ADHD And Substance Abuse
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral and developmental disorder marked by inattention, hyperactivity and/or impulsivity. It is characterized in brief by a person’s inability to focus, sit still and give prolonged thought to a decision-making process. It is also characterized by a person’s disposition towards distractibility, an inability to listen, excess talkativeness and even risky behaviors, such as substance abuse. Research shows that ADHD is heavily linked to instances of substance abuse, beginning in adolescence and extending through adulthood. Stimulant medications may help to prevent these risks, while various behavioral therapies may treat these dual diagnosis concerns, as in those offered by inpatient drug rehab programs.
Despite perhaps a greater focus on this age, ADHD is not simply a childhood disorder. Beginning in childhood, this disorder can actually extend beyond adolescence and young adulthood and plague an adult through the entirety of their life, if left untreated. At any point within this time, substance abuse and addiction may become an issue, as ADHD is closely linked to drug and alcohol abuse.
More common in young boys than girls, with an average age of onset of seven years, the most recent data from the Centers for Disease Control and Prevention asserts that roughly 11 percent of American children, ages 4 through 17 were diagnosed with this disorder in 2011. Other reports cite that approximately 50 percent of those diagnosed as a child will outgrow the disorder.
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral and developmental disorder characterized by inattention, hyperactivity and/or impulsivity, as explained by the National Institute of Mental Health. These states are marked by the following behaviors:
Inattention: People are prone to forgetfulness even in the completion of everyday tasks and obligations and they often lose things. Easily distracted by outside stimuli or another train of thought, these individuals struggle to stay focused and on task, often failing to complete a project once they start it, as they are easily distracted, poor at time management, disorganized, prone to losing pertinent resources. They may also have difficulty completing things in a proper sequence. As it is difficult for these people to maintain their attention, they appear to be poor listeners and struggle to remain engaged in tasks requiring prolonged focus, such as reading, paying attention to a speaker or presentation, or within an everyday conversation.
Hyperactivity: Constantly restless, a person struggling with hyperactivity commonly feels the need to move about, even in environments where it is not suitable behavior. This may manifest as an inability to stay seated, as a person may wander or pace around; uncontrollable fidgeting, tapping of the fingers or feet, or constant talkativeness is also apparent.
Impulsivity: An impulsive individual lacks the refrain to take pause and consider a decision and the results of their actions, for either the short- or long-term, instead jumping directly into a behavior, action or conversation without any thought to the consequences. These behaviors are not without risk and some may place a person in harm’s way. On a social scale, these individuals typically negate social cues, often interjecting themselves, their ideas or actions within an activity, especially within a conversation. Failing to wait for their peers to finish speaking, a person may constantly interrupt.
Further, there are three specific types of ADHD that are dictated by the prevalence, and possible combination, of these symptoms. As per the most current edition of the Diagnostic and Statistical Manual for Mental Disorders, the three types of ADHD are:
- Predominantly inattentive
- Predominantly hyperactive/impulsive
A true diagnosis must be made by a trained professional, and as outlined by the National Institute of Mental Health, a person’s symptoms must:
- Be persistent and long-standing
- Cause significant impairment to a person’s ability to function within the demands of their life
- “Cause the person to fall behind normal development for his or her age”
An adult with ADHD may encounter a variety of problems within both their personal and professional life, including poor or impaired performance within their job, struggles at the academic level, frustration at their inability to stay on top of tasks within home and family life, and a difficulty maintaining intimate relationships. These factors are also all issues that may contribute to a person’s risk of developing a substance use disorder (SUD).
Sadly, for an individual with ADHD, the connection between ADHD and substance abuse may have existed prior to his or her ever having developed an SUD themselves. Research illustrates, for instance, that ADHD may be linked to a mother’s alcohol or drug use while a child is in utero.
Are There Particular Risks For Young People?
Adolescents and teens with this disorder are at particular risk of developing a form of an SUD. Research focused on ADHD and alcohol abuse within this age group reports that within one study, the prevalence of alcohol use within ADHD teens was nearly double that of those without the disorder, at 40 percent and 22 percent, respectively. Science Daily reports that ADHD teens had over three times the instance of an SUD, at ten percent, when compared to peers without ADHD, at three percent. Keep in mind, those who begin abusing substances earlier in life have an increased risk of developing substance use disorders later in life.
Additionally, individuals with ADHD often struggle with a co-occurring disorder, which may then increase their risk factor for substance abuse. A Medscape article which examines the correlation between ADHD and substance abuse asserts that “Approximately one third of adolescents with ADHD and a diagnosis of substance abuse have psychiatric comorbidities, primarily conduct disorder but also major depressive disorder, generalized anxiety disorder, and traumatic stress disorder.”
In order to circumvent these risks, parents and practitioners both must inform children of the hazards of substance abuse, screen adolescents for an SUD, especially those who have ADHD; and begin prompt treatment for youth with ADHD.
Why Does ADHD Increase A Person’s Risk Of Substance Abuse?
Contrary to characteristics of recreational drug use, many ADHD substance abusers do not illicitly use substances in an attempt to get high or achieve a euphoric state, rather they are using drugs or alcohol as a means to self-medicate symptoms associated with this disorder. ADDitude Magazine reports on this, quoting Timothy Wilens, M.D., associate professor of psychiatry at Harvard Medical School, as saying that only 30 percent of young adults surveyed used substances for the pleasurable effect, in comparison to the 70 percent who used them to “improve their mood, to sleep better, or for other reasons.” He continued, saying “They need something to calm their brain enough to be productive.”
In lesser instances, a person may abuse their own stimulant ADHD medications, most typically, again, in an attempt to self-medicate. Stimulant medications work differently on the brain of an individual with ADHD versus that of a non-ADHD individual. The latter individual experiences a pleasurable effect, whereas the former–those in need–experience an adjustment to their thought process by becoming more balanced and focused, while not experiencing the euphoria illicit drug users seek. Administration of stimulant medications may actually help to prevent the occurrence of an SUD, especially in youth.
The Scientific Link Between ADHD And Substance Abuse
A 2014 publication from the American Academy of Pediatrics outlines findings from a meta-analysis on research relating to this subject published in 2011. What it found was that children with ADHD experienced:
- Nearly double the risk of meeting diagnostic criteria for an alcohol use disorder
- Roughly 1.5 times the likelihood of fulfilling the criteria for a marijuana use disorder
- Double the chance of succumbing to a cocaine use disorder
- An increased risk of developing any substance use disorder by two and a half times
To further explain this connection, an everyday HEALTH article writes that certain research calculates that of those adults with a lifetime history of substance abuse, up to 25 percent could potentially have ADHD. They continue to cite research published by the Journal of the American Academy of Child & Adolescent Psychiatry whose findings caution that a substance use disorder may potentially afflict roughly one-third of young adults diagnosed with ADHD. ADHD is closely linked to instances of alcohol use disorders, to the extent that Medscape reports that “Studies show that 35%-71% of adult alcoholics had childhood-onset ADHD that persisted into their adult years.”
How Might A Person With ADHD Seek Treatment For Substance Abuse?
Most importantly, to avoid the risk of substance abuse accelerating into an addiction, appropriate treatment, including ADHD medications, is essential both for youth and adults. In many instances, this may be best supported when used within the context of medication-assisted treatment, either during instances of abuse or addiction. As ADHD is, in part, a behavioral disorder, certain behavioral therapies that impart behavioral modifications may be vastly beneficial.
Cognitive behavioral therapy has been shown to be an effective treatment for co-occurring ADHD and substance use disorders. This aids an individual in uprooting dysfunctional ways of thinking, behaving, and feeling, while developing more positive alternatives, strengthened even further by the development of a diverse set of coping skills.
Balance Your Mind To Find Sobriety
If you’re overwhelmed with your life due to the adverse effects of ADHD and you find that you’re turning to drugs or alcohol to quell the effects, please reach out before this negative behavior accelerates into an addiction. If you’re currently struggling with a dual diagnosis of both ADHD and an addiction, we can help you to examine your treatment options within our comprehensive inpatient drug rehab program. Contact us at Turning Point today.
Centers for Disease Control and Prevention — Children with ADHD
Psychology Today — ADHD
National Institute of Mental Health — Attention Deficit Hyperactivity Disorder
Medscape — Attention Deficit Hyperactivity Disorder (ADHD)
MedlinePlus — Attention deficit hyperactivity disorder