The Co-Occurrence of ADHD and Substance Use Disorders

Investigating the connection between alcohol and substance use disorders (SUD) and attention-deficit/ hyperactivity disorder (ADHD) has been of great interest due to the potential of improving outcomes for people with both diagnoses. A high risk for cigarette smoking and SUD exists in youth who grow up having ADHD. Conversely, high rates of ADHD are noted in SUD. Reasons for the excessive bidirectional overlap appear multifactorial, including neurobiological and psychosocial risk factors. Data suggest that medication treatment of ADHD reduces the subsequent onset of cigarette smoking, drug and alcohol misuse, and SUDs. Treatment of patients with co-occurring SUD and ADHD necessitates consideration of both disorders. Cognitive-behavioral therapy with the consideration of nonstimulant and sustained-release stimulant medication appears useful in these comorbid patients. Stimulant misuse and diversion needs to be considered in high-risk groups with ADHD, such as those with SUD.