ADHD Weekly, March 20, 2025

Question: My son’s mother and I preferred behavioral management to address our son’s ADHD symptoms. We have been diligent in schedules, routines, and reinforcing the good behaviors we see. But no matter how hard we try and how well we co-parent, it only seems to help so much, and then there are meltdowns at home and calls from the school. We’ve talked with his doctor and think we’re ready for a medication trial.

Medication for ADHD is back in the news, and I’ve heard people say it can be risky. I’ve heard it can keep a boy from reaching his full height. Or that families rely on it too much. Is medication for ADHD worth the risk?

CHADD’s Health Information Specialist: Medical scientists and clinicians have done more than seventy years of observations and research on the benefits and effects of medication treatment for ADHD. Over these many years, there have been improvements in how medications are prescribed and monitored. For the majority of people who choose to include medication, the results have been positive. And for patients who do not see an improvement, or drawbacks outweigh improvements, medications are changed or discontinued in favor of behavioral management.

Recent executive orders regarding ADHD medications have brought parents’ concerns back into popular discussion. These concerns are valid, and it is important for parents, adult patients, and medical providers to refer to established science when seeking answers. Many parents, and adults who have ADHD, are worried that their choices regarding medication as part of treatment could be limited in the future.

“[P]eople are worried that it may become more difficult to get ADHD medication. Patients of mine, the parents of patients of mine, have stated their concerns about being able to access medications that are helpful for their children,” says Max Wiznitzer, MD, a pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland and co-chair of CHADD’s professional advisory board.

Deciding to include medication

Medication for ADHD falls in three groupings: stimulants, non-stimulants, and medications designed for other conditions and prescribed off-label because they help manage ADHD symptoms. Most people who express concern regarding medications are questioning the use of stimulant medications, so we’ll discuss that group of medications.

Parents who decide to add medication to their child’s treatment plan usually do so after a lot of discussion with their child’s medical practitioner or ADHD specialist. Two frequent worries over medication are dependency and possible substance abuse and loss of adult height and size.

Ari Tuckman, PsyD, MBA, says that even though hundreds of studies on medications commonly prescribed for ADHD show the medications to generally be safe and effective, reluctance to include them in treatment continues.

“There is often a strong resistance to trying medication or a preference to try everything else first,” he says. “Whether you decide to hold off on medication or to try it, I hope you use a good process to come to that decision and that you will re-evaluate your decision as circumstances change.”

Addressing concerns

Dependency and substance abuse. Many parents worry their child could become dependent on medication, not just as a form of treatment but similar to other chemical dependencies in which the body requires a substance to feel “normal.” A related fear is medication could lead to experimenting with drugs or alcohol.

As teens progress through puberty, or as adults acclimate to the medication, medication dosages may need to be updated. This doesn’t necessarily indicate the person has developed a tolerance to the medication, says Dr. Roy Boorady, a Child Mind Institute child and adolescent psychiatrist. For teens, it may reflect their livers maturing and becoming more effective at their job, metabolizing medication. This maturing can prompt a need to change dosage levels.

“When I treat a child from, say, age seven, I find I have to increase dose, maybe 20 percent, to recapture the [original] benefit,” he says. “But after 15 or 16, I find that kids end up needing less, not more.”

Research into the connection between untreated ADHD and substance abuse indicates an increased risk for teens and young adults. The risk is believed to be related to the symptoms of inattention, impulsivity, and hyperactivity, along with a desire to be liked by a group of friends that overrides good decision making.

The good news is the same research also shows using medication as part of treatment can reduce the risk of substance use. In fact, no studies have yet shown that stimulant treatment is associated with worsening substance use in adolescence. This is often referred to as a “protective effect” of medication management.

Adult height and weight. Children who have ADHD tend to grow more slowly than their non-ADHD peers. Research shows that medication, which can also suppress a child’s hunger, can sometimes affect growth but the height difference is often overstated.

In fact, if there is a difference in actual height and potential height, it may only be an average of an inch. Most often there doesn’t appear to be a difference in height or weight between children who employ medication and children who do not.

A better indicator of a child’s adult height is the height of their parents and grandparents. Parents can discuss a “medication holiday” during the summer or when a child is approaching a growth spurt with their child’s doctor if they are concerned.

Benefits of including medication in a treatment plan

“Using medication to appropriately treat ADHD enables the person to live a bigger, more interesting, more effective life,” says Dr. Tuckman. “If medication helps you live a better life, then perhaps that is a worthy tradeoff, even if it isn’t perfect.”

Medication can help a child to pay attention better at home and in school, to remain on tasks and have a better follow-through with directions, and to be able to complete the things she actually wants to do. Medication makes it easier for a child to learn new skills and coping techniques. It can decrease a child’s sense of frustration, which can decrease anger and anxiety.

The decision to include medication can even affect how long a person with ADHD lives. Research by Russell A. Barkley, PhD, states it can increase someone’s life by nine to thirteen years.

Could medication options be restricted in the future?

The recent executive order, Make America Healthy Again, calls for a commission to study “the prevalence of and threat posed by” several prescription medications, including stimulants used to treat ADHD in adults and children. Members of the ADHD community are concerned this commission could have a preconceived bias against the use of stimulant medications, the first-line treatment for ADHD, based on both the language in the executive order and statements made in the past by the new secretary of health and human services.

“We already know the pros and cons of the medications, and so it’s perplexing to us as to why they have to get a new panel and review it again,” Dr. Wiznitzer says. “That’s why [people] are now very concerned. They do not want the government to tell them how to take care of their children. They do not want the government to limit the access to medications that have helped their children be successful, to help their children function much better.”

Restricting any medication, for ADHD or other medical conditions, would require action by the Food and Drug Administration or the Drug Enforcement Agency, following procedures established by Congress. This could take years to resolve. Recommendations from this commission could have a more immediate effect on how doctors prescribe medications or the willingness of insurance companies to include ADHD medications on their lists of covered medications.

Do you have a question about ADHD or are you looking to find support from professionals or peers? Call CHADD’s ADHD Helpline, Monday-Friday, 1-5 PM ET, at 866-200-8098.

Looking for more?

• Treating ADHD in Children
• Behavior Management in ADHD Treatment
• Complementary Approaches for ADHD
• ADHD Advocacy
• ADHD and Life Expectancy: Treatment Matters More Than You Might Think
• Behavior Therapy Before Medication Recommended for ADHD in Young Children
• Your Child’s Meds Affect His Height? Likely Not
• Questions About ADHD Medication
• Benefits and Risks of Medication Treatment
• Choosing the Best Medication for Adult ADHD

How did your family decide on medication management?