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Half of Adults With ADHD Have Struggled With Alcohol, Drug Use

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Fully half of all young adults with concentration shortfall hyperactivity disorder (ADHD) may also battle alcohol or drug abuse.

And folks with ADHD who have a narration of depression or anxiety are particularly vulnerable to substance abuse problems, a new study showed.

“People with ADHD may be self-medicating with drugs or alcohol to keep their depression under control, and of course, that is a recipe for tragedy,” said study author Esme Fuller-Thomson. She is a professor of social work, medicine and nursing at the University of Toronto’s Factor-Inwentash Faculty of Social Work, and director of the Institute for Life Course and Aging in Toronto.

The findings “underline the need for effective interventions to address substance use disorders among those with ADHD,” she additional.

The new study included close to 6,900 Canadians aged 20 to 39 with and without ADHD, a disorder marked by trouble concentrating, sitting still and/or controlling impulsive behaviors.

People with ADHD were significantly more likely to have a substance abuse disorder than their counterparts without ADHD. Alcohol use disorders were the most common in the new study, followed by marijuana. And more than 1 in 6 young adults with ADHD had an issue with illicit drugs such as cocaine, LSD or heroin, the study found.The study didn’t look at how ADHD treatment affects risk for substance abuse. But cognitive therapy “has been shown to have a very positive effect on ADHD symptoms, substance abuse problems, and depression and anxiety,” Fuller-Thomson said.

Therapy often comprises sessions paying attention on developing coping skills and preventing relapse for substance abuse while also cultivating preparation and problem-solving skills to help manage ADHD symptoms.

The study is published in the August issue of Alcohol and Alcoholism.Substance abuse treatment programs can be trickier for people with ADHD, said psychologist Ari Tuckman, from Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

“When ADHD is untreated, it can be harder for folks with ADHD to get to meetings on time, commit to getting to bed earlier, eating a healthier diet, and reaching out for support in advance, not during a crisis,” said Tuckman, who was not involved with the new research.It may also be harder for people with ADHD to stay the course. “Given the lack of impulse control, people with ADHD may be more likely to break sobriety in the moment,” he said.

This is why getting a better handle on substance abuse begins with effectively treating the ADHD. “This is the first domino,” Tuckman said. ADHD treatment typically involves medication, counseling and behavioral therapy.

Dr. Scott Krakower, an attending psychiatrist with Zucker Hillside Hospital in Glen Oaks, N.Y., also looked over the study and agreed. “Treating the ADHD and any underlying mental health issues such as depression and anxiety will likely help with substance abuse as well,” he said.
More information

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) offers more information on substance abuse and ADHD.

SOURCES: Esme Fuller-Thomson, PhD, professor, social work, medicine and nursing, University of Toronto, Factor-Inwentash ability of Social Work, and director, Institute for Life Course and Aging, Toronto; Ari Tuckman, PsyD, MBA, clinical psychologist, West Chester, Pa.; and CHADD expert; Scott Krakower, DO, attending psychiatrist, Zucker Hillside Hospital, Glen Oaks, N.Y.; Alcohol and Alcoholism, Aug. 3, 2021
Meditation, yoga, breathing exercises, and other mindfulness behavior can help children with attention deficit hyperactivity disorder, but it’s not just the kids who benefit.

When families of children with ADHD total a mindfulness program together, a new study suggests, children and parents can profit, with potential boosts to self-control, self-compassion, and psychological symptoms.
The findings do not suggest children should ditch medication in favor of focusing on the present moment. Instead, the study adds to growing evidence that mindfulness can be a helpful tool along with other strategies for children and adults with ADHD, says John Mitchell, PhD, a psychologist at Duke Universitywho was not concerned with the new study. Mindfulness might help families ease stress and improve excellence of life.

“We talk about ADHD because one person has that diagnosis, but we don’t live in bubbles,” he says. “We’re all interconnected and impact one another. And having treatments that acknowledge that and measuring that in the scientific literature is pretty important.”

Mindfulness training, which has its roots in Eastern traditions, generally aims to teach people how to be present in the moment and let go of judgment. Over the last couple of decades, researchers working on depression and other conditions have gathered evidence that practicing mindfulness can help in a variety of ways, including with the self-regulation of attention and emotions. It didn’t take long for those findings to draw interest from researchers who study ADHD, Mitchell says.

Research on mindfulness for ADHD started with adults, and results have been encouraging, Mitchell says. People who complete a mindfulness program tend to show some improvement in focus, impulsivity, and hyperactivity, studies show. In one small pilot study, Mitchell and colleagues reported improvements in symptoms and executive function in adults with ADHD.

Studies with children have lagged behind, but recent work has been promising. When looking at data from a number of studies, researchers have found small reductions in inattentiveness, hyperactivity, and impulsivity in young people with ADHD. Several randomized controlled trials have also shown a reduction in symptoms as rated by parents and teachers.

Greater Understanding, Acceptance
In related research, there was a noticed decrease in stress among parents who get mindfulness training that teaches them to listen with their full attention, accept and develop compassion for themselves and their children, and regulate themselves within the association with their kids.

Still, first-line treatment for kids with ADHD usually includes a combination of medication, cognitive behavioral therapy, and education, even though those strategies don’t always work well for everyone, says Corina Greven, PhD, a psychologist at Radboud University Medical Centre and Karakter Child and Adolescent Psychiatry in the Netherlands.

Despite suggestive results, the data on mindfulness remains murky, in part because early studies that looked at mindfulness training for children with ADHD have been small. Few trials of mindfulness treatment for ADHD, Greven says, have included parents.

To fill in some of the gaps, Greven and colleagues conducted a trial with 103 families who had a child with ADHD between ages 8 and 16. Half of the families were randomly assigned simply to continue care as usual, which included medication for most.

i have always been extroverted and well, kinda adhd and can’t barely focus on one thing/ learning and expanding my spirituality made me practice mindfulness and it caused me peace ngl. i love it here and my peace as well as protecting it and knowing how precious it is.

— 444 (@444SAFESPACE) July 12, 2021
The other half continued their usual care and also took part in a program called MYMind, which used mindfulness-based cognitive therapy for children and mindful parenting training for parents.

Families attended 90-minute group sessions once a week for 8 weeks, with an extra session 2 months later. The mindfulness group also completed homework every day that took about 30 to 45 minutes for parents and 15 minutes for children. Homework included workbooks and guided meditations.

In the short term, the team reported, children who received the mindfulness intervention showed small improvements in ADHD symptoms, anxiety, autistic symptoms, and problems falling asleep. One in 3 children who received mindfulness training improved on measures of self-control, Greven adds, compared with just 1 in 10 who got only their usual care.

Benefits were larger and longer-lasting for parents. Compared with parents who didn’t get mindfulness training, those assigned to the mindfulness group improved in self-control, self-compassion, depression, anxiety, stress, well-being, and their own ADHD symptoms. Given a large genetic component to the disorder, it is common for parents of children with ADHD to have a diagnosis or ADHD symptoms as well. In addition, Greven says, families who completed the mindfulness-based intervention reported improvements in their relationships as well as acceptance of ADHD.

A New Therapy?
The findings suggest new possible behavior options for children with ADHD, and for their parents, Greven says, as well as a need to study the condition more broadly. “Although parents of children with ADHD often have elevated parenting stress, anxiety, or their own ADHD symptoms, usual interventions for children with ADHD do not typically target parental mental health,” she says. “As researchers, we need to go broader than just looking at whether an intervention reduces symptoms and include additional outcomes that families find significant.”

It will take more research to find out who is most likely to benefit from mindfulness training and how long those benefits last, but the new study is a useful starting point, experts say.

“Mindfulness training had potentially short-term and long-term helpful effects to children with ADHD and their parents,” says Samuel Wong, MD, director of the JC School of Public Health and Primary Care at the Chinese University of Hong Kong. He says mindfulness is more likely to become an add-on than a substitute for other kinds of therapies.

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