Addiction and ADHD: Understanding the Connection and Getting Help

Research shows that people who suffer from attention deficit hyperactivity disorder (ADHD) are more likely to develop an addiction. While no specific cause for this has been identified, several factors are thought to contribute. If you think that you are suffering with both ADHD and addiction, understanding the connection and how to get help can be the first step to recovery.

What Is ADHD?

ADHD is characterized by an inability to focus and hyperactivity or impulsivity that interferes with a person’s ability to function normally. It often onsets in childhood and continues into adulthood, although sometimes onset comes in adulthood.

No single cause of ADHD has been identified, but it’s thought to be caused by a combination of genetics, differences in brain structure, and environmental factors.

ADHD Symptoms

Symptoms of ADHD can be divided into three categories.

Inattention symptoms

• Disorganization
• Forgetfulness
• Lack of attention to detail

Hyperactivity symptoms

• Excessive talking
• Fidgeting
• Trouble keeping still

Impulsivity symptoms

• Impatience
• Interrupting

Some people have only inattention symptoms, others have only hyperactivity/impulsivity symptoms, and some have a combination of all the symptoms.

What Is Addiction?

While most people have a general idea of what addiction is, it has a clinical definition that specifies 11 criteria that indicate that an addiction, also known as substance use disorder (SUD), is present.

1. Using a substance more than intended or for longer than intended
2. Wanting to reduce or stop substance use but not being able to
3. Spending excessive amounts of time using a substance or recovering from using a substance
4. Feeling cravings for the substance
5. Failing to live up to responsibilities due to substance use
6. Having relationship problems because of substance use
7. Giving up activities that you enjoy in order to use the substance instead
8. Engaging in risky behaviors like driving while under the influence
9. Continuing to use the substance in spite of negative consequences like health issues
10. Needing more of the substance to get the same effects
11. Having withdrawal symptoms when you are not using the substance

Having two to three of these symptoms indicates a mild substance use disorder, four to five is considered moderate, while six or more is severe.

The Connection Between Addiction and ADHD

Factors that are thought to contribute to a co-occurrence of addiction and ADHD include:

• Self-Medication: People with ADHD may use substances to ease their symptoms.
• Neurobiological Factors: People with ADHD have deficits in dopamine transmission. Dopamine is a brain chemical associated with pleasure. Substance use boosts dopamine, thus compensating for the deficits associated with ADHD. However, the brain changes with substance use, needing the substance to produce feelings of pleasure, which leads to addiction.
• Impulsivity: The impulsivity that comes from ADHD can lead to risky behaviors, such as substance use.
• Genetics: Some research shows that certain genes may hold an increased risk for both ADHD and addiction.
• Environment: Because ADHD impairs normal functioning, it may lead to problems in a person’s life that are stressful. They may then turn to substance use to cope with that stress.

Certain substances are used most often by people with ADHD because of the specific effects of the drugs that ease ADHD symptoms. These include:

• Alcohol: Alcohol may be used to slow racing thoughts, which people with ADHD commonly experience, and to ease the stress that comes with ADHD.
• Marijuana: Marijuana has a calming effect and can ease the restlessness that is characteristic of ADHD.
• Nicotine: Nicotine may be used to increase alertness.
• Stimulants: Stimulants including both medications prescribed for ADHD and illegal drugs like cocaine may be abused for increasing focus and motivation.
• Opioids: Opioids may be used for their calming effects.

While all of these substances can provide temporary relief of ADHD symptoms, their abuse can actually often worsen symptoms and lead to other mental and physical health issues.

Dangers of Addiction and ADHD

People who have both ADHD and an addiction have a higher risk for:

• Suicidal thoughts or suicide attempts
• Hospitalizations
• Faster escalation of both conditions
• Using multiple substances

In addition, recovery from a substance use disorder may be more difficult for people with ADHD to attain.

Treating Addiction and ADHD

When someone has ADHD and an addiction at the same time they are known as co-occurring disorders. Treating one has to include treatment for the other in order for recovery to be possible. It’s not uncommon for people with substance use disorders to seek treatment and be diagnosed with ADHD or another mental health disorder upon their initial assessment at an addiction treatment facility. In these cases, a personalized treatment plan must be created to address both disorders.

The first line of treatment for ADHD is medication, so when co-occurring disorders are identified, prescribing medication may be the first step. However, medication use must be closely monitored to prevent misuse which can lead to addiction.

Several types of therapies can also treat both ADHD and addiction concurrently.

Cognitive behavioral therapy (CBT) is the most commonly used therapy to treat both disorders. In CBT, you’ll learn to recognize your negative and irrational thoughts and learn strategies to change those thoughts into more positive, productive thoughts. You’ll also learn healthy coping mechanisms, and practical skills to manage your ADHD such as organizational and time management skills.

Another therapy used is dialectical behavioral therapy (DBT), which is similar to CBT but focuses on strategies to regulate emotions and to change negative behaviors. Mindfulness, meaning focusing on being in the present moment, is a key part of DBT.

Motivational interviewing may also be a part of ADHD and addiction treatment. In motivational interviewing, the therapist will help you to find your own, personal motivation for changing your behaviors and learning to manage your ADHD symptoms. This helps you to be more engaged in the treatment process.

Treatment for ADHD and addiction may be inpatient or outpatient. However, because treating these co-occurring disorders is complicated, a comprehensive treatment program is generally recommended. This kind of program includes:

• A 30 to 90 day inpatient program: This will include a period of detox, followed by intensive therapy, mostly in a group format. Medication, if recommended, will also be part of the treatment.
• A partial hospitalization program (PHP): After inpatient treatment, a PHP program allows you to live at home while continuing therapy four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks.
• An intensive outpatient program (IOP): An IOP consists of two to three hours of therapy several days a week for eight to twelve weeks. Often, sessions are held in the evenings so that you can still go to work or attend school.

Even after IOP, support should continue through support groups, individual therapy, or both. This can support both the ADHD and addiction recovery.

In Closing

ADHD and addiction have a complicated relationship, often going hand in hand and requiring concurrent treatment. However, recovery from addiction and ADHD are possible with professional intervention. Bridges of Hope is here to help with comprehensive treatment programs. We are committed to providing individualized, compassionate treatment to help you move on to a more fulfilling life. Give us a call today to learn more.