Both Attention-Deficit/Hyperactivity Disorder (ADHD) and Alcohol Use Disorder (AUD) are common disorders that can significantly impair daily life. ADHD is a neurodevelopmental disorder involving a persistent pattern of inattention and/or hyperactivity-impulsivity that often interferes with development and functioning. AUD is a pattern of alcohol use that leads to clinically significant impairment or consistent distress [1].
Interestingly, ADHD and AUD often co-occur, meaning that if you are diagnosed with ADHD, you may also experience problems related to alcohol use. While exact percentages are unknown, research suggests that approximately 25% of adults and 30% of adolescents who receive treatment for drug and alcohol abuse also meet the diagnostic criteria for ADHD [2].
Due to the severity and frequent overlap of ADHD and alcohol use, treatment requires an individualized and comprehensive approach. That’s why Clear Behavioral Health offers our dual diagnosis program that focuses on maintaining sobriety and mental wellness by implementing relapse prevention, teaching coping skills, and addressing underlying mental health issues through evidence-based therapies and medication management.
Understanding ADHD
ADHD causes inattention and/or hyperactivity-impulsivity, negatively impacting social, academic, or occupational functioning. When you have ADHD, you can often experience reduced behavioral inhibition, difficulty exercising restraint and control, and/or elevated novelty-seeking behavior [1]. Together, these traits result in impulsive behavior and a reduced ability to consider consequences before acting.
Types of ADHD
There are three types of ADHD: predominantly inattentive presentation, predominately hyperactive-impulsive presentation, and combined presentation ( (both inattentive and hyperactive-impulsive). Symptoms of inattention include frequently losing things, difficulty maintaining organization, failing to pay attention to details, and being easily distracted. Symptoms of hyperactivity/impulsivity include challenges staying seated, frequent fidgeting, interrupting, and difficulty waiting [1]. If you suffer from combined inattentive and hyper-impulsive behaviors, you will experience a combination of those symptoms.
Related: What is ADHD?
The Link Between ADHD and Alcohol Use
When experiencing ADHD, you may turn to alcohol for various reasons; in turn, drinking alcohol worsens the symptoms of ADHD, leading to a constant cycle of substance abuse and ADHD symptoms.
Self-Medicating
Having attention deficit hyperactivity disorder, you may experience academic, occupational, and social impairment, which can lead to chronic feelings of failure and inadequacy. For some, alcohol abuse could develop as an attempt to alleviate these feelings of mental distress [3].
Impulsivity and Risk-Taking Behaviors
When you have ADHD, you experience underactive reward systems [4] and lower levels of dopamine in the forebrain, which often cause problems with executive functions, or mental skills, related to attention and impulse control [2]. Having ADHD, you are more often prone to engage in impulsive and risky behaviors, such as binge drinking or abusing other drugs.
Social Challenges and Peer Pressure
As someone with ADHD, you may experience social challenges and rejection due to difficulties attuning to social behavior, such as talking when inappropriate and being easily distracted in conversation. These characteristics have been attributed to lower popularity among peers. As a possible effort to gain status or avoid rejection, you may be susceptible to peer pressure and alcohol abuse [5].
The Impact of Alcohol on ADHD Symptoms
With ADHD, you may have lower thresholds for tolerating alcohol. Due to lower baseline levels of attentiveness and impulse control, you will likely experience extremely heightened levels of inattentiveness and impulsivity when consuming alcohol as compared to your peers without ADHD [2].
The Cycle of ADHD and Alcohol Addiction
How Alcohol Worsens ADHD Symptoms
Alcohol abuse and ADHD affect the brain similarly. Both disorders inhibit activity in the frontal lobe, dampening your ability to think clearly and make healthy decisions. When the effects of alcohol are combined with the effects of ADHD, you may engage in extremely risky behaviors and experience intensified inattentiveness and restlessness [6, 7].
The Development of Tolerance and Dependence
When you drink alcohol in excessive amounts for an extended period, it can lead to alcohol dependence. Alcohol dependence occurs when you consume so much alcohol that your tolerance grows higher, and eventually, you require larger amounts of alcohol to achieve intoxication [8]. When you depend on alcohol, you experience withdrawal symptoms when alcohol consumption is reduced or eliminated. Withdrawal is comprised of physical and psychological symptoms that lead to distress [9].
Related: The Dangers of Detoxing From Alcohol at Home
Long-Term Consequences of Untreated Co-Occurring Disorders
If ADHD or alcohol abuse goes untreated, it can lead to an array of long-term consequences. Untreated ADHD can lead to impulsive behavior which can result in traumatic brain injuries, bone fractures, sexually transmitted infections or teenage pregnancy as well as substance abuse, cigarette smoking, educational underachievement, depression, suicide, and criminal activity [4]. Meanwhile, drug and alcohol abuse, when left untreated, is a leading risk factor for disease burden, suicides, traffic accidents, interpersonal violence, liver diseases, and increased mortality [4].
Challenges in Diagnosis and Treatment
Alcohol use and ADHD share similar characteristics, including difficulties with memory, decision-making, and cognition, increased anxiousness, challenges with managing emotions, impulsivity, and reward-seeking [10]. Due to their overlapping symptoms, diagnosing ADHD and/or alcohol use disorder can pose some challenges; it’s important to carefully assess your symptoms when seeking treatment.
Properly assessing your symptoms is key to determining treatment outcomes, with an ADHD diagnosis, you require specialized care. For example, a great option when diagnosed with alcohol addiction and ADHD is to engage in cognitive behavioral therapy (CBT) or semi-structured group therapy. Effective treatment of the core symptoms of ADHD and alcohol use disorder requires individualized and comprehensive care [2].
ADHD Medications and Their Interaction with Alcohol Recovery
ADHD medication, including stimulants such as methylphenidate and amphetamine, is the primary treatment for ADHD. However, given the potential abuse factor associated with stimulant medications, concerns exist when you are being treated for co-occurring ADHD and substance abuse. Due to the complex nature of these co-occurring disorders and symptoms, co-occurring ADHD and alcohol addiction may require alternative medication regimens.
Delayed-release stimulants may be a safer option for ADHD as they have a lower abuse potential than immediate-release stimulants [11]. Additionally, non-stimulant ADHD medications, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), bupropion, monoamine oxidase inhibitors, atypical antipsychotics, clonidine, atomoxetine, and venlafaxine have also been used in the treatment of co-occurring ADHD and alcohol use disorder.
Evidence-Based Therapies for ADHD and Alcohol Addiction
Dialectical Behavior Therapy (DBT)
Dialectical Behavioral Therapy (DBT) is a modified version of CBT that teaches you to accept your thoughts, feelings, and behaviors while providing techniques to change them. The four components of DBT are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT can help you with ADHD and alcohol use disorder, notice your behaviors and take tangible steps to make healthy choices.
Motivational Interviewing
Motivational Interviewing (MI) is a collaborative, goal-oriented, conversational style of treatment that focuses on strengthening your motivation for healthy change. MI can help you with ADHD and AUD by providing you with a purpose and meaning behind your recovery and wellness journey.
Mindfulness-Based Interventions
Mindfulness-based interventions combine present-moment awareness and acceptance strategies to help relieve stress and anxiety, develop life skills, and improve well-being. Some examples of these interventions include body scans, meditations, breathing exercises, guided visualizations, and mindful appreciation. These strategies can help you, with ADHD and AUD, return to the present moment when experiencing inattention, hyperactivity, or the compulsion to abuse drugs or alcohol.
Lifestyle Changes and Coping Strategies
Developing Healthy Routines and Structure
Self-care is an important component of managing attention deficit hyperactivity disorder (ADHD) and maintaining sobriety. Self-care consists of daily decisions that aid physical, emotional, mental, spiritual, and environmental well-being. Developing an exercise regimen and eating balanced meals, for example, is an effective way to incorporate self-care into daily life and minimize the symptoms of ADHD and AUD.
Stress Management Techniques
Relaxation and stress management techniques are an important part of recovery. Common methods include breathing exercises, progressive muscle relaxation, taking a time-out, mindfulness meditations, and guided visualizations. Reducing stress can reduce symptoms of ADHD and AUD by creating a baseline of inner peace and calm, thus minimizing the potential for risky behaviors.
Building a Supportive Environment
To create a sense of balance and fulfillment, focus on building connections and improving existing relationships with healthy and supportive people. When you strive to maintain social connections, you are less likely to hurt your relationships by abusing drugs or neglecting daily self-care routines.
The Importance of Family Involvement
Education for Family Members
Involving family members can be helpful in treatment to provide their loved ones with additional support. An effective first step towards family involvement is proper education about the symptoms, causes, and treatments of ADHD and AUD so that family members know how to best support their loved one’s recovery.
Creating a Supportive Home Environment
A supportive home environment can promote a sense of peace and safety so you can focus on recovery. Efforts should be made to reduce temptations and physical reminders to use substances, and, whenever possible, you should choose housemates who endorse sobriety and healthy interpersonal connections.
Relapse Prevention
Identifying Triggers Related to Both ADHD and Alcohol Use
Identifying triggers related to attention deficit hyperactivity disorder (ADHD) and alcohol use is a good preventative measure for relapse prevention. Perform a self-inventory to understand your unique physical, emotional, and mental indicators that an urge to engage in risky behaviors is emerging. Once triggers are identified, it’s important to take early action to prevent relapse.
Developing a Personalized Relapse Prevention Plan
Creating and utilizing a relapse prevention plan is a helpful tool for those in the mental health or addiction recovery process. With a prevention plan in place, you can refer to coping strategies, relaxation techniques, self-care routines, enjoyable activities, and reliable people to turn to when warning signs surface.
The Role of Ongoing Support and Aftercare
When you have reached a sense of stability in your sobriety and ADHD management, it is important to maintain well-being by engaging in consistent therapy and support groups.
By maintaining ongoing social support, self-care, a healthy lifestyle, and a sense of purpose, with co-occurring ADHD and AUD, you can experience a satisfying life in recovery.
ADHD and Alcohol Treatment Approaches with Clear Behavioral Health
Research suggests that dual diagnosis treatment for mental health and substance use is one of the most effective treatment strategies and results in longer-lasting recovery [12]. That’s why Clear Behavioral Health offers dual diagnosis programs that are comprehensive and highly individualized to help you heal from complex and co-occurring mental health and substance use disorders.
Clear offers multiple levels of care for when you are seeking treatment for ADHD symptoms and substance use disorders. These treatment programs are comprised of various therapeutic modalities and evidence-based interventions that target co-occurring substance use disorders and mental health challenges to ensure long-term wellness.
Outpatient Programs
If you are stable and maintain sobriety, you will often participate in our outpatient treatment programs. These programs vary in length and intensity depending on the level of support needed. While enrolled in outpatient programs, you can engage in structured comprehensive treatment while living at home and balancing the demands of your personal and professional life.
Outpatient programs offer a combination of individual and group therapy, and some treatment locations provide family therapy to provide education about ADHD and AUD. During treatment, you may engage in Dialectical Behavioral Therapy (DBT), Motivational Interviewing (MI), and mindfulness-based interventions to manage your ADHD symptoms and AUD.
Residential Programs
Should you be seeking extra support and intervention, you can participate in our detoxification programs or residential treatment programs. These live-in programs provide around-the-clock support and supervision from trained mental health professionals as well as routine drug testing, relapse prevention techniques, and individual therapy. We also offer life skills training to ensure that, when you return home, you are prepared to maintain your sobriety and mental wellness.
Treat ADHD and Alcohol Use Disorder Today
In our inpatient and outpatient programs, Clear Behavioral Health provides options for you to include family members and loved ones in your treatment. We offer multi-family groups, individual family sessions, and parent support groups to facilitate education about ADHD symptoms and AUD and provide guidance for family members who wish to support their loved one’s recovery.
While ADHD and AUD are complex, and often debilitating, disorders, treatment and recovery are possible. With a comprehensive assessment, specifically tailored treatment modalities, and proper medication management, for ADHD symptoms and AUD, you can recover and achieve long-term wellness. If you or a loved one is struggling with ADHD and AUD, don’t hesitate to get help. Reach out to Clear Behavioral Health today to learn more about our treatment programs for ADHD and alcohol in Redondo Beach, CA, and the surrounding Los Angeles, CA areas.
References:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
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- How alcohol Abuse Affects ADHD – Alcohol Help. (2024, January 8). Alcohol Help. https://www.alcoholhelp.com/resources/dual-diagnosis/alcohol-and-adhd/
- Gateway Foundation. (2024, September 11). Alcohol and ADHD: How They’re Linked. https://www.gatewayfoundation.org/blog/adhd-alcohol-relationship/
- Elvig SK, McGinn MA, Smith C, Arends MA, Koob GF, Vendruscolo LF. Tolerance to alcohol: A critical yet understudied factor in alcohol addiction. Pharmacol Biochem Behav. 2021 May;204:173155. doi: 10.1016/j.pbb.2021.173155. Epub 2021 Feb 23. PMID: 33631255; PMCID: PMC8917511.
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- Curtis, L. (2021, August 18). What to know about ADHD and alcohol. Psych Central. https://psychcentral.com/adhd/adhd-and-alcohol#addiction-and-adhd
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