Co-Occurring ADHD & Drug or Alcohol Addiction

Attention deficit hyperactivity disorder (ADHD) is a mental disorder that occurs at higher rates among those with drug and alcohol addiction than it does the general population.

Understanding the ways these two complex disorders influence the course and treatment of the other can be difficult. This article will discuss the connection between ADHD and substance use disorders, symptoms, risk factors, and options for treatment.

Understanding ADHD & Substance Use Disorder

In recent years, emerging research has indicated a growing number of people are diagnosed with both ADHD and substance use disorder (SUD).1 While ADHD affects an estimated 2.5% of the general U.S. population, it is more prevalent among people with drug or alcohol addiction.1

Likewise, substance use disorders are more prevalent among adults with ADHD, who are roughly three times as likely to have a SUD than those without ADHD.2

What Is ADHD?

Attention deficit hyperactivity disorder, or ADHD, is a mental health condition characterized by difficulty with attention and focus, and/or hyperactive and impulsive behavior that impairs a person’s ability to function in daily life.3

ADHD can present very differently from person to person and frequently occurs alongside other mental health conditions, making it difficult to diagnose.4 The most common comorbidities with ADHD include:4

  • Mood disorders, such as depression and bipolar disorder.
  • Anxiety disorders.
  • Personality disorders.
  • Substance use disorders.

What Is the Connection Between ADHD and Substance Use Disorder?

woman sitting on sofa with her knees pulled up to her chest and head down, distressed by her ADHD and substance abuse symptomsSubstance use disorders are one of the most common conditions that present with ADHD. The connection between ADHD and addiction is complicated, and researchers are still working to better understand how one disorder impacts the other.3,4

When ADHD and substance use disorder exist in the same person at the same time, they are known as co-occurring disorders; this is also sometimes called a dual diagnosis.

The relationship between ADHD and addiction is said to be bidirectional, meaning one condition can influence or worsen the course of the other, and vice versa.4

When symptoms of ADHD are combined with symptoms of SUD, impairment is likely to be more severe. Also, having cooccurring ADHD can make addiction treatment a bigger challenge than for someone without a co-occurring disorder.2

The most frequently misused substances linked to ADHD are:4

Individuals with ADHD also more frequently report the use of substances in order to manage their mood or as sleep aids.4

How Common Is Co-Occurring ADHD & Substance Use Disorder?

Substance use disorders are twice as common in people with ADHD than in the general population,4 and about 23% of adults with SUD also suffer from ADHD.5

Broadly speaking, comorbid conditions are extremely common in people with ADHD. Some studies suggest as many as 80% of adults with ADHD suffer from at least one other co-occurring psychiatric disorder.4

Symptoms of Co-Occurring ADHD & Addiction

The symptoms of ADHD and addiction can vary greatly depending on the individual.

While many people have occasional problems with inattention and/or hyperactivity and impulse control, these symptoms are persistent and debilitating for people with ADHD and affect their relationships, careers, and ability to function on a daily basis.6

In turn, the American Psychiatric Association details the criteria for a substance use disorder as the following:6

  • Using or drinking more, or over a longer period of time, to achieve the same effect.
  • Unsuccessful attempts to cut back or quit drinking or using drugs.
  • Spending a lot of time trying to get alcohol or drugs, or spending a lot of time recovering from using or drinking.
  • Cravings or urges to drink or use.
  • Failing to meet certain roles, responsibilities, or expectations at work, school, or home due to drinking or using.
  • Giving up things that were once important in order to drink or use drugs.
  • Using or drinking in places or ways that are dangerous.
  • Using or drinking despite knowing that it causes physical or mental health problems.
  • Developing a tolerance for drugs or alcohol (i.e., needing to use more and more to get the same effect, or experiencing less effect when using the same amount).
  • Experiencing withdrawal symptoms, when cutting back or stopping use.

For example, stimulant intoxication can mimic symptoms of ADHD. This highlights the importance of ensuring symptoms cannot be better explained by another mental or physical condition.5

However, misattribution of ADHD symptoms to SUDs may be a contributing factor in the underdiagnosis of ADHD.5

The co-occurrence of ADHD and substance use disorder can also lead to more severe symptoms for both conditions, including increased risk of polysubstance use and decreased chances of maintaining abstinence.4

Some people with ADHD may use drugs or alcohol to alleviate ADHD symptoms , which can increase the likelihood of a developing an SUD.4

Risk Factors for Co-Occurring ADHD & Addiction

Several risk factors can increase a person’s risk of developing co-occurring ADHD and addiction.

One of the main factors is genetics. Both conditions have similar genetic vulnerabilities, which may include difficulty with impulse control and dysfunction of the pleasure and reward center in the brain.7

Brain activity also plays a role in the symptoms associated with both disorders, as both disorders impact a similar region in the brain.4

Children diagnosed with ADHD at a young age have a higher risk of developing a substance use disorder in adulthood.7

Can ADHD Medication Lead to Addiction?

When used as prescribed, stimulant medications do not increase the risk of addiction.8 Prescription stimulants, such as Adderall (dextroamphetamine-amphetamine), are considered a first-line pharmaceutical treatment for ADHD, and have proven effective at reducing symptoms.4,8

However, there is some evidence that if a person with ADHD misuses stimulants or uses them recreationally to get high, there is an increased risk of SUD.9

If needed, doctors may prescribe a non-stimulant ADHD medication to treat patients with an increased risk of addiction.5

How to Treat Co-Occurring ADHD & Substance Use Disorder

doctor holding patient's hand during rehab therapyCo-occurring ADHD and substance use disorder requires appropriate time and therapy to treat effectively. The current standard of care is an integrated approach that addresses both mental health conditions concurrently.4,5

At Sunrise House Treatment Center, we specialize in the treatment of co-occurring disorders. Our programs combine various evidence-based therapies for addiction treatment, such as cognitive behavioral therapy (CBT) and treatment medications (as needed).

Our facility in the tri-state area offers various levels of rehab and services including:

For more information about our quality programs, ways to pay for rehab, or using insurance to pay for rehab, call us at . Our admissions navigators are available 24/7 to answer any questions and start the admissions process.

You can also quickly find out whether we accept your health insurance plan by filling out this confidential .

If you or a loved one is struggling with co-occurring ADHD and substance use disorder, we can help you begin the journey to recovery. Contact us today.

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