Understanding ADHD and alcohol and other drugs

People’s use of alcohol and other drugs (AOD) can be influenced by many factors, such as their environment, genetics, and overall wellbeing.

And while each person’s experience is different, we’re starting to learn more about the relationship between AOD and Attention Deficit Hyperactivity Disorder (ADHD).

Here we explore the link between ADHD and AOD use and some considerations for treatment.

What does it mean to be neurodivergent?

To be neurodivergent means having a mind that functions in a way that falls outside of, or diverges from, what is widely considered ‘normal’.

People can be born neurodivergent, can develop neurodivergence, or have a combination of the two. Autism and ADHD are examples of neurodivergence that people are born with.¹

Some people with ADHD prefer to use the term ‘neurodivergent’ or ‘neurodiverse.’ It’s best to check with the person to see what term they use.

What is ADHD?

ADHD is a condition that can make it hard for people to focus, pay attention and control their impulses. Some people may experience one of these symptoms, or a combination of both.

ADHD can make it hard for people to do things like make decisions, stay organised, develop social skills and recall information. This can impact many areas of their life including study and work, relationships and day-to-day living.²

ADHD often starts in childhood, with about 40-50% of people continuing to experience symptoms into their teens and adulthood.³

In Australia, ADHD affects around 6-10% of children and 2-6% of adults.²

How common is ADHD and substance dependence?

ADHD can increase the risk of developing an AOD dependence, particularly if someone’s ADHD has been undiagnosed or not treated.

For instance, one large study comparing adults with ADHD to those without, found they were around:

• one and a half times more likely to experience nicotine dependence
• two and a half times more likely to experience polydrug use dependence
• four times more likely to experience alcohol dependence.⁴

A separate study estimated that about one in five people who have been diagnosed with a substance use disorder also have ADHD.³

It’s important to remember that not everyone who has ADHD will drink alcohol, use drugs or experience dependence.

What’s the link between ADHD and alcohol and other drug use?

The impulsivity that some people with ADHD experience may lead them to experiment with AOD use, particularly for young people.

Using alcohol and other drugs can also provide short-term relief from the symptoms and impact of untreated ADHD, such as:

• restlessness
• negative emotions
• depression
• anxiety
• sleeping challenges
• racing thoughts.^5,6

Some people with ADHD report using alcohol and other drugs to help them feel ‘normal’ in their social and day-to-day life.⁶

Does stimulant treatment for ADHD increase the risk of AOD use?

ADHD is often treated with stimulant medication like dexamphetamine. Stimulant medication can reduce the risk of people with ADHD developing anxiety, depression and suicidality. It can also prevent accidents and injuries and improve learning.⁷

There have been concerns around the potential for stimulant treatment to cause, or increase, the risk of people developing AOD dependence. This is not true.

In fact, we know that early treatment for ADHD can help reduce the risk of AOD dependence in young people, and reduce the risk of relapse among adults recovering from AOD dependence.⁸

Stimulant treatment supports people with a co-occurring substance use disorder by helping to reduce the need to use alcohol or other drugs.⁶

There are also many other effective treatments available for people with ADHD, including non-stimulant medication, psychological therapy, occupational therapy and coaching.²

ADHD and alcohol and other drug treatment

Given the strong relationship between ADHD and substance use disorders, both conditions should be considered in healthcare settings.⁸

For example, some people report their ADHD symptoms worsen after they stop using drugs such as nicotine, so it’s important they are provided with support specific to their needs.⁶

Sadly, some people with lived experience of dependence have also reported experiencing stigma and discrimination when seeking stimulant treatment for their ADHD.⁶

The Australian ADHD clinical guidelines state that:

• if a person is seeking treatment for their substance use, their treating health professional should screen them for ADHD and vice versa
• if a person with ADHD is seeking treatment for their substance use, they should be offered support for both issues.²

More resources

• ADHD Professionals Directory
• ADHD Foundation
• ADHD Australia
• Comorbidity guidelines for ADHD and co-occurring AOD disorders
• Australian Evidence-Based Clinical Practice Guideline For ADHD