ADHD and Drug/Alcohol Addiction Treatment

As mentioned above, an ADHD diagnosis involves various symptoms, and people can display different symptoms depending on the type of ADHD they have.3 To receive an ADHD diagnosis, a person needs to experience persistent symptoms that have been observable for at least 6 months and occur in more than one setting.4 Qualified medical professionals use criteria in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to provide a diagnosis.5

Predominantly Inattentive Presentation Symptoms

Someone with predominantly inattentive ADHD will present with symptoms that involve difficulty paying attention, maintaining focus on tasks, or staying organized.6

The DSM diagnostic criteria for this type of ADHD includes:5

• Does not give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities
• Has difficulty sustaining attention, such as during lectures, conversations, or lengthy reading
• Does not seem to listen when spoken to directly
• Does not follow through on instructions and often fails to complete schoolwork, chores, or job duties
• Having difficulty organizing tasks and activities
• Avoids or dislikes tasks that require sustained mental effort
• Often loses things needed for tasks or daily life
• Is often easily distracted by external stimuli
• Is forgetful in daily activities

Predominantly Hyperactive/Impulsive Presentation Symptoms

A person with predominantly hyperactive/impulsive symptoms primarily experiences symptoms relating to hyperactivity, such as not being able to sit still.6

The DSM diagnostic criteria includes:

• Fidgeting, tapping hands or feet, or squirming in their seat
• Leaving their seat in situations when remaining seated is expected
• Running around or climbing in situations where it is inappropriate (in teens and adults, this may only involve feelings of restlessness)
• Is unable to play or engage in leisure activities quietly
• They are often always “going” or act like they are “driven by a motor”
• Talks excessively
• Blurts out an answer before a question has been completed
• They have problems waiting for their turn
• Interrupts or intrudes on others

Combined Presentation Symptoms

Combined presentation ADHD involves a combination of symptoms of the two above-mentioned types of ADHD. A person receives this diagnosis when they meet the diagnostic criteria for both disorders mentioned previously.4

Co-occurring disorders, such as ADHD, may increase a person’s risk for substance use and addiction.2 Although the reasons for this are not fully understood, researchers believe that factors such as low impulse control, poor academic performance, behavior dysregulation, and poor executive functioning, as well as attempts to self-medicate symptoms, may play a role.2

Research also suggests that childhood treatment with stimulant medications, which are often used to treat ADHD, could also be a potential factor.2 In addition, studies indicate that ADHD involves brain changes similar to those linked to drug cravings, which may help explain why those with co-occurring ADHD and drug addiction often experience stronger cravings.7

Substances Commonly Misused by People with ADHD

People with ADHD may misuse any substance, sometimes as a way to self-medicate their symptoms, which could subsequently increase the risk of SUD over time.2 Substances that are commonly used among this population include:8

• Alcohol
• Nicotine
• Prescription stimulants
• Marijuana
• Psilocybin
• 3,4-methylenedioxymethamphetamine (MDMA)
• Cocaine
• Benzodiazepines

In one study on ADHD and substance misuse, 37% of respondents with ADHD reported using cannabis, making it the most commonly used substance in this group.8 Another study indicates that, out of adolescents with ADHD, alcohol and cannabis (marijuana), or the combination of these, are the most commonly used substances in this population.10

Why Is ADHD Often Undiagnosed or Misdiagnosed?

ADHD can be a challenging disorder to diagnose, especially in those with co-occurring SUDs, and it often goes underdiagnosed or misdiagnosed.2 This partly occurs because of the lack of universally accepted diagnostic criteria, the overlap of symptoms with other psychiatric conditions, and the difficulty of retrospectively confirming whether symptoms were present in childhood.2,9

Many adults are not diagnosed with ADHD until later in life for several reasons. ADHD symptoms may be hidden by coping strategies, complicated by stigma, or mistaken for conditions such as anxiety or depression, which can lead to misdiagnosis.11 Additionally, many clinicians are not as familiar with adult presentations of ADHD, particularly among women and in those with primarily inattentive symptoms, so recognition and diagnosis are often delayed.11

Integrated treatment for ADHD and SUD addresses both the ADHD and SUD at the same time. This approach is the most advisable form of treatment for co-occurring disorders, as complex needs and overlapping symptoms can significantly influence treatment outcomes. Research shows that integrated treatment leads to an increased likelihood of treatment success.7

Individualized treatment for ADHD and substance abuse may vary from person to person, but can include pharmacotherapy with medications to reduce ADHD symptoms and substance use. 2,10 This can include medications such as:

• Psychostimulant ADHD treatment medications, such as amphetamines (Adderall, Vyvanse) and methylphenidate (Ritalin, Concerta)4
• Medications to treat the specific SUD, which can vary widely depending on the specific substance a person uses7

Treating ADHD and addiction also often involves a variety of addiction therapies and interventions, such as:4,12

• Cognitive-behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Other forms of behavioral therapy
• Lifestyle changes
• Psychosocial support
• Support groups

Empowered Recovery Center offers evidence-based treatment for dual diagnosis, ADHD, and addiction in a flexible outpatient setting. Outpatient programming allows you to get the help you need without needing to commit to an inpatient rehab stay.

Empowered Recovery Center in Atlanta can help you get started on your recovery journey from co-occurring ADHD and SUD. We offer a variety of flexible rehab programs to suit all needs, including:

• Partial Hospitalization Program (PHP)
• Intensive Outpatient Program (IOP)
• Virtual IOP
• Standard Outpatient

We accept and work with several types of insurance companies (both in-network and out-of-network), as well as major credit cards, cash, and checks. Additionally, we offer payment plans to help you cover the cost of rehab so you can start treatment right away. Call us or visit us online to learn about rehab admissions, paying for rehab with insurance, and quickly verifying your insurance.

References

1. Sinclair Hancq, E., South, K., & Vencel, M. (2021, March). Dual diagnosis: Serious mental illness and co-occurring substance use disorders [PDF]. Treatment Advocacy Center. Retrieved September 10, 2025, from https://www.tac.org/wp-content/uploads/2024/01/Dual-Diagnosis.pdf
2. Mariani, J. J., & Levin, F. R. (2007). Treatment strategies for co-occurring ADHD and substance use disorders. The American journal on addictions, 16 Suppl 1(Suppl 1), 45–56. https://pmc.ncbi.nlm.nih.gov/articles/PMC2676785/
3. Centers for Disease Control and Prevention. (2024, October 23). About ADHD. Retrieved September 10, 2025, from https://www.cdc.gov/adhd/about/index.html
4. American Psychiatric Association. (2022, June). What is ADHD? Retrieved September 10, 2025, from https://www.psychiatry.org/patients-families/adhd/what-is-adhd
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
6. National Institute of Mental Health. (2024, December.). Attention-deficit/hyperactivity disorder (ADHD). Retrieved September 10, 2025, from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
7. National Institute on Drug Abuse. (2024, September 30.). Co-occurring disorders & health conditions. Retrieved September 10, 2025, from https://nida.nih.gov/research-topics/co-occurring-disorders-health-conditions
8. Więckiewicz, G., Stokłosa, I., Stokłosa, M., Więckiewicz, W., Gorczyca, P., & Gondek, T. M. (2023). Psychoactive substance use in patients diagnosed with attention-deficit/hyperactivity disorder: an exploratory study. Frontiers in psychiatry, 14, 1184023. https://doi.org/10.3389/fpsyt.2023.1184023
9. Federico, A., Mantovani, E., Casari, R., Bertoldi, A., Lugoboni, F., & Tamburin, S. (2021). Adult attention-deficit/hyperactivity disorder symptoms, cognitive dysfunction, and quality of life in high-dose use of benzodiazepine and Z-drug. Journal of neural transmission, 128(7), 1109–1119. https://doi.org/10.1007/s00702-020-02285-w
10. Zulauf, C. A., Sprich, S. E., Safren, S. A., & Wilens, T. E. (2014). The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Current psychiatry reports, 16(3), 436. https://pmc.ncbi.nlm.nih.gov/articles/PMC4414493/
11. Johnson, J., Morris, S., & George, S. (2020, June 8). Misdiagnosis and missed diagnosis of adult attention-deficit hyperactivity disorder. BJPsych Advances, 27(1), 60–61. doi:10.1192/bja.2020.34
12. Zhang, Z., Gu, W. J., Wei, Y., Wu, S., & Wang, C. (2025). Dialectical behavioral therapy for adult attention deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials. Psychiatry research, 351, 116551. https://doi.org/10.1016/j.psychres.2025.116551