How do you address parental concern about children becoming addicted to stimulants for ADHD treatment?

In the current environment with an epidemic of fatalities from opiates, the question about addiction to stimulants is timely. I present the parents with the data, which shows that controlled dosing leads to a steady level of dopamine and does not produce a high. Further, studies find that treated kids do not have higher levels of substance disorder later in life, particularly compared with untreated children with ADHD. The impulsivity of ADHD may, in fact, be a risk factor for subsequent substance use if untreated.

I've also had not only parents, but other physicians share their belief that stimulants are the same and work the same as cocaine. If professional, this is how I manage it. "Cocaine is addictive because it produces a fast, high‑amplitude dopamine surge.

Prescription stimulants can be addictive because they also elevate dopamine, but therapeutic dosing produces slow, controlled increases that do not hijack the reward system in the same way."

For the lay person, "They work on the same brain chemicals, which is why people compare them, but cocaine hits the brain like a lightning bolt and creates an intense “rush” that drives addiction. Prescription stimulants raise those same chemicals much more slowly, so when taken as directed, they don’t pr...