ADHD is an acronym for attention deficit hyperactivity disorder. This is a type of mental health disorder that has often been misunderstood for several decades. In 1968, there was the first conditional report of “hyperkinetic reaction of childhood.” However, symptoms described in documented individuals’ histories have gone back as far as the 16th century.
You may be more familiar with the term ADD, or attention deficit disorder, which appeared in 1980; it was eventually changed to its current descriptor ADHD by 1987. Now, ADHD is the clinically accurate term and is most understood as having three separate subcategories: impulsive presentation, inattentive presentation, and combination presentation.
What Is ADHD?
Attention deficit hyperactivity disorder is largely defined by the various symptoms a sufferer presents. It is the brain’s unique function and structure that play the biggest roles in ADHD. There have been a multitude of studies attempting to link how a brain looks and behaves between those who don’t suffer from ADHD and those who do.
Primarily, these studies focus on the brains of children. For example, some researchers learned that kids with very severe ADHD tended to have smaller frontal lobes. This was an important discovery because the frontal lobes are what help both children and adults govern levels of native inhibition, concentration, impulse control, and fine motor movements. Therefore, it’s no surprise when the symptoms of ADHD can include subpar concentration, fidgeting around, inappropriate activity, and behavioral issues. Other research has uncovered that people with ADHD might have neural pathways that cause them to be predisposed to impulsivity and concentration issues.
Statistics Regarding Attention Deficit Hyperactivity Disorder
According to the Centers for Disease Control and Prevention, there are several key facts relating to ADHD:
• Polls have illustrated that more boys and men receive an ADHD diagnosis than girls or women, although many suspect that the numbers of female sufferers are underreported.
• The average child with ADHD will receive a clinical diagnosis by the age of 7.
• As of 2012, there is believed to be approximately 11% of the population between the ages of 5-17 who are living with a diagnosis of ADHD. This is roughly 6.5 million children.
• The rate of ADHD diagnosis has increased from 7.8% to 11% in only one year.
• There is no cure for ADHD, and the condition’s symptoms typically will last for a lifetime.
• It is thought that up to 5% of adults in the United States have ADHD, representing about 11 million people in the general population.
• ADHD is frequently the most encountered mental health issue that is diagnosed in children.
The Connections Between Substance Addiction and ADHD
Getting a grasp of the basics of ADHD is just the beginning when seeking a deeper understanding regarding ADHD and addiction. In the beginning, however, it’s important to consider that there is no study indicating that ADHD leads to addiction or that addiction can cause ADHD. Anyone who is a victim of substance use disorder is thought of as having a coexisting disorder along with ADHD. In a clinical setting, there isn’t anything that can be seen as medically causing the other to begin, although the two conditions can play off one another and can make each condition worse, usually depending on the environment.
There have been several studies showing ADHD and substance use disorder as linked issues. As a result of years of research, when compared to the broader population, kids with ADHD are at an increased risk of having issues with alcohol and other drugs once they mature into adulthood.
The data supporting the links includes the following:
• Individuals suffering from ADHD are more likely to begin consuming drugs and alcohol at earlier ages than the general population.
• Young adults in the 20-25 years range are more likely to abuse alcohol and to drink to excess if diagnosed with ADHD.
• Kids who have been diagnosed with ADHD have a higher incidence of beginning this abuse of drugs and alcohol sometime in their teen years.
• Twenty-five percent of all adults who are undergoing a recovery process for substance abuse have ADHD.
• ADHD is up to 10 times more common in adults who suffer from alcohol use disorder.
These statistics and facts lead to one very important question: Why are people who suffer from attention deficit hyperactivity disorder at such a high risk of drug abuse? The theory is that the truth can be found in the lowered inhibition sense and the lack of impulse control that are all too typical of those with ADHD. However, these behavioral associations are merely complementary to the addiction; the risks can be highly varied.
For example, let’s pretend that there’s a young adult with minor behavioral problems and general ADHD who skips his or her college classes. Since this person is not in school and not keeping occupied with studies, the doorway opens to substance abuse to fill the gap. Compounding the issue, the lack of proper impulse control that so frequently appears in those with ADHD will lower the person’s resistance to any substances offered or otherwise happened upon.
The Genetic Factors of ADHD
The risks of developing ADHD are not simply environmental; your genetics inherited from your family also play an important part in the risk. A great amount of research has been dedicated to the role that genes play; there have been more than 1,800 studies published on the subject as of 2019. There’s a mean risk of 76% in relation to your genetics in causing ADHD. Thus far, dopamine D5 and D4 genes have been implicated, but it is a challenge to nail down exactly which is culpable due to the complexity of the disorder.
Genetic studies can focus on either specific genes or the full genome. Testing is performed to gauge links between various chromosome regions and DNA variations with clinical ADHD symptoms. Chromosome 16 has been linked to ADHD in multiple tests. In fact, the response of each individual to drug treatment may even vary based on how the genes in that chromosome perform.
Ideally, the more that the medical community is able to learn about genetics and ADHD, the more individualized treatment programs can become. This holds especially true in the world of pharmaceuticals. The most important role anyone can play as a doctor is to support the victim of ADHD with nuanced treatments that could increase long-term compliance. Although genetics cannot 100% guarantee that someone will inherit the family line of ADHD, it looks as though the overall risks are quite significant and should be taken with a high degree of seriousness should there also be a family history of substance abuse.
Could Someone Become Addicted to ADHD Medication?
Under the proper circumstances, medicine taken to treat attention deficit hyperactivity disorder can certainly lead to addiction. Adderall and Ritalin are the two most commonly prescribed treatments for ADHD.
Adderall is a stimulant that has even found its way onto college campuses; it’s not uncommon for an underground drug market to sell it to stressed-out students who are looking to pull all-night study sessions. Generally, Adderall is considered to be a habit-forming drug. It carries risks of heart attacks, strokes, and even death. These dangers are pronounced in those who have a family history of heart issues such as high cholesterol or heart failure. Adderall can also cause visual and auditory hallucinations, especially in those with preexisting mental conditions that predispose them to such episodes.
Ritalin acts as a central nervous system stimulant. It was invented to primarily address the lack of impulse control that is common in ADHD victims. However, there are risks involving seizures in those who take too much Ritalin too frequently. A history of drug and alcohol abuse also raises red flags; these combined with Ritalin could lead to circulation problems and, in some cases, failure of the heart.
When talking about abuse of ADHD medication, it’s critical to have two groups in mind: those who have ADHD and those who do not. For the past few years, media outlets have been awash with stories regarding tales of Adderall and Ritalin abuse on college campuses and even in high schools. However, it’s false to believe that these drugs will help you concentrate on a final project or enable you to focus better on an exam. A sort of “survivorship bias” has become entrenched in some campuses, pushing the idea that those who do well in school do so thanks to the use of ADHD medicine. For people who do have a positive clinical diagnosis for ADHD, research from the University of California demonstrates that taking Ritalin or Adderall doesn’t increase addiction risks to the two attention-improving drugs or to any other drugs.
It all boils down to the individual or that person’s legal guardian to evaluate the merits of each treatment course for ADHD and the proper route to take. It is useful to understand that when someone is prescribed Ritalin or Adderall, it is going to be utilized as part of a comprehensive medical treatment plan under the supervision of medical professionals. The doctor who prescribed the medication will regularly meet with the patient to evaluate in a clinical setting how the treatment plan is progressing and what tweaks to make. As long as the physician’s orders are followed, the risk for any medication addictions are lowered.
Taking ADHD medication is generally not seen as a risky decision in the medical world when weighed against the odds of developing a substance addiction. However, it’s important to remember that those who do have ADHD are at increased chances of developing a substance use disorder in general due to the nature of the disease.
Getting Treated for Simultaneous ADHD and Substance Use Disorder
Individuals suffering from ADHD in isolation from other mental illness or substance addiction generally receive Ritalin or Adderall first. However, there is a large number of supportive measures that can be selected that further increase the likelihood of controlling ADHD. This can include but is not limited to:
• ADHD group education
• Skill-building workshops and hobbies
• Stress-management tactics
• Dietary intervention and nutritional education
• Regular exercise routines
• Parental counseling and advice
• Life coaching
Articles published in many leading journals highlight some of the complex problems with dealing with ADHD and a substance use disorder. For example, someone taking medication for ADHD is more likely to remain in a rehabilitation program for longer than someone who isn’t. However, there is always a risk that with access to a stimulant such as Adderall that there will potentially be abuse.
The critical point is to attend a rehabilitation program that can cope with the difficulty that is a dual diagnosis. By coordinating substance rehab treatments with a local psychiatrist, proper monitoring is ensured. It is not uncommon for there to be no ADHD medication prescribed for up to 120 days during a substance abuse recovery protocol.
Treatment Should Always Conform to the Individual
Never forget that there are more choices out there than relying on a bottle of pills alone. With the right level of help and a positive support network, it is never impossible to defeat substance use disorder while simultaneously taking control of your ADHD. Frequently, these overlapping treatment sessions result in a new lease on life for the victim involved and in a far faster way than what was once possible. As medical and clinical advancements march on, so does the outlook of those suffering from ADHD and substance use disorder.