Key takeaways
- People with ADHD are more vulnerable to early and problematic substance use due to core traits like impulsivity, emotional dysregulation, and difficulty with decision-making.
- Substance use is often a way to cope with unmanaged ADHD symptoms, especially in those who are undiagnosed or lack access to appropriate treatment.
- Timely diagnosis and integrated care can significantly reduce the risk of substance use disorders, particularly among adolescents and individuals with co-occurring conditions.
Attention-Deficit/Hyperactivity Disorder (ADHD) is linked to an increased risk of substance use. Individuals with ADHD are more likely to begin using substances such as alcohol, nicotine, cannabis, or stimulants at a younger age and face a higher risk of developing substance use disorders (SUDs) over time. This relationship stems from identifiable and core symptoms of ADHD, particularly impulsivity, difficulty regulating emotions, and poor decision-making, which are key risk factors for early and problematic substance use. Many individuals with ADHD report using substances to “self-medicate” for symptoms like restlessness, anxiety, or difficulty focusing, especially when they are unaware that they have the condition or are not receiving treatment. In adolescence and early adulthood, these risks are even higher. Studies show that teenagers with ADHD are twice as likely to develop SUDs compared to their peers. If ADHD is combined with other conditions such as depression, conduct disorder, or oppositional defiant disorder, the risk increases further. Neurobiological differences may also play a role. ADHD is associated with disruptions in brain circuits involved in reward processing and impulse control, which are also implicated in substance use. This shared neurobiology may partly explain why ADHD and addiction often co-occur.
Importantly, the link between ADHD and substance use does not mean one causes the other directly. Rather, ADHD creates a set of vulnerabilities that, without early support and treatment, can lead to higher substance use risk. Understanding this link is essential for prevention. Identifying ADHD early and managing symptoms through behavioral strategies, therapy, and, when appropriate, medication can reduce the likelihood of substance misuse and support better long-term outcomes.
References
- Molina, B. S. G., & Pelham, W. E. (2014). Annual Review of Clinical Psychology, 10, 607–639.
- Humphreys, K. L., Eng, T., & Lee, S. S. (2013). JAMA Psychiatry, 70(7), 740–749.