It is not uncommon for those with ADHD to self-medicate to try to control symptoms, especially prior to receiving a diagnosis. This may happen without the individual realizing that is what they are doing…
So, I read this and it got me to thinking about how prevalent substance abuse is with ADHD. I myself am not immune. I consume caffeine and I smoke. Luckily, I have been able to avoid other vices. But many with ADHD, especially those who are not diagnosed, struggle with substance abuse. This is true for many mental illnesses, but I want to focus on ADHD for this post.
Research suggests that one to five percent of adults suffering from ADHD are unaware that they have it or that it affects their daily lives. (3)
15% of people diagnosed with ADHD struggled with substance abuse. The scary thing about this number is that people tend to under report their addictions and this is looking mostly at alcohol and illegal drugs. So, this doesn’t include things like caffeine and cigarettes. This number also doesn’t (and can’t) consider the number of people who are undiagnosed and thought to be at the highest risk for substance abuse. Alcohol and marijuana were the substances most commonly reported as being abused (1).
“When people with ADHD get older, the hyperactive component often diminishes,” says William Dodson, M.D., an ADHD specialist in Denver. “But inside, they’re just as hyper as ever. They need something to calm their brain enough to be productive.” (1)
Half of all adults with untreated ADHD will develop a substance use disorder at some point in their lives. (1)
50% is a crushing number. It pains me to think that there are so many people out there struggling to get by and their only answer is to use drugs from the street. Sure, when you get treatment from a doctor a part of the treatment is often medication. But there are important differences. The first being that there is at least some regulation and quality control for the medications that the doctor prescribes. Second, there is someone supporting you and helping you figure out the risk vs. benefit of the medication. Lastly, it won’t be just medications, if things are going the way that they should. And there are plenty of things that a person can do beyond getting medicated!
The medications most widely prescribed for ADHD, methylphenidate and amphetamine, are controlled substances — meaning they have the potential to lead to abuse and addiction. Because of this, some people assume that it’s risky to take these drugs. In truth, it’s the opposite: ADHDers who take these medications as prescribed are less likely than untreated ADHDers to drink or abuse drugs. Put another way, treating ADHD effectively is powerful protection against substance abuse. (1)
Despite this truth, it can be a challenge for people with substance abuse disorder to get prescribed these medications because these medications are frequently abused. This is a nasty trap to put someone in. Even though this is the best way to help these people get out from under their addiction, they are frequently denied this treatment. The myths surrounding these disorders and the medications has built up a stigma that can feel impossible to scale. Yet, that’s what we ask these people to accomplish in order to achieve wellness. The system has to change. The myths need to be dispelled. The stigma must be washed away. The alternative is to allow these people to continue to struggle in dark despair.
Self medicating is a slippery and dangerous slope. When these behaviors first start, the substance can be helpful and make things easier. But over time, the effects of the substance lessens and the addiction takes hold. With addictions comes a long list of other potential problems, putting the person at risk for further stress and need for symptom control. It is a fatal spiral downward.
People who abuse substances, or have a history of substance abuse are not “bad” people. They are people who desperately attempt to self-medicate their feelings, and ADHD [or other disorder’s] symptoms. (2)
It is important to remember that those who struggle with addictions are still people and that they should be treated with respect and dignity. Stigma is a powerful force that keeps many people from getting the treatment that they need.
When we see ADHD it is important to look for substance abuse and addictions. And when we see substance abuse and addictions, it is equally important to look for ADHD. (2)
It is very difficult to say no to drugs when you have difficulties controlling your impulses, concentrating, and are tormented by a restless brain or body. (2)
The challenge of these symptoms are all encompassing. It effects every part of your life. Things that seem to be simple for other people are difficult and challenging. Interacting with other people appropriately can be impossible. Just the sense of isolation alone is crushing. How can we be surprised that those of us with ADHD want to bring these symptoms into control? Can we blame them? But here’s the thing:
Psychostimulant medication when properly prescribed and monitored is effective for approximately 75-80% of people with ADHD. (2)
Very few other treatments for any medical diagnosis can offer such a high efficacy. The majority of people treated for ADHD can find relief and symptom management. This is the single most important factor in people with ADHD recovering from their addiction. For those who are self medicating: addiction is not the illness, it is another symptom.
References and More Reading:
- Addiction and Adults with ADHD
- The Link Between ADHD and Addiction
- Is Adult ADHD Linked to Addiction?
- ADHD and Substance Abuse: A risky Combination
- ADHD and Substance Abuse
- Co-Occurring ADHD and Substance Use Disorders
- ADHD in Adults: It Rarely Travels Alone
- Comorbidity of alcohol and Substance Dependence with ADHD