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Let's talk about ADHD and addiction.
Or rather, let's have a go at a nuanced take on this, instead of the typical "but they'll ABUSE STIMULANTS~" conversation.
Or rather, let's have a go at a nuanced take on this, instead of the typical "but they'll ABUSE STIMULANTS~" conversation.
Facts first: While estimates vary, we know that a large percentage of people struggling with substance abuse meet the criteria for ADHD, and vice versa.
Yet this isn't something that's talked about very much, in large part because folks are afraid to have their meds taken away.
Yet this isn't something that's talked about very much, in large part because folks are afraid to have their meds taken away.
However, the majority of folks with ADHD who are abusing substances are (by and large) falling into two groups:
(1) Folks self-medicating with stimulants to try to regulate their ADHD,
(2) Folks abusing alcohol and cannabis to cut down on their hyperactivity/slow down.
(1) Folks self-medicating with stimulants to try to regulate their ADHD,
(2) Folks abusing alcohol and cannabis to cut down on their hyperactivity/slow down.
Which isn't to say there aren't folks with ADHD who have a different relationship to substances! But this information becomes important in determining how to care for folks abusing substances with co-occurring ADHD.
There are prescribers who won't treat folks with ADHD with stimulants if they have any history whatsoever of substance abuse.
However! The percentage of folks with ADHD abusing stimulants versus those without? Drastically different. ADHD folks = exceedingly more "med compliant."
However! The percentage of folks with ADHD abusing stimulants versus those without? Drastically different. ADHD folks = exceedingly more "med compliant."
If we know that the majority of ADHD folks with co-occurring substance abuse issues are self-medicating in some way... it stands to reason that we might actually, I don't know, offer them proper medication?
My drugs of choice, like most people with ADHD, were alcohol and cannabis. It helped to cut down the hyperactivity. It helped me tolerate the restlessness and unbearable boredom that comes with ADHD.
Like many undiagnosed/unmedicated ADHDers, I unknowingly was drawn to substances that were downers, because I was self-medicating for hyperactivity.
Without stimulant medication, I likely still would be.
Without stimulant medication, I likely still would be.
ADHD brains also have a lower tolerance for negative emotions, difficulty delaying gratification, and are struggling to get the necessary dopamine to function optimally... all of this sets us up to seek out substances without proper treatment.
Are there folks with ADHD who can't be on stimulant medication? Absolutely!
Does this mean that every person with ADHD and co-occurring addiction can't be on stimulant medication? Nope!
Does this mean that every person with ADHD and co-occurring addiction can't be on stimulant medication? Nope!
The real trouble with ADHD and addiction isn't that ADHD sets us up to fail... it's that a system that isn't properly intervening and treating ADHD results in a large percentage turning to self-medication when no other options are available.
And this is true of many mental health conditions! But it's particularly tricky with ADHD, as some of the very best treatments we have involve controlled substances.
Which is why this conversation is one that involves so, so much nuance.
Which is why this conversation is one that involves so, so much nuance.
I was incredibly fortunate to have found a psychiatrist who understood that my risk for relapse was actually MUCH higher without properly medicating my ADHD. But too many folks at this intersection aren't getting the care they need and deserve.
If you have ADHD and you struggle with substance abuse, you aren't alone. So many of us have been there.
You deserve to have a clinician that will advocate for the best possible care — without letting stigma and skepticism dictate what those treatments are.
You deserve to have a clinician that will advocate for the best possible care — without letting stigma and skepticism dictate what those treatments are.
Nowadays? Drinking makes me sleepy, so I don't. Cannabis makes me anxious, so I largely avoid it. I no longer feel the urgency I did before, because my ADHD is being properly treated.
And no, I didn't end up "addicted" to Adderall. I got my life back — and it's amazing.
And no, I didn't end up "addicted" to Adderall. I got my life back — and it's amazing.
Regardless of how your ADHD shows up, I think a few things are true:
1. Your situation is unique and deserves to be treated as such.
2. You deserve to be trusted by your clinicians.
3. Your relationship to substances now (or in the past) doesn't have to define your future.
1. Your situation is unique and deserves to be treated as such.
2. You deserve to be trusted by your clinicians.
3. Your relationship to substances now (or in the past) doesn't have to define your future.
Anyway. Let me link some resources for you all!
First, this piece by @alainaskeys: https://www.healthline.com/health/mental-health/adhd-and-addiction
First, this piece by @alainaskeys: https://www.healthline.com/health/mental-health/adhd-and-addiction
And a piece I wrote about being afraid to take Adderall because of these myths: https://www.additudemag.com/adhd-adderall-stigma/
I completely forgot to mention! This was a Twitter thread requested by one of my patrons. If you have an idea for a topic or question you'd like me to cover, hop on over, sign up, and submit your ideas! https://www.patreon.com/samdylanfinch?fan_landing=true
