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ADHD in Addiction Recovery: How to Focus On Healing

By Martha McLaughlin

If you’ve been diagnosed with ADHD, you may find that creativity, spontaneity and energy come to you easily. You may also find that you often feel scattered, unorganized or forgetful, which in turn, may leave you feeling foolish, ashamed or altogether inadequate.

It’s not unusual for individuals with ADHD to experience these feelings. And when they do, self-medication through drugs and alcohol may become a learned coping mechanism. Sadly, the use of these substances can easily pave the way toward addiction.

One reason that people with ADHD may consciously or unconsciously try to manage the disorder with drugs and alcohol is that many substances raise levels of the neurotransmitter dopamine, and low levels of that brain chemical are associated with ADHD symptoms. Individuals with ADHD tend to have higher numbers of proteins called dopamine transporters in their brains and nervous systems, which inhibit the ability of dopamine to pass from cell to cell. This lowers the effect dopamine has in the body.

Unfortunately, drugs and alcohol aren’t a good long-term solution to managing ADHD or its related symptoms. In fact, over time, the body reacts to substance use by lowering the amount of dopamine it naturally produces or by making receptor cells less sensitive.

The Complication of Stimulant Medications

It’s always best to treat addiction and any co-occurring mental health conditions together. And if you deal with both ADHD and addiction issues, addressing the ADHD is important. One complicating factor, however, is that many of the medications commonly used to treat ADHD are stimulants, which are controlled substances themselves and could be potentially problematic for people in recovery. You and your doctor can address this issue in a number of ways, including:

  • Use non-stimulant medication – You may want to try a non-stimulant ADHD medication, such as Strattera, Kapvay or Intuniv. A handful of drugs used to treat high blood pressure have also been proven helpful in managing ADHD symptoms, and some patients have success with certain antidepressants, such as Wellbutrin.
  • Use timed-release stimulants – Many ADHD medications come in long-acting forms which make them less likely to be abused. Your doctor may prescribe slow-release capsules or a skin patch.
  • Involve others – Many practitioners and patients find it helpful to include other people in the treatment process. One of your family members, for instance, can store the medication for you.
  • Optimize your physical health – Physical conditions, such as blood sugar issues or disordered sleep, can contribute to or worsen ADHD symptoms. Diagnosing and addressing them can reduce the need for ADHD medication.
  • Use non-medical modalities of treatment – Cognitive Behavioral Therapy (CBT) has been shown to reduce ADHD symptoms in adults with the condition.1 Dietary interventions, such as supplementing free fatty acids and avoiding artificial food colors, have also been proven beneficial.2

Maintaining Focus

Many of the suggestions addiction counselors commonly give to their patients may be especially important for people managing ADHD during their recovery:

  • Keep the goal in mind. Anything you can do to remind yourself of why the effort of recovery is worth it will be helpful. This can include keeping lists or photos on your wall or smartphone that remind you of the ways that life is not better and will continue to become better when it’s not ruled by addiction.
  • Remember the negative consequences of substance use. In addition to keeping a written list of the problems caused by drugs and alcohol, it’s helpful to use mental strategies to keep memories accessible enough to be helpful. The author of an article on impulse control for people with ADHD recommends picturing a TV or computer screen in your mind, then playing a video on it of what happened in the past when you acted impulsively. He notes that the more often you practice, the more automatic it will become.3
  • Prepare for cravings. Everyone has their own personal relapse triggers, and having a plan in place to combat them and keeping reminders at hand is important. The list may include things like removing yourself from the situation, urge surfing (a technique that involves riding out cravings like surfing a wave), calling a friend and distracting yourself.
  • Make an effort to manage stress, which is a common relapse trigger. Stress can come from many sources and is often related to unresolved problems. Identifying potential solutions to troubling issues and breaking those down into manageable steps and goals can go a long way toward lowering stress levels.
    • Learning stress reduction techniques like meditation, progressive muscle relaxation and breathing exercises is also wise.
    • Many people find it helpful to set timers which remind them to check in with themselves and consciously release any tension they are carrying.

All people enter addiction recovery with a personal combination of factors that affect the process in both positive and negative ways. Comprehensive treatment programs know how to identify them and how to help people build on their strengths and overcome their challenges. When people’s unique situations are addressed, there’s much hope for a full, healthy and joyful life.

1 Safren, S.A., et al. “Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms.Behaviour Research and Therapy, July 2005.

2 Sonuga-Barke, Edmund J.S., et al. “Nonpharmacological Interventions for ADHD: Systematic Review and Meta-Analyses of Randomized Controlled Trials of Dietary and Psychological Treatments.” American Journal of Psychiatry, March 1, 2013.

3 Barkley, Russell. “How to Shut Your Mouth — and Your Wallet.” ADDitude Magazine, Winter 2011.