Treatment for ADHD and Co-Occurring Substance Use

What Is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder described in the DSM-5 as a persistent pattern of inattention, hyperactivity, or impulsivity that negatively impacts functioning or development.[1] ADHD is one of the most common mental health disorders among children and adults, though it is very underdiagnosed, especially for adults who learned coping strategies that masked symptoms earlier in life.[2]

According to the DSM-5, ADHD can present in three different ways [3]:

• Predominantly Inattentive: A combination of symptoms involving difficulties in sustaining attention, completing tasks, organizing, or remembering small details. This type is sometimes referred to as ADD.
• Predominantly Hyperactive-Impulsive: These symptoms involve fidgeting, inability to stay seated, excessive talking, interrupting others, and acting impulsively.
• Combined Presentation: This is the most common presentation where a person shows symptoms from both above criteria.

Common symptoms of ADHD in adults include difficulty focusing and completing tasks, chronic disorganization, impulsivity and poor impulse control, emotional dysregulation, low frustration tolerance, difficulty managing time, and a sense of always being on alert or restless. All of these symptoms impact daily life and the ability to maintain relationships and succeed at work. In addition, these symptoms increase the risk of developing a substance use disorder.

ADHD and Addictive Personality: Understanding the Connection

“Addictive personality,” while not a clinical diagnosis, does have a characteristic pattern, and in people with ADHD, it is rooted in their neurobiology. 

Research shows that the prevalence of ADHD among people with substance use disorder is far greater than in the general population, with studies showing up to 25% of addiction treatment seekers have ADHD.[4]

ADHD involves differences in the dopamine system, specifically in how the brain regulates motivation, reward, and self-control.[5] The same neurological differences that create challenges in maintaining attention and lead to impulsivity also increase the desire for a substance that produces an immediate flood of dopamine into the system, providing the brain with stimulation, focus, or emotional relief.[6]

Additional connections between ADHD and substance use disorder include:

• Self-medication: A large proportion of people who have untreated ADHD or undiagnosed ADHD have discovered that by using a certain substance (typically stimulants, cannabis, or alcohol), they receive temporary relief from their symptoms or from the frustrations and emotional dysregulation associated with the disorder.
• Impulsivity: The impulsivity associated with ADHD makes it difficult for adults with the disorder to evaluate the potential consequences of their actions, creating an increased risk for substance experimentation that then increases to serious use.
• Emotional dysregulation: Most people with ADHD experience considerable distress associated with their inability to manage their emotions. Those who have ADHD may discover that there are many substances that help them cope with emotional distress.
• Early onset of substance misuse: Research supports that adolescents with ADHD misuse substances at an earlier age than their peers without ADHD. The earlier a person begins to abuse substances, the more likely they are to develop a substance use disorder.

When to Get Help for ADHD and Addiction

If you are living with both a substance use disorder and ADHD, it can be difficult to know which condition is influencing your symptoms and, in turn, what the best method of treatment may be. That’s where a comprehensive treatment program comes in. You don’t have to wait until you have figured it all out before you reach out. Consider accessing integrated dual diagnosis treatment if:

• You have previously been diagnosed with ADHD, but are currently struggling with substance use.
• You believe you may have undiagnosed ADHD and have been using substances to help you focus, gain energy, or help regulate your emotions.
• Your symptoms of ADHD are making it difficult to stay engaged in the recovery process.
• You have attempted to manage your substance use but have not made significant improvements to your inattention, impulsivity, and emotional regulation issues.
• Your substance use is interfering with the effectiveness of your ADHD medications.
• You consistently feel overwhelmed by daily life, work, relationships, and responsibilities.

ADHD and Addiction Treatment at Meridian Recovery

People who have both ADHD and substance use disorders will benefit from treatment planning that considers both conditions equally and addresses both simultaneously. At Meridian Recovery in New Jersey, our clinical staff has worked extensively with adults who are navigating both of these conditions, and our programs are designed to provide the structure, flexibility, and individual assistance necessary for recovery.