Substance Abuse and ADHD

September 14, 2009

 

If you are diagnosed with ADHD then you should know you are also at a higher risk for developing alcohol or other substance abuse problems. 52% of individuals who are diagnosed with ADD will have to deal with substance abuse during their lifetimes.

In a study of young adults with ADHD, Timothy Wilens, M.D., associate professor of psychiatry at Harvard Medical School said, “70 percent were using substances (not to get high, but) to improve their mood, to sleep better, or for other reasons”.

Many of my clients who have abused cocaine, alcohol or marijuana say that when they first started using, the drugs helped them concentrate, they made fewer “stupid” decisions and most of all they felt much calmer. The term “self-medicating” is used to describe this type of use.

“When people with ADHD get older, the hyperactive component often diminishes,” says William Dodson, M.D., an ADHD specialist, “but inside, they’re just as hyper as ever. They need something to calm their brain enough to be productive.”

Treating ADHD with medications appears to reduce the tendency to abuse drugs and alcohol. In a study at MGH and Harvard Medical School, 75 percent of boys diagnosed with ADHD and not receiving medication started abusing marijuana, alcohol, hallucinogens, stimulants, or cocaine within 4 years of the study’s beginning, while only 25 percent of the boys diagnosed with ADHD and taking medication and 18 percent of the boys without ADHD did. This means the medications reduced the risk of substance abuse or dependence by 84 percent.

When I first started treating high functioning adults with ADHD there was a debate about whether to first treat the ADHD or the substance abuse; many people felt it wasn’t effective to deal with both at the same time. I encouraged my patients to tackle the two issues together and I’m pleased to see that that is now the accepted approach.

We have research to show that the combination of medication where necessary along with therapy is a potent approach to many mental health issues. My experience shows that this is certainly true for the treatment for ADHD. Medication, therapy, coaching or a blend of these approaches helps my clients manage their lives more effectively including managing their substance use and abuse.

How can you tell if you’re on the road to abusing alcohol? These statistics from William R. Miller and Ricardo F. Munoz’s, “How to Control your Drinking: A Practical Guide to Responsible Drinking” (1982) give some guidance on how Americans drink. Where do you fall?

  • Over 80% drink less than 3 or more drinks per week or not at all (32%)
  • Only 16-18% drink at least 10-13 drinks per week (about 2 per day on average)
  • Only 11% drink 20 drinks per week (about 3 per day on average)
  • Only 6% drink 40 drinks per week (about 6 per day on average)
  • Only 3% drink 10 or more per day

If you would like to take a closer look at your substance use, I’d encourage you to get an experienced professional’s help in evaluating whether you need to make some changes.

Szifra Birke, M.S.

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