Why ADHD And Drug Abuse Commonly Occur Together

According to psychiatric literature, as many as five percent of the American population deals with attention deficit hyperactivity disorder (ADHD), and half of those people may also have a problem with substance abuse. That’s because the two conditions frequently appear together, a relationship referred to as comorbidity. Because both stem from dysfunction in the reward system, it can be hard to untangle and treat the conditions simultaneously.

Connection Factors Between ADHD And Drug Addiction

Past studies of twins have shown a high comorbidity between ADHD and drug addiction. These studies point to shared genes which make a person more susceptible to both conditions. When a person has a genetic predisposition combined with environmental risk factors, the likelihood of the two conditions arising increases. To compound the problem, other studies reveal that people with ADHD are at greater risk for earlier onset of drug abuse, more serious abuse and a harder time remaining abstinent.

Diagnosing Adult ADHD

Both ADHD and substance abuse are diagnosed by using established tools which are essentially checklists of symptoms. In order to diagnose ADHD, a person must demonstrate a minimum of six symptoms of either hyperactivity or distractibility, but not necessarily symptoms in both categories. Doctors may be hesitant to diagnose adult ADHD, and even more so when a patient appears to be dealing with substance abuse as well, just because it requires a bit of detective work and a delicate balancing act in terms of treatment.

One way doctors can diagnose adult ADHD is by asking open-ended questions such as, “Why do you suspect that you may have ADHD?” this may result in symptoms being displayed without prodding. If this doesn’t happen right away, doctors can ask clarifying questions such as, “What does your work life look like?” or “Describe several of your closest relationships.” In terms of substance abuse, it is best to be forthright with questions such as, “Do you use any substances? “followed by, “Describe your substance use.”

A long-term picture will be the most accurate, so asking about grade school and high school experiences can be helpful. However, in some cases a parent may have performed the role of compensating presence – monitoring homework, ensuring the student was on time, helping them keep things organized, etc. – so with adult patients asking about college life or work life may actually provide the clearest idea of what symptoms are present. Whenever possible, having the added perspective of another person such as a spouse, parent or sibling is useful.

Symptoms Doctors Will Explore When Diagnosing ADHD

• Trouble focusing on a single task. The person has difficulty reading, leaves tasks unfinished, is not a good listener, engages in a lot of daydreaming and frequently loses things.
• Trouble staying focused. The person finds it hard to plan and organize. Time management is a problem issue. The person has difficult in recognizing potential consequences of actions.
• Trouble with motor control. The person exhibits restless, non-goal oriented movement and they can’t sit still for extended periods of time. It is important to note that the person who doodles and draws or who packs their daily schedule may also be showing signs of difficulty.
• Trouble with self-control. The person is impulsive, talking and acting without thinking. They frequently interrupt others and have little patience.

What These Brain-Function Symptoms Reveal

Each of these symptoms reveals sluggishness within the brain’s mesolimbic dopamine system, or reward pathway. Healthy people feel a certain amount of elation when they embrace another, hear beautiful music or engage in fun physical activity, and the reward circuitry in the brain is pre-set to respond positively to these things. When a person has an ill-functioning reward system, they may engage in riskier behaviors in order to stimulate or activate the reward response.

Treatment For ADHD And Substance Abuse

Drug use exacerbates this problem. Therefore, the best treatment will result from a multi-pronged approach. Persons with comorbid ADHD and substance abuse will probably require individual counseling, support group therapy, carefully monitored medication therapy and specific lifestyle changes.

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