Untreated attention deficit hyperactivity disorder (ADHD) is a significant risk factor for developing a substance abuse problem. According to Dr. Sarper Taskiran, a clinical psychiatrist from the Child Mind Institute, many of the ADHD patients she has treated do not begin abusing drugs to get high, but rather to cope with symptoms of ADHD such as racing thoughts, hyperactivity, and sleep difficulties [1].
It’s important that treatment takes an integrated approach to treat ADHD and substance abuse, and their overlap through a combination of medication, behavioral therapies, and holistic healing such as mindfulness.
Understanding The Link Between ADHD and Substance Abuse
ADHD is a developmental disorder that emerges in childhood (although symptoms may not be recognizable until adulthood). People with ADHD are thought to lack essential neurotransmitters in the brain, such as norepinephrine and dopamine. Studies have also found that key regions, such as the basal ganglia and prefrontal cortex, may be altered in shape or volume.
These regions are essential for pleasure-driven behaviors like food or sex, habit formation, motivation, and attention. They also affect mood, emotional regulation, and impulse control [2].
The structural differences found in ADHD brains cause distressing symptoms that increase the risk of addiction, with many individuals turning to substance abuse to cope. According to the National Institute of Health, people with ADHD are nearly 50% more likely to develop an addiction to drugs or alcohol [3].
A few factors that influence the link between ADHD and substance abuse include:
- ADHD symptoms, such as restlessness, fidgeting, and irritability, cause many users to self-medicate with drugs or alcohol
- ADHD symptoms, such as impulsivity or poor judgment, may increase the risk of individuals trying drugs without thinking of long-term consequences
- The chemistry of ADHD brains (e.g., altered shape of basal ganglia) makes people more prone to developing compulsive behaviors (e.g., addiction to shopping)
- ADHD has a high co-morbidity rate with other mental health disorders, such as depression and anxiety (60% to 80%), potentially increasing the risk of substance abuse
Signs of Addiction in Individuals with ADHD
There are several symptoms associated with ADHD, such as restlessness, irritability, inability to focus, easily forgetful, and short-term memory loss. Symptoms of substance abuse may include excessive use of drugs or alcohol, physical and mental deterioration, strained relationships, and financial issues.
Other distinct symptoms present in individuals who struggle with both ADHD and substance abuse include:
- Strong physical cravings for drugs and alcohol or intense emotional urges for compulsive behaviors (e.g., gambling).
- No control over consumption or behaviors. This is often worsened for those with ADHD who already struggle with impulse control.
- Continues to use despite the consequences—a common occurrence in those struggling with addiction.
Common Addictions in ADHD Patients
There are several addictions commonly found in individuals with ADHD. Detox and treatment plans are tailored to meet each patient’s unique recovery needs.
ADHD and Alcohol Abuse
Research shows that ADHD is five to ten times more common in adult alcoholics. Furthermore, studies found that teens with untreated ADHD were nearly 15% more likely to abuse alcohol during adolescence, leading to an increased risk of alcoholism in adulthood. People with ADHD often turn to alcohol to calm their thoughts, reduce anxiety, and increase sociability [3].
ADHD and Drug Addiction
ADHD increases the risk of addiction to several drugs, especially substances such as marijuana and benzodiazepines, which are often used to slow down racing thoughts in those with ADHD. Individuals are also 3x more likely to struggle with nicotine dependence and have a harder time quitting smoking than those without ADHD [4].
Patients with unmedicated ADHD often feel bored, understimulated, and may seek out illegal or illicit stimulants such as cocaine or methamphetamines. It´s important for those with ADHD to have access to psychiatric services so they can receive proper stimulant medication and mitigate the risk of seeking out medication on the street.
ADHD and Behavioral Addictions
Addiction isn´t limited to drugs or alcohol. Individuals with ADHD are also more prone to developing behavioral addictions. These are intense desires or urges to complete a certain behavior, regardless of the negative consequences. Common behavioral addictions include:
- Gambling
- Shopping
- Food (binge eating)
- Porn or sex
- Social media (“addicted to scrolling”)
- Video games
Integrated Dual Diagnosis Care for ADHD and Addiction
Treating ADHD and addiction requires a balanced approach. Medical detox and substance abuse counseling can help stabilize patients to get clean from drugs or alcohol. And psychiatric medication, therapy, and holistic approaches can treat ADHD and other co-occurring mental health disorders that drive substance abuse.
Detox and Medical Intervention
The first step in recovering from substance abuse (for ADHD or non-ADHD individuals) is detox. Detox helps rid the body of addictive substances and lays the groundwork for long-term recovery. Substance abuse treatment programs often provide medically supervised detox to stabilize patients, monitor vitals, and ensure necessary social supports are in place.
Medication Management
Stimulant medication is often the first-line treatment for adults with ADHD. These medications, such as Adderall, Vyvanse, Ritalin, and Concerta, work by increasing levels of dopamine, norepinephrine, and other neurotransmitters in the brain to improve symptoms such as restlessness, inattention, and impulse control.
Evidence-Based Therapies
Evidence-based mental health therapies such as Cognitive Behavioral Therapy (CBT) support adults with ADHD in substance abuse recovery by helping them set and achieve goals, develop coping skills to manage stress, rebuild relationships, and treat co-occurring disorders such as anxiety or depression.
TMS and Neurofeedback are two other evidence-based therapies growing in popularity for their ability to help patients with ADHD manage symptoms such as inability to focus and impulse control.
- Transcranial Magnetic Stimulation (TMS): Uses magnetic pulses and sensors on the scalp to stimulate activity in certain brain regions. For ADHD, TMS targets the prefrontal cortex to reduce symptoms such as inattention and impulsivity.
- Neurofeedback: Trains the brain to self-regulate by observing and tracking brain wave frequency and activity. For ADHD, neurofeedback aims to increase beta frequencies (associated with concentration and problem-solving) and decrease theta frequencies (associated with daydreaming, creativity, and intuition).
Mindfulness Therapies
Mindfulness practices such as deep breathwork, guided meditation, and yoga can support individuals with ADHD in substance abuse recovery by teaching them to manage stress or triggers and slow down racing thoughts.
Mindfulness-based stress reduction (MBSR) is a structured, evidence-based therapy to reduce physiological stress, emotional distress, and alleviate substance abuse cravings.
MBSR consists of:
- Body Scan: A form of physical meditation that helps patients understand where they are holding stress or tension in the body.
- Self-awareness: Practice daily awareness around one´s thoughts, feelings, mood, and how they influence behavior.
- Gentle Movement: Light yoga or stretching can release pent-up emotions and stress in the body, aiding overall recovery.
Holistic Treatment for ADHD and Substance Abuse at Maple Mountain Mental Health and Wellness
Whether through therapy, medication, or holistic practices, recovery is within reach. We understand the complex nature of neurodivergent disorders and offer comprehensive ADHD treatment.
Maple Mountain Mental Health & Wellness Center has a compassionate team of clinical psychiatrists and experienced therapists who are here to help you effectively manage ADHD. Healing starts with taking the first step.
Reach out to our Admissions team today.
References
[1] Frank, C. 2024. ADHD and Substance Abuse. Child Mind Institute.
[2] Curatolo, P., et al. (2010). The neurobiological basis of ADHD. Ital J Pediatr. 2010 Dec 22;36(1):79
[3] Wilens, T. E, et al. (2014). The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Curr Psychiatry Rep. 2014 Mar;16(3):436.
[4] McClernon, F, et al.(2008). ADHD and smoking: from genes to brain to behavior. Ann N Y Acad Sci. 2008 Oct;1141:131-47
