ADHD and Addiction  

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that is characterized by a persistent pattern of inattention and/or hyperactivity and impulsivity that interferes with functioning or development.² 

Recent research indicates an increase in the diagnosis over the last few decades, with approximately 10% of children and adolescents estimated to have an ADHD diagnosis in 2016.^3,4 An estimated 2.6% of adults have childhood-onset ADHD with symptoms that have persisted into adulthood, and an estimated 6.8% of adults have symptoms of ADHD regardless of childhood onset.³

Childhood ADHD is a risk factor for substance misuse and developing a substance use disorder (SUD)—the compulsive use of drugs or alcohol despite causing clinically significant impairment in one’s life (i.e., addiction).² 

What Are the Signs of ADHD?

Symptoms and signs of ADHD can be divided into 3 categories: inattention, hyperactivity, and impulsivity.²

Common ADHD symptoms of inattention may include:²

• Forgetfulness.
• Disorganization.
• Trouble with details.

Symptoms of hyperactivity include:²

• Fidgeting, 
• Excessive talking, 
• Trouble staying still.

Impulsivity symptoms of ADHD may include:²

• Trouble with waiting turns.
• Impatience.
• Interrupting.

Using these categories and their symptoms, ADHD can be diagnosed into 3 types: hyperactive-impulsive type, inattentive type, or combination type.⁵

Receiving an ADHD diagnosis requires seeing a licensed mental health professional, such as a psychologist or licensed therapist.^2,4 Several ADHD symptoms must be present before age 12, and impairments from symptoms of the disorder must occur in more than one setting (e.g., home, school, work).⁵ Children with ADHD often experience a waxing and waning of symptoms throughout their development and into adulthood, coinciding with some degree of impairment.⁶

How Do ADHD & Addiction Develop?

More research is needed to determine why and how addiction and ADHD develop, but there has been some insights pointing to shared vulnerability.⁷ 

Studies suggest that dysfunctions in the reward pathways and inhibitory systems in the brains of people who live with ADHD may result in impulsivity and inability to delay gratification that may contribute to substance use.⁵  These dysfunctions are theorized as being at least partly attributed to impaired dopamine transmission.^5,6 Likewise, the reinforcing effects of alcohol and drugs with abuse liability are thought to be a result of the direct or indirect release of dopamine in reward pathways. This could both provide a certain level of relief of some of the symptoms of ADHD. However, when use of substances continues, dopaminergic pathways are altered or disrupted in ways that often lead to escalating levels of substance use.⁷ In someone with ADHD who has impaired dopamine transmission as well as abnormalities in inhibitory self-control, exposure to drugs and alcohol could result in both continued and heavy substance use.⁸

Epigenetics—genes, as well as the effects environmental factors have on a person’s gene expression—may also play an important role as a shared risk factor for developing both ADHD and an SUD. Researchers believe that epigenetics account for around half of a person’s risk of addiction,⁹ and studies suggest that up to 76% of someone’s propensity for ADHD involves genetic and environmental influences and heritability.¹⁰

Substance Use & ADHD

Research suggests that people with ADHD struggle with substance use at a higher rate and their use may progress into addiction faster than those without ADHD. In addition, some of the associated dangers with substance use may be greater among people with ADHD.¹¹

A 2018 study that followed children with and without ADHD as they aged into early adulthood found that weekly and daily cannabis use and daily smoking was significantly more prevalent among the early adults with ADHD.¹¹

The most common substances used by adults with ADHD include alcohol, nicotine, cannabis, and cocaine.¹¹

People with ADHD and addiction have a greater risk for:¹¹ 

• Suicide attempts. 
• Hospitalizations.
• More extreme condition course (for both ADHD and the SUD).
• Polysubstance use. 

ADHD may complicate recovery from addiction as well, people with ADHD demonstrate poorer treatment adherence overall and lower abstinence rates.¹¹ However, there are evidence-based treatment methods that have enabled many people with ADHD and SUD to live fulfilling, sober lives.^8,11 

What Are the Treatment Options for ADHD & Addiction?

If you live with ADHD and addiction, there are treatment options available. Many addiction treatment centers provide screening and treatment for co-occurring disorders.

Treatment for ADHD primarily involves psychostimulant medications. While misuse and addiction to these medications is possible, studies suggest that early medication treatment of ADHD reduces the risk of substance use disorder.⁸

A combination of pharmacological treatment of ADHD and SUD-specific behavioral therapy strategies (cognitive-behavioral therapy, contingency management, motivational interviewing, and psychoeducation) can often benefit people who need help with both conditions.⁸

Reach out to American Addiction Centers (AAC) to begin treatment at a rehab facility near you. All of our facilities screen and treat co-occurring disorders in addition to addiction. You can verify your insurance coverage online or by calling one of our compassionate admissions navigators.