Experts interviewed: Medical cannabis and ADHD awareness

On the studies findings, Dr McKechnie comments “it’s likely that more and more people will be diagnosed with, and treated for, ADHD, so, specialist services need to be made available to handle this.”

And, as a specialist, private healthcare clinic who provide care and support for patients with ADHD, we know this is an important subject, as is ADHD Awareness Month’s theme for 2024: ‘Awareness is Key’.

So, to celebrate this campaign, and help to improve the education and understanding around this condition, we wanted gain insights from one of our expert doctors about the potential of medical cannabis in ADHD management, and Releaf’s Clinical Director and ADHD advocate, Dr David Tang, was eager to be involved.

Dr Tang explained:

“I wouldn't put my hand up and say I'm an ultra-expert in ADHD, for that, you need a neurodevelopmental psychiatrist, of which I'm not. But, let's just say I have a personal vested interest in this - I have actually tried to get a diagnosis for ADHD myself, but apparently under the formal criteria I don't fit the bill.

However, in reality, we all exist on a spectrum - none of us sits perfectly in a box.  A box ticking exercise of ‘I am normal’ or ‘I am abnormal’ is an unhelpful way to think. People need to change that way of thinking - especially when it comes to health.” 

So, to contribute to the change he wants to see - here’s Dr Tang’s take on the rising rates in ADHD diagnosis, his insights on traditional and holistic treatment approaches, and information on how medical cannabis may offer support to patients with ADHD.

Please note, in this interview, Dr David Tang shares real-life anecdotes and real-world experiences of how medical cannabis can be utilised in ADHD treatments. The insights and experiences shared here by our specialist reflect real-world observations and are intended to inform and broaden the conversation, while we await further research in this area.

Q: In your opinion, what explains the increasing rate of ADHD diagnoses in the UK?

“I think there are a lot of different aspects, as always, to the rising number of ADHD diagnoses. I think on the one hand, people feel more empowered to speak up about their symptoms, and there's more information readily available on the internet, so people self identify with that. 

There's also what we call secondary gain in that when they get a diagnosis, people get almost a psychological blue badge - they get the additional help and support which they wouldn't have otherwise had. But secondary gain can also infer that this sort of support further reinforces a self-imposed stigma and perpetuates their own story. Whether or not that's a help or a hindrance, that's up to the individual.

For me, a diagnosis is helpful. You know, potentially now I can have some joy finding some medication that might help me when I need it. That said, for other people that have been segregated all their life because of their neurodiversity, a diagnosis brings meaning to why they've been on the periphery so much.

Eventually, we all find our own tribe. It’s true in the workplace, it is true in our friends, and we find comfort and empathy amongst people that understand our story and how we see the world, people that accept us for who we are. It’s really deep in terms of who we are as human beings. So to bring meaning to why people are so segregated, is possibly another reason why people are seeking out these ADHD, autism, OCD diagnoses now they're more readily available.”

Q: And, how is Attention Deficit Hyperactivity Disorder diagnosed?

“There are a fair few hoops to jump through when trying to get an ADHD diagnosis, including the DIVA questionnaire, and then whoever is trying to diagnose you speaks to your parents to get an idea of what you were like as a child. 

The hallmarks of ADHD are neurodevelopmental, it's something that's inherited and passed down. It's not something you really acquire. So the features of it will definitely be noticeable as a child, in terms of disruptiveness in class, poor academic performance, ‘chatterboxing’, etc, etc.

But on the flip side, when they find something they're really, really into, they hyper focus to the exclusion of absolutely everything else, and they can't be nudged or communicated with. Therein lies the ADHD child.

In my case, I definitely wasn't disruptive as a child, but I was probably bored quite a lot. Whether or not that was because of the amount of work I didn't have to do to keep me occupied, I don't know. 

When it came to the conversation with my parents, that’s probably where my diagnosis fell through - my mum probably didn't want me to have any sort of label, and may have not answered the questions as fully as she could have done, and I’m sure this is the case for a lot of people.”

Q: After a person is diagnosed with ADHD, what treatments are they typically offered in the UK?

“Usually stimulant medications, which stimulate the part of the brain that's underdeveloped in people with ADHD. Gabor Maté in his book Scattered Minds, talks about the pre orbital, the prefrontal lobe, just behind the eye, as being the part of the brain is like a policeman. 

So in patients without ADHD, that policeman is at a crossroads, and it can control the traffic of all the different stimuli coming in. In people with ADHD, that policeman is asleep, the traffic is just doing its own thing and there's no flow, which causes the patient to get completely overwhelmed with all these different stimuli.

Most would think you have to calm an ADHD brain down, but actually the stimulant medication wakes up that sleeping policing so it can control the traffic. And while these work really well for some, there are complications associated with long term use and a lot of patients report a ‘come down effect’ when these medications wear off.”

Q: And, how do cannabis-based medicines work for ADHD?

“Unlike conventional pharmaceuticals, which are generally one receptor type targets, medical cannabis has a team of different compounds that all work to almost ‘graphic equalise’ a human being. It's the best way I can describe it. 

If there's too much bass, it brings the bass down, if there's not enough treble, it brings it up, and if there's not enough mid, it sort of tweaks it, so everything's nice and rounded.

We know medical cannabis helps to regulate dopamine, it helps regulate anxiety, helps regulate reward and sleep. When it comes to ADHD, there are so many different aspects, so to be managed just by one pill targeting just a few receptors - I just think the concept is fanciful. 

Q:How does medical cannabis affect daily life with ADHD?

“Medical cannabis can help to reduce inattentiveness and anxiety while promoting focus - it can stop all the millions of thoughts racing round from escaping instantaneously - because that is how noisy the ADHD brain is. 

With ADHD, you're always thinking of all these things and you're able to cope with all these different stimuli. But, when you're poorly slept, as many patients with ADHD are, they can start ruling, and it gets really noisy and that can be really frustrating, because you just want to focus on something to get it done.

So medical cannabis, it replenishes the focus. It just keeps you railroaded on the task. If you need to complete a task, complete a spreadsheet, complete a graphic design, complete an article, it can give you that focus, and stop you finding excuses to stopping what you're doing.

I would also say it calms down the anxiety associated with not being able to start or finish a project. A lot of people with ADHD, don't start projects because they know they won’t finish them, or they have this in combination with perfection, and they think there's no way I'm going to be able to do this perfectly within a certain time frame. And so they get this procrastination, which is a hallmark of ADHD.

By evaporating the anxiety, it gives people the confidence they can start a project, and then the focus kicks in and then allows them to finish the project. 

It almost acts like an antidote to 21st century life: the hyper-anxious, social media driven lifestyle - the inflammation, the chronic conditions, the poor sleep, the substance misuse. It lets us check out from it for a bit and just recuperate - if it's applied properly that is.”

Closing thoughts

At Releaf, we’re proud to participate in awareness campaigns just like this, by spreading accurate and reliable information, and in this case experts insights, that demonstrate the true potential of medical cannabis. 

ADHD is a lifelong condition, one that requires personalised treatment and varying levels of symptom management throughout a person’s life. And we hope this interview with Dr David Tang has helped to shed some light on just one of the possibilities when it comes to ADHD treatment in the UK. 

For further information on ADHD and medical cannabis, head over to our blog or education section, or to find out if you may be eligible for cannabis-based treatments, our online eligibility checker can assess your suitability in a matter of minutes. 

Remember, awareness is key.