“My ADHD made me viscerally uncomfortable in my own body, desperately bored, and so impulsive that it was maddening. I often felt like I was crawling out of my skin,” says Sam Dylan Finch, an advocate and blogger at Let’s Queer Things Up, which focuses on mental health in the LGBTQ+ community.
Like many people with attention deficit hyperactivity disorder (ADHD) — it’s estimated that of adolescents with substance use problems fit the diagnostic criteria for ADHD — Sam is currently in recovery for addiction.
He’s also a part of the mere 20 percent of adults with ADHD that have been properly diagnosed or treated, since he was diagnosed with ADHD at 26.
Although he only started using substances when he turned 21, Sam rapidly found that he was using them — particularly alcohol and marijuana — in unhealthy ways.
“I wanted to slow myself down, cope with the unbearable boredom, and try to take the edge off of my reactive and tense emotions,” he says.
People with ADHD have above-typical levels of hyperactive and impulsive behaviors, and may have trouble focusing their attention on a task or sitting still for long periods of time.
Symptoms of ADHD include:
- having trouble focusing or concentrating on tasks
- being forgetful about completing tasks
- being easily distracted
- having difficulty sitting still
- interrupting people while they’re talking
Teens and adults with ADHD often turn to substances, like Sam did.
While there’s no clear cut answer as to why, Dr. Sarah Johnson, MD, medical director at Landmark Recovery, a treatment center for drug and alcohol dependency, says that people with ADHD have issues regulating neurotransmitters such as dopamine and norepinephrine.
“Drug-seeking behavior may be used as a means of self-medication in order to compensate for this lack of balance and to avoid feelings of unpleasantness,” she explains.
It’s particularly challenging for adults with untreated or completely undiagnosed ADHD.
“It’s like playing with fire you can’t see, and wondering why your hands are burning,” explains Sam.
Sam is now in recovery for his substance use and receiving treatment for ADHD, and he feels the two are inextricably linked. He’s on Adderall now to manage his ADHD and says that it’s like night and day — he’s calmer, happier, and doesn’t have an overwhelming sense of dread when he has to be still or sit with himself.
“For me, there’s no recovery from substance abuse without treatment for my ADHD,” Sam says.
He and his therapist also noticed that boredom was one of his common triggers for his substance use. His treatment needed to center around helping both manage and channel that inner restlessness, without inducing it through drugs or alcohol.
The best treatments for people who have both ADHD and an addiction will treat both at the same time.
“In the case of substance abuse issues, patients need to be sober before beginning treatment for their ADHD,” explains Dr. Johnson.
Dr. Johnson says that properly taking prescribed medication helps reduce the risk of substance use issues. Some general steps that people with ADHD can take to reduce their risk of addiction include taking ADHD medication as prescribed, exercising regularly, and having continual behavioral health checkups during treatment.
She also says that prescribers and clinicians can help their patients reduce their risk for misusing stimulants or becoming addicted to them by prescribing long-acting medications rather than shorter-acting ones.
For adults with ADHD, the key is diagnosing and properly treating the condition. But it’s also possible to reduce the risk that teens and adults will turn to substance use in the first place.
“One of the strongest predictors of substance use disorders in adulthood is the early use of substances, and children and teens with ADHD have an increased likelihood of using substances at an early age,” says Dr. Jeff Temple, a licensed psychologist and director of behavioral health and research in the department of OB-GYN at the University of Texas Medical Branch.
The best way to prevent addiction for people with ADHD is by receiving treatment earlier.
This means that clinicians and parents need to work together after a child or teen is diagnosed with ADHD to figure out what the best treatment plan is — whether that’s therapy, medication, behavioral interventions, or a combination.
Rachel Fink, a mother of seven kids and an editor at Parenting Pod, has three kids who have been diagnosed with ADHD. Her kids’ treatment is a combination of medication, accommodations at school, and regular exercise.
She was originally reluctant to medicate her children, but says that it’s been highly beneficial. Two out of three of her kids with ADHD are currently on medication.
“Both children who took medication went from getting sent home daily and almost being completely expelled from school, to getting high grades and being successful students,” she says.
Sam wishes that his parents had known what Rachel knows — and that he’d been able to get a diagnosis and proper treatment for his ADHD earlier.
Many parents are reluctant to medicate their children, like Rachel was at first, but it’s extremely important to find an effective treatment plan for ADHD as early as possible.
Treatment may differ for individuals, but it can stop kids and teens from experimenting dangerously with drugs and alcohol early in an attempt to self-medicate.
“That’s really what I wish I’d understood — to take ADHD seriously,” Sam says. “Weigh the risks carefully. Intervene early. It can change the course of your entire life.”
Alaina Leary is an editor, social media manager, and writer from Boston, Massachusetts. She's currently the assistant editor of Equally Wed Magazine and a social media editor for the nonprofit We Need Diverse Books.