ADHD and Substance Abuse

Attention deficit hyperactivity disorder (ADHD) may continue from childhood into adulthood about 1/3 to 1/2 of the time. Some studies have shown that children with ADHD may be more likely than the general population to develop alcohol and drug use problems when they get older. Unfortunately, there is often a strong connection between ADHD and substance abuse.

In fact, ADHD is 5 to 10 times more common among adult alcoholics than it is in people who don’t have it. Among adults who are in treatment for alcohol use disorder (AUD) and substance use disorder (SUD), the rate of ADHD is about 25%. When there are two co-occurring conditions, it is called a dual diagnosis. Here at Coastal Detox, we understand the seriousness of dual diagnosis cases. We work to help those who enter our facility, seeking help for addiction and mental health disorders.

What is ADHD?

It is estimated that nearly 17 million Americans have ADHD. In comparison, the population of the state of New York is 19 million. ADHD (Attention Deficit Hyperactivity Disorder) is one of the most common neurodevelopmental disorders of childhood. This means that it is an impairment in the growth and development of the brain and/or central nervous system. This disorder of brain function affects emotion, learning ability, self-control, and memory. 

Types of Attention Deficit Hyperactivity Disorder

There are a few different types of ADHD. They include the following:

• Predominantly Inattentive Presentation: This means that it is difficult for the person to organize or finish a task, pay attention to details, or to follow instructions or conversations. The person is easy to distract or forgets details of daily activities.
• Predominantly Hyperactive-Impulsive Presentation: With this type of disorder, individuals tend to fidget and talk a lot. they may have a hard time sitting still for long. For example, they may struggle while doing homework or sitting for a meal. Children may run, jump, or climb constantly. Restlessness and impulsive behaviors often occur. An impulsive person may interrupt others, grab things from people, and speak at inappropriate times. It’s hard for individuals with this disorder to wait for their turn or listen to directions. They are also likely to have more accidents and injuries than others. 
• Combined Presentation: This simply means that the symptoms of the previous two types are combined in one person.

Since symptoms may change over time, the presentation can change over time as well.

ADHD in Adults

Anybody can have moments of being inattentive, impulsive, or hyperactive. However, adults with ADHD experience these symptoms constantly and in a way that is severe enough to affect their work life, home life, and social life. Although it’s called Adult ADHD, symptoms start in early childhood and continue to adulthood. Sometimes it’s not recognized or diagnosed until the person is an adult.

Symptoms of ADHD in adults may not be as clear as the symptoms in children. For adults, hyperactivity may decrease but the struggle with impulsiveness, restlessness, inattentiveness may continue. Symptoms range from mild to severe.

Adult symptoms may include:

ADHD and Substance Abuse: The Connection

It is common for children with ADHD to start abusing alcohol during their teenage years. In one study, 14% of children ages 15-17 with ADHD had problems with alcohol abuse or dependence compared to other teens the same age without ADHD. 

Another study found that at an average age of 14.9 years, 40% of children with ADHD began using alcohol. This is compared to 22% of children without the diagnosis. This disorder appears to be a strong indicator of who will abuse alcohol and illegal substances during adulthood.

Also, researchers have found connections between ADHD and the use of marijuana and other recreational drugs. This is especially true in people who have other mental disorders like obsessive-compulsive disorder. People with ADHD typically begin having problems with drugs and alcohol at an earlier age than people without the condition.

Why is There a Connection?

Because, as mentioned, people with ADHD tend to be more impulsive and likely to have behavior problems. The core symptoms of ADHD, inattention, impulsiveness, and hyperactivity have been known to predict substance use in adolescents who have not been diagnosed with ADHD. These symptoms may increase the risk for several reasons through the variety of problems they cause in school, at home, and with friends.  

A lot of these problems are known risk factors for the development of substance use disorder. Behavior problems such as lying, stealing, and skipping school are more common to children with ADHD and also add to the development of SUDs. Poor performance in school increases the risk of teen substance abuse. 

Drug-seeking behavior may be used as a way to self-medicate to make up for the lack of balance and to avoid unpleasant feelings. It is especially challenging for adults with untreated or undiagnosed ADHD.

Family Connection

Interestingly, ADHD and SUDs tend to run in families. Each of these problems has strong family ties and they co-occur at a greater rate than just by chance. A child with ADHD whose parent has alcohol use disorder is more likely to also develop an AUD. Research points to common genes shared between ADHD and AUD.

Treatment For ADHD and Substance Abuse

The best treatments for people with ADHD and addiction will treat both at the same time. However, in the case of substance abuse issues, patients need to be sober at the time they begin treatment for ADHD. In many cases, detox is necessary. 

Detox

Drug detoxification is meant to help with removing drugs from the body and managing the withdrawal symptoms. Detox can last from a few days to several weeks. During this time, the individual may be prescribed medications to ease cravings and withdrawal symptoms. Drug and alcohol withdrawal can very painful and a medication-assisted detox can relieve the distress.

Of course, a person going through withdrawal symptoms will be safer and more comfortable in a detox facility, with 24-hour medical monitoring in case of an emergency. The person’s blood pressure may rise or become unstable, or he may sweat severely, or develop tremors. Severe nausea and pain are also common. Even mild physical withdrawal symptoms can be accompanied by psychosis which poses a risk of suicide. 

Heroin and Opioids Detox

These drugs cause physical dependence. This means that the person depends on the drugs to prevent withdrawal symptoms. After a period of use, more of the drug is needed for the same effect. This is called tolerance. When the person stops using the drug, the body needs to recover and it causes withdrawal symptoms.

These symptoms are extremely uncomfortable but generally not life-threatening. But they are enough to make a person relapse.

Medications

Methadone is an option for heroin addiction. It relieves symptoms during the detox process. This is basically switching an illegal drug for a legal one. However, methadone treatment has been proven as a long-term treatment to help keep heroin addicts away from criminal behavior and become more productive members of society. Other medications used are:

• Buprenorphine
• Clonidine
• Naltrexone
• Suboxone

Most people will need long-term treatment after detox. People going through treatments should be checked for co-occurring disorders.

Alcohol Detox

If you have been a heavy drinker for weeks, months, or years, you will have mental and physical issues when you stop or cut back severely. This is alcohol withdrawal. Alcohol slows down your brain function and changes the way your nerves send messages.

Eventually, your central nervous system gets used to having alcohol around all the time and your body has to work hard to keep your brain in an awake state and to keep your nerves from talking to each other. When the alcohol level suddenly drops, your brain stays in this fired-up state. This is what causes withdrawal.

Common medications for alcohol withdrawal include:

• Benzodiazepines for anxiety, insomnia, and seizures
• Antipsychotics for hallucinations
• Medications for nausea

Detox from Cocaine and Other Stimulants

Withdrawal from stimulants (cocaine and amphetamines) does not typically cause life-threatening symptoms, seizure, or delirium. Withdrawal symptoms include:

• Anxiety
• Hunger
• Depression
• Excessive sleep
• General unhappiness with life

Withdrawal and treatment medications include:

• Benzodiazepine tranquilizers have been prescribed for years as a way to ease the symptoms. Although they are also addictive, people use them to treat withdrawal from cocaine and methamphetamines.
• Bupropion eases mood symptoms of withdrawal.
• Propranolol reduces anxiety and may weaken the cravings and cocaine intoxication.

Cocaine withdrawal symptoms add to patients’ difficulties quitting the drug. Studies have indicated that people who have severe withdrawal symptoms are twice as likely to drop out of treatment and less likely to achieve abstinence. They may keep taking the drug to avoid withdrawal symptoms.

Medication Risks

Addiction medications such as methadone and Suboxone have some risks of their own. Their use must be supervised by medical professionals. Guidelines are necessary for these medications to be paired with counseling or behavioral therapy to be effective.

After Detox: Treatment for ADHD and Substance Abuse 

After detoxification, treatment for the co-occurring disorders of ADHD and substance use can begin. In the case of some substances, and the severity of the abuse, treatment may begin while the person is still detoxing at a mild level. It is necessary for the two conditions to receive treatment at the same time. 

Therapy

There are studies that show specific types of family therapy and cognitive-behavior therapy are effective in the treatment of substance use disorder in with teenagers. However, they are not effective for the treatment of ADHD for teens. There is actually little treatment information for adolescents with ADHD but there is some support for therapy for teens as well.

Adults with SUD and ADHD benefit from a complete evaluation that looks at their history of symptoms and treatment, and a full evaluation of ADHD after the addiction is stabilized. Beneficial methods that consider motivation, use cognitive-behavioral therapy, and encourage a 12-step involvement are all effective for adults with substance use disorders. Medication management of SUDs has not been shown to make existing substance abuse problems worse among those people getting treatment for addictions.

ADHD Treatment

Treating ADHD typically requires medical, educational, behavioral, and psychological methods. Sometimes, professionals refer to a comprehensive approach to treatment such as “multimodal”.

Depending on the age of the patient with ADHD, it might include:

About Recovery

Although there isn’t a cure for ADHD, people with the problem can experience mental health recovery. In this case, recovery can be defined as the ongoing management of ADHD symptoms. Through detox, treatment, and therapy, individuals can develop the tools they need to overcome addiction.

According to the Substance Abuse and Mental Health Administration (SAMHSA), the two indications of mental health recovery are “living a meaningful life” and growing to one’s “full potential.”

Suffering from ADHD and Substance Abuse? Find Hope Today!

Do you know someone battling these two disorders? Maybe it’s you. You or your loved one can get help and live a meaningful life at last. At Coastal Detox, we can help you rid your body of the toxic substances you’re using to cope with the symptoms of ADHD or any other disorder. And we will help you through the withdrawal process.

Our medical professionals will supervise you through detox and on into treatment. Waiting won’t make it better. Make the move and contact us. You deserve the opportunity to grow to your full potential.