Co-Occurring ADHD & Substance Abuse

For many people, addiction is just one of multiple mental illnesses they are fighting at once. These are known as co-occurring disorders and can make diagnosis and treatment even more complex.¹

Attention-deficit/hyperactivity disorder (ADHD) is a type of mental illness commonly linked to substance abuse. Read on to learn more about ADHD, its association with addiction, and how to get help if you or someone you love is suffering with co-occurring disorders, such as ADHD and substance use.

What Is Attention-Deficit/Hyperactivity Disorder (ADHD)?

Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric disorder characterized by a persistent lack of attention or focus, hyperactivity, and impulsive behaviors that impair daily functioning or development.

Clinicians often use the word “heterogeneous” to describe ADHD. This means the disorder presents quite differently depending on the individual, especially in adults. These wide variations can make diagnosis extremely tricky.²

But despite its complications, ADHD has a relatively high prevalence among the general population, existing in about 4%–7% of children and 2.5% of adults.²

ADHD in Adults

Attention-deficit/hyperactivity disorder is typically first noticed and diagnosed in children. However, diagnostic criteria put forth by the American Psychiatric Association (APA) in 2013 allows for a diagnosis of ADHD in adults age 17 and older without a specific documented history of the symptoms in childhood.

Adult ADHD can cause profound difficulties in a person’s life, affecting their relationships, education, career, community, and even life expectancy due to certain risk-tasking behaviors associated with the disorder.²

Signs & Symptoms of ADHD in Adults

Attention-deficit/hyperactivity disorder is a challenging condition to recognize and diagnose. Medical professionals utilize criteria laid out in the APA’s Diagnostic and Statistical Manual of Mental Health Disorders (5th ed.) to make a clinical diagnosis.

This criteria is separated into two groups, differentiating between behaviors of inattention and hyperactivity. Adults with ADHD may consistently display some or many of the symptoms listed below.³

ADHD and Other Co-Occurring Disorders

Attention-deficit/hyperactivity disorder commonly co-occurs with other mental illnesses. Research suggests an estimated 80% of adults with ADHD suffer from at least one other psychiatric disorder.^4,5

These frequently coexisting disorders include:²

• Anxiety and mood disorders, such as depression and bipolar disorder.
• Personality disorders, such as borderline personality disorder.
• Substance use disorders (SUD).

The presence of ADHD increases the risk of developing a comorbid condition. Studies show that adults with ADHD are 3 times more likely to have major depressive disorder (MDD), over 4 times more likely to have a mood disorder, and 6 times more likely to experience dysthymia (chronic depression).⁶

The overlapping symptoms of these different disorders can complicate diagnosis.

ADHD and Substance Use Disorder

Substance use disorder (SUD) is one of the most common conditions that co-occurs with attention-deficit/hyperactivity disorder. Research indicates that someone with ADHD is twice as likely to develop a SUD.⁷

Experts believe there are multiple factors that drive this increased risk, including genetics, brain chemistry, and the intersecting characteristics associated with both ADHD and substance use disorders. The relationship between the two disorders is “bidirectional,” meaning one can influence or worsen the course of the other, and vice versa.²

Additionally, some people with ADHD may use drugs or alcohol to self-medicate and manage their mood, sleep issues, and other problematic symptoms.

The most frequently misused substances linked to ADHD are:²

• Alcohol.
• Nicotine.
• Marijuana (or cannabis).
• Cocaine.

Symptoms of Co-Occurring ADHD and Addiction

In addition to the signs of attention-deficit/hyperactivity disorder listed above, a person with co-occurring ADHD and addiction may also exhibit some of the symptoms consistent with substance use disorder.

Signs and symptoms of addiction include:

• Cravings for drugs or alcohol.
• Skipping important activities to drink, use drugs, or recover from the effects of substance use.
• Engaging in substance use for longer periods of time than intended.
• Continuing to use substances despite knowing it has caused or worsened a medical or mental health problem.
• Having a desire to quit but failing to do so.
• Experiencing social problems due to drinking or drug use.

Evidence also shows that individuals with co-occurring ADHD and SUD are at increased risk of:²

• Suicide attempts.
• Hospitalization.
• Poly-substance abuse.

Can ADHD Medications Be Addictive?

Yes and no. Research shows that, when used as prescribed, common ADHD medications, like methylphenidate (Ritalin), dextroamphetamine-amphetamine (Adderall), and other stimulants, do not increase the risk of addiction in patients with attention-deficit/hyperactivity disorder. But, illicit or non-medical use of the same medicines may lead to a substance use disorder.^8,9

Because of their potential for abuse, the Drug Enforcement Administration has classified certain stimulant medications as Schedule II drugs to limit their distribution.

Clinicians usually recommend that people with ADHD, who also have a history of substance abuse, take a non-stimulant medication to treat their ADHD symptoms.²

Treatment for ADHD and Substance Abuse

Although they are both complex conditions, attention-deficit/hyperactivity disorder and substance abuse can be treated.^2,10

Patients who appear to have one condition should undergo tests for other co-occurring disorders.¹ If two or more disorders are present at the same time, experts advise that both disorders be treated simultaneously, or that the condition with more acute symptoms be treated first.^2,10 In the case of ADHD and addiction, the latter is often the more acute disorder.²

Clinicians typically utilize an integrated approach to effectively treat co-occurring disorders. This means physicians, psychiatrists, therapists, counselors, case managers, and other specialists all work together as a team to address both disorders at once, setting the same goals and keeping the treatment plan consistent.

A combination of evidence-based therapies, treatment medications, and counseling may be used throughout the course of care. Addiction rehab provides related to the use of drugs or alcohol, teaches coping and relapse prevention skills, and may also include career counseling to assist those with job or school issues.

At our inpatient rehab facility in Las Vegas, Nevada, we specialize in the treatment of co-occurring disorders and provide a full range of care, from medical detox and inpatient or residential treatment to sober living and various levels of outpatient services. We also provide customized programming for veterans and first responders, who may be suffering from co-occurring mental disorders.

To learn more about our high-quality programs, paying for rehab, or how to help a loved one with addiction, call us at  today. Our admissions navigators are available around the clock to answer any questions and start the admissions process.

Or you can check whether we accept your insurance and verify your benefits by filling out this quick and confidential

A dual diagnosis can feel frightening and overwhelming. But treatment can help put you or your loved one on the path to recovery. At Desert Hope, we are here to offer hope and guide you along this life-saving journey.