In this article, we explore the connection between ADHD and addiction, how ADHD contributes to an individual’s risk for addiction, and how ADHD impacts treatment for substance use disorders.
The Connection Between ADHD and Addiction
According to the International Collaboration on ADHD and Substance Abuse, approximately one out of six adults with a substance use disorder has ADHD. While there is not one exact reason why people with ADHD are at higher risk for substance use disorders compared to those who do not have ADHD, a few different variables are thought to contribute to this connection:
Genetics: We know that there are genetic components to both ADHD and substance use disorders, and it is possible that some of the genetics that make someone more at risk for a substance use disorder also increase the likelihood that they will have ADHD. Impulsivity: People with ADHD have more difficulty regulating impulses compared to those who do not, which can increase risk for using addictive substances. Dopamine Seeking: ADHD brains process dopamine differently than non-ADHD brains. This difference may contribute to higher risk for substance dependence among those with ADHD. Daisy, who has ADHD and struggles with cannabis dependence, said: “I definitely feel that weed gives me dopamine which my [ADHD] brain lacks, so it would help me focus and sometimes get stuff done that I normally wouldn’t have been able to.” Maya, who also has ADHD and a history of substance dependence, also shared, “I hated harming myself with that poison but my ADHD cried for stimulation and thrill.” Self-Medication: Barriers to appropriate, evidence-based treatments for ADHD and common comorbid mental health issues may drive some to attempt to self-medicate with substances, which can lead to addiction. Maya said that her substance use “allowed me to hide my disability.” Daisy shared that substance use helps her process her emotions. Trauma: People with ADHD are more likely than those without ADHD to have a history of childhood trauma and abuse. Trauma history increases the risk for developing a substance use disorder.
Complications of ADHD and Addiction
Individuals who have ADHD are at higher risk for developing a substance use disorder in their lifetime, and ADHD can complicate recovery from a substance use disorder. Impulse control issues and dopamine seeking can make quitting especially difficult for someone with ADHD. Regarding her experience with cigarettes, Maya shared, “Nicotine satisfied my constant ADHD need for stimulation.” Of course, those with ADHD can still overcome their addictions! They may just need specialized treatment and care from providers who understand the unique intersection of their symptoms.
Diagnosing ADHD and Addiction
ADHD is a neurodevelopmental diagnosis, meaning that it develops early in life. Although many people are not diagnosed until adulthood, symptoms typically begin in early childhood. A qualified evaluator will use various psychological assessments to determine whether or not someone meets the diagnostic criteria for ADHD. A substance use disorder, according to the Diagnostic and Statistical Manual for Mental Disorders, occurs when an individual engages in “a pathological pattern of behaviors related to use of the substance” and continues using the substance despite “significant substance-related problems,” such as losing jobs or harming relationships as a direct result of the substance use. If an individual finds that they cannot regulate or control their substance use, experiences cravings when they are unable to use, develops tolerance to the substance, experiences withdrawal when not using the substance, or continues use despite negative consequences, they might be experiencing a substance use disorder.
Treatment for ADHD and Addiction
It is vital to remember that no study has shown a link between stimulant treatment for ADHD and increased risk for substance dependence or stimulant use disorder. In fact, appropriate treatment for ADHD can regulate impulsive behaviors and mitigate self-medicating, effectively reducing the risk for substance dependence. Each individual must determine the treatment options and plan that is right for them, and what works best for one person may not be the best option for someone else. Current research suggests that the most effective treatment for ADHD with comorbid substance use disorder is a combination of either stimulant or non-stimulant medication and outpatient therapy such as Cognitive Behavioral Therapy. Maya shared that CBT was helpful to her in overcoming her addiction, as well as learning about the underlying reasons behind her substance use. She said, “It took me years to learn this but ultimately I gained the knowledge and insights and could stop.”
Coping With ADHD and Addiction
Community support can be huge for addiction treatment, especially for those with ADHD. Daisy shared that she joined a discord server for people struggling with similar issues. She said, “Being able to talk to people going through the same thing is a godsend.” Maya has also found support from online groups and connecting with others going through similar challenges. It can be challenging to overcome addiction, which is particularly true for people with ADHD. However, treatment and support are available. It is okay to ask for and receive help. If you struggle with addiction and have ADHD, remember that addiction is not a moral failing but something that you can overcome with appropriate treatment and support.
