Need Help with ADHD and Alcohol?
Attention Deficit Hyperactivity Disorder (ADHD), is a neurodevelopmental disorder characterised by inattention, impulsivity, and hyperactivity. This condition increases the risk of developing alcoholism due to self-regulation difficulties, trauma sensitivity and dopamine-seeking behaviours. These behaviours overlap with those seen in addiction, making alcohol a common coping mechanism.
Research shows that ADHD is 5 to 10 times more common in adults with alcohol addiction than without.2 This page will look at the shared characteristics and underlying factors that increase the risk of alcohol addiction in people with ADHD and why these co-occurring conditions go together.
Is ADHD Genetic?
ADHD has a strong genetic component with up to 70% of cases inherited.3 If one or both parents have ADHD – especially if it is undiagnosed – they may have developed ways to self-medicate, such as using alcohol to manage their ADHD symptoms. This generational pattern increases the risk that children of parents who have alcohol use disorders will also develop both ADHD and alcohol use disorders at some stage.
Why Are People with ADHD More Impulsive and Socially Vulnerable?
People with ADHD are more prone to impulsive behaviours which can lead to risky decisions including excessive alcohol use. They also struggle with social cues and peer interactions so are more susceptible to external influences including peer pressure. Undiagnosed individuals may use alcohol as a way to self-medicate and this increases the risk of addiction.
High Comorbidity Rates
ADHD often comes with other mental health conditions like depression and anxiety which also increase the risk of alcohol misuse. However, research shows that people who are on ADHD medication are less likely to develop an alcohol use disorder so early diagnosis and treatment are key.4
This condition is comorbid with depression and anxiety which are both well-documented to be linked to alcohol and drug misuse. The combination of ADHD and these other mental health problems increases the risk of alcohol addiction. Addressing these comorbidities is key to preventing the progression from ADHD to alcoholism.
The Role of Dopamine in ADHD and Alcoholism
Dopamine, a neurotransmitter involved in mood regulation and impulse control, is at the heart of the ADHD and alcoholism connection. People with ADHD have dysregulated dopamine systems and so are constantly searching for activities or substances that increase dopamine levels – like alcohol.5
This dopamine-seeking behaviour can create a vicious cycle where alcohol is used to temporarily alleviate the discomfort of low dopamine levels. Over time this self-medicating behaviour can lead to addiction as the brain becomes dependent on alcohol to maintain dopamine levels and emotional balance.
Why Do People with ADHD Self-Medicate with Alcohol?
People with ADHD struggle with emotional regulation and stress management so are more prone to self-medicating behaviours. From a young age self-soothing behaviours – like thumb sucking or other repetitive behaviours – are common in neurodivergent people. As they get older these behaviours may evolve into more harmful coping mechanisms like alcohol use.6
Using alcohol as a replacement for childhood self-soothing behaviours is particularly concerning as it can lead to dependency and addiction early on in life, especially in those with underlying ADHD.
Living with ADHD or alcohol addiction can feel isolating enough on its own, but struggling with both can be overwhelming, as each condition can exacerbate the other. At Castle Craig, we understand how difficult it is trying to cope with both of these struggles, and we’re here to help. Contact our team today to start your recovery journey.
Alcohol and the ADHD Brain
Drinking alcohol can significantly impact the ADHD brain, making ADHD symptoms worse rather than alleviating them. Alcohol affects executive functioning, impairing essential cognitive abilities like planning, impulse control, and decision-making.
While alcohol interactions may temporarily increase dopamine levels and provide a false sense of relief, this can lead to dependence, as the brain starts relying on alcohol for dopamine release. Although drinking alcohol might seem to calm hyperactivity or reduce anxiety in the short term, it ultimately exacerbates attention and hyperactivity issues, increasing the risk of addiction.
Alcohol interactions with ADHD medications can also reduce their effectiveness, causing ADHD symptoms to worsen and potentially leading to increased side effects when taking ADHD medication.
How Does Trauma and Emotional Sensitivity Affect Those with ADHD?
ADHD also makes people more sensitive to rejection and emotional dysregulation so are more prone to traumatic experiences. Their impulsive nature can lead to situations that result in trauma and combined with a genetic predisposition can create a cycle of generational trauma.
Children of undiagnosed parents with ADHD are at even higher risk as they are exposed to both the genetic factors and the environmental stressors that contribute to addiction. This overlap of trauma and ADHD increases the risk of alcohol addiction.
Peer Pressure and Social Isolation
People with ADHD feel isolated or like they don’t fit in with their peers. This feeling of alienation combined with their impulsive nature makes them more prone to peer pressure. In an attempt to please others or feel accepted, they may engage in risky behaviours including alcohol use which can quickly lead to addiction.
Effective Treatment Strategies
Fortunately, the correct support and treatment can reduce the risk of substance misuse in people with ADHD. Stimulant medications that increase noradrenaline and dopamine reuptake have been shown to decrease dopamine-seeking behaviours and reduce the risk of alcohol addiction.
For the best outcomes, it’s essential to treat both ADHD and any comorbid conditions at the same time. A comprehensive approach that includes self-help strategies (balanced diet, omega 3 supplements, zinc, exercise), treatments (detox and rehab programmes, CBT) and psychiatric care (medication management for ADHD and comorbidities) is the way to recovery.
Treatment for ADHD and Alcohol Addiction at Castle Craig
At Castle Craig, co-occurring disorders such as ADHD and alcoholism are approached with an integrated treatment plan designed to address both conditions. Our medical team follow the Royal College of Psychiatry guidelines that state that stimulant medications should be avoided in patients with unstable addiction disorders.7 NICE guidelines also recommend avoiding stimulants in this population of patients, therefore we do not prescribe them.
“At Castle Craig, we take the problems associated with ADHD very seriously and provide tailored approaches for these patients. There is a lot of good quality research showing that behavioural interventions are effective in adult ADHD.
We provide structured psychological interventions focused on ADHD including cognitive behavioural therapy interventions with one of our CBT-trained therapists. We directly support patients to find specific executive functioning tools that work for them to improve deficits they have in organisation, planning and concentration.
Our treatment plans provide emotional regulation skills groups to address difficulties with regulating emotions and increased impulsive behaviour, both of which are found more in people with ADHD. In patients who don’t respond to these measures, we would provide a psychiatric assessment to determine if a non-stimulant medication such as Atomoxetine would be appropriate.”
– Dr Peter McCann
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References
- Attention deficit hyperactivity disorder and future alcohol outcomes: Examining the roles of coping and enhancement drinking motives among young men.
- ADHD and Substance Abuse. Is there a risk?
- ADHD Causes: Is ADHD genetic?
- Attention deficit hyperactivity disorder and comorbidity: A review of literature.
- The Clinically Meaningful Link Between Alcohol Use and Attention Deficit Hyperactivity Disorder. Alcohol Res Health. 2002;26
- Do Individuals with ADHD Self-Medicate with Cigarettes and Substances of Abuse? Results from a Controlled Family Study of ADHD. The American Journal on Addictions, 16: 14-23.
- Royal College of Psychiatrists. ADHD in Adults: Good Practice Guidelines
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