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Attention Deficit Hyperactivity Disorder (ADHD) & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

Published on May 4, 2021
Attention Deficit Hyperactivity Disorder (ADHD) & Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that affects attention and self-control. 

Like many mental illnesses, ADHD often co-exists alongside drug addiction (also called substance use disorder). This is called a dual diagnosis. It requires specialized treatment that addresses both ADHD and addiction. 

How Common Is A Dual Diagnosis Of ADHD & Addiction?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 15.2% of adults with ADHD have drug addiction, compared to only 5.6% of adults without ADHD. 

Many people with ADHD start using substances earlier in life than people without ADHD, which increases the risk of addiction. 

Symptoms Of ADHD & Addiction

To receive a dual diagnosis of ADHD and addiction, you must display symptoms of both conditions.

Symptoms Of ADHD

Symptoms of ADHD fall under two categories: inattention and hyperactivity-impulsivity. 

Common symptoms of inattention include:

  • trouble paying attention
  • forgetfulness
  • frequently getting distracted
  • trouble organizing tasks
  • trouble focusing on one task, especially if it’s difficult or time-consuming
  • making careless mistakes at work, school, or other settings
  • frequently losing important items such as keys, wallets, paperwork, or glasses 

Common symptoms of hyperactivity and impulsivity include:

  • acting without thinking
  • trouble concentrating
  • trouble sitting still
  • fidgeting, tapping, or squirming
  • excessive movement
  • excessive talking
  • frequently interrupting others
  • trouble waiting for one’s turn 

Symptoms Of Addiction

Symptoms of drug addiction include:

  • withdrawal from family and friends
  • avoidance of responsibilities at work or school 
  • mood swings
  • decline in personal hygiene
  • change in appetite or sleep patterns
  • sudden weight loss or gain
  • change in pupil size
  • strange smells on the breath, body, or clothes
  • tolerance, which means you need increasingly higher amounts of a drug to feel the desired effects
  • physical dependence, which means you experience unpleasant withdrawal symptoms when you stop using a drug
  • inability to stop using drugs despite wanting to

Risk Factors For ADHD & Addiction

Researchers have identified several factors that create an increased risk of ADHD, including:

  • certain genes
  • brain injury
  • exposure to alcohol or tobacco while in utero
  • exposure to lead or other environmental hazards while in utero or at a young age
  • premature delivery
  • low birth weight

The main risk factors for drug addiction are certain genes, stress, and trauma. 

Many people with untreated ADHD experience stressful or traumatic situations, such as job loss, poor academic performance, and damaged relationships. In these cases, they may abuse drugs to feel better, leading to addiction.

Similarly, some people turn to drugs to self-medicate ADHD symptoms. They may abuse prescription ADHD medications, such as Adderall, Vyvanse, or Ritalin, which can all be addictive. 

Drug abuse occurs when someone uses a drug in a manner not prescribed by a doctor. For example, they might take the drug more frequently than prescribed or at higher doses than prescribed.

Some ADHD patients also self-medicate with other drugs, such as alcohol, cocaine, or methamphetamine. No matter what drugs they use, self-medication can lead to addiction. 

Dual Diagnosis Treatment For ADHD & Addiction

If you have ADHD and addiction, you should attend a dual diagnosis treatment program. These programs offer treatment for drug addiction alongside other mental health conditions. They’re available on an inpatient or outpatient basis, depending on your needs. 

When you first enter the program, a team of doctors will create your personalized treatment plan. Most plans include the following treatment services:

Therapy

Therapy helps people with ADHD and addiction understand their symptoms and develop coping skills. Most dual diagnosis treatment programs offer the following types of therapy:

  • cognitive behavioral therapy (CBT), a form of psychotherapy (or “talk therapy”) that can help you change unhealthy beliefs and behaviors related to ADHD and addiction
  • contingency management, where you can receive cash, gift cards, or other rewards for staying sober and making other healthy choices
  • motivational interviewing, where you can strengthen your motivation for recovering from both ADHD and addiction 
  • group therapy, where you can share your experiences with other people who’ve faced substance abuse problems and other mental health issues
  • family therapy, where you and your family members can learn to navigate challenges associated with recovery

Medication

The treatment of ADHD usually includes stimulant medications such as dextroamphetamine-amphetamine (Adderall), lisdexamfetamine dimesylate (Vyvanse), and methylphenidate (Ritalin or Concerta). 

As mentioned above, these drugs can be addictive, especially if they’re abused. To reduce the risk of addiction, many doctors only prescribe these drugs in extended-release form. 

An extended-release stimulant enters the bloodstream more slowly than an immediate-release stimulant. It has more subtle effects and a lower abuse potential. 

Other doctors avoid stimulant treatment altogether. Instead, they prescribe non-stimulant medications, such as atomoxetine (Strattera), guanfacine (Intuniv), and clonidine (Kapvay). 

These drugs aren’t as addictive as stimulants. However, some studies suggest they’re less effective in treating ADHD. 

Along with stimulant and non-stimulant medications, a person with ADHD may also benefit from antidepressants. That’s because ADHD can cause depression and anxiety. 

Aftercare Planning

Before you leave a dual diagnosis program, your treatment team will help you create an aftercare plan. It will include services to help you manage your ADHD and maintain recovery, such as:

  • ongoing therapy
  • support groups
  • medication management
  • wellness activities like exercise, journaling, meditation, and arts and crafts 

If you or someone you love struggles with ADHD and addiction, please contact an Ark Behavioral Health specialist to learn about our comprehensive treatment options.

ADHD & Addiction FAQ

Do People Use Cocaine To Self-Medicate ADHD?

Yes, though cocaine is not a safe option for managing ADHD symptoms in the long-term. Self-medicating with a stimulant drug like cocaine increases the risk of developing a dual diagnosis of cocaine use disorder and ADHD.

Learn more about ADHD & Cocaine Use

Is It Safe To Take Xanax For ADHD?

Xanax is not recommended for ADHD. While it can help with some of the symptoms of ADHD, it’s addictive properties and potential for abuse make the risks outweigh the rewards.

Learn more about ADHD & Xanax Abuse

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

Centers for Disease Control and Prevention - Data and Statistics About ADHD
Centers for Disease Control and Prevention - Symptoms and Diagnosis of ADHD
Substance Abuse and Mental Health Services Administration - Adults With Attention Deficit Hyperactivity Disorder and Substance Use Disorders
U.S. Department of Health and Human Services - Warning Signs of Substance and Alcohol Use Disorder

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