ADHD and Addiction

Is There a Link?

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The National Institutes of Health has a long list of studies supporting substance use disorder as a common comorbidity in people with ADHD.

ADHD symptoms can overlap with certain addictive behaviors, making it a particularly challenging combination to manage.

Below, you’ll learn the connection between ADHD and addiction and how to effectively treat both conditions at once.

ADHD

Understanding ADHD and Addiction

ADHD stands for Attention Deficit Hyperactivity Disorder. It’s a neurodevelopmental disorder that usually begins in childhood and persists into adulthood.

People with ADHD often struggle with:  

  • Paying attention, staying focused, or following through on tasks 
  • Excessive restlessness, fidgeting, or talking
  • Acting without thinking, impatience, or interrupting others

ADHD often runs in families. If you have a parent with ADHD, you have at least a 25% chance of developing it. Other early life factors are:

  • Being born premature
  • Prenatal exposure to nicotine or alcohol
  • Head injuries
  • Environmental toxins (rare)

Meanwhile, addiction is a chronic and relapsing disease characterized by compulsive alcohol and drug use, despite harmful consequences. It involves changes in the brain that affect motivation, reward, and learning.  

Key characteristics of addiction include:

  • An overwhelming urge to use a substance
  • The need for increasing amounts of the substance to achieve the desired effect
  • Physical or psychological discomfort when reducing or stopping substance use
  • Difficulty reducing or stopping substance use

Is There a Connection Between ADHD & Addiction?

More young adults who both have ADHD and SUD use substances to improve sleep, mood, and focus—to self-medicate, in short—rather than get high.

The ADHD brain tends to have a faulty “off” switch, which can be exhausting. As a band-aid solution, many turn to dopamine-boosting substances, like nicotine or cocaine, to calm down.

Some use intoxicants, like alcohol or cannabis, to take a break from constant mental activity and repetitive thoughts.

Sadly, self-medication puts you at a higher risk of slipping into patterns of substance misuse. You might feel better for a while, but it really doesn’t fix the root of your condition. This can lead to escalating use as you try to chase the desired effect. Impulsivity makes it hard to quit, too.

What’s more alarming is that it can mask ADHD symptoms, which puts undiagnosed individuals in more trouble. It can delay diagnosis, worsening the effects of ADHD on someone’s life.

And when you finally seek professional help, the treatment process becomes more complicated. When your brain has adapted to self-administered substances, it’ll need some work to rewire the circuitry.

Does ADHD Predict Substance Use Disorders?

The sobering truth is that mental health conditions make you more likely to develop substance use disorder (SUD). Adult ADHD puts you at three times more risk than the general population. Common SUD comorbidities include:

  • Alcohol abuse 
  • Alcohol dependence
  • Drug abuse
  • Drug dependence

Adults with ADHD are more likely to smoke daily and quicker to light their first cigarette of the day. They do try to quit more often but without much success.  

Cigarette smoking starts early and develops into a habit faster in ADHD patients. And the more severe the ADHD symptoms, the higher the risk of chain-smoking.

Impulsivity, recklessness, and thrill-seeking behavior—common ADHD symptoms—are major risk factors. People with ADHD are prone to experimenting with drugs, and their social awkwardness can lead them to overindulge to fit in.

How to Prevent Developing Substance Use Disorders When You Have ADHD

ADHD medicines like amphetamine (Adderall) and methylphenidate (Ritalin) are controlled drugs. These are stimulants that can easily get you hooked, so it’s natural to worry about addiction. But this is not the case at all.

A study led by ADHD expert Dr. Timothy Wilens found that stimulant medications lower your odds of developing substance abuse issues.

Young people treated for ADHD are less likely to abuse drugs and alcohol from adolescence to early adulthood. The key here is proper and continuous treatment.

Adolescence is a vulnerable period for people with ADHD. That’s because the impulse control center of a juvenile brain is still immature at this point. With ADHD’s high sensitivity to rewards, it’s the perfect recipe for developing substance use disorder.

The best time to prevent addictive behaviors is while they’re young. Research shows that those who don’t start abusing substances by age 21 are unlikely to form the habit later in life.

If you’re a parent of a child with ADHD, start early intervention:

  • Discuss the risks and ill effects of substance use disorder.
  • Encourage complete avoidance of illicit drugs and waiting until adulthood to drink alcohol, as much as possible.
  • Keep them active. Physical activity combats boredom and helps manage ADHD symptoms.

Unfortunately, adults don’t stay abstinent for long due to poor medication adherence. Many miss their meds for all sorts of reasons, like forgetting to take it or not being able to afford it. Just as important as early prevention is keeping a consistent medication routine.

Treatment Options for ADHD and Addiction

Effective treatment of ADHD with co-occurring SUD involves a combination of medication and psychosocial therapy. Here’s what you need to know:

1. ADHD Medications

If you’ve had issues with alcohol or drug addiction along with an ADHD diagnosis, your doctor might start you on non-stimulants.

These meds are not controlled drugs, so you’re not likely to misuse them. They may not work as well for some symptoms, but they’re safer and longer-lasting.

Some doctors might prefer giving extended-release amphetamine and methylphenidate because they’re less attractive for abuse. The long-acting formula slowly releases the active ingredient, reducing the “high” that can come from taking a stimulant all at once.

Be patient; finding the right medication, dosage, and schedule can take some time. Work closely with your doctor to monitor how well you respond to your treatment.

2. Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) helps you break down situations into specific moments: trigger, thought, feeling, reaction, and consequence. By identifying these elements, it’s easier to recognize patterns in your behavior. Basically, you train to become your own therapist.

We’ve established that impulsive decisions lead to substance misuse. CBT trains the mind to pause and analyze the situation before reacting. When you’re more self-aware, you make conscious choices that better support your recovery.

For instance, if you find stress as your trigger, you can include relaxation techniques in your relapse prevention plan. Listen to music, take a walk, or meditate. CBT enhances motivation and builds confidence through small, achievable goals.

3. Behavior Modification Therapy

Although primarily used in children, behavioral modification works just as well for adults dealing with ADHD and SUD. It’s never too late to learn new habits that attach specific actions with positive and negative outcomes.

Think of it like training a pet. When a dog sits, you give it a treat (positive reinforcement). Over time, the dog learns to sit because it expects a reward.

Similarly, behavior modification for humans involves identifying the behaviors you want to change or develop and then creating a system of rewards or consequences to encourage or discourage them.

4. Psychoeducation

Understanding ADHD, its symptoms, and its impact on your life can empower you to take control of your condition

Resources and support groups like CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) can provide valuable information and connect you with others who share similar experiences.

5. Structured Skills Training

Specific skills like time management, organizational techniques, and methods for improving focus and attention help with symptoms of ADHD. By learning them, you’ll gain greater independence and confidence in your day-to-day life.

6. Support Groups

Support groups are invaluable resources for people dealing with ADHD, addiction, or both. Connecting with others who face similar battles can be incredibly encouraging.

How to Stay Sober When You Have ADHD

ADHD patients struggle with impulse control, inattention, and organization, which seem like an impossible challenge when trying to get help for SUD. The symptoms can make it harder for them to stick to their treatment plan and cope with triggers.

So, is it possible for people with ADHD to stay sober?

Absolutely, but it’ll require some effort and strategies. Getting better and staying better is all about managing both conditions at the same time. Here’s what experts recommend:

  • Take your ADHD medications religiously. When your symptoms are under control, you’re better prepared to resist relapse.
  • Keep up with support programs. If you find 12-step programs or other support groups helpful, don’t miss them.
  • Get cognitive behavioral therapy. CBT isn’t a cure-all, but it helps with negative thinking and avoidance.
  • Avoid common triggers: HALT (hunger, anger, loneliness, tiredness).
  • Watch out for red flags of relapse: restlessness, irritability, sleep problems, or urges to contact old drinking or drug-using friends. Keeping a journal to track your moods helps.
  • Develop a plan to fight off those urges. Know exactly what you’ll do when cravings hit. Hit the gym, call a friend, attend a meeting—whatever works for you.
  • Enlist the support of friends and family. People with ADHD sometimes struggle with self-awareness, so ask others to watch out for your warning signs.

Final Thoughts

ADHD and addiction are chronic conditions, and staying sober is a life-long process. You’ll have struggles along the way, but the good news is that long-term sobriety isn’t far from reality. You just need to develop the right support system and coping strategies to avoid relapsing.

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Published on: 2024-09-09
Updated on: 2024-09-09


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