The Connection Between ADHD and Addiction

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that affects focus, organization, impulsivity and related areas. Individuals with ADHD rarely just have ADHD. People with ADHD frequently also experience difficulties with anxiety, depression, and other mental health challenges (Ramsay, 2020). One common mental health challenge that appears to be especially associated with ADHD is addiction. In fact, those with ADHD are as much as 2-3 times more likely to develop an addiction compared to those without it (Frank, 2024). It's worth asking - why? What’s the connection between ADHD, substance use, and addiction, and why are individuals with ADHD so much more likely to experience addiction-related challenges? Read on to learn about the connection between ADHD and addiction. 

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Impulsivity and Risk-Taking Behavior

One of the hallmark traits of ADHD is impulsivity. People with ADHD are more likely to act without thinking, engage in risky behaviours, and seek instant gratification. This means they are not only more likely to try substances like alcohol, nicotine, and drugs, but they also have a harder time resisting continued use once they develop a dependence. Many find that depressants like alcohol or marijuana provide a bit of relief from the constant buzz and restlessness, as well as increased stress and anxiety that can come with ADHD. It can feel like a useful, easy-to-access way to feel better quickly which, unfortunately, can increase the likelihood of addiction. Individuals with ADHD are also more likely to engage in other addictive behaviours outside of substance use, including porn and sex addiction, gambling, and addictive patterns of excessive video game use (Bőthe et al., 2019; Theule et al., 2019; Matthews et al., 2019). ADHD brains are more likely to tell people to go and struggle with following instructions to stop. The impulse control issues that can be a part of ADHD can predispose individuals with this disorder to a significantly greater risk of addictive behavioural patterns. 

ADHD brains are more likely to tell people to go and struggle with following instructions to stop. 

The Dangers of Self-Medication

ADHD is commonly treated with stimulant medications like Adderall or Ritalin, which can help improve focus and impulse control. However, for a variety of reasons including stigma and fear of dependence on prescription drugs, individuals with ADHD may choose to self-medicate instead. Ironically, studies show that proper ADHD treatment with medication actually lowers the risk of addiction, yet many avoid it, fearing they’ll become reliant on it and develop an addiction (Frank, 2024). Instead, they may turn to substances like marijuana, which is often viewed as a “natural” alternative to ADHD medication. While marijuana may initially help with restlessness and anxiety, using marijuana over time can actually make ADHD symptoms worse, making it harder to focus and think clearly (Stueber et al., 2021). This can create a vicious cycle of self-medication and increasing reliance on substances. Paradoxically, the fear of medication dependence leads some to substance dependence. 

Social and Environmental Factors

Challenges with ADHD are not just limited to core attention or impulsivity difficulties. Many children and teenagers with ADHD face academic and social challenges, leading to frustration, isolation, and low self-esteem. These challenges might push them to engage in risky behaviours like substance use as they seek out a way to cope with stress, anxiety, and difficult emotions. 

Peer pressure can also play a significant role, especially for younger individuals. Because of their impulsivity and desire to fit in, young people with ADHD might find themselves hanging out with a more behaviourally challenged yet ‘cool’ and socially desirable crowd. As a result, they may have more exposure to others using substances and modelling addictive behaviour, influencing young people with ADHD to mirror the behaviour that they are seeing their peers engage in. 

What starts as experimenting can quickly shift to regular use, especially if they feel that it helps them manage their emotions or connect with others. For adults with ADHD, challenges don’t disappear - they just take different forms. Many struggle with stress, emotional regulation, and workplace challenges, which can also lead some to turn to alcohol, drugs, or other forms of addiction as a coping strategy. If ADHD goes undiagnosed or untreated, those struggles can ramp up, making the risk of developing an addiction even higher.

For adults with ADHD, challenges don’t disappear - they just take different forms.

The Challenges of Addiction Treatment for People with ADHD

Even after acknowledging the issue, those with ADHD face unique challenges in addiction recovery. Many addiction treatment programs follow structured, step-by-step approaches, which can be particularly difficult for individuals with ADHD who struggle with organization, focus, and long-term goal-setting. This is why a personalized approach to addiction treatment is necessary and especially important for this population. Treatment plans should consider both ADHD and addiction, incorporating strategies that accommodate difficulties with focus and impulse control. Therapy, particularly Cognitive Behavioral Therapy (CBT), can be highly beneficial in helping individuals manage both conditions (Van Emmerik-van Oortmerssen et al., 2019).

Finding the Right Balance in Treatment

ADHD medications can complicate recovery as well. Stimulants like Adderall and Ritalin work well for many people but can be misused, especially for someone already struggling with addiction. This creates a difficult situation; individuals with ADHD need the medication to manage their ADHD symptoms, but those same medications can pose a risk of dependency. For this reason, a holistic treatment plan may work best. This could include:

• Non-stimulant ADHD medications (like Strattera) that pose a lower risk of addiction

• Therapy to address emotional issues and challenging behavioural patterns

• Lifestyle changes such as establishing routines, regular exercise, and mindfulness practices

• Developing alternative, more helpful and less problematic stress and anxiety coping skills

It is also essential that physicians and mental health clinicians work together to develop a collaborative care plan, ensuring that medication and physical considerations are addressed, while a behavioural care plan is set in place. By addressing both ADHD and addiction simultaneously, individuals have a greater chance of achieving long-term recovery and leading a balanced, healthier life.

By addressing both ADHD and addiction simultaneously, individuals have a greater chance of achieving long-term recovery and leading a balanced, healthier life.

Conclusion

The link between ADHD and addiction is multidetermined. Neurobiological, behavioural, and lifestyle predispositions for individuals with ADHD all intersect to provide those with ADHD with an increased likelihood of experiencing addiction-related risk factors and of developing behavioural patterns of addiction. Understanding the connection between ADHD and addiction is crucial for effective prevention and treatment. ADHD increases the likelihood of addiction due to impulsivity, self-medication, and environmental factors, while addiction recovery presents additional challenges for those with ADHD. The good news is that with proper diagnosis, personalized treatment, and support, individuals with ADHD can successfully manage both ADHD and addiction. By breaking the cycle and seeking the right help - help that takes into account both ADHD and addiction - they can take control of their lives and build a healthier future.

If you are interested in support for ADHD and addiction, our team at Radcliffe Psychotherapy Clinic can help. We offer therapy for ADHD and addiction, including Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, mindfulness, and support for ADHD-related challenges in adults, teens, and children in Toronto and throughout Ontario.

Contact Radcliffe Psychotherapy Clinic at (289) 801-4133, admin@angerandanxiety.com, or book a consultation at https://sra.janeapp.com/. To see a full list of our Toronto and Ontario based-therapists who specialize in ADHD therapy, visit our Toronto ADHD therapy page.

This article was written by Hadassah Luss, MSW, RSW, a Registered Social Worker at Radcliffe Psychotherapy Clinic. To learn more about Hadassah or to book a session with her, please visit her booking page https://www.angerandanxiety.com/hadassah-luss.

Medical Disclaimer

This article is written by an Ontario-based Registered Social Worker with experience in ADHD and addiction treatment for children, teens, and adults. The information provided is based on current research and clinical experience but is for informational purposes only. Readers should consult a qualified medical professional for specific guidance regarding addiction, and ADHD treatment tailored to their specific circumstances. The information in this article should not be interpreted as medical advice, diagnosis, or treatment. Decisions regarding ADHD, addiction, and mental health treatment, should always be made in consultation with a qualified healthcare provider. For individualized mental health support, consult a registered mental health professional.

References

Bőthe, B., Koós, M., Tóth-Király, I., Orosz, G., & Demetrovics, Z. (2019). Investigating the associations of adult ADHD symptoms, hypersexuality, and problematic pornography use among men and women on a large scale, non-clinical sample. The Journal of Sexual Medicine, 16(4), 489-499.

Frank, C. (2024). ADHD and substance abuse. Child Mind Institute. https://childmind.org/article/adhd-and-substance-abuse/#full_article

Mathews, C. L., Morrell, H. E., & Molle, J. E. (2019). Video game addiction, ADHD symptomatology, and video game reinforcement. The American journal of drug and alcohol abuse, 45(1), 67-76.

Stueber, A., & Cuttler, C. (2021). Self-reported effects of cannabis on ADHD symptoms, ADHD medication side effects, and ADHD-related executive dysfunction. Journal of Attention Disorders, 26(6), 942–955. https://doi.org/10.1177/10870547211050949

Theule, J., Hurl, K. E., Cheung, K., Ward, M., & Henrikson, B. (2019). Exploring the relationships between problem gambling and ADHD: A meta-analysis. Journal of attention disorders, 23(12), 1427-1437.

Ramsay, J. R. (2020). Rethinking adult ADHD: Helping clients turn intentions into actions. American Psychological Association.

Van Emmerik-van Oortmerssen, K., Vedel, E., Kramer, F. J., Blankers, M., Dekker, J. J. M., van den Brink, W., & Schoevers, R. A. (2019). Integrated cognitive behavioral therapy for ADHD in adult substance use disorder patients: Results of a randomized clinical trial. Drug and alcohol dependence, 197, 28–36. https://doi.org/10.1016/j.drugalcdep.2018.12.023