Untreated ADHD: A Hidden Risk Factor for Substance Use Disorders
The link between mental health disorders and substance use disorders is undeniable. Specifically, people with ADHD are at a much higher risk of abusing drugs or alcohol than those without ADHD; almost three times more likely (Saline, n.d.). While the exact reason for this relationship is unknown, factors such as self-medication and impulsivity are thought to play a role. Understanding how ADHD increases the risk of addiction is a crucial part of treatment and prevention..
What the Research Says
Substance abuse is not definable by quantity or frequency of use, but by the impact the substance has on a person’s life. If substance use negatively impacts a person’s health, work, relationships, or legal status, it may meet the criteria for a use disorder. The research varies, but most recently suggests that up to 30% of adults with ADHD will engage in drug or alcohol use that falls under the definition of abuse (Saline, n.d.). Given that an estimated 6% of the U.S. population has ADHD, this elevated risk is cause for concern.
Why the Risk is Higher
ADHD is a disorder affecting self-regulation, which impacts numerous mental processes that an individual will utilize every day. In relevance to the topic of addiction, deficits in self-regulation make it extremely challenging for a person to predict consequences of alcohol/drug use, and to act in accordance with those predictions. The immediate feel-good gratification of alcohol or drugs overpowers the distant, difficult-to-imagine consequences associated with alcohol/drugs (How to ADHD). The prefrontal cortex, responsible for executive functioning and impulse control, is particularly affected in ADHD, resulting in a higher risk of alcohol and drug use.
What Clinicians + Providers Can Do
The most effective way to manage and treat ADHD is medication combined with ADHD-focused therapy. Contrary to popular belief, stimulant medication is not likely to lead to drug abuse or relapse when taken as prescribed (Saline, n.d.). In fact, when a person’s ADHD is treated effectively, they are at no greater risk for a substance use disorder when compared to those without ADHD. Education about the link between ADHD and substance use — especially related to effective treatment — should be a priority among primary care providers, substance abuse treatment centers, mental health providers, and medication providers. Early, accurate ADHD screening, evaluation, and treatment can significantly reduce the risk of long-term substance use problems.
References
How to ADHD. (2018, November 14). ADHD and addiction: Why we’re more susceptible [Video]. YouTube. https://www.youtube.com/watch?v=j3pDm55f6rw
Saline, S. (n.d.). ADHD and addiction: Why teens and adults with ADHD are more likely to abuse drugs. ADDitude Magazine. https://www.additudemag.com/slideshows/adhd-and-addiction/