People with ADHD are significantly more likely to develop addiction or substance use disorders because both conditions are rooted in dysregulation. Understanding this overlap is essential because treating one condition without addressing the other dramatically reduces the chances of lasting recovery.
Why ADHD Increases Addiction Risk:
For those with ADHD, the risk of addiction stems from certain characteristics associated with ADHD:
- Neurodivergence predispositions
- Impulsivity
- Emotional dysregulation
- Social divergence factors
- Possible learning differences
- Relationship to other mental health conditions
- Self-medication
Those with ADHD function with a different brain structure than neurotypical individuals, contributing to these behavioral differences.
The level of impulsivity among those with ADHD shows a strong correlation to addiction, as impulsive actions can lead to drug experimentation and, by extension, addiction.
Social divergence may also present itself among those with ADHD, where peer acceptance may be lacking and maintaining relationships proves more difficult.
Struggling to create and keep friendships can contribute to experimentation with drugs, both by attempting a sense of inclusion among others who are abusing substances, or as a means of self-medicating any feelings of loneliness that stem from a lack of social community.
Both of these can occur at the same time, potentially causing a deepening addiction issue.
Likewise, knowing that many who have ADHD also struggle with learning differences, emotional dysregulation, and other mental health conditions, the use of drugs may become a method for self-medicating.
Without other coping skills and support, using alcohol and other drugs to manage autism, emotions, anxiety, depression or other mental health conditions may become the primary method of symptom management, thereby becoming a form of self-medication for ADHD.
ADHD Medication and Misuse
ADHD is sometimes treated with prescription stimulants, such as amphetamine and dextroamphetamine and is prescribed under several different names and dosages.
Stimulant use carries with it a high risk of misuse and addiction, especially among high school and college-aged students.
This particular age demographic shows a higher abuse rate than others, due in large part to the derived effects from stimulant abuse:
- Concentration boost
- Enhanced alertness
- Increased focus
- Euphora
- Weight loss
During the height of academic stress, stimulant use is seen as one way to offer a boost in potential and abilities, as students can stay awake longer to study and focus more intentionally during study times.
Others abuse them for perceived cognitive enhancement, such as increased IQ, despite studies refuting that claim.
Some people choose to abuse ADHD medications for recreational use, as they can also deliver a sense of euphoria.
The risks associated with stimulant abuse should be known, as side effects can be severe:
- Heart irregularities, including sudden death
- Psychosis
- Risky sexual behaviors
- Suicidal ideation
- Physical and psychological dependence
The risk of ADHD and drug abuse is lessened when taking ADHD medications as prescribed for a diagnosed condition. Yet, due to the known rate of stimulant misuse and ADHD, the Drug Enforcement Administration has listed ADHD medications as Schedule II.
This classification places tighter restrictions on the prescription availability and refills. Although this may curb the abuse rates, the risk of medication misuse remains high.
Common Substances Used by People with ADHD
Individuals with ADHD who struggle with substance use tend to gravitate toward three primary substances:
- Tobacco
- Alcohol
- Methamphetamines
Tobacco use is prevalent among those with ADHD, with some starting their nicotine use before adulthood.
The reasons behind this connection again stem from the symptoms of ADHD, as many begin using tobacco to curb the symptoms of inattention and/or hyperactivity.
ADHD and alcohol addiction do show similarities in neurobiological processing, thereby creating a strong relationship between an ADHD diagnosis and the development of alcohol use disorder.
Methamphetamines appear to be another drug often abused by those with ADHD. As both methamphetamine and ADHD medications are amphetamines, they therefore share similar effects.
Those with ADHD who also abuse methamphetamine are most likely self-medicating their symptoms.
Dual Diagnosis Treatment for ADHD and Addiction
Dual diagnosis, ADHD and addiction are frequently seen together, with reports noting 40% to 60% of those with ADHD also struggle with addiction.
Treating both conditions is essential for long-term success and requires a multifaceted approach.
- Limiting stimulant medications
- Opting for nonstimulant medication management
- Psychoeducation
- Cognitive behavioral therapy
- Social support increases
- Relapse prevention plans
Ensuring proper care may require the assistance of multiple providers, including a medical doctor, therapist, social worker, and psychiatrist.
Ultimately, the goal of treatment for ADHD and addiction is the reduction of harm and improved quality of life.
Therapy and Medication Strategies
Treatment for ADHD and substance use disorders usually occurs simultaneously, as untreated symptoms of ADHD may impair progress in addiction treatment, and substance use may limit progress in the treatment of ADHD.
With this simultaneous approach, treatment often begins with a change in mediation.
If the prescribed ADHD medication is being abused, doctors may suggest a non-stimulant option, which may include:
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Bupropion
- Atypical antipsychotics
- Clonidine
- Venlafaxine
- Atomoxetine
Although these medications have a lower efficacy rate for the management of ADHD symptoms, they are a safer option for the treatment of ADHD while overcoming addiction.
Psychoeducation remains a cornerstone for the treatment of mental health conditions and addiction. Ensuring awareness around the pervasiveness of addiction and how the diagnosis of ADHD can influence addiction can help improve the effectiveness of treatment.
Cognitive behavioral therapy (CBT) has been used to mitigate the symptoms of ADHD and reduce rates of addiction.
As well, social coaching proves fruitful in aiding progress, especially when focus is placed on overcoming ADHD-specific symptoms, such as procrastination, time management, and organization.
Additionally, a relapse prevention plan that addresses both conditions is vital for long-term sobriety and well-being.
ADHD and Addiction FAQs
Are People With ADHD More Likely to Develop Addiction?
Yes, people with ADHD are shown to be at a six times greater risk of developing an addiction than those without ADHD.
Is Adderall Addictive?
Adderall is considered an addictive substance due to its stimulant effects and is classified as a Schedule II medication, limiting its access to curb misuse.
Does Untreated ADHD Lead to Substance Abuse?
Untreated ADHD does not automatically lead to substance abuse, but research does show an increased risk of developing addiction when ADHD is untreated.
How is ADHD Treated in Rehab?
Treatment for ADHD revolves around symptom management and often includes a combination of talk therapy, such as cognitive behavioral therapy and social skills training.
Can Stimulant Medication Cause Addiction?
Using stimulant medication as prescribed for a diagnosed condition does not cause an addiction. However, there remains the potential for stimulants to be taken improperly or recreationally, which can lead to addiction.