ADHD and addiction are strongly linked. The link is so strong that ADHD is considered a predictor for substance use disorder. But, in addition to substances, people can also become addicted to certain behaviors and ADHDers are just as prone to becoming addicted to those.
Let's analyze these claims to understand the link between ADHD and addiction better.
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- Substance use disorder (SUD) is common in ADHDers, and an estimated 50% struggle with substance use or other forms of addiction.
- There's no definitive explanation for why ADHD and addiction are so strongly linked.
- ADHD traits like impulsivity and dopamine-seeking are risk factors for addictive behavior.
⚠️ Medical advisory and disclaimer: If you or somebody you know struggles with addiction or substance use disorder, there's no shame in asking for help.
The difference between substance use disorder and addiction
We use the term addiction in contrast to substance use disorder (SUD) to separate addictive behaviors that don't involve substances from those that do.
Signs of SUD and addiction:
- Loss of control (overuse)
- Risky use
- Social problems
- Withdrawal effects
- Struggling to quit
Addictive personality or tendencies?
People with SUDs are often labeled as having an 'addictive personality', but this is rooted in the false notion that certain personality types are more likely to develop addictions.
People in treatment for substance use disorders often share common traits, but this doesn't define an 'addictive personality'. Furthermore, these traits may increase the risk of developing an addiction, but they don't determine it.
Interestingly, the same traits are often found in ADHDers:
- Family history of addiction
- Difficulty with self-regulation
- Experiences of other mental health conditions
- Disconnected and cautious
- Obsessive and compulsive
Preventing addictive behaviors with ADHD treatment
The best prevention for addiction in ADHDers is ADHD treatment. If ADHD symptoms are treated early, the likelihood of addiction decreases significantly. Additionally, effective addiction treatment can often only begin once ADHD is treated.1
It might seem counterintuitive, but ADHD medication decreases the chance of forming addictive habits. Since the medication provides a more stable dopamine level, one is less likely to seek out these effects in uncontrolled substances and circumstances.
When ADHD medication is taken therapeutically, it does not cause addiction; it decreases the risk.2
What makes people with ADHD more prone to addiction?
Studies have found that ADHD is common among people in treatment for substance use. The risk for developing SUDs is twice as high among the ADHD population compared to non-ADHDers.1
Let's explore some possible reasons.
1. Impulsivity and novelty-seeking behaviors are common among ADHDers.
Impulsivity, novelty, risk-seeking behavior, and under-stimulation (boredom) are common ADHD traits that can cause a stronger predisposition to try substances.
The first time might be an impulsive decision, and the desire for stimulation might continue.
2. People with ADHD lack dopamine.
Drugs or addictive behaviors can include video games, gambling, exercise, or eating to set off a rush of dopamine that ADHD brains crave. The ADHD brain’s need for instant gratification also plays a role here.3
3. They’ve experienced negative social interactions their entire life.
By the time a child with ADHD turns ten, they may have received around 20,000 negative or corrective comments, which often leads to developing rejection-sensitive dysphoria.
Taking drugs in social settings might sound appealing, but it can become a form of escape from hostile surroundings.
4. Their brains are wired for it.
People in treatment for substance use disorder share some neurobiological traits with ADHDers, suggesting that their genetic makeup renders them more prone to addictive behavior. This ties in with ADHD and addiction being strongly hereditary through genes or environmental factors.5
5. They’re more likely to experiment with self-medication.
Self-medicating is using substances to alleviate symptoms without the supervision of a trained professional. While this isn't necessarily harmful, it becomes dangerous once the activity develops into addictive behavior.
Tackling boredom, looking for a dopamine rush, or creating a 'better mood' through substance use is a quick way to develop an addiction.
Common ADHD addictions
Certain substances and activities are more common in the ADHD population.
Cannabis use is very common among the ADHD population. One study concluded that 34-46% percent of people seeking treatment for cannabis misuse also had ADHD.6
Another study analyzed internet forums for popular opinions about the perception of cannabis use and found that 25% of posts suggested cannabis was therapeutic for ADHD symptoms.7
Disclaimer: There are currently no studies backing these claims. Despite several studies reporting short-term effects, beneficial long-term effects have yet to be found.
Alcohol misuse is widespread among the ADHD population, with one study speaking of numbers as high as 33%.8
The disinhibiting effects of alcohol are stronger in people with ADHD; if an alcohol use disorder is developed, it's often more severe. 9
3. Nicotine (vaping and smoking cigarettes)
Nicotine is a stimulant and is associated with enhanced cognitive abilities. ADHDers are significantly more likely to become daily smokers and experience stronger withdrawal symptoms and cravings than their neurotypical peers.10
4. Video games
Repeat after me: No, video games don't cause ADHD.
However, people with ADHD are more likely to play games excessively. Video games are particularly appealing to ADHDers due to the high pace of some games, the stimulating reward systems, and the state of focus one gets into while playing.11
ADHD brains tend to be very impulsive, so overspending is naturally a concern for many. As a result, compulsive buying, impulse spending, and shopping addictions are more prevalent within the ADHD population.
6-100. Literally anything else
You should get the gist by now.
ADHD brains are very prone to addiction. Therefore, anything that provides instant gratification or relieves ADHD symptoms in the short term can become an addiction.
1 Current Psychiatry Reports | The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders
2 Journal of Child Psychology and Psychiatry, and Allied Disciplines | Stimulant ADHD medication and risk for substance abuse
3 Frontiers in Human Neuroscience | Association of Affected Neurocircuitry With Deficit of Response Inhibition and Delayed Gratification in Attention Deficit Hyperactivity Disorder: A Narrative Review
4 Substance Use & Misuse | Family History of Alcohol and Drug Abuse, Childhood Trauma, and Age of First Drug Injection
5 Mental Health and Addiction Research | The overlapping neurobiology of addiction and ADHD
6 Journal of Attention Disorders (JAD) | ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders
7 PLOS ONE | "I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD
8 Alcohol and Alcoholism | Comorbidity of alcohol and substance dependence with attention-deficit/hyperactivity disorder (ADHD)
9 Neuroscience and Biobehavioral Reviews | Alcohol use disorders and ADHD
10 Psychology of Addictive Behaviors | Cigarette Smoking and ADHD: An Examination of Prognostically-Relevant Smoking Behaviors Among Adolescents and Young Adults
11 Frontiers in Pediatrics | Video Games in ADHD and Non-ADHD Children: Modalities of Use and Association With ADHD Symptoms