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The requirement to ask about heavy alcohol use reflects several clinical realities: Alcohol use disorder and ADHD frequently overlap People with active alcohol misuse may be more vulnerable to stimulant misuse Combined use may worsen self-control around both substances Ongoing alcohol misuse complicates interpretation of psychiatric and cardiovascular adverse effects Stimulant prescribing in substance-using patients requires closer monitoring The human evidence showing greater alcohol consumption during methylphenidate co-use suggests the combination itself may encourage escalation, creating concern for binge drinking patterns, recurring combined use in party settings, self-medication cycles, and dependence on one or both substances

The main dietary modification that I recommend is reduced size of meals, so more frequent but smaller meals, she said

References 1 VaduganathanMMensahGATurcoJVFusterVRothGA

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