Note: I am not a doctor. My aim is for this article to be an informal but informative springboard to start your own research. I have tried to mostly refer to my own experiences but balanced with expert sources (listed at the bottom).
Addiction is a major issue for ADHDers. Studies have shown that we have an increased risk for addiction to substances (e.g., nicotine) and behaviours (e.g., sex and video games) [1] [2].
I categorize my own experiences with addiction as either self-medicating (stuff that stopped me from feeling bad) or pleasure-seeking (stuff that made me feel better).
Self-medication involves using “non-prescription” methods to help us manage our symptoms. It is very common with ADHDers, especially when we are undiagnosed. Substances with stimulants can help us focus, so we naturally tend towards smoking and consuming caffeinated beverages from a young age.
While studying for my university exams (before my diagnosis), I used to drink multiple cans of energy drinks and cups of very sweet tea, while also vaping the highest legal concentration of nicotine. I still remember getting headaches from (what I assume was) acute nicotine poisoning
However, the most problematic self-medication substance for me was alcohol. It was very appealing as it would alleviate my anxiety (which is very common in ADHDers), stop my racing thoughts and help me fall asleep. I am very thankful that alcohol upsets my stomach, or I might have had a severe problem today.
Pleasure seeking activity is using/doing things that make us feel good. I really struggled with an addiction to video games and pornography during my teens and early twenties. Simply put, they made me feel good and I would want to do it more and more, especially when I was bored (which was all the time).
I still strictly manage my consumption of these activities as I know that I can easily fall back into addiction (like I have many times before).
Cycle of addiction
Addictions can be especially troublesome for ADHDers. An addiction cycle for ADHDers tends to go as follows (with the example of smoking) [3]:
1. ADHDers are likelier to start smoking at a younger age for reasons previously mentioned
2. Due to difficulties with self-control, ADHDers start chain smoking and become increasingly addicted to nicotine
3. ADHDers have a harder time quitting due to difficulties with impulsivity and self-inhibition
4. Due to issues with our dopamine system, ADHDers experience worse withdrawal symptoms and relapse much easier
I want to heavily stress that relapsing is not a sign of weakness or failure. Managing addiction is difficult for everyone but can be especially difficult for us ADHDers. With support and treatment, addiction can be managed, and the possibility of relapse reduced.
Treatment
Truthfully, what helped me the most with my addiction issues was my prescribed ADHD medication. The stimulants completely removed the need for me to self-medicate and helped curb my excessive pleasure-seeking activities.
There are fears that ADHD meds act as a ‘gateway drug’ but these fears are unfounded. It is quite the opposite; studies have found that meds can SIGNIFICANTLY reduce the likeliness of future addiction in youths [1]. For people who have already battled with substance abuse, there is also the option for non-stimulant ADHD medication (such as Strattera). Traditional addiction treatment options such as therapy are also a viable option.
Addiction is a very common issue for ADHDers. I would hazard a guess that most (if not all ADHDers) struggle with some degree of addiction at some point in their lives. However, it has to be stressed that addiction can become quite a serious problem.
If you are struggling with addiction, I would heavily advice consulting your doctor for options to treat your addiction issues alongside your ADHD, as one can make the other even harder to manage, and as such might need be treated simultaneously [4].
[1] ADDitude. 2020. The Truth About ADHD And Addiction. [online] Available at: <https://www.additudemag.com/the-truth-about-adhd-and-addiction>.
[2] Davis, C., Cohen, A., Davids, M. and Rabindranath, A., 2015. Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex. Frontiers in Psychiatry, 6.
[3] McClernon, F. and Kollins, S., 2008. ADHD and Smoking. Annals of the New York Academy of Sciences, 1141(1), pp.131-147.
[4] WebMD. 2020. ADHD And Substance Abuse. [online] Available at: <https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link >.