ADHD and addiction often overlap, and the relationship is complex and difficult to manage without professional support. Several factors increase the likelihood of individuals with ADHD developing substance use disorders. Understanding the relationship between ADHD and addiction, exploring the contributing factors, and pursuing dual-diagnosis treatment can help individuals and their families find healing.
What Is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects children and adults, characterised by persistent inattention, impulsivity, and hyperactivity. ADHD is commonly associated with difficulties in concentration and behaviour, and the impact can go far beyond that; many people with ADHD turn to substance use in an effort to cope with symptoms.
Anyone can develop ADHD, but some populations are more likely to be diagnosed:
- Males are three times more likely to be diagnosed with ADHD than females.
- Those primarily speaking English are four times more likely to be diagnosed with ADHD than those from bilingual homes.
- White people have the highest rates of diagnosis.
A higher diagnosis rate does not necessarily point to higher instances of ADHD, as many variables can affect someone’s likelihood of a diagnosis. For example, individuals from higher income backgrounds may have more access to quality healthcare and regular checkups; someone receiving consistent care is more likely to have an established relationship with a doctor who can observe symptoms and order an ADHD assessment.
The Connection Between ADHD and Addiction
Individuals with ADHD are more likely to experience substance use issues than those without the disorder. The National Comorbidity Survey Replication (NCS-R) surveyed 3,199 adults with ADHD in 2006 and found that 15.2% of adults with ADHD also struggled with a substance use disorder. This number is nearly three times higher than the 5.6% of adults without ADHD who struggle with substance use disorders.
According to a 2012 study from Advances in Psychiatric Treatment, substance use disorders frequently co-occur with ADHD. But why?
Untreated ADHD symptoms can make life extremely challenging. Individuals with ADHD are more likely to experience difficulties in the workplace, and they often experience increased rates of job discrimination. Adults with ADHD may struggle to manage their finances and romantic relationships. ADHD can lead to academic struggles and feelings of isolation, all of which can lead to a desire to escape through substance use.
Common Risk Factors: ADHD and Addiction
Several shared risk factors contribute to the comorbidity of ADHD and addiction.
Genetics play a critical role, as both conditions have a heritable component. Additionally, early exposure to adverse childhood experiences, trauma, or neglect can increase the risk of developing both ADHD and substance use disorders.
Individuals with ADHD may be more susceptible to peer pressure, especially as adolescents and young adults. ADHD often occurs with other mental health disorders like anxiety and depression. Co-occurring mental health issues can increase the risk of substance use as individuals may attempt to alleviate emotional distress through substance use.
The Role of Dopamine in ADHD and SUD
ADHD and substance use disorders (SUD) impact similar connections in the brain, particularly involving the part of the brain responsible for triggering feelings of reward.
Dopamine, the primary neurotransmitter responsible for making you feel happy and motivated, is like a “feel-good” messenger in the brain. In a neurotypical brain, doing something enjoyable or satisfying, like eating your favourite food or accomplishing a goal, releases dopamine. This dopamine release makes you feel happy and rewarded and encourages you to repeat the behaviour that led to that good feeling.
People without ADHD do not typically struggle with task completion because their brain naturally encourages them to do things that bring them joy or satisfaction. It’s easier for these people to form healthy habits because they trigger a dopamine reward.
ADHD, on the other hand, is associated with lowered dopamine levels in the brain. People with ADHD may struggle with executive functioning – the mental skills that help you plan, organise, focus, and complete tasks. Executive functioning is like the brain’s programming that helps us make decisions, solve problems, and control our behaviours and impulses.
People with ADHD may seek out high–risk activities (like drug use, unsafe sex, gambling, thrill-seeking behaviour, or drinking) to compensate for a dopamine deficiency and trigger the reward response. Substance use further compromises executive function, compounding the impact of ADHD and making it even more difficult for people with ADHD to recover from substance use disorders and behavioural addictions.
A lack of executive functioning and an impaired ability to complete tasks can add to feelings of inadequacy, shame, and so on, which can fuel substance issues and behavioural addictions.
Understanding Co-Occurring ADHD and Addiction
ADHD symptoms can significantly impact an individual’s ability to function daily, maintain relationships, and achieve academic or occupational success. They may struggle to regulate their emotions, manage stress, and manage their ADHD symptoms, and consciously or unconsciously turn to substances for relief from inattention, hyperactivity, and impulsivity. A dopamine deficiency can create a dependency on addictive behaviours, triggering a vicious addiction cycle.
Many addictive substances and behaviours can act as a coping mechanism for someone with ADHD – anything that triggers a dopamine release can be used for self-medication. The self-medication hypothesis theorises that individuals use substances to reduce their psychiatric symptoms. This hypothesis explains why people with ADHD often struggle with substance use and other process addictions involving social media, video games, sex, gambling, exercise, and food.
ADHD and Addiction: The Role of Impaired Decision-Making
One of the primary symptoms of ADHD is poor decision-making skills, as individuals may struggle to weigh the long-term consequences of their actions. Substance use further impairs decision-making abilities by affecting cognitive functions such as memory, attention, and reasoning.
Individuals struggling with ADHD and addiction may also struggle with regulating their impulses, leading them to act on their immediate desires or emotions without fully considering the potential long-term results or consequences. Impulsive behaviour can lead to risky decision-making and increase the likelihood of high-risk activities, including substance use.
Difficulties with executive functioning can increase a person’s risk for substance use, making it challenging for those with ADHD to resist the immediate gratification offered by drugs or alcohol, even in the face of adverse outcomes. Co-occurring ADHD and substance use compound the negative impact on decision-making, leading to even riskier decisions with potentially life-threatening consequences.
ADHD and Addiction Treatments
Behavioural therapies like cognitive behavioural therapy (CBT) and contingency management can help individuals with ADHD develop coping strategies for managing impulsivity and improving executive functioning. Contingency management utilises positive reinforcement to encourage abstinence from substances and adherence to treatment plans.
A supportive environment is essential for successful behavioural health treatment. Support groups can offer emotional support and education for individuals struggling with ADHD and addiction, and family therapy can do the same for their loved ones. Strengthening social connections and building a robust support network can help prevent relapse and promote recovery.
Medication can be a valuable component of dual-diagnosis treatment for individuals with ADHD and addiction. ADHD medications have evolved to include various stimulant and non-stimulant options, which can be especially helpful for those with a history of substance use as psycho-stimulant medications can be problematic with those in the early stages of a recovery journey.
A healthcare provider may recommend medication if ADHD symptoms are still causing significant impairment despite environmental adaptations. As with any medical condition, careful monitoring is essential to prevent misuse.
Treating ADHD and Addiction: Dual Diagnosis
ADHD and addiction share a complex and intertwined relationship. While individuals with ADHD are more susceptible to developing substance use disorders, it is crucial to understand the underlying factors that contribute to this connection.
Dual-diagnosis treatment, which addresses both ADHD and addiction simultaneously, is essential for effectively supporting individuals dealing with co-occurring disorders. By employing a holistic approach that includes behavioural therapies, supportive interventions, and careful pharmacological interventions, healthcare professionals can provide comprehensive care, promoting better outcomes and improved quality of life for those impacted by ADHD and addiction.
With dual-diagnosis treatment, you can find support for ADHD and addiction without having to prioritise one condition over the other; you don’t have to wait until your ADHD symptoms are under control to address substance issues, and you don’t have to settle into recovery before finding relief from ADHD (as is sometimes suggested).
Dual-diagnosis treatment is an essential component of long-term behavioural health: addressing only one condition while neglecting the other can lead to treatment failures and higher chances of relapse. Integrated treatment approaches that simultaneously target both disorders yield more effective and lasting results.
Diagnosing ADHD with co-occurring substance use can be challenging because the conditions share overlapping symptoms; for example, someone struggling with chronic drug use may experience memory impairment or impulsivity, which can mimic or exacerbate ADHD symptoms. Comprehensive assessments that include a thorough medical history, behavioural observations, and neuropsychological testing are necessary to distinguish between the two disorders accurately.
Removing Stigma from ADHD and Addiction Treatment
Stigma surrounding behavioural health treatment can deter people from seeking help due to fear of judgment, discrimination, or negative social consequences. Behavioural health stigma can compound shame and make it difficult for some individuals to disclose their substance use or ADHD symptoms.
We want to be clear: behavioural health is essential to overall wellness, and there is no shame in getting support from dedicated professionals. ADHD and addiction are valid health conditions like any other chronic illness or injury.
At APN London, we treat our clients with the respect and care they deserve. We recognise our clients as individuals and work to gain a holistic understanding of the impact of ADHD, substance use, and other behavioural health concerns.
We believe a comprehensive, evidence-based, and person-centred approach is the best foundation for ADHD and addiction treatment. We work with every client to build a treatment plan that honours their lived experience, current circumstances, preferences, and goals. We view client input as a valuable tool that helps shape our treatment plan as much as ongoing collaboration between specialists, accurate assessment and diagnosis, and alternative healing modalities.
Professional Support Rooted in Compassion
APN London offers a wide variety of treatments, including individual therapy, where a clinician will work with you to understand the impact of ADHD and delve into the root cause of any co-occurring disorders. You’ll learn how to help manage your emotions and behaviours, process stress, and achieve goals outside of recovery. We also offer group therapy sessions, encouraging empathy and understanding towards others while treating the cultural and social aspects of addictions and mental health issues.
Not all individuals with ADHD may present with the more well-known symptoms, and the severity can differ significantly from person to person. APN London will work with you to gain as much insight as possible for the most accurate diagnosis and create a treatment plan that addresses your unique needs.
We want to help you move from surviving to thriving. Treatment is more successful when healing addresses the root cause, not just the symptoms. Alcohol or drug addiction can mask mental health conditions and vice versa. Without getting to the root cause, treatment is simply a patch for the underlying condition, making the likelihood of relapse more probable.
APN London can work with you to address co-occurring disorders and help you find long-lasting recovery. Contact our team today for a free initial consultation by calling 0203 984 7699 or completing our online contact form. We’ll help you take the next step and work with you to build a treatment plan that helps you thrive in mind, body, and soul.