are all seeing some approval from the AAP and APA.  So seeking out medication alternatives is not unreasonable so long as it is not taken to an extreme.

ADHD medications are artificial substances that can have significant untoward effects, whereas insulin is a hormone given in a way that mimics the way it is produced in a normal body.  Now, insulin actually can have side effects because we can't give it the way it is normally produced.  But it cannot cause psychosis, nightmares, tics, sudden cardiac arrest, or give you a "high".  To be fair, the vast majority of children treated for ADHD do not have any severe side effects, but they can happen and it is completely rational to take this risk into account when deciding whether medication is the best choice or not.

Most ADHD medications are scheduled drugs, but insulin is not.

 Insulin is also not sold on the street by drug dealers.  You don't have to get a special prescription from your doctor every month.  You cannot be put in federal prison for selling your prescription for insulin.  For people who have a history of addiction, or who have teenagers, or who live in a neighborhood where drugs are a problem may really not want to have certain types of medication around the house.  (NOTE:  ADHD meds do not cause addiction if taken as prescribed, and may actually prevent addiction to certain classes of drugs if taken as prescribed.)

Although I am not personally against the use of medication for ADHD in most cases, I also feel it is belittling to compare ADHD medication to insulin.  Making the decision to use medication for ADHD isn't simple and every patient should make the decision only after weighing the severity of symptoms, the effectiveness of therapies already tried, and issues surrounding side effects and the potentially addictive nature of the medication.  You don't want to be paralyzed by fear of medication, but you shouldn't take it if you don't feel the risks outweigh the benefits.

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