ADHD, attention deficit hyperactivity disorder, is a common mental illness. ADHD commonly affects children and adolescents, although it can persist into adulthood. Based on a study published by the U.S. Centers for Disease Control and Prevention (CDC) in 2016, it impacts close to 10 percent of American children, ages two to 17.
The disorder involves poor impulse control, trouble focusing and concentrating, and hyperactivity. Problems at school or work and difficulties with interpersonal relationships can be the result of ADHD symptoms.
ADDitude magazine warns that around half of all adults who struggle with untreated ADHD will also battle addiction involving drugs and/or alcohol at some point in their lifetime. ADHD can increase the risks for abusing drugs and alcohol, making it more likely that a person will also have a co-occurring addiction.
The journal Pediatrics reports that children and adolescents who struggle with ADHD are over 2.5 times more likely also to battle addiction in their lifetime. Adolescents and children who have ADHD are also:
Alcohol, cocaine, marijuana, and nicotine are the most commonly abused drugs by individuals struggling with ADHD. Psychiatric Times reports that approximately 15 percent of adolescents and children who have ADHD also battle co-occurring addiction, while 11 percent of people struggling with addiction also have ADHD.
Someone with ADHD is more apt to abuse drugs and alcohol than someone who doesn’t have a mental health disorder. Drug use does not cause ADHD directly, but it can exacerbate the symptoms of the disorder and complicate treatment methods.
The relationship between drug use and ADHD is complex. It may involve the following possible connections:
ADHD is a neurological disorder that is highly heritable. According to the National Institute of Mental Health (NIMH), ADHD can be caused by both environmental and genetic factors.
The Attention Deficit Disorder Association (ADDA) publishes that there is a prominent genetic link for ADHD. When a family member is diagnosed with the disorder, the risk factor for also struggling with it is between 40 and 60 percent.
ADHD is thought to involve specific regions of the brain — the communications and reward pathways — that are involved in mood regulation, attention, memory, and learning abilities. Executive functions, including impulse control and decision-making, can be impacted by dysfunctions in the prefrontal cortex. Brain structure and function in someone with ADHD may not look the same as in someone without the disorder, for example.
Brain chemistry is also impacted. Neurotransmitters like dopamine, which helps to regulate moods, may not be produced, transmitted, and reabsorbed at the same rate in someone struggling with ADHD.
Some of these same risk factors exist for addiction and drug use. Individuals who have poor impulse control and an inability to make sound decisions or think through them clearly is more likely to misuse drugs and alcohol.
ADHD often impacts adolescents, and individuals between the ages of 18 and 25 run the highest risk for substance abuse as well. The National Survey on Drug Use and Health (NSDUH) publishes that almost a quarter of all people in this demographic used illicit drugs in the month leading up to the 2016 survey. This was the highest rate of any age group by more than double.
Psychoactive drugs often increase levels of dopamine in the brain, which is what causes the pleasurable high. Someone with a chemical imbalance may seek to increase dopamine levels artificially.
Poor impulse control, lack of judgment, and disinhibition are symptoms of ADHD, which can all be risk factors for drug abuse and addiction as well.
Someone struggling with ADHD often has difficulties sitting still, focusing on one thing, and concentrating on things. This can make school and work projects harder to complete and lead to feelings of inadequacy and frustration.
ADHD medications are stimulants that often contain amphetamine, dextroamphetamine, or methylphenidate. These medications help to improve focus and concentration while calming restless and hyperactivity, so a person can think and work more clearly and aptly.
Mind-altering drugs may be abused to self-medicate ADHD symptoms in an attempt to mimic what the actual medications do. For example, alcohol and marijuana can have a calming and relaxing impact, combating the restlessness and hyperactivity of the disorder. Cocaine and stimulant drugs provide a euphoric high and also work to quell certain ADHD symptoms and increase productivity.
Even though it is often thought of as a childhood disorder, ADHD can persist into adulthood. ADDitude magazine publishes that it is likely that three-quarters of adults who struggle with ADHD are undiagnosed and may not even know that they have the disorder.
Drugs and alcohol may be common forms of self-medication for a person to try and even out brain chemistry in an attempt to function in society. These substances may seem to offer a person a way to fit into social situations that were previously difficult due to ADHD symptoms.
Undiagnosed ADHD can lead to more serious problems and compounds the risk for also dealing with addiction.
When addiction and ADHD co-occur, it is vital for treatment programs to address both disorders at the same time in an integrated fashion. Trained professionals with experience managing co-occurring disorders will work together to implement a plan for treatment and recovery.
ADHD can interfere with and complicate treatment for drug use and addiction, and the reverse is also true. A specialized program that caters to co-occurring ADHD and addiction can be beneficial over standard rehab, as the complications of the mental health disorder can influence treatment needs for addiction.
For example, ADHD medications are commonly misused and have a high potential for abuse and addiction. They are tightly controlled substances. When used correctly by someone with ADHD, they can be very effective. Due to their high risk of misuse, they will need to be closely monitored in someone with a history of substance abuse and addiction.
Medications are often used to treat addiction too. Medical and mental health professionals and substance abuse treatment providers will need to work together to find the right pharmacological balance.
Treatment needs can change over time too, so regular assessments are beneficial.
Detox will need to be closely monitored through a medical detox program, as the side effects of withdrawal are often amplified in a person who struggles with co-occurring disorders.
Methods for managing both ADHD and addiction include group and individual therapy that can help to manage drug abuse, cope with triggers, and minimize relapse. Therapy will also teach clients how to manage ADHD symptoms and practice new skills to resist the temptation to relapse to substance abuse.
Support groups made up of peers who struggle with the same issues can be highly beneficial. They provide a safe space to be honest and learn skills for managing both disorders into recovery. Healthy peer interactions can be essential in both treatment and recovery.
Both ADHD and addiction can be managed through a complete treatment program that addresses both disorders.
(September 2018). Data and Statistics About ADHD. U.S. Centers for Disease Control and Prevention. from https://www.cdc.gov/ncbddd/adhd/data.html
(February/March 2007). The Truth About ADHD and Addiction. ADDitude. from https://www.additudemag.com/the-truth-about-adhd-and-addiction/
(July 2014). Attention-Deficit/Hyperactivity Disorder and Substance Abuse. Pediatrics. from https://pediatrics.aappublications.org/content/134/1/e293
(2016). Attention-Deficit/Hyperactivity Disorder: The Basics. National Institute of Mental Health. from https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/index.shtml
(2018). ADHD the Facts. ADDA. from https://add.org/adhd-facts/
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
(Spring 2016). The Downside of Undiagnosed ADHD. ADDitude. from https://www.additudemag.com/undiagnosed-adult-adhd-diagnosis-symptoms/