ADHD and addiction often occur together due to a variety of factors, but they don’t have to – with proper treatment, people with ADHD can lead successful and sober lives! This article will explore the relationship between ADHD and substance abuse. If you are currently struggling with addiction, remember that treatment is available to help you get back on track in your life.
What Is ADHD?
ADHD stands for Attention Deficit and Hyperactivity Disorder. It is a neurodevelopmental condition that affects how the brain regulates attention, impulse control, and activity levels. ADHD also affects brain areas responsible for executive functioning, including the prefrontal cortex, which manages working memory, cognitive flexibility, and inhibitory control. Neuroimaging studies show differences in brain structure and activity in people with ADHD, particularly in regions that regulate attention and behavior.
The key to understanding this disorder lies in the crucial neurotransmitters dopamine and norepinephrine, which are brain chemicals linked to feelings of motivation and alertness. Brain scans show that the region of the brain responsible for producing these chemicals is less active in people with ADHD. As a result, they constantly exist in a state of unease and anxiety, their bodies urging them to increase their levels of these chemicals. This primarily takes the form of novelty-seeking behavior, such as scrolling social media. Another example of novelty-seeking behavior is drug use – in fact, ADHD and addiction are closely correlated.
While it seems counterintuitive at first glance, when it comes to people with ADHD, stimulant medication actually calms them down, rather than “amps” them up, as it does neurotypical individuals. This is because it restores their levels of dopamine and norepinephrine back to baseline, thus alleviating the sense of anxiety and restlessness they feel.
The Link Between ADHD and Addiction
The relationship between ADHD and addiction is well-documented. Scientific research on the subject shows that people with ADHD are two to three times more likely to develop addiction compared to the general population. This elevated risk affects both children and adults, with studies showing that up to 25% of adults in addiction treatment programs have ADHD, compared to about 5% in the general population.
Several factors contribute to this increased vulnerability. The core symptoms of ADHD create conditions that can lead to substance use as a form of self-medication. Many individuals discover that certain substances temporarily alleviate their symptoms of inattention, hyperactivity, or impulsivity, which is a major reason ADHD and substance abuse often go hand in hand.
For example, some people find that stimulants help them focus, while others use alcohol (ADHD and alcohol abuse are highly correlated) or marijuana to calm racing thoughts or reduce hyperactivity.
The neurobiological underpinnings of ADHD also play a role. The ADHD brain often has reduced dopamine activity, which can make individuals more susceptible to seeking external sources of stimulation or reward through substances.
Why People with ADHD Are at Higher Risk
There are a couple of reasons why ADHD and substance abuse tend to occur together. First is self-medication, which we have mentioned. There is also poor decision-making and impulsivity that come with ADHD, which can cause a person to consume more substances than would ordinarily be considered wise or responsible, and this obviously can coincide with the desire to self-medicate as well, creating an interlocking set of incentives.
Another reason for the link between ADHD and substance abuse has to do with a lesser-known symptom of the disorder, namely, emotional dysregulation. People with ADHD sometimes experience difficulty managing emotions, including intense frustration, anger, anxiety, or mood swings. These emotional challenges can drive substance use as a coping mechanism. Many individuals discover that certain substances help numb difficult emotions or provide temporary emotional stability.
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Substances Commonly Abused by People with ADHD
The link between ADHD and drug addiction is not limited to one drug in particular – there is a wide range of substances involved.
Commonly abused substances among people with ADHD include:
- Alcohol – Used to manage hyperactivity or social anxiety, but often leads to increased impulsivity and poor decision-making.
- Nicotine – Many individuals with ADHD smoke or vape to improve concentration and regulate mood, though this can lead to long-term dependence.
- Cannabis – Sometimes used for its calming effects, but regular use may impair memory, focus, and motivation.
- Stimulants (e.g., cocaine, methamphetamine) – Misused for their short-term boosting effects on energy and focus, yet extremely addictive and harmful.
- Prescription Stimulants (e.g., Adderall, Ritalin) – Often misused by those without prescriptions or taken in higher doses, leading to dependency or adverse health outcomes.
- Benzodiazepines – Taken to cope with anxiety or insomnia, these sedatives can become habit-forming and dangerous when mixed with other substances.
Early intervention and proper ADHD treatment—often involving a combination of medication, behavioral therapy, and lifestyle changes—can significantly reduce the risk of substance misuse.
Diagnosing Co-Occurring ADHD and Addiction
It can sometimes be tricky, from a clinical perspective, to distinguish between ADHD and drug or alcohol abuse, as the two conditions have much overlap in terms of symptoms and interact in complex ways.
Both conditions can cause attention problems, impulsivity, mood swings, and executive functioning deficits. Active substance use can mimic or exacerbate ADHD symptoms, while ADHD symptoms can be mistaken for intoxication or withdrawal effects. This creates a diagnostic puzzle where clinicians must determine which symptoms are primary to ADHD, which result from substance use, and which represent the interaction between both conditions.
Complicating matters further, individuals with ADHD often begin using substances at a young age, potentially before receiving an ADHD diagnosis. By the time they seek treatment, their substance use history may span years or decades, making it difficult to establish a clear timeline of symptom onset and progression.
Effective diagnostic protocols for a case of co-occurring ADHD and addiction will involve a battery of tests, done while the patient is sober. These tests will include things like the Adult ADHD Clinical Diagnostic Scale or the Conners’ Adult ADHD Diagnostic Interview.
When ADHD and substance abuse occur together, this is known as a dual diagnosis. This often means the two conditions feed into each other and thus must be treated simultaneously.
Get Dual Diagnosis Treatment for ADHD and Addiction
ADHD and substance abuse often occur together, but just because you have ADHD doesn’t mean you can never live a normal life – far from it. Lots of people with ADHD lead successful and productive lives. Medication is often a major component of this, but cognitive behavioral therapy, mindfulness, and other forms of therapy can be very helpful for ADHD.
These forms of therapy are also highly effective for treating addictive behaviors in adults with ADHD, and all of them, as well as advanced medications and highly specialized professionals, can be found at Footprints to Recovery. A drug and alcohol rehab in Hamilton, New Jersey, Footprints to Recovery, is dedicated to providing affordable and compassionate behavioral health treatment. We offer treatment for co-occurring disorders like ADHD and other alcohol and drug abuse disorders.
