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A Christchurch woman who struggled for years with chronic pain and opioid addiction says an ADHD diagnosis and medication changed her life.
Natasha Howell was working in a pharmacy, a job she loved, when a workplace accident kicked off some serious back problems.
After repeated hospital admissions for the pain, she had surgery, an L5/S1 spinal fusion - an operation to join the fifth lumbar vertebra to the first sacral vertebra at the base of the spine - in 2013, aged 39.
She had hoped it would let her return to normal life, but the surgery failed, with the bolts and screws causing yet more issues.
Four years later, another surgeon identified the issue as her sacroiliac joint instead. This led to three more surgeries, the most recent in September last year.
Howell has previously shared with media the details of her battle with ACC for compensation, with the Sunday Star Times reporting in 2018 she was awarded $84,797 in compensation, after her weekly payments were cancelled.
Speaking to RNZ now, she described this period as 14 lost years of her life - her relationship broke down, and she was still raising three sons while on high doses of prescription drugs like oxycodone, morphine, tramadol and codeine.
"I was like a zombie, basically, trying to work through my pain," she said.
An initial attempt at an ADHD diagnosis in 2022 was unsuccessful, with the doctor questioning why she would want to start medication in her forties.
RNZ has seen a letter from the psychiatrist, who wrote: "It is somewhat unusual to start treatment for ADHD at 48, given ADHD is conceptualised as a neuro developmental disorder, but not completely unheard of."
He also questioned whether prescribing a stimulant would be appropriate, given Howell's use of other medication.
But earlier this year, she saw a doctor who didn't share those concerns, and prescribed her Ritalin.
Howell said as soon as she started her course, the need for painkillers dropped off completely, and the brain fog lifted.
'Grief process immense'
But, there were downsides to her newfound mental clarity.
"To be honest, it's quite sad because everything comes back to light and everything that you because you weren't focused or you were in pain, you weren't able to think properly. Now my head's so clear and now I'm going, 'Oh my gosh, why did I do that? Or why did I do this? Or why didn't I do that?' The grief process is immense for me at the moment."
Psychiatrist Dr David Codyre, who is clinical director of the wellness support team at private healthcare group Tamaki Health in Auckland, said he had noticed a definite association between medication for ADHD and reduced severity of chronic pain among his own patients.
"I would see people who clearly had a history of lifelong ADHD, who had also along the way developed a chronic pain problem of some kind," he said.
"And there was a subset of them who reported not only were they doing better with their ADHD-caused symptoms and function as a result, but also they were managing their pain better."
So far, there was only "a smattering" of research on the topic, but what had been published indicated there was a link between treating ADHD and improvements in chronic pain.
Why? "That's the million-dollar question, isn't it?" said Codyre. "There's a lot of conjecture."
One possible explanation was that treating ADHD reduced stress, which was already known to help with pain management.
The other possibility was that the medication itself could be treating the underlying cause of the pain - but that was still unknown.
Howell said she was telling her story so that other people might find relief through a diagnosis.
"If I can help just a few people, that will make me feel I've done something good."
