The relationship between attention deficit hyperactivity disorder (ADHD) and substance abuse is a complicated one. People who struggle with both issues face a more complex path to recovery.
Attention deficit hyperactivity disorder is a condition that makes it difficult for an individual to continually pay attention or control impulses. A person having ADHD may constantly be active and struggle with feelings of restlessness. They may find it difficult to control their energy levels and physical movement.
ADHD is very prevalent in the U.S., with approximately 8.4 percent of children exhibiting signs of the disorder, and around 2.5 percent of adults exhibiting signs. Because symptoms of the condition are so varied, and because many adults may have the disorder but are never diagnosed, these estimates may be lower than the actual numbers.
The co-existence of ADHD and substance use disorders in adults is also prevalent.
Individuals with ADHD are more likely to struggle with a substance use disorder. According to a 2017 article in Psychiatric Times, “The presence of comorbid disorders is often the rule rather than the exception in individuals with ADHD.”
ADHD is considered a neurobehavioral disorder. The core characteristics include hyperactivity, distractibility, impulsive behavior, and inability to pay attention.
Medical professionals usually categorize the “presentation” of ADHD into three categories. No matter which presentation is assigned to an individual, the diagnosis is the same: attention deficit hyperactivity disorder. The presentation will help the practitioner decide on the best treatment approach.
The presentations of ADHD are:
ADHD is considered the most common childhood mental health disorder. It is estimated to affect between five and 11 percent of children.
While thought of as a disorder that affects primarily children, ADHD and its symptoms —which can make day-to-day life and personal obligations and goals harder to manage — often continue into the teen years and adulthood.
Children, teenagers, and adults who struggle with ADHD may not receive the treatment they need. Individuals may receive medication but not learn necessary coping and life skills. Some may be misdiagnosed with other mental health conditions or receive no appropriate treatment at all.
Those who have ADHD may feel frustrated by their inability to live in a more organized and focused manner. Some may develop other conditions, including depression and substance use disorders (SUDs), as a result. This is just one of many links between ADHD and substance abuse.
The relationship between ADHD and substance abuse is evident in studies relating to ADHD and children, teenagers, and young adults. More research has been done about the disorder in these age groups. They reveal an increased likelihood of substance abuse among sufferers of attention deficit hyperactivity disorder.
According to a study published in 2014 by the American Academy of Pediatrics, compared to those without ADHD, children with ADHD were:
The study found that ADHD was associated with individuals developing a substance use disorder at an early age and a higher likelihood of using a variety of substances.
The research also found that the diagnosis of ADHD as a child was associated with an increased risk of the individual developing a substance use disorder in their 20s and 30s.
Although research clearly demonstrates a link between ADHD and substance abuse, the exact reason for this connection is still not fully understood, and research on this is ongoing. There are several factors that are usually cited for the connection between ADHD and substance abuse.
In order to effectively treat ADHD and substance abuse problems, most medical professionals first try to distinguish between underlying ADHD symptoms and ADHD-like symptoms caused by substance abuse.
This can be difficult, as long-term use of some substances can result in side effects that mimic those of the disorder. Excessive and long-term marijuana use, for example, can result in problems like motivation troubles, organizational difficulties, and inability to pay attention.
Medications may be used by professionals treating a dual diagnosis of ADHD and substance abuse. Since many of the medications commonly prescribed for ADHD are stimulants that are habit-forming and prone to abuse, medication management is crucial.
Psychotherapy is always recommended in the treatment of ADHD and substance abuse.
Through ongoing therapy, a professional will help an individual identify underlying emotional problems that may be related to their ADHD and contributed to their substance abuse problem. They will address issues that were the result of unresolved frustrations and problems related to their lifelong struggle with ADHD.
A comprehensive therapy program will also help an individual struggling with both ADHD and substance abuse problems to develop necessary life skills. These coping skills will help them succeed not only in addiction recovery but also in life after treatment.
ADHD is a prevalent mental health disorder that can make it difficult for an individual to organize and manage their life effectively. Individuals who live with ADHD are more likely to develop substance abuse problems.
There are multiple theories on why this connection exists, and research continues on the subject. One thing the medical community is clear on is that recovery requires integrated treatment of these disorders. Treatment must include therapy to address underlying mental health issues as well as coping skills for dealing with day-to-day life.
(August 2017) ADHD and Substance Use: Current Evidence and Treatment Considerations. Chardee A. Galan, MS and Kathryn L. Humphreys Ph.D. Psychiatric Times. Retrieved February 2019 from https://www.psychiatrictimes.com/special-reports/adhd-and-substance-use-current-evidence-and-treatment-considerations
(November 2018) What to Know About ADHD. Rachel Nall. Medical News Today. Retrieved February 2019 from https://www.medicalnewstoday.com/articles/323667.php
(July 2014) Attention-Deficit/Hyperactivity Disorder and Substance Abuse. Elizabeth Harstad and Sharon Levy. American Academy of Pediatrics. Retrieved February 2019 from http://pediatrics.aappublications.org/content/134/1/e293
(May 2009) Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders. John J. Mariani, M.D. PubMed Central. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676785/
(July 2014) ADHD and Substance Abuse. Joel L. Young M.D. Psychology Today. Retrieved February 2019 from https://www.psychologytoday.com/us/blog/when-your-adult-child-breaks-your-heart/201407/adhd-and-substance-abuse