Addictions

by Gina Jadwisiak LCSW-C

Individuals with ADHD have many characteristics that put them at higher risk for developing addictions.  Impulsivity, craving excitement and the tendency to be easily bored, naturally go hand and hand with ADHD and may also be biological booby-traps for addictions.

Biological Factors

Dopamine is the pleasure drug of the brain.  It helps you find enjoyment and to pay attention to the less interesting parts of life.  When there is low dopamine tone, the body craves excitement which increase attention and stimulation. (Hallowell)  When the excitement of choice becomes a drug, we call this self-medicating.

Addiction to Drugs and Alcohol

Here is a list of signs and symptoms that parents can use to determine if their child might have a problem:

1. Your child just doesn’t seem him/herself
   
2. Mood changes (crying, irritable)
   
3. Changes in physical appearance (hygiene, unusual style change)
   
4. Money or valuables become missing
   
5. Secretive behavior (door locked and takes a long time to answer)
   
6. Hostile or aggressive outbursts
   
7. New or unusual sleeping habits
   
8. Missing school (skipping or is too tired or sick)
   

Other problems that may increase:

1. Forgetfulness
   
2. Decline in school/work
   
3. Motivation worsens
   

Signs that You Might Have an Addiction to Drugs or Alcohol:

1. Your friends think you have a problem
   
2. Your family thinks you have a problem
   
3. You experience negative consequences because of your use (loss of friends, police involvement, etc.)
   
4. You have been unsuccessful with your attempts to cut back or stop
   
5. Poor grades or work performance
   
6. You no longer want to do activities that do not involve your drug of choice
   
7. You feel guilty about your drug or alcohol use
   
8. You have violated your own value system (stolen, harmed others, etc.)
   
9. You think you might have a problem
   

Help is Near By

If you think you are experiencing a problem with addiction, the first step is to talk to someone about it.  We recommend an evaluation from someone who knows about both ADHD and addiction.  Self-help groups like AA and NA may also be useful.   

Recovery is Not Easy But it is Achievable

1. It is common to have false starts and to relapse. 
   
2. Individuals with ADHD may have more frequent relapses
   
3. Why?
   
4. Impulsiveness
5. Boredom with the recovery process.
6. Missing relapse cues. 
   

If relapse occurs, it is cause for evaluation not devastation.  Changes in your recovery plan can help prevent relapse or help one restart if a relapse has occurred.  Such changes might be discussed with your counselor or support group.

Example of changes could include:

1. Attendance at more varied support groups
   
2. Increasing high energy activities with sober friends (e.g. skiing, rock climbing)
3. Changing sleep and eating habits
   
4. Talking daily to a supportive friend
   
5. Journaling
6. Joining a group counseling program
7. Exploring medication
   

Medication

There are a variety of opinions on whether an individual should take stimulant medication if they have an addiction history.  Most studies agree, that it is important to stabilize the addiction first, (Riggs).  Once the addiction is stabilized, depression and ADHD can then be addressed, (Wilens). Others fear that without stimulant medications, relapse is more likely to occur due to impulsivity and inattention to warning signs.    Some suggestions might be to have medication closely monitored by a parent or school system.  Medication such as Strattera,(Brady,Wilens), Effexor and Wellbutrin may also be considered as alternatives to stimulants.  This is an important issue that should be discussed between you and your health care provider. 

Abuse of Stimulant Medication

There is a great deal of concern about the abuse of stimulant medication.  It is estimated that 11% of prescribed stimulant medication is sold on the streets.(Wilens) Abuse of stimulants also occurs when medication is taken at a higher dose than prescribed simply to alter mood or to overcome irresponsible behavior (e.g. - college student takes higher dose to cram for finals).  If medication is being abused, it is important to assess why.  New skills and strategies might then be developed to help.  A coach, therapist and/or self-help group sponsor may all be useful in achieving this goal.

Prevention

Some fear that the use of stimulants may lead to an addiction to drugs.  Research, however, suggests that it may pose as a safeguard.  (Biederman) Individuals who start taking stimulants early may have:

1. Higher self-esteem
   
2. Are less impulsive
   
3. Choose healthier peer groups
   
4. Develop effective problem solving skills
   

These qualities will better equip them for when they are faced with the choice to use or walk away.      

Talking early, (age 10-12) and often about the impact of alcohol and drugs is vital for prevention of substance abuse problems.  Topics for discussion with your child could include:

1. What drugs are abused in their school
2. Why people use drugs
3. What might they do if approached about drugs
4. The differences between Rx medication and illegal drugs use
   

Sometimes it is helpful to use a TV show or a class assignment as a jumping off spot to start the conversations.

If your child displays aggressive behavior and has had many problems with authority and rule violation, he/she is at a higher risk for substance abuse.  Consider counseling to address these issues and the dynamics they cause in the family.  Family therapy, familial play therapy and individual counseling may be of assistance. 

Substance abuse is hereditary.  If a parent has a problem or  is in recovery, talk about this and its effects on the family.  If, as a parent, you feel you abuse drugs/alcohol, be aware of the message you are sending your child.  If a family member attends a recovery support group, attendance at a support group like AA or Al-teen might be educational.

Dealing with Other Addictions

If we return to our discussion on biological factors, we know that poor dopamine tone leads to cravings for excitement.  Other behaviors can become habitual and problematic as well.  Examples are:

1. Eating disorders
2. Gambling
3. Compulsive spending
   
4. Love addictions
5. Addiction to work
6. Addiction to high risk behavior (speeding etc.)
7. Porn
8. Gaming
9. Internet Surfing
   

If you or someone you know is experiencing a problem in any of these areas, you are not alone.  It is first important to asses what purpose the behavior is serving.  Is it fulfilling a need to socialize, be stimulated, reduce stimulation, avoid emotions?  Is it a by product of hyper focus?  It is important to remember that a habitual behavior always serves a psychological purpose, initially. 

Once the purpose of the behavior has been explored, strategies and a plan for change can be developed. 

Conclusion

Individuals with ADHD have a higher risk for developing addiction problems, potentially due to low dopamine tone.  Early communication about risk factors can help in prevention of addictions.  If an addictions develop, help is available.  The first step is to talk to a counselor with experience in ADHD and Addictions or attend a self-help group.

Gina Jadwisiak, LCSW-C, has a particular interest in working with individuals who have both ADHD and addictions.

Top | Home | Services | ADHD | About Us | Clinic Info | Appointment | Contact | Privacy Policy

Designed and Developed by flyte new media
email Web Master