ADHD And Substance Abuse. Articles, Blog Posts And Books

While adults with ADHD are only 5% of the population, ADDers are dramatically over-represented in people with substance abuse.

The SMALLEST numbers I’ve seen on ADHD and substance abuse are 20-25%+ in peer-reviewed clinical journals in Pub Med, and I’ve frequently seen much larger ones. Substance abuse is one of the most damaging ADHD problems.

If adults with ADHD aren’t diagnosed and treated, and 85% of them aren’t, they will find ways to treat themselves or self-medicate with chemical substance abuse, like alcohol, tobacco, marijuana, illegal drugs, and food.

Or self-medicate with behavioural substance abuse, like TV, internet, videogames, shopping, gambling etc.

Unfortunately, as many former substance abusers have told me, many Adders going through rehab or drug and alcohol counselling, aren’t told about the connections between Attention Deficit Hyperactivity Disorder and substance abuse, which will make it harder for them to stop and stay sober.

Articles on ADHD and Substance Abuse

Severity of ADHD in Children Increases Risk of Drug Use in Adolescence

says a longitudinal study in The Journal of Abnormal Psychology. “Those children with the most severe attention problems in childhood were most at risk for alcohol and marijuana problems and cigarette smoking by their teens. Executive functions associated with inattention and not impulsivity-hyperactivity may be at the root of the progression to substance use.”

The Economic Costs Of ADHD

By Dr. Margaret Weiss MD, Ph.D

I’m just including 4 slides from her great presentation on the economic costs of ADHD you should read the whole slide deck and show parts of it to your politicians and reporters.

It’s designed to make the case for governments and medical bureaucracies and others to take ADHD seriously and develop policies on it vs the current neglect or harm they all do whether it’s a left-wing, centrist or right-wing government.

Or show it to anyone denying ADHD is real or minimizing the costs and impact of ADHD.

Substance use disorders in adolescents with ADHD. Non medicated ADHD, Medicated ADHD vs Non-ADHD Controls

ADHD and smoking in adults

Stimulant treatment of ADHD in youth was associated with a 2-fold reduction in risk for Substance Use Disorder

High prevalence of ADHD in youths. High risk of youths with ADHD developing Substance Use Disorders. So the identification and treatment of youths with ADHD may affect a large segment of the adolescent and young adult populations at risk for Substance Use Disorders.

Those With ADHD Are More Likely To Get Addicted to Opioids

I called into Canada’s national broadcaster the CBC’s Cross Country Checkup and they did a blog post on it, the audio and the transcription.

“For example, look at people with ADHD. If you look at the actual research, 47 percent of teen prescription opioid abusers had ADHD (21% used heroin).

33% of methadone patients had ADHD.

Thirty-five percent of cocaine users have ADHD. Five percent of adults have ADHD.

If we’re four to nine times more likely to self-medicate with legal drugs, why aren’t we getting properly diagnosed?

Why aren’t we being properly screened?

Why aren’t rehabs looking for ADHD?”

So, the B.C. government, as well as governments across this country, are not taking ADHD seriously.

They’re not properly training doctors, psychologists and psychiatrists to be able to diagnose and treat.

And if we’re four to nine times more likely to abuse drugs or alcohol, shouldn’t we mandate doctors to be able to diagnose and treat ADHD?

I live in the third biggest city in Canada. I have been emailing out a list of people who can diagnose ADHD since 2003.

I’ve sent that out thousands of times. I don’t live in a tiny, small hamlet of 50 people and I can guarantee outside of Metro Vancouver it’s even worse.”

ADD, Alcoholism and Other Addictions

Wendy Richardson explores how some ADD people self-medicate. She’s also the author of these 2 books on ADHD and substance use.

Attention Deficit Disorder Impulsivity Symptoms and Internet Addiction

Psychiatry and Clinical Neurosciences, Volume 58 Issue 5 Page 487 – October 2004. Evaluates the relationship between the two.

I believe that the internet is like crack cocaine for ADDers. Many of my Adult ADHD coaching clients have problems spending too much time on the internet. I’ve also heard other ADHD professionals talk about the huge problems ADDers have with the internet.

Does Stimulant Therapy of ADHD Beget Later Substance Abuse? A Meta-analytic Review of the Literature.

By the Clinical Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Boston, Harvard Medical School, Pediatrics 2003.

Conclusion? No. They found it actually reduced the risk of later substance abuse.

Children on Methylphenidate Less Likely to Abuse Drugs

“Pre-teens who have been treated with methylphenidate may develop an aversion to abusable drugs, according to a team of researchers from Harvard Medical School.

The Harvard study also rebuts arguments that treating children with stimulants such as Ritalin, Concerta or other medications containing methylphenidate may lead to later substance abuse.”

Deep Cravings

Harvard Magazine. Great article on understanding the process of substance abuse focused on new understanding of neurochemistry.

“…draws a parallel between the hormonal responses caused by cocaine and those associated with thrilling or frightening pursuits like hang-gliding and bungee-cord jumping:

“Cocaine triggers major stress hormones like epinephrine [adrenaline], norepinephrine, adrenocorticotropic hormone [ACTH], and serotonin. These are the same ones that surge up during bungee jumping.”

Impact of ADHD and Its Treatment on Substance Abuse in Adults

8 page PDF By Timothy E. Wilens, M.D. J Clin Psychiatry.

Discusses the prevalence of ADHD and substance abuse, course of substance use disorders in adults with ADHD, connections between substance use and ADHD, stimulants and substance abuse, treatment of adults with ADHD and substance abuse, ADHD medications, concerns and monitoring.

Investigating the Associations Of Adult ADHD Symptoms, Hypersexuality, and Problematic Pornography Use Among Men and Women on a Largescale, Non-Clinical Sample

The Journal of Sexual Medicine. By Beáta Bőthe MA, Mónika Koós BA István Tóth-Király MA, Gábor Orosz Ph.D., Zsolt Demetrovics DSc.

“Aim:
To (i) examine ADHD symptoms in relation to hypersexuality and PPU and (ii) identify possible similarities and differences in relationship with hypersexuality and PPU in a large, (14,043 participants) non-clinical sample between both sexes.

Results
Results indicated that hypersexuality had positive and moderate association with problematic pornography use among women (r[14041] = .50, P < .01) and positive and strong association among men (r[14041] = .70, P < .01). ADHD symptoms had positive and moderate associations with hypersexuality in both men and women (β = .50, P < .01; β = .43; P < .01; respectively). Regarding men, ADHD symptoms had a positive, moderate association with PPU (β = .45, P < .01), whereas ADHD symptoms had a positive, but weak, association with PPU, problematic pornography use in the case of women (β = .26, P < .01).

Clinical Implications
When men have high levels of hypersexuality or PPU, ADHD should be assessed as a potential comorbid disorder. With regard to women, ADHD should be assessed as a potential comorbid disorder only in the case of hypersexuality.

Conclusion
ADHD symptoms might play an important role in the severity of hypersexuality between both sexes, whereas ADHD symptoms might only play a stronger role in PPU among men but not women.

The findings corroborate previous results that PPU may not be unambiguously considered as a subcategory of hypersexuality. In addition, potential background mechanisms behind problematic pornography use should be examined separately between men and women.”

Long-Acting Stimulants for the Treatment of ADD in Cocaine-Dependant Adults

Ricardo Castaneda, M.D.,Robert Levy, M.D.,Marcos Hardy, M.D., Ph.D.,Manuel Trujillo, M.D. “This column offers recommendations about the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) among cocaine-dependent adults based on our year-long study of long-acting stimulants in the treatment of patients with these disorders.

The lack of phenomenological information about these comorbid disorders hinders diagnostic and treatment efforts by clinicians.”

Blog Posts on ADHD and Substance Use.

30% of Teenage Cannabis Users in Outpatient Study had ADHD

30% of the teenage pot smokers in a study of 600 adolescent cannabis abusers in outpatient treatment had ADHD.

Only 8% of kids and 5% of adults have Attention Deficit Hyperactivity Disorder.

“Only 20% of the participants perceived any need for help with problems associated with their drug or alcohol use.

Clients participating in the study typically presented multiple problems at treatment entry, most often including conduct disorder, attention deficit hyperactivity disorder (ADHD), internal (mental) distress, and physical health distress.”

33% of Alcoholics had ADHD 65% of Drug Users Had ADHD Study

From the Journal Alcohol and Alcoholism.

“CONCLUSIONS: These results reveal that habit-forming illnesses can be associated with a high comorbidity with ADHD, expressed in the form of alcohol abuse and also in the consumption of illegal drugs.

The results underline the great importance of early and adequate diagnostics and therapy of ADHD for the prevention of habit-forming illnesses.”

ADHD And Substance Use 5 More Clinical Studies

ADHD adults are 5% of the population, but check out these clinical peer-reviewed studies.

35% of Cocaine Abusers had ADHD

24% of Psychoactive Substance Abusers had ADHD

32% of Cocaine Users and Alcoholics had ADHD

70% of Crystal Meth (Methamphetamine) Inpatients had ADHD

83% of Inhalant Abusers and 55% of Methamphetamine Abusers in Japan had ADHD.

ADHD and Crystal Meth, the missing connection

I’ve blogged about this in 3 parts on my Adult ADD Strengths blog. Here’s one quote

“One third of the subjects (32%) who began using between the ages of 10 and 15 reported doing so because of the calming effect that methamphetamine had on them. These participants were classified using the Wender Utah Rating Scale as having ADHD symptomatology”

ADD Crystal Meth Connection Part One Part Two Part Three

Books on ADHD and Addictions

Overload: Attention Deficit Disorder and the Addictive Brain

by David K. Miller and Kenneth Blum

“This fascinating collaborative effort explores many of the causes, cases and concerns surrounding ADD. With the insights of clinician Dave Miller and scientist Ken Blum, Overload gives an in-depth picture of what attention deficit hyperactivity disorder really looks like, how it’s related to addiction, and how it happens in certain people.”

The Twelve Steps–A Guide for Adults with Attention Deficit Disorder

By Friends in Recovery

“A spiritual resource that applies the 12 steps of Alcoholics Anonymous to adults with Attention Deficit Disorder in a way that combines structure, self-discovery and the support of others with the proven spiritual principles of the 12 steps.”

The Link Between A.D.D and Addiction: Getting the Help You Deserve

By Wendy Richardson

“As many as 50% of people with Attention Deficit Disorder (ADD) use drugs, alcohol, and other addictive behaviours to self-medicate their ADD symptoms. Here’s what you need to know to get help or help others in this situation.

Includes:

• self tests
• checklists of symptoms
• practical solutions”

When Too Much Isn’t Enough: Ending the Destructive Cycle of ADHD and Addictive Behavior

By Wendy Richardson

“This insightful book takes a thorough look at the link between AD/HD and addiction and offers tips on how to combat its devastating effects.”

In the Realm of Hungry Ghosts: Close Encounters with Addiction

By Dr. Gabor Mate who has ADHD and has written a book on ADHD, Scattered Minds: A New Look At the Origins and Healing of Attention Deficit Disorder, was a staff doctor at the Portland Hotel, in Vancouver’s downtown east side the poorest postal code in Canada, home to many with substance use and addictions and many of them have ADHD.

This book gives very personal stories of some of his patients with addictions and he talks about the root causes of addiction the different types of substance abuse (it’s not all booze and drugs) and what should be done about the problem.