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Areas › Focus, starting, and ADHD › Medication and how it works
It changes what a conversation about stopping looks like. If a cigarette is doing a job, taking it away and leaving the job undone is a plan that rarely survives a bad week. Ask what smoking gives them and when they reach for it, then make sure the attention difficulty itself is properly treated before expecting the habit to move.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
'do not despair of God's mercy' (Quran 39:53), said to people who have harmed themselves by their own excess. Shame makes a poor engine for change, and it is not what is being asked of anyone here.
الزمر
۞قُلۡ يَٰعِبَادِيَ ٱلَّذِينَ أَسۡرَفُواْ عَلَىٰٓ أَنفُسِهِمۡ لَا تَقۡنَطُواْ مِن رَّحۡمَةِ ٱللَّهِۚ إِنَّ ٱللَّهَ يَغۡفِرُ ٱلذُّنُوبَ جَمِيعًاۚ إِنَّهُۥ هُوَ ٱلۡغَفُورُ ٱلرَّحِيمُ
Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful
Qur’an 39:53read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A randomised trial in adults who had both ADHD and cocaine use disorder found extended-release mixed amphetamine salts improved ADHD symptoms and cocaine abstinence compared with placebo. It studied cocaine rather than tobacco, and one trial in one population cannot be stretched into a general rule. It does support the shape of the idea, that treating the ADHD properly can loosen a substance's hold.
Levin FR, Mariani JJ, Specker S, Mooney M, Mahony A, Brooks DJ, Babb D, Bai Y, Eberly LE, Nunes EV, Grabowski J. (2015). Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial.. JAMA psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A habit that is doing a job is easier to replace than to forbid.
Nicotine replacement and proper cessation support still belong in the plan, since treating the ADHD is not a substitute for them.
Stimulant medication does not install an ability you did not have. It raises how much signal is available at the junctions between nerve cells, so the circuits you already own can hold that signal long enough to use it.
Half the useful health information arrives sideways. Someone says 'I am so tired' on the way into another subject, and that is an opening worth taking gently.
Pill swallowing can be taught in a few short sessions with sweets. Start with the tiniest ones, give two to eat for every one swallowed whole, and work up in size across a week.