An ADD tangent

I did a search and didn't find another discussion, and 21's thread on Adult ADD didn't really cover this angle. That said, my apologies if this meanders into d_b territory.

Adam LaRoche went on outside the lines the other day for a piece on whether drugs used to treat ADD ... ritalin, Adderall, Concerta, etc. ... should be considered performance-enhancing drugs. ESPN presented it in a way that indicated his decision to take ritalin and Concerta was responsible for his offensive explosion in the second half. He said it was hard to tell whether it was that or just getting to play every day.

ESPN has been taken to task in the Atlanta media; LaRoche agreed to be interviewed for the ESPN piece because he said he wanted to provide a positive example for kids who have it. He has a prescription and went through MLB's certification process to be allowed to take the medication.

So, two questions: 1.) Should these drugs be considered performance enhancers? And 2.) Was ESPN right to couch its treatment of the subject as it did in the piece?

 

I didn't see the piece, but I did read Dave O'Brien's article. I'm a big fan of his work -- I follow the Braves, and I also think he does a great job with his blog on ajc.com.

What was weird about O'Brien's article, though, was that LaRoche didn't seem to have a problem with the way the story was presented -- O'Brien did.

It's a meaty issue - great story to do. O'Brien's article seemed a little nitpicky to me. We spend so much time criticizing ESPN - why not give credit when they devote time to a serious issue?

A discussion on the waiver LaRoche got? Seems perfectly legit to me.

 

If a player NOT afflicted with ADD or whatnot was taking Adderall or Ritalin, then I would consider that performance enhancement. Like how college students take them to get the energy and drive to cram.

For LaRoche, the drugs technically enhanced his performance because he, in theory, would play better because he's more focused. But it wouldn't be performance-enhancing, per se, because he needed the drugs to function, to put it way too bluntly, like a normal person.

If you consider what LaRoche does performance enhancement, then you would consider the same for glasses, contact lenses and laser eye surgery, too.

 

You could make the case that professional athletes, as a rule, DON'T function like normal people. But every time this comes up I can't help but think back to Bob Gibson and the Primatene commercials. I have asthma, and I can tell you, Primatene will jack you up pretty good. So, given what we know about various and sundry medications, what are we now to make of Gibson's accomplishments?

 

Focus is pretty important in athletics, so I would assume that ritalin et al could give you a bit of a helpful boost even if you don't have ADD -- just like valium could make you feel kinda relaxed even if you aren't uptight in the first place.

 

The conundrum is that there's no real test for diagnosing ADD....it's observational. You could convince yourself--and any doctor--that you have certain symptoms, and you could easily get a prescription.

The doctor I consulted about whether I had ADD told me he'd never schedule me for an early morning appointment, because that's when he saw all the athletes....before office hours. Very discreet, very private.

Can ADD meds make an average athlete great? No. Can they make a great athlete better? Absolutely. At the very least, ritalin/concerta/adderall/focalin/etc are powerful amphetamines....seems almost certain that they would enhance performance, regardless of whether the user actually had ADD.

 

i can see the argument both ways. but i lean toward saying that it's not a performance enhancer. you can take this to the extreme. for example, let's say you have a deviated septum -- this is something that afflicts lots of people and they don't even know it. it makes you feel congested almost all the time. so if you take sudafed and can breathe easier, are you enhancing your performance? what if you have migraines and take headache meds? what if you have vertigo and take something for it?

 

leo, the difference is that ADD drugs are very powerful stimulants...they can have the same basic effect as greenies, which are banned. So you're allowing one group of athletes to play under the influence of amphetamines, while telling other athletes they can't.

In no way am I saying that players with ADD shouldn't be allowed to take prescribed medication....but there's no doubt in my mind that their performance would be enhanced by taking it.

By definition, that's what ADD meds do: they enhance your performance. Whatever you do in life, they allow you focus better, pay attention longer, be more disciplined in your thinking. Result: enhanced performance.

 

Going back to the glasses example -- if you have laser-vision correction and can see the ball better is that "performance enhancement"?

Also, just because you're taking an ADD medication, and you have ADD, doesn't mean you're all better. Particularly with mental illness-related drugs, it can be a crapshoot as to whether you have the right prescription and mix. Also, a drug can solve one problem but cause another. One of my 9-year-old son's friends took Stratera (sp?), which gave him an unnerving facial tic.

To me, it goes back to whether you're being prescribed the drug for a medical problem, or whether you're doing it just to boost yourself otherwise. So the ADD sufferer taking meds -- OK. The non-ADD sufferer getting Ritalin under the table -- not OK.

 

Not in the way you're suggesting. There's nothing fancy about the drugs traditionally used to treat ADHD symptoms and for most of you, they don't increase your ability to focus.

Ritalin (methylphenidate, also sold as Metadate or Methylin) and Adderal (a mixture of dextroamphetamine [Dexedrine] and laevoamphetamine salts) are nothing more than high-end stimulants, much like a large dose of caffeine --- except for those of us who have ADD/ADHD. Then they stimulate the areas of the brain responsible for focus, attention and impulse control. This is a very good thing. Caffeine in the right dosage (two cans of Red Bull or a 16-ounce can of one of the other energy drinks seems to hit my personal bullseye) has the same effect without forcing me to resort to a DEA Schedule II controlled substance.

(One stimulant drug occasionally prescribed to treat ADHD goes under the brand name Desoxyn. You may be more familiar with its generic name: methamphetamine. :-\ )

ADHD has something to do with dopamine transporters in the brain; in the frontal lobes, dopamine controls the flow of info from other areas of the brain and dopamine disorders in that region can cause a decline in neurocognitive functions like memory, attention and problem-solving. Supposedly, stimulants like Ritalin and Adderall treat ADHD by forcing the release of dopamine that had been blocked up.

There are also non-stimulant drugs like Bupropion and Atomoxetine (Strattera), which are in a new class of drugs called norepinephrine uptake inhibitors that need up to six weeks of usage before they start taking effect. (Yeah, I agree --- smells like money-soaking bullshit to me, too.) The facial-tic thing is something I was not aware of. Perhaps I will not partake of that treatment.

I was a Ritalin kid from first grade (when I was diagnosed --- apparently I was my pediatrician's easiest ADHD diagnosis ever) through sixth. In elementary school, I was a straight-A student. After my folks took me off Ritalin going into seventh grade, I dropped to a low-B to middling-C student and school time became an unholy bitch to get through each day. The schoolwork wasn't particularly difficult --- I just couldn't pay attention to something for that long. I think I had one A between the beginning of 7th grade and high school graduation.

(I just got distracted by the phone and spent a couple of minutes trying to figure out what I was just writing --- I added the last graf in well after I started this reply --- and where the verdammt thing was in the "post reply" box. No joke.)

I thought it was interesting that, to quote the Wikipedia article on ADHD, "(R)esearch studying ADHD sufferers who either receive treatment with stimulants or go untreated has indicated that those treated with stimulants are in fact much less likely to abuse any substance than ADHD sufferers who are not treated with stimulants." I have no idea why that is so. I do know that some illegal drugs affect the dopamine pathways in the brain; I suspect that has something to do with those addiction statistics.

I also found this statement interesting: "While the A students are learning the details of photosynthesis, the ADHD kids are staring out the window and pondering if it still works on a cloudy day" (Underwood, Newsweek, 14 MAR 2005). I've had that experience, too --- funny though, it seemed my teachers didn't have room for alternate possibilities in their lesson plans.

Here's a pair of PET scans of the brains of two people performing the same task. The normal brain is on the left; on the right, this is your brain on ADHD:



In Adam LaRoche's case ... no, I don't think it should be seen as a performance-enhancing drug. And ESPN's angle on the story betrays a general lack of knowledge at The Worldwide Leader.

I don't necessarily agree. Would those drugs give such an athlete an energy boost (at the end of the season, say)? Sure. But it would not have the same effect as it would on LaRoche --- as you correctly noted, it would be more like now-banned greenies.

And now I step down from the soapbox.

 

John Hawkins had an interesting look at this . ...
Scroll down to the "Golf's Little Helper" monologue

http://blogs.golfdigest.com/hawkins/