ADHD (ADD) and Addiction Dual Diagnosis – How They Co-Occur Together

ADHD or ADD and addiction dual diagnosis is a complex illness. Nearly 50% of the time, ADHD will last into adulthood. Studies have found that children with ADHD are more likely to fall into addiction. As they get older, they are likely to fall into substance abuse problems. This is known as a dual diagnosis. It’s when two or more disorders occur simultaneously. There is a high percentage of people with ADHD that will also form an addiction. In fact, it can be up to 80% of those with ADHD. Researchers have found a connection between ADHD substances like marijuana and other recreational drugs. People with ADHD will often start having problems with substances earlier in life than the general population.

Why does this occur? There are a variety of reasons. One might believe that because patients diagnosed with ADHD become addicted to their medication, this is not actually the case. It’s been found that teens and adults who get treatment for their symptoms are less likely to form a substance abuse disorder. So what is the connection between the two and how do they co-occur together?

What is Dual Diagnosis in Mental Health?

Dual diagnosis is also referred to as a co-occurring disorder. It is a term that describes someone who has both a mental illness and a substance use disorder at the same time. Research has found that substances will actually worsen mental illnesses, making dual diagnosis a complex and debilitating issues.

ADHD and substance addiction would be an example of a dual diagnosis disorder. ADHD itself is a very common neurobehavioral disorder. It occurs in 8% of children. It is defined by children and youth having a problem paying attention. They can often be hyperactive and impulsive. It is a chronic disease and stimulant medication is often prescribed as therapy for kids in school. Behavioral therapy should also be introduced.



To see the connection between dual diagnosis that occurs between ADHD patients abusing substance, here are some facts:

  • Adults with ADHD will have co-occurring alcohol abuse problems with a rate of 17% to 45%. Drug dependence ranges from 9% to 30%.
  • Studies have found that those with ADHD are more likely to develop substance abuse problems at a young age.
  • They are more likely to need substance abuse treatment throughout their whole life. There is a tendency to bounce from one addiction to the next.
  • It’s been found that medication treatment will reduce the risk of substance substantially. In teenagers, the risk is reduced by 18%.

Children who have ADHD are at a greater risk of having other mental health or behavioral issues on top of the original disorder. This can include substance use disorders (SUDS). It isn’t known if the stimulant treatment given to patients would reduce the chances of SUDs for youth. Studies have been looking to see if the relationship between the disorder and repressing certain behaviors would be the reason for less risk of substance abuse.

There are studies that have show early medical treatment actually reduces the chance of patients with ADHD abusing substances. There are no studies that have shown risks of patients becoming addicted to their medications. With all this being said, there are cases where those with ADHD will misuse their medications by mixing them with other substances.

Enough studies have proven that ADHD patients who use stimulants are not more likely to abuse those medications than their peers. Those on stimulants for the disorder aren’t more likely to abuse cocaine. So these wouldn’t be relevant reasons why they would abuse substances.

Someone with ADHD may suffer from more than one mental health issue. This can cause them to abuse substances based on those symptoms. Statistically, more than two-thirds of ADHD patients have more than one co-occurring disorder. About 40% of patients also have oppositional defiant disorder (ODD) or there’s a similar percentage of those who have a coexisting mood disorder.

Here are some of the most common reasons ADHD patients become addicted to substances:

  • Drugs or alcohol will calm them down. They can become more relaxed and focused.
  • Due to a lack of self-esteem, they take alcohol or drugs to gain more confidence in social situations.
  • Patients become frustrated with the symptoms that hold them down.
  • Drugs and alcohol have the potential to numb a person, making them feel as they’ve eased their anxiety and depression.

There are about 14% of children who experience symptoms of depression as a result of ADHD. Compare that to children who don’t have ADHD, which is a mere 1%. There are symptoms of bipolar disorder in about 20% of patients. Over 50% of adults with ADHD experience anxiety with 30% of children experiencing anxiety. In a report, it was found that about 25% of children with the disorder had problems sleeping.

Do You Have ADHD?

Some people will deal with having ADD as children and when not diagnosed, it can cause problems in children and adolescence. The child won’t have the opportunity to make good grades so getting onto college is less likely. What happens as an adult then? ADHD in adults can cause just as many problems. Addiction is one of those problems. Getting help for ADHD is essential in allowing someone to live a normal life. If you notice any of the following symptoms in yourself or in someone else, seek out professional advice:

In Children,

  • Trouble focusing.
  • Easily distracted and easily bored with tasks.
  • Often they appear to not be listening when directly spoken to.
  • They have challenges remembering things and following instructions.
  • They might make careless mistakes because they don’t pay attention to details.
  • They have a hard time organizing.
  • They may be prone to losing things.
  • They fidget and squirm.
  • They have a hard time sitting still and just relaxing.
  • They have to keep on moving around or climbing on things.
  • They will talk constantly.
  • They often have a temper that comes on quickly when provoked over small things.

In Adults,

  • Disorganized with challenges in prioritizing.
  • They may often be late due to poor management skills.
  • Problems focusing on tasks.
  • They have a hard time multitasking.
  • Noticeable restlessness.
  • Can become frustrated easily.
  • Constant mood swings.
  • Tend to not follow through on things.
  • When they do get angry, they have a hot temper.
  • They have challenges when it comes to dealing with stress.

Self-Medicating Causing Dual Diagnosis

As there is a percentage of kids with ADHD that feel depressed or have anxiety, it becomes challenging to manage their feelings. People with co-occurring disorders and self-medicating are very common. It may be with prescription pain killers, illicit drugs, or alcohol. Due to the feelings that are conjured up when someone has ADHD, there is a risk of self-medicating. Those with the disorder are more prone to depression.

So a person will seek out methods to relieve themselves of their chronic symptoms. The condition can lead people to feel low about themselves and they may experience debilitating self-esteem issues. People with ADHD are often misunderstood and looked down on because they don’t understand the disorder. Therefore, the feelings of low self-esteem then seem warranted.

Cocaine boosts a person’s energy and also makes them feel invincible or expands feelings of self-worth. Alternatively, someone with ADHD may take depressants like smoking marijuana to gain a feeling of relaxation. This leads to abuse as a patient will likely take more medication than necessary. Self-medication can also be illicit drugs.

Eventually, your brain isn’t able to create much dopamine on its own at all. This can lead to depression and withdrawal symptoms when you attempt to stop using. At this point, an individual discovers that they’ve become addicted to the drug.

For those who have ADHD, there is a symptom of being impulsive. When there are drugs or alcohol available to them, they’re more likely to indulge. They don’t consider consequences of their action and can suffer from poor judgement. This contributes to the potential of substance abuse that can lead to various addictions. There is a biological vulnerability to addiction in comparison to those without the disorder.

The receptors in the brain that cause ADHD in the first place are also the same receptors involved in substance abuse problems. The dopamine transmission of part of ADHD and SUDs. ADHD patients have a greater density of dopamine transporters. This is what causes a lower level of dopamine in their brain. So amphetamines, cocaine, nicotine, heroin or prescription pain killers and other drugs that raise dopamine levels are a welcoming feeling for those with ADHD. These positive feelings encourage repeated use.

There is a theory that those with ADHD have an altered dopamine response. This feel good chemical may be released in smaller amounts. This give them a reduced ability to feel normal pleasure that the general population experiences. So once they try a drug that gives them a pleasurable feeling, it can be highly alluring. Initially, substance can provide a reduction in symptoms but over time, it will cause the ADHD to worsen. Symptoms will get worse, which can cause greater use of any given substance.

ADHD Challenges that Make Substance Addiction More Likely

So the characteristics of an ADD/ADHD patient make development of substance addiction more prevalent. The disorder is connected with poor academic and professional development. The constant feeling that they go through because they “underperform” in formative years can really damage self-esteem. Low self-esteem has been connected to a high potential of abusing substances.

It can also be challenging for patients to develop meaning friendships and romantic relationships. They can often isolate themselves so they don’t have the necessary social support that all humans require to feel safe and happy. They will often feel lonely. All of these aspects sum up to high risks of depression which is another indicator of substance abuse potential.

Most Common Dual Diagnosis with Substance Abuse

Oftentimes, ADHD comes with feelings of anti-social behavior because of the symptoms. This leads to alcoholism.

The National Institute on Alcohol Abuse and Alcoholism states that any kind of antisocial personality disorder is most closely linked to alcoholism. Anxiety can be prevalent in those with ADHD and ADD. Many times, someone will use cocaine to feel uplifted and powerful, feelings they don’t get to experience normally. Heroin use has been found to be prevalent in those who experience depression. It can also involve prescription drugs.

Most Common Dual Diagnosis with Substance Abuse


Dual Diagnosis Treatment For Young Adults

Between 30% to 50% of children with ADHD will continue to display symptoms into their adult life. As kids, they will fidget, get distracted, and run around. As adults, it can become an agitation to cope with the symptoms of the disorder. It can be challenging to function at work. They are unorganized, forgetful, and will often not attend social commitments. This conflicts with relationships because there is a tendency to make offensive remarks.

With all the symptoms surrounding ADHD, it can become common practice to turn to alcohol or drugs to relax. For teens, it’s also a way for them to fit in socially or relax. Drinking or taking drugs can also be a method of managing frustration. Not only does a teen need to recover from ADHD itself but they may also require treatment to stop substance abuse. If unattended, any type of substance abuse can manifest into full on addiction in adulthood. This is why there are dual diagnosis treatment centers for young adults that suffer from ADHD and ADD.

What is Dual Diagnosis Treatment?

ADD and ADHD increase the potential of addiction and also makes it complicated to treat. Specific dual diagnosis treatment is highly effective.

To treat both disorders, co-occurring treatment disorders are necessary. Addiction and ADHD are both incurable so treatment is about managing the disorders. It is a complex, multi-layered disorder that required comprehensive care that is evidence-based. This has been found to be the most effective way to help someone fully recover.

It may be that patients are put on medications which will manage the ADHD. Ritalin, Adderall, and Vycanse are some of the example. They are all stimulants that come with the risk of abuse. If a patient has a history of abusing substances, they will likely get a non-stimulant medication. Medications have been found to be important in managing symptoms of ADHD. Therapy however, is just as important.

It is a multi-dimensional approach that involves counseling, family therapy, self-help groups, and holistic methods. Ways to ensure this include:

  • Counseling sessions that are individual, group therapy, and with family.
  • Modify destructive thoughts and behaviors that lead to substance abuse.
  • Build self-esteem.
  • Control symptoms of ADHD with behavioral modification and the right medication.
  • Identify triggers and teach patients to manage impulses.
  • Educate the people that are closest to the patient in order to best support them.

The medication for ADHD helps keep patients from using drugs and alcohol because it evens out the symptoms that would cause substance abuse. It takes a lot more than that though. When it comes to self-esteem and other emotions that generally come with ADHD, it’s important to explore activities that make you feel good. With any dual diagnosis treatment plan, they will promote exercise and diet along with therapy.

Exercising and maintaining a diet that feeds you necessary nutrients can great help how severe your ADD/ADHD is. Many substances deplete your body from necessary nutrients as well. If you’re being treated for a co-occurring disorder, it’s beneficial in many ways to eat right. A healthy diet should include a low carb diet so balance out blood sugar. This also promotes an evenness of mood and energy levels.

Exercise can highly improve many aspects of both ADHD and substance addiction. Not only is your mood stabilized, but you also gain greater self-esteem. Self-love through pushing yourself with exercise and acknowledging how strong and capable you are can help you stay clean. Rigorous exercise is recommended as well as balance type exercises. Yoga has been found to increase ones ability to focus because it impacts hypothalamic functioning.

Why Therapy is Important for ADHD and Addiction

The afflictions that those with ADHD have to deal with need to be dealt with in order to ensure that they don’t continue drinking or abusing drugs. The lack of confidence, isolation, and low self-esteem that those with ADHD suffer from make it hard to cope with the realities of life. They have great psychological distress along with symptoms of reckless behavior from the disorder. All of this needs to be addressed properly if recovery is to be successful.

A therapist can help patients understand their disorder. They will work together so the patient will see their disorder and self-worth are two different entities. They will also learn important coping skills for the incurable disorder. Therapists will also help patients to create the habit of organizing their day so they can better manage life and responsibilities. When someone with ADHD is disorganized, this is where they can become highly frustrating or bored. Along with medication that helps to alleviate the symptoms, dual diagnosis therapy for substance addiction and ADHD is the best hope for a full recovery.

Group Therapy

Addicts have long benefitted with their recovery by going to group therapy. This is often something they will participate in after inpatient or outpatient addiction therapy. It’s a long-term recovery tool that many believe is highly effective. For those with ADD and ADHD, it might be even more necessary. It’s important to have consistent reinforcement of the lessons learned in recovery. For those who have a hard time focusing on long-term goals, reminders of recovery techniques in their daily life is essential. Meeting offer structure as well which is good practice for those with the disorder.

Addicts with ADHD tend to isolate themselves. Aftercare peer groups are designed to accept any and all people that want to help themselves. This puts someone with the disorder in a unique position of being accepted for who they are. This may be the first time in their life they’ve been listened to and perhaps are receiving true compassion for the first time. Groups like AA and Na are a safe space for social support. Long-time friendships can be formed with people that understand each others struggles.

Additionally, many ADD/ADHD patients in recovery find aftercare peer groups such as AA or NA great places for social support, often making lasting friendships with like minded people. Many alcoholics in recovery suffer from ADD/ADHD, and there can be an understanding and fellowship in recovery groups that is hard to find in regular society. Sober support helps.

Professional Therapy for Co-Occurring Disorder

Due to the nature of this complex disorder, it’s recommended that an addict attend inpatient or outpatient addiction therapy. It takes a lot of support and attention to help someone with co-occurring disorder. The skills and training that addiction specialists have will make a patient feel hope. Recovery programs can treat both conditions at the same time. Addiction will be treated first and then further treatment will get to the nature of ADHD. Rehabilitation may be necessary for quite some time, especially for the addiction. From there, as the patient begins to understand what ADHD does to them, they can begin to use the tools to manage the disorder. Once one part of the co-occurring disorder has been treated, it becomes much easier to treat and manage the other disorder. Clarity can be gained, making it easier to tackle the original disorder that lead to addiction in the first place.

Get Help for Your Co-Occurring Disorder Today

Here at Women’s Recovery, we want you to know that we understand the pain of your dual diagnosis addiction. However, with the right support, you can get the help you need to successfully recover.

Our program is designed to provide you with the help you need during this critical time. Do you have questions about dual diagnosis addiction, or how to get recovery assistance? Please contact us right away.