Anna Lembke

that people with ADHD might at baseline actually have lower levels of dopamine firing in the reward pathway.

And by that, I mean might be to some degree reward insensitive.

So might at baseline need more potent rewards to feel the rewarding effects.

One of the things that I think is important, though, to get out into public awareness is this idea that was promulgated in the field about 20 years ago based on some early analyses.

that suggested that if you take a group of kids with ADHD and you give half of them stimulants to treat the ADHD and the other half you don't give those stimulants, the idea was that the kids that you give stimulants to will have a decreased risk of developing addiction in adulthood, the idea being that somehow the stimulants would protect them from that problem.

That has essentially been debunked.

So a more recent meta-analysis does not give credence to that idea.

So medications to treat ADHD looks like it's not protective in terms of later life development of addiction.

And in my practice, and of course my practice is an addiction practice, so it comes with some inherent bias there, but in my practice,

What I see is individuals who are exposed to stimulants to treat their ADHD and then become addicted to those stimulants.

So that's obviously not going to be everybody who gets stimulants for ADHD.

But again, if you're exposed to a drug, if that drug then changes your brain, it may change your brain in a way that actually makes you more vulnerable.

I work at a high school and it's by far the biggest challenge I encounter.

Kids cannot stay off their phone for more than five minutes at a time despite all the rules and policies we have about putting phones away and constant reminders.

Kids just cannot get off it and the addiction is real.

And I worry that we're not, as an institution, not addressing it as the serious addiction it is.

I worry about kids' mental health, and I worry about them also not learning because they can't focus for more than 5, 10 minutes at a time.

What do you recommend?

What solutions should we do at the high school level to keep kids off their phones?

Thanks.