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How Alcohol Affects Those with ADHD

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What is Attention Deficit/Hyperactivity Disorder (ADHD)?

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder. It typically presents in childhood, but lasts into adulthood. ADHD causes problems with focus, behavior, and movement.

Three key behaviors of ADHD include:

  • Difficulty staying on task and maintaining focus
  • Excessive movement, including fidgeting and talking too much, even in inappropriate situations
  • Engaging in impulsive or risky behavior with no regard for the consequences

Not everyone experiences all three components of ADHD symptoms.

Because of this, there are three different types of ADHD:

  • Impulsive/hyperactive
  • Inattentive and distractible 
  • Combined
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ADHD and Alcohol Risk Factors 

ADHD does not cause alcohol use disorder (AUD). There is no guarantee that people with ADHD will develop alcoholism. 

However, the disorder is linked to AUD and increases the risk for someone to develop it. 

Links between ADHD and AUD include:

  • According to a 2018 study, severe ADHD is associated with early-in-life consumption of alcohol. There’s also a higher risk of binge drinking.1,2 
  • A 2009 study also showed that people with ADHD tend to have a higher sensitivity to alcohol and experience faster impairment after drinking.3
  • Drinking can exacerbate common symptoms like focus and impulsiveness in children and adults with ADHD. 
  • Alcohol interferes with memory, decision-making, and cognition. People with ADHD struggle with these issues and alcohol can worsen them. 

How Does Alcohol Affect People With ADHD?

The effects of alcohol in someone without ADHD are similar to those with the disorder. 

But the issue is that these symptoms are already a challenge for people with ADHD and substance use makes them worse. 

In other words, people with ADHD face challenges that become more challenging when they consume alcohol. 

For instance, people with ADHD struggle with focus and attention. Alcohol makes focusing on things more difficult. 

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Does Alcohol Make ADHD Worse?

People with ADHD may “self-medicate” with alcohol to alleviate ADHD symptoms. 

For many, this leads to binge drinking, increasing the risk of long-term misuse and addiction.

Drinking alcohol to ease ADHD symptoms creates a self-destructive cycle that can be avoided with proper treatment. It is a dangerous combination that makes recovery tougher and symptoms more intense. 

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Can Alcohol Interact With ADHD Medications? 

Yes. The effects vary based on the type of medication a person uses. For example:

Stimulants

This category includes Adderall and Ritalin, both of which are commonly prescribed to people with ADHD. They increase central nervous system (CNS) activity. Alcohol decreases CNS activity.

The effects of alcohol don’t cancel or neutralize the intended effects of Adderall or Ritalin. 

Instead, it increases the negative side effects of these medications, including:

  • Elevated blood pressure
  • Increased heart rate
  • Insomnia

Non-stimulants 

Atomoxetine (Strattera) is a non-stimulant medication used to treat ADHD. 

The risks of mixing this drug with alcohol are lower than stimulant drugs. However, nausea is common among people who drink heavily while using Strattera. 

It’s important to note that a person’s reaction to mixing alcohol with ADHD medications varies greatly. 

For example, the amount of alcohol consumed and the dosage of the mediation play a significant role in a person’s reaction. 

Many adults with ADHD who take medications are fine having an occasional alcoholic drink. But they should speak to their doctor before combining substances. 

Treatment for Alcohol Misuse & ADHD

It’s important that people with ADHD and alcohol addiction seek treatment that addresses both issues. 

People with co-occurring disorders have a better chance of successful recovery if their mental health condition(s) are treated in combination with the substance use disorder(s). ADHD is no exception. 

Left untreated, the effects of ADHD and abusive alcohol use can worsen over time.

The first stage of AUD treatment is detox and withdrawal. 

For many adults with ADHD and AUD, this is the most difficult phase because their bodies are purging the substance. The risk of relapse is great and symptoms can be fatal. It’s important to seek medical supervision for moderate to severe alcohol withdrawal.

Once the detox and withdrawal phase is complete, comprehensive treatment can begin. 

There are various levels of care, all of which provide effective treatment. 

Determining whether an inpatient, outpatient, or long-term care treatment program is the best option is based on a variety of factors, including:

  • Budget
  • Employment obligations
  • Personal responsibilities
  • Schedule
  • Location
  • Insurance coverage

Comprehensive or integrated treatment plans address both ADHD and AUD. Treatments that are helpful for adults with ADHD and AUD include:

  • Cognitive-behavioral therapy (CBT)
  • Motivational enhancement
  • Contingency management
  • Self-help and peer group meetings

Additionally, medications are effective for treating ADHD symptoms and AUD. Common medications prescribed to treat these co-occurring disorders include:

  • Disulfiram
  • Naltrexone
  • Acamprosate
  • Stimulant medications for ADHD (used according to doctors’ orders and/or are given in extended-release forms)
  • Non-stimulant medications

All of these treatments are best used in combination with one another to treat ADHD and alcohol misuse.

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Updated on November 16, 2021
9 sources cited
  1. The Clinically Meaningful Link between Alcohol Use and Attention Deficit Hyperactivity Disorder.” Pubs.niaaa.nih.gov.
  2.   Howard, Andrea L., et al. “Developmental Progression to Early Adult Binge Drinking and Marijuana Use from Worsening versus Stable Trajectories of Adolescent Attention Deficit/Hyperactivity Disorder and Delinquency.” Addiction, vol. 110, no. 5, 24 Mar. 2015, pp. 784–795, 10.1111/add.12880.
  3. Weafer, Jessica, et al. “Increased Sensitivity to the Disinhibiting Effects of Alcohol in Adults with ADHD.” Experimental and Clinical Psychopharmacology, vol. 17, no. 2, Apr. 2009, pp. 113–121, 10.1037/a0015418.
  4. Centers for Disease Control and Prevention. “What Is ADHD?” Centers for Disease Control and Prevention, CDC, 19 Sept. 2018.
  5. Mariani, John J., et al. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” American Journal on Addictions, vol. 16, no. s1, Jan. 2007, pp. 45–56, 10.1080/10550490601082783.
  6. Mayo Clinic. “Attention-Deficit/Hyperactivity Disorder (ADHD) in Children - Symptoms and Causes.” Mayo Clinic, 25 June 2019.
  7. ADHD | NAMI: National Alliance on Mental Illness.” Nami.org, 2020.
  8. Luderer, Mathias, et al. “Alcohol Use Disorders and ADHD.” Neuroscience and Biobehavioral Reviews, vol. 128, 1 Sept. 2021, pp. 648–660,  10.1016/j.neubiorev.2021.07.010.
  9. Sterling, Stacy, et al. “Integrating Care for People with Co-Occurring Alcohol and Other Drug, Medical, and Mental Health Conditions.” Alcohol Research & Health : The Journal of the National Institute on Alcohol Abuse and Alcoholism, vol. 33, no. 4, 2011, pp. 338–49.

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