ADHD And Addiction

Understanding ADHD And Addiction

Attention-deficit hyperactivity disorder (ADHD) and addiction can be closely related, and studies show that people with ADHD have an increased risk of developing a substance use disorder (SUD). This increased risk has to do with using drugs and alcohol to self-medicate unwanted and intrusive ADHD symptoms. People with ADHD also have poor impulse control, which is a risk factor for drug-seeking behaviors and addiction.

When both addiction and ADHD are present, this is known as a dual diagnosis, and both of the disorders should be treated simultaneously. Addiction treatment programs for individuals with ADHD emphasize this dual diagnosis approach and utilize various types of therapy in addition to medications for ADHD to allow for healing and healthy habits to take form.

Why Do People With ADHD Abuse Substances?

Individuals with ADHD have trouble paying attention and controlling impulsive behavior. As a result, they may turn to drugs or alcohol as a way to self-medicate and cope with their intrusive ADHD symptoms.

For example, a person with ADHD may misuse stimulants such as cocaine to improve their focus and concentration, and misuse alcohol, benzodiazepines, or other depressants to calm their hyperactivity, alleviate boredom, and cope with anxiety, stress, and emotional dysregulation.

Dopamine is a key brain chemical involved in the reward pathway and released during pleasurable behaviors. Drugs, alcohol, gambling, and other activities also increase dopamine. People with ADHD have lower dopamine levels and poor impulse control, leading to impulsive drug-seeking to boost dopamine and experience instant rewards.

While experimenting with drugs and alcohol may provide temporary relief from ADHD symptoms, repeated substance abuse can lead to the dysregulation of dopamine and the reward cycle in the brain, resulting in tolerance, dependence, and addiction as the brain becomes rewired. This dysregulation of dopamine can make it incredibly challenging for people with ADHD to find pleasure in naturally rewarding behaviors. As a result, they will continue to impulsively use drugs and alcohol despite the negative consequences that substance abuse has on many aspects of their lives.

How Do ADHD And Addiction Develop?

There are several factors that can affect someone’s chance of developing ADHD or a SUD, including:

• Genetics: Heredity is the most common cause of ADHD. Children with ADHD are four times as likely to have a family member also diagnosed with ADHD. Genetics also plays a role in the development of addiction, and studies show that a person with a first-degree relative with addiction (parent or sibling) is four times more at risk of developing an addiction to drugs or alcohol.
• Exposure to toxic substances: Researchers have found a connection between the maternal use of tobacco products, drugs, and alcohol during pregnancy and the development of ADHD in their children. Lead exposure has also been linked to hyperactivity; exposure to illicit substances in the womb may result in substance dependency in the newborn upon birth.
• Trauma: Injury to the brain, complications during birth, brain tumors, stroke, or disease can cause inattention and poor regulation of motor activity and impulses, and are risk factors for ADHD. Past emotional and psychological trauma, such as abuse, natural disasters, bullying, violent events, and traumatic accidents, are risk factors for the development of addiction.

ADHD Symptoms And Effects

ADHD symptoms can vary from person to person but core symptoms include:

• Difficulty finishing tasks
• Problems listening to others
• Struggles with organizing projects or responsibilities
• Forgetfulness
• Being easily distracted
• Constant fidgeting
• Inability to control speech or actions
• Frequently losing or misplacing personal items
• Difficulty being on time and keeping a schedule

Additionally, there are three subtypes of ADHD that reflect the different ways symptoms can present and impact daily functioning. They include:

• Hyperactive and impulsive: marked by hyperactive behavior, constant physical activity, and impulsive behavior.
• Inattentive: marked by a lack of ability to pay attention or focus.
• Combined: the most common subtype of ADHD, marked by inability to pay attention and focus, in addition to hyperactivity and impulsivity.

Understanding these subtypes can help clinicians tailor assessment and treatment approaches to better support individuals with ADHD.

Adults with ADHD often have trouble performing adequately at work. They can feel chronically disorganized and misplace important items needed to complete a task. They also might forget appointments or overlook social commitments. Relationship problems may also develop, as individuals with ADHD are inclined to make offhanded remarks without thinking, or they may fail to pay attention to others because they are distracted.

ADHD symptoms are characterized as ego dystonic, meaning that the person finds these thoughts and behaviors displeasing and unpleasant because they cause significant distress in their life. These ego-dystonic symptoms can trigger people with ADHD to misuse or abuse alcohol or drugs as a way to minimize, forget, or escape their symptoms, relax, fit in socially, or slow down and escape their reality.

How Do I Help Someone With ADHD And Addiction?

If your loved one is struggling with ADHD and addiction, you can support them in seeking help by doing the following:

• Encourage them to learn more about ADHD, addiction, and available treatment options.
• Urge them to visit both a psychiatrist and a psychologist, as ADHD is primarily treated with medications.
• Encourage them to seek help from a treatment center or provider that offers dual diagnosis treatment.
• Help them develop structure and habits by keeping a schedule and staying organized. This can be done by using lists, calendars, alarms, and reminders. If a task can be done within five minutes, teach them to do it now rather than later. Help and encourage your loved one to say “no” to things and people that do not serve them. Help them prioritize tasks, remind them always to be early, and give themselves more time than they need.
• You can also learn more about ADHD and addiction so that you can arm yourself with the knowledge about these disorders. This allows you to better understand your loved one, emphasize their needs, and help them with treatment options.
• Encourage your loved ones to attend support groups, whether in person or virtual, as there are many groups for people struggling with mental health conditions and addiction. There are also support groups for loved ones like you, such as Al-Anon and Nar-Anon.

What Are The Treatment Options For ADHD And Addiction?

Dual diagnosis treatment programs focus on addressing both ADHD and addiction. Treatment often includes psychotherapy, primarily cognitive behavioral therapy.

Prescription stimulants are the most common medications to treat symptoms of ADHD, and they include:

• Methylphenidate: Ritalin, Concerta, Focalin
• Amphetamines: Adderall, Vyvanse, Dexedrine

Nonstimulant prescription medications are often prescribed if stimulant medications are ineffective or the person has unwanted side effects. Nonstimulant prescription medications include the following:

• Atomoxetine (Strattera)
• Guanfacine (Intuniv, Tenex) and Clonidine (Kapvay)

Prescription medications for ADHD work to increase levels of dopamine and norepinephrine in the brain, which help with focus and concentration.

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Additionally, counseling, family therapy, and holistic therapy can help provide structure, techniques, and coping methods to minimize ADHD triggers and symptoms.

Overall, a dual diagnosis program focuses on:

• Modifying destructive thoughts and behaviors that promote substance abuse
• Building self-esteem and encouraging internal motivation
• Controlling the symptoms of ADHD through behavioral modification and medication therapy
• Identifying substance abuse triggers and learning how to manage impulses
• Educating partners and family members about ADHD

Dual diagnosis programs assist with managing the symptoms of ADHD and modifying the individual’s responses and triggers while in recovery. This will allow people struggling with ADHD and addiction to live a healthy and functional life without being dependent on any substance.

If you or your loved one has ADHD and is struggling with substance abuse, it is time to consider treatment. Contact a treatment provider today or explore our rehab directory to discover your rehab options.