By Mary Fetzer
Recreational use of alcohol and cannabis is common among U.S. adults. But both come with risks, and those risks are higher for people who have ADHD.
Research suggests that ADHD symptoms, such as difficulty with impulsivity or self-regulation, can lead to substance experimentation and misuse. And some individuals may use substances to self-medicate their ADHD symptoms.
One study has shown that about 25% of people seeking help for addiction to substances have ADHD. Other studies have shown that one-half of adults aged 20-39 with ADHD have had a substance use disorder in their lifetime, a rate that is significantly higher than the 24% rate of substance abuse disorder among young adults without ADHD.
“People with ADHD are more prone to drug and alcohol use, and several factors contribute to this trend,” says Holly Sargent, a mental health counselor and neurofeedback specialist at Braincode Centers in Denver, Colo. “One significant factor is impulsivity, a common symptom of ADHD, which leads people with ADHD to seek immediate gratification and take risks, making substance abuse more likely.”
Sargent says the symptoms associated with ADHD can drive individuals to self-medicate with alcohol, cannabis and other substances. (Learn more about what research shows on whether stimulants to treat ADHD have any effect on substance abuse.)
Alcohol and ADHD
People drink for a variety of reasons. For people with ADHD, alcohol — a depressant — can seemingly help to calm prominent ADHD symptoms, such as hyperactivity and impulsivity. But because alcohol and ADHD both affect the frontal lobes of the brain, people with ADHD can be more sensitive to the impact of alcohol.
“The effect of alcohol for people with ADHD can be distinctly different than the effect it has on those without ADHD,” Sargent says. “It is sought to induce relaxation but can impair executive functions and increase impulsivity.”
In the short term, alcohol impairment can aggravate ADHD symptoms and lead to poor decision-making. Long-term alcohol use can cause problems with cognition, memory and speech, all of which can further worsen ADHD symptoms.
“Alcohol can exacerbate ADHD symptoms such as impulsivity and difficulty focusing,” says Carolina Estevez, a clinical psychologist at Infinite Recovery, an addiction rehabilitation facility in Austin, Texas. “Over time, alcohol misuse or abuse may lead to further impairment, resulting in uncontrollable behaviors and unstable emotions.”
ADHD is five to 10 times more common among adult alcoholics than it is in people without ADHD. Not everyone with ADHD will experience drinking problems. Still, the risk of developing an alcohol use disorder is higher in people with ADHD.
Some research has explored more detailed aspects of the association between ADHD and alcohol use disorder. A 2015 multi-institution study, for example, showed that people with ADHD — especially children, adolescents and young adults — had an increased risk of binge drinking. And a 2017 study by the University of Minnesota found that more severe childhood ADHD was associated with earlier alcohol use, frequent alcohol use and heavy alcohol use.
“Genetic predisposition also plays a role,” says Sargent. “Research indicates a genetic link between ADHD and alcohol dependence.”
Researchers have found that several genes, including the dopamine transporter gene, are responsible for both ADHD and alcohol abuse.
Cannabis and ADHD
ADHD has been linked to frequent cannabis use, and researchers from the California Institute of Behavioral Neurosciences and Psychology reviewed 10 years of relevant studies to better understand the relationship between cannabis use and ADHD symptoms. They found that nearly half of people with cannabis use disorders also have ADHD. And the more severe a person’s ADHD symptoms, the greater their likelihood of developing cannabis use disorder.
The researchers determined that people with ADHD use cannabis to self-medicate their symptoms, such as anxiety and sleep disturbances. A 2021 study on the self-reported effects of cannabis on ADHD symptoms revealed the challenge of balancing potential short-term relief with potential negative consequences in the long term. The authors of the study found that when the immediate relief provided by the cannabis wears off and the ADHD symptoms return, the cannabis user increasingly turns to the drug, which can lead to cannabis use disorder.
Ben Parker, a cannabis researcher and editor for StateCannabis.org, has studied cannabis and its interactions with various conditions, including ADHD.
“ADHD can manifest differently in each individual, so responses to substances like cannabis can also vary greatly,” Parker says.
Parker says that because each person’s response is different and because long-term effects are unknown, people should be very careful about self-medicating with cannabis.
“It’s crucial for anyone with ADHD considering cannabis use to consult with their health care provider first,” he says. “More research is needed to fully understand the relationship between ADHD and cannabis use.”
Overall, it’s important for people with ADHD to be aware of the risks associated with drug and alcohol use, and to seek help if they are struggling with addiction or other issues related to substance use. Treatment options may include therapy, medication, or other forms of support.