ADHD and Addiction
Dual Diagnosis

ADHD, the acronym for attention deficit hyperactivity disorder, is one of the most common neurodevelopmental disorders in children and can persist into adolescence and adulthood.[1] It’s defined largely by its symptoms, which include hyperactivity, poor concentration, and behavioral problems.

The medications most commonly used to treat ADHD are stimulants, which can be associated with a risk of misuse and the development of substance use disorders.[2] Abuse of other substances, such as alcohol, is also common among people with ADHD.

WRITTEN Review by:

Amanda Stevens, BS

On: Dec 12, 2023
Medical Review by:

Dr. Po Chang Hsu MD, MS

On: May 7, 2024
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    Common Symptoms of ADHD

    Reports of similar symptoms to ADHD have been recorded as late as the 1700s. However, it wasn’t until the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980 that the condition was defined as attention deficit disorder (ADD).[3] Later editions began the shift from ADD to ADHD before the latter appeared in the 5th and most current edition in 2013.[4]

    There are three sub-specifications for ADHD: predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, and combined presentation.[5] ADHD involves an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

    People with ADHD experience the following symptoms:

    • Inattention: Difficulty staying on task, sustaining focus, and staying organized
    • Hyperactivity: Moving around constantly, fidgeting, incessant talking or finger-tapping, restlessness
    • Impulsivity: Acting without thinking, difficulty with self-control, an inability to delay gratification[6]

    As mentioned, ADHD can have sub-specifications with more symptoms of inattention, more hyperactivity-impulsivity, or a combination of both:


    People with symptoms of inattention may:

    • Overlook or miss details and make careless mistakes in schoolwork, work, or other activities
    • Have difficulty sustaining attention during tasks like lectures or reading
    • Not seem to listen when spoken to
    • Struggle to follow through on instructions or finish schoolwork, chores, or duties
    • Have difficulty organizing tasks and activities, following tasks in sequence, keeping materials in order, or managing time
    • Avoiding tasks that require sustained mental effort, like homework or writing lengthy papers
    • Lose things necessary for tasks or activities, such as school supplies, books, tools, wallets, keys, or cell phones
    • Become easily distracted by unrelated thoughts or stimuli
    • Become forgetful in daily activities, such as chores, errands, or keeping appointments


    People with symptoms of hyperactivity-impulsivity may:

    • Fidget or squirm when seated
    • Leave seats in situations when staying seated is expected, such as a classroom or office
    • Run or climb at inappropriate times (in children) or feel restless
    • Be unable to engage in hobbies quietly
    • Be constantly in motion or on the go
    • Talk excessively
    • Answer questions before they are asked or finish other people’s sentences
    • Have difficulty waiting one’s turn
    • Interrupt or intrude on others[7]

    The symptoms must be chronic or long-lasting, impair the person’s functioning, or cause them to fall behind on typical development to receive a diagnosis of ADHD.

    Attention Disorders Statistics

    According to the National Library of Medicine:[8]

    • About 6 million children aged 3-17 were diagnosed with ADHD from 2016 to 2019
    • Boys are more likely to be diagnosed with ADHD than girls
    ADHD and Addiction

    ADHD and Addiction

    A person with a diagnosis of ADHD and substance use disorder is considered to have a co-occurring disorder. Neither condition caused the other – they coexist, influencing and impacting one another.

    Research suggests a connection between ADHD and addiction.[9] Compared to the general population, children with ADHD face an increased risk of becoming dependent on alcohol or other drugs when they are adults.

    • Among adults who have alcohol use disorder, ADHD is 5-10 times more common[10]
    • Among adults receiving treatment for alcohol and substance abuse, about 25% have ADHD[11]
    • Young adults with an ADHD diagnosis are more likely to use alcohol excessively compared to their counterparts without ADHD[12]

    There are several possible reasons for this:

    • Poor executive functioning is intrinsic to ADHD, so when adolescents and young adults with ADHD are exposed to alcohol, tobacco, and illicit drugs, they lack self-restraint.
    • ADHD may contribute to experiences of demoralization and perceived failure, which can be associated with an increased risk of substance use disorders in adolescents.
    • People with ADHD may have an impaired reward system. Substances activate that reward system in a similar way to stimulant medications that are used to treat ADHD.
    • Misusing drugs or alcohol may alleviate the tension that people with ADHD experience.
    • Disorders like ADHD and substance use disorder may be related to shared genetic risk factors.[13]

    Understandably, treatment for ADHD and drug addiction or alcohol addiction presents specific challenges, especially if the addiction involves prescription stimulant medication for ADHD.

    Typically, treatment for ADHD and alcohol abuse or drug abuse involves a tailored combination of supportive services with medication, possibly including nonstimulant, antidepressant, or psychostimulant medications.

    Along with medication, dual diagnosis treatment for ADHD with substance abuse may include individual or group therapy, 12-step support groups, and behavioral therapies like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).[14] Behavioral therapies seek to identify and change potentially self-destructive or unhealthy behaviors by focusing on current problems rather than the past.

    Cost of Dual Diagnosis Treatment for Attention Disorders

    Dual diagnosis treatment for ADHD and substance abuse can vary in costs, depending on the facility, the therapies, and other factors. Fortunately, insurance may cover ADHD dual diagnosis treatment. Contact us to see if your insurance provider is in-network.

    Untreated ADHD and Substance Abuse

    Untreated ADHD and Substance Abuse

    Though it can begin in adulthood, ADHD commonly begins in childhood. When it’s not recognized or treated properly in early adolescence, ADHD can lead to compulsive, disorganized behaviors that cause reckless and risk-taking behaviors – including experimenting with alcohol and drugs.[15]

    Research suggests that ADHD could be a result of the dopaminergic neurotransmission system malfunctioning or not releasing the appropriate amount of feel-good hormones like dopamine when appropriate.[16] There are also links between low dopamine activity and addiction.

    For some individuals with ADHD, using substances may provide temporary relief due to the increased dopamine levels they produce, which can lead to feelings of euphoria. However, this effect is complex and varies from person to person.[17] The desire to recapture that feeling is more intense, leading to substance abuse.

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    Frequently Asked Questions about Attention Disorders

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