Attention-deficit hyperactivity disorder (ADHD) is diagnosed in about one in ten adolescents (and fewer young children), yet many cases go unnoticed for years and remain undiagnosed and untreated.
It is those cases that are at the most risk of developing substance abuse issues later in life. In many cases, teens with ADHD who began using drugs were not looking to get high – instead, they sought drugs to combat the symptoms of an untreated disorder.
While the treatments for ADHD rely on controlled and addictive substances (amphetamine and methylphenidate), research also shows that teens with ADHD who are treated early and routinely take prescribed ADHD medication are much less likely to struggle with drug use later in life. When used appropriately, ADHD medications play a crucial role in managing ADHD symptoms and can significantly reduce the risk of substance abuse by addressing the underlying disorder.
For reasons not yet completely understood, there is a strong link between ADHD and drug abuse, with potential factors including genetic proclivity, unrecognized ADHD symptoms, how they respond to self-medication, and the link between drug-seeking behavior and risk-taking novelty-seeking behavior linked to ADHD diagnoses. Either way, ADHD often co-occurs with addiction, and concurrent treatment through a holistic, multimodal approach is often necessary.
Introduction to ADHD and Substance Abuse
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition marked by persistent patterns of inattention, hyperactivity, and impulsivity.
These core ADHD symptoms can significantly impact daily functioning and increase vulnerability to other challenges, including substance abuse. Research consistently shows that individuals with deficit hyperactivity disorder ADHD, especially adults with ADHD, face a heightened risk of developing substance use disorders compared to the general population. In fact, adults with ADHD are nearly three times more likely to experience substance use disorders, including drug abuse and alcohol dependence.
The connection between ADHD and substance abuse is complex. Impulsivity, difficulty with organization, and challenges in managing emotions can make it harder for people with ADHD to resist the temptation to abuse drugs or alcohol. These struggles often begin early, with substance use sometimes serving as an attempt to self-medicate for untreated ADHD symptoms. This increased risk highlights the importance of treating ADHD symptoms effectively. Pharmacological treatment, combined with therapy and support, can help reduce the likelihood of substance use and improve overall outcomes for those with ADHD and substance abuse concerns.
The Link Between ADHD and Substance Abuse
Adult alcoholics are five to ten times more likely to have undiagnosed ADHD than the general public.
Among adults being treated for addiction, about a quarter have been diagnosed with ADHD. Among teens, some studies note that as many as 40 percent of teens with ADHD start drinking at an early age, versus 22 percent of teens without ADHD. Among young adults, the likelihood of using alcohol evened out, but those with ADHD were more likely to use alcohol excessively. Alcohol use in individuals with ADHD is often linked to self-medication or risk-taking behaviors, as they may turn to alcohol use to cope with symptoms or impulsivity.
The two significant factors that researchers consider are behavior and genetics. Both alcoholism and ADHD can be hereditary, and there is an increased rate of addiction in close relatives of people with an ADHD diagnosis. The impulsive, novelty-seeking behavior associated with ADHD may make some teens more likely to try or overindulge in drugs than others. While ADHD medication itself is addictive in large doses, most cases of ADHD-related addiction are not because of the medication.
Instead, teens diagnosed and treated with ADHD meds early were less likely to struggle with drug use later. However, that does not mean these drugs are not dangerous for teens without ADHD symptoms. It seems amphetamines and methylphenidate work differently in the brains of teens with ADHD and those without.
In other words, addiction to alcohol and other drugs is linked to ADHD, not to ADHD medication.
Risk Factors and Triggers
Understanding the risk factors and triggers for substance use disorders in people with ADHD is crucial for prevention and effective treatment.
One of the most significant risk factors is impulsivity, a common ADHD symptom that can lead to poor decision-making and experimentation with illicit drugs or alcohol. Adults with ADHD are also more likely to experience co-occurring anxiety disorders and other psychiatric disorders, which can further increase the risk of substance abuse as individuals may turn to self-medication to cope with their symptoms.
Untreated ADHD is another major risk factor. When ADHD symptoms go unaddressed, individuals may seek out substances as a way to manage their difficulties with focus, restlessness, or emotional regulation. The use of stimulant medications to treat ADHD can be beneficial when properly managed, but for those with a history of substance abuse or comorbid psychiatric conditions, careful monitoring and consideration of non-stimulant medications may be necessary.
Other contributing factors include a history of childhood ADHD, conduct disorders, and a family history of substance use disorders. Early exposure to substance use, especially in the context of untreated ADHD or coexisting mental health disorders, can set the stage for ongoing substance abuse problems. By recognizing these risk factors and triggers, healthcare providers and individuals can work together to develop comprehensive treatment plans that address both ADHD and substance use, utilize early medication treatment when appropriate, and help patients avoid illicit drugs altogether. This proactive approach is essential for reducing the risk of substance use disorders and supporting long-term recovery and well-being.
Recognizing ADHD in Teens
ADHD is a condition with multiple subtypes, and a correct diagnosis can only be achieved through a mental healthcare professional.
But knowing what to look for in yourself or a loved one can help you make the important decision of seeking a professional diagnosis. Common signs of ADHD in teens include:
- Trouble finishing tasks.
- Mood swings and emotionality.
- Difficulties with executive functions.
- Lack of focus, chronic distractibility.
- Poor decision making, impulsiveness.
- Fidgety movements often characterize hyperactivity.
- May have one or more hobbies where they excel – everything else feels impossible to concentrate on.
ADHD is not just easily excitable, somewhat hyperactive, or scatterbrained. Children and teens with ADHD are often all over the place, cannot sit still, are easily consumed by boredom (even when everyone else is engaged), and are incredibly prone to risk-taking and dangerous, self-destructive behavior. Their executive dysfunction has often advanced to the point that it leads to chaos in their daily lives, including:
- At school
- At home
- With friends
- In relationships
- And more
Teens with ADHD develop more slowly than their peers when it comes to time management and metacognition, and many undiagnosed cases of ADHD are unfairly labeled as lazy or just plain difficult.
Treating ADHD and Substance Abuse in Teens
Drug addiction with a concurrent mental health issue is often known as a dual diagnosis.
Treating the dual diagnosis of ADHD and substance abuse requires a holistic approach because the two conditions are heavily entwined. There are neurological and psychological considerations during both heavy use and total withdrawal, and their effect on the efficacy of a targeted treatment plan. Comprehensive dual diagnosis treatment often takes on the form of an inpatient or outpatient program with:
- Multiple talk therapy methods are used to address and modify destructive thoughts and habits.
- Skill-building to help identify and improve upon alternative coping mechanisms.
- A consistent medication plan.
- Group therapy helps patients become part of a larger support network and benefit from shared experiences.
- The incorporation of friends and family is a crucial element in ongoing, long-term treatment, extending well beyond the initial treatment period.
ADHD is a condition that requires a combination of behavior-modifying therapy and medication. Teens with ADHD often cannot just learn to overcome their nature – they are inherently struggling with an atypical brain structure. Their addiction is often the result of numerous attempts to cope with these abnormalities and the problems they bring to the table during day-to-day activities. Addressing both concurrently means providing ample treatment for ADHD while arming the patient with the means to recognize, address, and avoid signs of recurring drug abuse.
Long-Term Treatment and Consistent Support
In some cases, the most important skill is knowing when to call for help and recognizing – and embracing – the importance of support networks when self-motivation is not enough.
Coping with ADHD itself can be difficult; coping with addiction on top of that is even harder. The journey towards a fully functional and healthy life is a long one for many teens, and it cannot be walked alone.
The role of a friend or family member differs from that of a therapist or doctor, but it remains crucial, especially in the long term. These conditions are not treated over the course of several weeks, but instead require consistent effort over the years and a commitment to alternative coping mechanisms and the lessons learned from therapy. It is also a loved one’s job to recognize when family support is insufficient and when it is essential to seek professional help again.
Is Your Teen Struggling with ADHD and Substance Use? We’re Here to Help.
If your child is showing signs of ADHD and is beginning to experiment with drugs or alcohol—or already struggling with addiction—know that you’re not alone, and early intervention can change everything.
At Visions Adolescent Treatment Centers, we specialize in helping teens and families navigate the complex relationship between ADHD and substance use.
Our integrated, evidence-based programs are designed to treat both conditions simultaneously, providing your teen with the tools they need to manage their symptoms, develop healthy coping strategies, and reclaim their future.
Don’t wait for things to get worse. The earlier you act, the better the outcome.
Contact us today to speak with an admissions specialist and learn how we can support your family with compassionate, comprehensive care.
