There may be a link between attention deficit hyperactivity disorder (ADHD) and substance use disorders.

People with ADHD may have an increased risk of alcohol or substance misuse as a means to self-treat undiagnosed or undertreated symptoms of the condition, such as impulsiveness or lack of focus.

Keep reading to learn more about the relationship between ADHD and substance misuse, including the signs to look out for and treatment options.

A hand with green background. to represent ADHD and addictionShare on Pinterest
Rufat Gadimov/EyeEm/Getty Images

People with ADHD are at risk of developing substance use disorders. A literature review cites that, compared with the general population, adolescents with substance use disorders are more likely also to have ADHD. For example, in one study of cannabis use disorders, 38% of participants had ADHD. Another study showed that 23% of young adults with substance use disorders also have the condition.

The likelihood of substance use disorders is almost twice as high among individuals with ADHD and four times as high among those with ADHD and conduct disorder.

In conduct disorder, individuals appear to enjoy misbehaving and hurting others.

Learn more about conduct disorder.

Experts are unclear as to the exact reasons behind the connection, but they have several theories linking ADHD and substance use, including:

  • The traits of ADHD, including impulsivity, judgment issues, and resulting school challenges, may increase an individual’s likelihood of beginning substance use.
  • A genetic link may exist between ADHD and the risk of developing a substance use disorder.
  • People living with ADHD may feel tempted to try psychoactive drugs to self-treat ADHD symptoms.

Additionally, the brains of individuals with ADHD and SUD may share similar structural characteristics, including a smaller frontal cortex and cerebellum.

Cigarette smoking also seems to influence the likelihood of developing substance use disorders in children and adolescents with ADHD. For example, some research shows that more than 50% of adolescents who smoke and have ADHD go on to develop substance use disorder as young adults. The study suggests this may be because friends who smoke might also use other substances. The authors also suggest that nicotine use changes the developing brain.

It seems that children who receive ADHD treatment at a younger age are less likely to develop substance use disorders than those who start treatment later. Additionally, treating mental health issues, such as anxiety and depression, that often occur alongside ADHD is essential and could lower an individual’s chance of developing this risk.

However, the connection between ADHD and substance use is complex, and further research would help explain the link fully.

Experts associate ADHD with traits such as:

  • impulsivity
  • reward-seeking behavior
  • anxiousness
  • negative affect, which involves emotions such as anger, guilt, fear, and contempt

However, these traits do not explain the underlying causes of addiction. Common risk factors of addiction include the following:

  • family history of substance use
  • parents that use or have favorable attitudes toward substances
  • issues with parental monitoring
  • family rejection due to sexual orientation or gender identity
  • friends who use substances
  • no feelings of connection with a person’s school
  • challenges with academic achievement
  • childhood sexual abuse
  • mental health issues

It is important to note that while ADHD presents several potential challenges, there are also numerous strengths and benefits to having the condition.

Learn more about the strengths and benefits of ADHD.

No matter the substance, the signs of addiction are often similar. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) states that addiction occurs when at least two of the following symptoms present within a 12-month period:

  • a person often takes substances over a longer period and in larger amounts than intended
  • a persistent desire or unsuccessful efforts to cut down or control substance use
  • an individual spends a great deal of time on activities necessary to obtain the substance, use them, and recover from the effects
  • craving, or a strong desire to use substances
  • recurring substance use resulting in issues fulfilling obligations at work, school, or home
  • continued substance use despite having persistent or recurrent social or interpersonal problems that the effects of substances cause or worsen
  • a person gives up or reduces important activities
  • recurrent substance use in physically hazardous situations
  • continued substance use despite knowledge of having a persistent or recurrent physical or psychological concern that the substance may have caused or worsened
  • a need to continually increase amounts of substances to achieve intoxication or a desired effect
  • a clearly diminished effect with continued use of the same amount of a substance
  • experiencing withdrawal when not using the substance

There are various effective treatments for substance use disorders.

A healthcare professional should assess the individual to determine the best treatment options. They should consider the individual’s specific situation and any co-occurring medical, mental health, or social issues. For many people, doctors recommend a combination of medication and therapy.

Medications can help control cravings, ease withdrawal symptoms, and prevent returning to substance use. In addition, therapy can help people better understand their motivations for substance use, boost self-esteem, learn healthy coping mechanisms, and address other mental health issues.

Everyone’s recovery plan is unique to them and their circumstances but may include:

  • hospitalization for substance detoxification
  • therapeutic communities, which are substance-free environments
  • medication management
  • psychotherapy
  • intensive outpatient programs
  • residential treatment, known as “rehab”
  • support groups such as Alcoholics Anonymous and Narcotics Anonymous

When taking therapeutic doses as a healthcare professional prescribes, the risk of developing an addiction to ADHD medication significantly decreases.

Doctors may prescribe medications, such as methylphenidate (Ritalin) or dextroamphetamine (Adderall), for individuals with ADHD. These stimulant medications help people focus and control their emotions. They should not lead to addiction or substance misuse as long as people use these while following guidance from a doctor. However, they risk addiction or substance misuse if they use them for nonmedical reasons, such as trying to stay awake to study or work.

Additionally, there is no evidence that taking stimulant medications for ADHD makes individuals more likely to develop a substance use disorder later in life. Therefore, although children with ADHD have an increased risk of substance use disorders, this relates to the condition and not stimulant medication.

Learn more about ADHD medication.

Individuals with substance misuse stand the best chance of avoiding addiction or a substance use disorder by seeking help as soon as possible before the condition progresses.

People should speak with their doctor if they have difficulties controlling their substance use. A doctor can recommend treatment or refer the individual to a specialist service. Experts can now treat substance use disorders successfully with low recurrence rates, and with comprehensive and continuous care, recovery is possible.

Individuals can find help for substance use on the Substance Abuse and Mental Health Services Administration website.

Living with ADHD can make day-to-day life challenging, but some strategies can make a person’s life easier. Support is available if people are having challenges managing their ADHD symptoms or would benefit from talking with people living the same experience.

People can contact Children and Adults with Attention Deficit Hyperactivity Disorder to learn about their online and in-person support and information.

Raising ADHD awareness is also important in our understanding of the condition.

Learn more about ADHD awareness and its importance.

There appears to be a strong connection between ADHD and substance misuse. And while experts are unclear on the exact reason behind the link, several theories exist. These include genetics, some personality traits, and using substances to self-treat lingering ADHD symptoms.

Doctors have a range of treatments to help people with substance misuse. For example, many people can benefit from a tailored program that includes a combination of medication and therapy.

Medications can help with substance cravings, reduce withdrawal symptoms, and prevent returning to substance misuse. Additionally, therapy can help people understand their reasons for substance use, boost self-esteem, and learn healthy coping strategies.

People should contact a doctor as soon as possible if they are starting to increase their substance use or believe they meet the criteria for substance use disorder. Early intervention can help individuals avoid substance use disorder, and with the correct care, recovery is possible.