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Substance Use and ADHD: What is the Link?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. It affects both children and adults, often impairing various aspects of daily function. Undiagnosed ADHD can lead people to seek coping mechanisms to manage their symptoms, which sometimes involves self-medication through substance use. Undiagnosed ADHD is a significant concern among young people in particular, as it can interfere with academic performance, social relationships, and overall well-being.

According to the Centre for ADHD Awareness, ADHD affects approximately 5-7% of children and 4-6% of adults in Canada. However, many cases of ADHD go undiagnosed, leaving a substantial number of people without appropriate support and treatment. The relationship between substance use and undiagnosed ADHD, may shed light on the upsurge in stimulant use over the past few years.

Undiagnosed ADHD and Substance Use

According to a study published in the Journal of Attention Disorders, undiagnosed ADHD was associated with an increased risk of substance use disorders, including alcohol, tobacco, and restricted substances. The self-medication hypothesis suggests that individuals with undiagnosed ADHD may use substances as a means of self-regulation. 

The stimulant effects of certain substances, such as nicotine or illicit drugs like cocaine or amphetamines, can temporarily alleviate ADHD symptoms, providing a sense of focus and calmness. However, this self-medication approach can lead to a cycle of dependence and further exacerbate underlying ADHD symptoms.

Young People and ADHD

Young people are particularly vulnerable to this cycle, as a study published in the Journal of the American Academy of Child and Adolescent Psychiatry revealed that adolescents with undiagnosed ADHD were at a higher risk of developing substance use disorders compared to those without ADHD. The study found that by the age of 18, 35% of individuals with ADHD had a substance use disorder, emphasizing the urgent need for early intervention.

ADHD Treatment with Substance Use Disorder

Recognizing the link between SUD (Substance Use Disorder) and undiagnosed ADHD is crucial for effective intervention and treatment. Early diagnosis of ADHD and appropriate management can reduce the reliance on self-medication through substances. Evidence-based treatments, such as cognitive-behavioral therapy, can help individuals develop coping strategies, enhance self-regulation skills, and reduce the risk of substance use.

Risk Factors

There are also distinct gender differences in the manifestation of ADHD symptoms and substance use. While ADHD is more commonly diagnosed in boys, studies suggest that undiagnosed ADHD in girls may be associated with a higher risk of substance use. A study published in the Journal of Consulting and Clinical Psychology found that girls with undiagnosed ADHD were more likely to engage in substance use compared to girls without ADHD. Understanding these gender differences can help tailor interventions to address the specific needs of young people.

Neurodivergence and the Pandemic

The COVID-19 pandemic has also posed unique challenges for neurodivergent individuals, potentially contributing to a rise in unmonitored stimulant use to self-medicate. Understanding the relationship between neurodiversity like ADHD and substance use is crucial for providing appropriate support and interventions. The connection between unmonitored stimulant use, the overdose crisis, and the toxic drug supply underscores the urgent need for harm reduction strategies, improved access to evidence-based treatments, and efforts to ensure the safety of the drug supply.

Awareness and Early Intervention

Undiagnosed ADHD poses a significant risk factor for substance use, highlighting the importance of early identification and intervention. This is particularly true for young people who are especially susceptible. The association between undiagnosed ADHD and substance use can be attributed to self-medication for coping and management of symptoms, which can lead to Substance Abuse Disorder.

It is important to keep in mind age and gender differences when treating ADHD and managing SUD. The COVID-19 pandemic has also raised the risk of neurodivergent individuals using substances because of isolation. By promoting awareness, conducting comprehensive assessments, and providing appropriate treatments, individuals with undiagnosed ADHD can address symptoms effectively and reduce the potential harm associated with substance use.