ADHD & Alcohol: Understanding The Link

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a mental health condition characterized by inattention, impulsivity, hyperactivity, and restlessness.¹ Generally, symptoms of ADHD emerge during childhood but persist into adulthood. Individuals often experience relationship, academic, work-related, and personal issues because of their differences and difficulties with procrastination, emotional dysregulation, and low self-esteem.²

Common symptoms of ADHD include:²

• Impulsivity
• Restlessness or trouble sitting still
• Forgetfulness
• Low motivation
• Difficulty with decision-making
• Hard time concentrating
• Difficulty completing tasks
• Disorganization

ADHD & Alcohol: How They’re Connected

Those with ADHD consume alcohol for many reasons. Some may find short-term relief from ADHD symptoms, like overthinking and hyperactivity. Others experience pleasure from taking risks, making them more likely to experiment with alcohol or other drugs at a young age.³

Moreover, the connection between ADHD and alcohol use is partly related to brain biology, as both conditions show impairments in areas related to impulsivity, rewards, and dopamine regulation. These factors make someone with ADHD more likely to drink alcohol.

Possible links between ADHD and alcohol abuse include:

Earlier Alcohol Use

ADHD impulsivity is a common symptom, meaning many individuals with ADHD have a higher tolerance for risk-taking. This tendency can lead them to experiment with alcohol earlier than their neurotypical peers. One study showed that 40% of teens with ADHD reported alcohol use compared to 22% of those without the condition.⁴

Higher Risk of Binge Drinking

Brain scans have shown both ADHD and alcohol use relate to low dopamine levels in the brain. This deficit affects impulsivity and risk-taking, possibly leading to binge drinking. Additionally, individuals are more likely to binge drink when attempting to self-medicate ADHD symptoms with alcohol.⁴

Increased Sensitivity to Alcohol

Some evidence suggests people with ADHD have increased sensitivity to alcohol, meaning they can experience the effects after drinking less than their neurotypical peers. This sensitivity can worsen symptoms of ADHD, including impulsivity, inattention, and poor focus.⁵

Higher Likelihood of Alcohol Use Disorder

People with ADHD are at a higher risk of an alcohol use disorder. Many are also less likely to benefit from therapy, with one study showing a 50% longer treatment duration for those with ADHD.⁶

Other research suggests ADHD and alcohol use disorder share the same brain network connections associated with impulse control, reward processing, and dopamine. Reduced dopamine can lead to unhealthy behaviors and seeking instant gratification. Therefore, many individuals with ADHD respond to the immediate effects of alcohol, putting them at higher risk for alcoholism.⁴

Unhealthy Coping Mechanisms

Some evidence suggests people with ADHD often use alcohol to self-soothe symptoms.⁵ For example, they may drink to mask low self-esteem, poor emotion regulation, and instability in relationships.⁵ However, this behavior does not improve the situation and often worsens overall well-being.

Stimulation-Seeking Behavior

Individuals with ADHD commonly seek stimulation to boost low dopamine levels.⁵ Alcohol is an easily accessible and almost immediate way to stimulate dopamine release. For this reason, those with ADHD may gravitate toward heavy or frequent alcohol consumption.

Does Alcohol Make ADHD Worse?

Like ADHD, alcohol affects cognitive, emotional, and social capacities. Because of this, symptoms of ADHD can feel more intense after drinking. For example, someone may notice they are more prone to risky behavior, poor concentration, and forgetfulness.

Symptoms of ADHD impacted by alcohol may include:

• Lack of attention and concentration
• Poor decision-making skills
• Impulsivity
• Sleep disturbances
• Issues in relationships
• Forgetfulness or tardiness
• Losing items or forgetting events
• Restlessness or hyperactivity

Impacts of Alcohol Misuse in ADHD

Alcohol misuse in ADHD is associated with various emotional and physical impacts. Studies suggest the transition from alcohol misuse to abuse happens faster in people with ADHD than in those without the disorder.⁵ Additionally, mixing stimulants with alcohol can result in dangerous health complications.⁶

Possible complications of alcohol misuse for those with ADHD include:⁶

• Depression: Depression is a possible long-term effect of mixing stimulants and alcohol. Unfortunately, hopelessness and sadness can cause a person to continue their cycle of abuse.
• Issues with sleep patterns: Mixing stimulants and alcohol can cause unpredictable sleep patterns, as one substance increases alertness while the other works as a depressant.
• Alcohol poisoning: Alcohol poisoning is a scary consequence of mixing stimulants and alcohol. Because stimulants increase attention and alertness, individuals may not notice the effects of alcohol on their bodies until they drink too much.
• Addiction: Studies indicate individuals with ADHD are at an increased risk for addiction than their non-ADHD counterparts.⁵
• High blood pressure or heart rate: Uncontrollable heart rate and blood pressure are two common and serious physical health complications that can arise when consuming alcohol with stimulants.

Do Alcohol & ADHD Medications Interact?

Mixing alcohol and ADHD medications can be dangerous. Drinking alcohol while taking stimulants like Ritalin and Adderall increases heart rate, blood pressure, and anxiety. Alcohol can intensify side effects from medication, leaving room for unpredictable reactions.⁶

Consuming alcohol with non-stimulant ADHD medications is not safe, either. Some of these medications can be hard on the liver (like alcohol), possibly leading to long-term, severe damage.⁷

Side effects of mixing alcohol and ADHD medications may include:

• Alcohol poisoning
• Seizures
• Increased heart rate
• Restlessness
• Vomiting
• Dehydration
• Impaired judgment

Treatment for ADHD & Alcohol Misuse

Treating ADHD and alcohol misuse simultaneously is essential. Untreated ADHD contributes to anxiety, impulsivity, and instant gratification seeking, which can create a vicious cycle of self-medicating with alcohol use. Furthermore, alcohol withdrawal can lead to insomnia, irritability, and worsened ADHD symptoms.

Treatment is available to address co-occurring ADHD and alcohol use disorder, offering someone the best chance at recovery. A comprehensive treatment plan often includes medication, therapy, medical care for alcohol withdrawal, and group support for maintaining sobriety. Therapy can help individuals address potential triggers, develop coping skills, and build support systems.

Treatment options for ADHD and alcohol use include:

• Rehab: Rehab is an intensive treatment that helps a person safely detox from alcohol and learn tools for recovery. Patients often reside in inpatient settings and receive medical care and mental health support.
• Partial hospitalization: This treatment approach is a step down from inpatient rehab. People can receive several hours of treatment daily and return home afterward.
• Intensive outpatient treatment: An intensive outpatient program (IOP) usually involves roughly nine weekly hours of treatment. IOP provides more intensive treatment than regular outpatient therapy while a person continues working and fulfilling other obligations.
• Medication: Many stimulants or non-stimulants are available for ADHD. Managing ADHD symptoms will help individuals stop drinking, and some prescriptions can also reduce cravings for alcohol. A psychiatrist can help determine the best medication regimen for you.
• Behavioral therapy: Behavioral therapies, including CBT for ADHD, can help a person address unhealthy thought patterns and behaviors that lead to alcohol use. Therapy can help break the cycle between alcohol use and ADHD by identifying the triggers, changing unhelpful thoughts, and establishing coping skills.

How to Cope With ADHD & Alcohol Misuse

Along with traditional treatment, self-help strategies are essential when addressing alcohol misuse. Explore different approaches that suit your needs, whether exercise, seeking social support, or trying a new hobby. Find something that brings you joy, and make self-care a regular practice to stay motivated, stable, and healthy.

Below are ways to manage alcohol consumption for those with ADHD:

• Monitor your alcohol consumption: Losing track of how much you drink is easy, especially when dealing with ADHD forgetfulness. Keep logs of your consumption to stay on track toward your goal of drinking less.
• Have an accountability buddy: Social support can help keep you accountable. Your loved ones can also provide validation and motivation as you make positive changes.
• Explore sober-curious groups: Changing your environment can help you create the conditions necessary to stay sober. Consider joining a sober-curious community or a local Alcoholics Anonymous group.
• Track your triggers: Identifying the people, places, and situations that prompt you to drink can help you minimize or avoid these triggers in recovery.
• Seek therapy: Therapy offers another environment of accountability and validation. Your therapist can also guide you through necessary changes and develop a recovery plan.
• Find other self-soothing strategies: Avoid using alcohol to self-soothe. Find healthier alternatives, such as journaling, mindfulness, or meditation for ADHD.

How to Find Professional Support For ADHD

A person with ADHD should consider seeking professional assessment, testing, and treatment from a psychologist, psychiatrist, or other ADHD specialist. Online psychiatrist options are also available.

You can find a neurodiverse-affirming therapist by searching an online therapist directory to start your journey toward sobriety. An online therapy platform can be a good choice, especially if in-person visits pose barriers to treatment.