Adults with ADHD are three to five times more likely to have a substance abuse disorder than adults without ADHD. With growing numbers of UK adults now on waiting lists for ADHD diagnosis and a new BBC Panorama episode set to highlight the risk of incorrect diagnosis procedures at some private clinics, addiction rehabilitation service Rehabs UK says that those struggling with both ADHD and substance abuse must receive specialist treatment faster.

Studies have found that children with ADHD are more likely to develop problems with substance abuse, particularly alcohol. One study found that 40% of children with ADHD began using alcohol at an average age of 14.9 years, compared to 22% of children without ADHD. Additionally, while rates of alcohol use were similar in those aged 25, young adults with ADHD are more likely to use alcohol excessively than those without ADHD.

Speaking to Rehabs UK on the reasons for the link between ADHD and substance abuse, co-founder of ADHDadultUK, Dr James Brown, says: “Many adults with ADHD have issues with impulsive behaviour and risk perception, which may lead to earlier exposure to drugs.”

“Beyond this, many adults do report that they ‘self-medicate’ with substances to deal with their ADHD and associated psychiatric issues, with one study reporting more than one-third of adolescents and young adults endorsed using cigarettes and substances for self-medication.“ 

“As the brains of people with ADHD often feel like they cannot “switch off,” engaging with substances which either provide dopamine (like nicotine and cocaine) to cause ‘paradoxical calming’, or slowing down of thought processes, or use substances that are intoxicants as these can temporarily  relieve  much of the internal hyperactivity and repetitive thought patterns which can be distressing.” 

As common ADHD medications such as methylphenidate and amphetamines are controlled substances, some people may worry that these can lead to addiction. However, research shows that individuals with ADHD who are being treated with medication are less likely to abuse drugs or alcohol compared to those who are not receiving treatment. The period of ‘titration’ before an ADHD prescription is formally and permanently signed off is typically a minimum of three months of supervised, monitored medication trialling, often double this.

“ADHD diagnosis and access to treatment are essential to battling substance abuse in those with ADHD.” Rehabs UK founder, Lester Morse, says in a new statement.

While it is difficult to establish exact waiting times for ADHD diagnosis in the NHS, it is widely reported that ADHD services are struggling to keep up with demand. In a recent survey conducted by the House of Commons, 82% of respondents stated that current waiting times for ADHD diagnosis are not adequate. Consequently, many individuals with ADHD may not receive the assistance they require.

It’s estimated that 23% of adults being treated for substance use disorders have ADHD, despite ADHD adults only making up around 3–4% of the general population.

“ADHD symptoms can lead to impulsive behaviour, difficulty concentrating, and problems with organisation and planning. These symptoms can make it challenging for patients to engage in substance abuse treatment, adhere to a treatment plan, and cope with triggers.” Morse goes on to say. “Without appropriate diagnosis and treatment of ADHD, patients continue to struggle with these symptoms, making it more difficult to achieve and maintain sobriety.”

Current guidelines advise that for patients struggling with ADHD and substance abuse disorder, treatment of both conditions should happen simultaneously.