At the ASPARD conference, a poster was presented: Substance Use Motives and Patterns in People With and Without ADHD

A total of 404 individuals within the age range of 18-65 were enlisted for the study.
Among these 404 participants, 175 acknowledged having ADHD based on self-reports.
The evaluation of ADHD and substance use was conducted utilizing ASRS-v1.1 and ASSIST, respectively.
Additional measurement tools, such as GAD-7 and an updated Substance Use Motives Measure (SUMM), were employed.
Participants also underwent brief questionnaires to elicit information about their usage patterns.
Data analysis encompassed the application of correlation and regression models.
The findings showed distinctive motivations and usage patterns related to substance use in both the ADHD and control cohorts.

Key Findings

Treatment of ADHD did not reduce substance misuse, especially if there are severe ADHD symptoms.

Substance Use in ADHD patients Versus Non- ADHDers

Paradoxical Reactions:

Individuals with ADHD may exhibit paradoxical reactions to substances, meaning they might experience opposite effects compared to non-ADHD individuals. For instance, some people with ADHD might become more hyperactive or agitated after consuming certain substances instead of being calmer as expected.

Solitary Substance Use:

People with ADHD are more likely to use substances alone compared to their non-ADHD counterparts. This could be due to various reasons such as social anxiety, difficulty concentrating on group activities, or a preference for privacy while using substances.

Heightened Susceptibility to Cues:

Individuals with ADHD show increased susceptibility to substance-related cues in their environment. Environmental triggers like seeing someone smoking or smelling alcohol can be particularly potent for those with ADHD, increasing their likelihood of substance use.

Motives Driven by Coping, Social Interaction, and Performance:

The primary motivation for substance use among individuals with ADHD is often related to coping mechanisms, social interactions, and performance enhancement rather than pleasure seeking. In contrast, non-ADHD individuals might be more motivated by the desire to seek pleasure or fit in socially.

Self-Medication Hypothesis:

Although the self-medication hypothesis suggests that suffering is the driving force behind addictive disorders for both groups, the prevalence and motivation behind substance use may differ significantly between individuals with and without ADHD. Research indicates that only about 36% of individuals with ADHD use substances for self-medication purposes, unlike non-ADHD individuals who might use substances primarily for pleasure or other reasons.

Comorbidity and Most Commonly Misused Substances:

People with ADHD are highly likely to have comorbid substance use disorders, which is not the case for non-ADHD individuals. The most commonly misused substances among those with ADHD are marijuana, alcohol, or a combination of the two, while for non-ADHD individuals, it could be different types of drugs based on individual preferences and circumstances.

What do these findings imply?

Targeted Interventions for Individuals with ADHD: Policymakers should prioritize developing targeted interventions for individuals with ADHD aimed at promoting healthier coping strategies and addressing the unique motivations behind their substance use. This could include psychotherapy approaches tailored to the needs of individuals with ADHD, education and awareness programs, and accessible resources for substance abuse treatment.

Early Detection and Prevention: Given the high likelihood of comorbidity between ADHD and substance use disorders, early detection and prevention efforts are crucial. Policymakers should invest in initiatives that promote early identification and intervention for both conditions to minimize the potential harm and negative consequences associated with these issues.

Addressing Stigma and Accessibility: Stigma surrounding mental health conditions, including ADHD, can prevent individuals from seeking help. Policymakers should work towards reducing stigma by increasing public awareness, normalizing discussions around mental health, and ensuring equal access to treatment for individuals with ADHD.

Collaborative Approaches: Policymakers should foster collaborative approaches between healthcare professionals, educators, law enforcement agencies, and community organizations to address the complex interplay of substance use and ADHD. By working together, stakeholders can develop comprehensive, evidence-based policies that address the root causes of substance use in the context of ADHD and provide effective interventions for those in need.

Research and Funding: Continued research is essential to better understand the relationship between ADHD and substance use disorders. Policymakers should invest in funding for studies on this topic, as well as advocate for increased resources to support ongoing research and improve our understanding of these issues.

Policy Prioritization and Implementation: Ultimately, policymakers must prioritize addressing substance use and ADHD as critical public health concerns. This includes implementing evidence-based policies, allocating sufficient funding, and promoting collaboration between various stakeholders to create a supportive environment for individuals with ADHD and substance use disorders.

Reference:

Ágoston, C., Urbán, R., Horváth, Z., van den Brink, W., & Demetrovics, Z. (2022). Self-Medication of ADHD Symptoms: Does Caffeine Have a Role?. Frontiers in psychiatry, 13, 813545. https://doi.org/10.3389/fpsyt.2022.813545

Khantzian, E. J., MD. “The Theory of Self-Medication and Addiction.” Psychiatric Times, 16 Nov. 2020, www.psychiatrictimes.com/view/theory-self-medication-and-addiction.
Kuntz, L. (2024, January 19). Unique motivations and patters of substance use in individuals with ADHD. Psychiatric Times. https://www.psychiatrictimes.com/view/unique-motivations-and-patters-of-substance-use-in-individuals-with-adhd

Wilens, T. E., Adamson, J., Sgambati, S., Whitley, J., Santry, A., Monuteaux, M. C., & Biederman, J. (2007). Do individuals with ADHD self-medicate with cigarettes and substances of abuse? Results from a controlled family study of ADHD. The American journal on addictions, 16 Suppl 1, 14–23. https://doi.org/10.1080/10550490601082742

Wilens, T. E., Martelon, M., Joshi, G., Bateman, C., Fried, R., Petty, C., & Biederman, J. (2011). Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 50(6), 543–553. https://doi.org/10.1016/j.jaac.2011.01.021

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://doi.org/10.1007/s11920-013-0436-6

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