Rehab 4 Addiction

The relationship between attention-deficit hyperactivity disorder (ADHD) and addiction has been the subject of several studies. Research has found that treating the two conditions together can help to make ADHD symptoms easier to manage, while also making substance abuse recovery more attainable.

What is ADHD?

Attention-deficit hyperactivity disorder is a neurodevelopmental disorder that can have an impact on a person’s energy levels, attention span, and impulse control.

It is typically diagnosed in young children, who often find that their symptoms have lessened by adulthood, but more than 60 percent of children with ADHD continue to have symptoms as adults.

It is common for those with ADHD to also suffer with sleep problems, anxiety, and depression, and while it is not in itself a learning disability, many of the symptoms can affect how a person takes in and retains information.

Symptoms of ADHD include:

  • Difficulty focusing on tasks
  • Hyperfocus – being so engrossed in a certain task that you lose track of time
  • Being forgetful
  • Disorganisation and chronic lateness
  • Being easily distracted
  • Being fidgety, or having difficulty sitting still
  • Having trouble controlling impulses, such as interrupting people when they are talking

There isn’t a single, perfect test for diagnosing ADHD. As children are often very active and can go through periods where they quickly lose interest in things, diagnosing ADHD in children can be difficult, and it is therefore becoming common for people to be diagnosed in adulthood.

Treating ADHD

The symptoms of ADHD are often controlled using medications known as stimulants, and as the primary patients are children, there has always been some controversy over their prescription. Prescribed stimulants can increase cognitive function, improve focus, and decrease hyperactive behaviour.

The most commonly prescribed medicine for ADHD in the UK is methylphenidate, which many will know by the brand name Ritalin. However, it has been known to cause agitation and irritability, and it can worsen anxiety in some patients.

Stimulants can also put strain on your heart and nervous system, with heart palpitations being a common side effect. They can therefore be dangerous, and even life-threatening, for those with pre-existing heart conditions.

Stimulants are generally considered to be addictive. While they are typically safe to take in their prescribed dosages, higher doses can produce effects similar to cocaine, hence Ritalin’s nickname as “fake cocaine”.

ADHD and Substance Abuse

A child with ADHD is five times more likely to suffer with depression than a child without, and up to 31 percent of adults with ADHD also experience depression. The early use of strong medication, combined with the high chance of developing depression, has highlighted an increased risk of substance abuse in those with ADHD.

The symptoms of ADHD, such as difficulty concentrating, or trouble finishing tasks, can impact negatively on both your social and professional lives, which can lead to depression and anxiety.

Furthermore, those with ADHD naturally produce less dopamine than those without, and so it can be tempting for adults, and even adolescents, with ADHD to try to force dopamine production by abusing certain substances.

Research has shown that more than half of the adults with symptoms of ADHD experience co-existing substance abuse disorders. In fact, around 25 percent of those who attend treatment centres for addiction are also living with ADHD.

Self-Medicating for ADHD

Self-medication is when you experiment with various substances, including prescription drugs, illegal drugs, nicotine, or caffeine, in order to mange your symptoms without consulting a physician.

Just like ADHD medications, many substances can boost your dopamine levels, making them attractive to those with ADHD who don’t naturally produce much dopamine. These substances can include:

  • Alcohol: It is not uncommon for people with ADHD to turn to alcohol in the hopes that it will relax them, or offer a distraction from work and social problems. However, as mentioned earlier, the way that alcohol affects the brain means that it can actually make symptoms worse. It is considered self-medicating when you drink an excessive amount of alcohol in the hopes of better dealing with your symptoms. “Excessive amount” is classed as more than 14 drinks a week for men, and more than 7 drinks a week for women
  • Cannabis: Due to its reputation for being a relaxant, cannabis can be appealing to those with ADHD for similar reasons as alcohol. However, cannabis has been known to worsen your ability to focus, and further impairs impulse control. Cannabidiol (CBD) is one of the active compounds in cannabis, and is legally sold across the UK as a natural remedy for various problems, but research suggests that it can, again, worsen the symptoms of ADHD
  • Caffeine: Small amounts of caffeine can improve concentration, and one or two cups of coffee a day will not typically be a cause for concern. However, research shows that caffeine’s effects are lessened when taken with some ADHD medications. This can mean that you go from a couple of cups of coffee to five or more a day, as you are not getting the results you want. Excessive amounts of caffeine can, in the long run, make your memory worse, so even if you do find some small improvement with multiple cups a day, it will affect you negatively in the long-term
  • Cigarettes: As well as the obvious major health risks that come with smoking, such as various cancers and heart diseases, smoking can make ADHD symptoms harder to manage. This is because the active compounds in tobacco can thin your brain’s frontal cortex, which is responsible for learning, memory, and attention
  • Prescription drugs: If you take medications to manage your ADHD, your GP will prescribe a dosage which is the safest and most effective for you. Increasing the dosage without first discussing it with your GP can introduce major health risks, including increased risk of strokes, seizures or heart attacks. If you’re on ADHD medications and also self-medicating with other substances, consult your GP, as they may need to adjust your dosages or try you on a different medication

Treatments for ADHD and Co-Occurring Substance Abuse Disorders

For individuals with ADHD who also have a substance abuse disorder, the best course of action is typically to treat both issues simultaneously. This is known as a dual-diagnosis plan.

At the first instance, determining which disorder came first can pave the way for the most effective and thorough treatment. This is because years of alcoholism and other substance abuse can actually produce symptoms of ADHD in those who did not have them during childhood.

Even if you have suffered from both a substance use disorder and ADHD for a number of years, discussing your history with your GP or specialist can help to determine which came first, and therefore identify the root cause.

Treating ADHD in those with a history of substance abuse presents challenges, as the medications typically used to manage ADHD can be addictive or habit-forming. Stimulants like Ritalin and Adderall are the most widely prescribed as they can be extremely effective, but there is a high potential for abuse.

Therefore, when seeking treatment for ADHD it is crucial to mention to your GP or specialist if you have prior issues with substance abuseso that their treatment plan does not inadvertently do more harm than good.

Alcoholism and drug use can interfere with your ADHD medications, and your ADHD symptoms, like poor planning and impulsivity, can mean that it takes much more effort to stick to your treatment plan. Combating both issues at the same time, therefore, presents its own challenges but is also more likely to produce positive results.

While you are undergoing treatment for your substance abuse disorder and your ADHD, you may have regular urine testing to ensure that any medications you have been prescribed are being used correctly. This also helps to keep you accountable during your recovery as the tests will pick up on any illicit substances you may have taken.

Routine is key when it comes to living with ADHD, and research has shown that it also helps during addiction recovery. Treatments can take some getting used to, but the more you practice routine, the more quickly it becomes second nature.

If you find your treatment plan frustrating, this can tempt you to self-medicate, and so it is imperative that you discuss all issues with your GP or specialist so that amendments can be made before you fall off the wagon.

As well as medications, some of your treatment may involve counselling, attending support groups, and holistic therapies. The purpose of a counselling-led dual-diagnostic program for ADHD and substance abuse is to focus on the destructive thoughts that lead to using drugs and alcohol, as well as to help you to better manage your impulses.

By improving your impulse control and reframing the negative thoughts that can tempt you towards substance abuse, you will find that your ADHD symptoms contribute less to your substance abuse issues.

The ultimate aim, when tackling both ADHD and substance abuse, is to put you on the path to a healthier life where you can manage your ADHD symptoms without needing to be dependent on any illicit substances. Any medications you take should only be those that have been prescribedand must be taken in the correct dosages.

References

https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699665/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469239/

https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link

https://www.verywellmind.com/adult-alcoholism-adhd-connected-63078

boris

Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.