ADHD patients unable to access medication due to record waiting lists are turning to illicit stimulants to treat their condition. With a medication supply crisis this autumn, we spoke to two such individuals to understand how they have been impacted…
“It was only two or three years ago I properly went, ‘Look, this is actually something that I’ve really struggled with’, you know?” said Ben*, 30, tapping his foot while speaking. “I have this condition, and it’s really affected and defined my whole life.”
Ben is one of a large number of people with attention deficit hyperactivity disorder (ADHD) who are turning to speed and other illegal stimulants to self-medicate, while they face waiting times of up to seven years for assessment and diagnosis in the UK. He temporarily halted his PhD earlier this year after his symptoms made it impossible to continue.
About 1.5 million adults in the UK have the condition, according to the charity ADHD Action. But due to a lack of awareness of adult ADHD, insufficient specialised care within the NHS, and years-long waiting lists, only 120,000 are formally diagnosed.
NHS Business Services Authority figures show more than 10,000 patients in Greater Manchester were prescribed some form of ADHD medication between April and June.
This has been compounded in recent months by disruption to the supply of ADHD medication in the UK. Of those on ADHD medication, charity ADHD UK found that 97% have been impacted by the crisis, with the overwhelming majority receiving no alternative support.
ADHD is usually treated with stimulant medications, alongside coaching and talking therapies. In individuals with ADHD, the increased stimulation reduces the need for external stimulation, improving focus and reducing hyperactivity.
Prescription medications have very few side-effects, are easily excreted by the body, and are extremely effective for most patients. Without a diagnosis, however, they are very hard to come by.
Graphs illustrating the issues surrounding ADHD treatment. Source: ADHD UK
In its purest form, speed contains the same mixture of amphetamines found in Adderall — one of the most common medications used to treat ADHD — albeit in different ratios.
In the absence of prescription drugs, street speed is often the closest thing many individuals can get to manage their symptoms, despite the lethal health risks and serious legal repercussions.
“Self-medicating with speed has changed things,” said Ben, who has been using speed to manage his symptoms since July.
“When there are tasks I need to execute, I can get them done better. I’m able to enjoy social situations way more because I can be more present, and not distracted by all these other thoughts.
“And that is good, but it’s not that life-changing. It’s not as life-changing as I hope just being able to go on [prescribed] medication will be.”
Alongside symptoms of distractibility and hyperactivity, ADHD can affect one’s impulse control and motivation, and is associated with much higher rates of mental health problems like depression and anxiety. Left untreated, it increases the risk of addiction, poorer physical health outcomes, and even fatal driving accidents.
“I do typical ADHD things — interrupting people, having quite erratic emotional fixations, talking even when I feel like I’ve got nothing to say,” explained Ben.
“I find it incredibly hard to maintain friendships or relationships — most people I like end up not wanting to talk to me after a few months or years. At the very core of it, it’s this awful grief of being misunderstood, that what I am actually trying to do, or actually trying to say, is so different to what you hear.”
Ben describes himself as “very ambitious”, but his ADHD means that often he feels “unable to do the most basic things”.
“You do get really, really depressed. You get angry at other people, but at the centre of it, you are just frustrated with yourself,” said Ben, who recently spent £700 on a private diagnosis because of the long NHS waiting times.
“I think that’s something everyone with ADHD kind of deals with, in one way or another.”
Sunny, 24 (below) has also turned to self-medicating. He has been on the waiting list for a year so far, and does not know when he will be seen.
“I definitely haven’t received any support while I’ve been on the waiting list, either from my GP or the specialists,” he says.
Sunny does not use illicit stimulants, as he is wary of the variable quality of black market drugs. Instead, he uses Modafinil: an anti-narcolepsy medication which has gained popularity as a ‘study drug’.
Dr. Luqman Khan, a psychiatrist working in addiction recovery and a member of the UK Adult ADHD Network (UKAAN), has seen many patients with symptoms of ADHD use stimulants like speed and cocaine in order to mitigate the effects of the condition.
“My interest first was piqued by looking at male prisoners in Scotland. I felt that these people should have had a diagnosis of ADHD but at that time in the UK there was virtually no one being diagnosed with adult ADHD,” he said.
“When I was taking [patient] history, they’d say that when they’re taking street cocaine or speed, unlike people who are going off and having a high, they felt quite calm. They could focus, some could even sleep. People talked about this constant running engine in their mind which would slow down.”
He continued: “For me, it becomes virtually like a diagnostic tool. When people have been taking street stimulants and they have a sense of calm, I think that if they have a diagnosis, they’ll virtually always be helped by medication.”
For Ben, this has certainly been the case.
“When I’m on speed, I can just not think about loads of other stuff,” he said. “If I need to clean the kitchen, it’s so much easier, because otherwise I’ll start to clean and then I’ll be on my phone, or I’ll want to rearrange the knife drawer, or I’ll want to hoover the living room.
“You’re actually surprised by how much space you can actually have in a day if you’re not constantly thinking about so much shit that you just don’t even want to be thinking about.”
However, black market stimulants are less effective than prescribed ADHD medication, carry legal risks, and can be extremely dangerous.
“To use a very colloquial expression, there’s a lot of shit in street drugs that’s extremely harmful and leads to the vast majority of sudden drug deaths,” said Dr. Khan.
The Department of Health and Social Care recently said it was “aware of supply issues affecting medicines used for the management of ADHD due to increased global demand”. A spokesperson added: “We continue to work closely with the respective manufacturers to resolve the issues as soon as possible and to ensure patients have continuous access to ADHD medicines in the UK.”
*Not his real name
Image: Dominic Milton Trott/Flickr
