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ADHD & Substance Abuse: Understanding the link, breaking the cycle

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ADHD: Low Dopamine

ADHD is naturally geared to lower levels of dopamine—the brain chemical that affects motivation, focus, and reward. Daily activities feel less satisfying, such as sports, movies or visiting with friends. When nothing can make you feel better, what is left?

Alcohol and other substances stimulate dopamine-releasing neurons, which can enhance the sensation of dopamine release. These substances do not increase dopamine, but rather can make it easier to feel the effect. When you’re struggling to enjoy simple activities at home, being able to briefly feel normal is like a dream.

“When dopamine levels are low, it’s hard to feel motivated or find joy in daily life,” child and adolescent psychiatrist Dr. Ayame Takahashi, MD explains, “Substances are like a shortcut to feeling happy, but the relief is temporary. This forces individuals to repeated use.”

Over time, the brain becomes adjusted to the use of substances, and builds a tolerance. Not only do individuals suffering from ADHD repeat use, but the use must increase to continue feeling the same level of enjoyment as the first.

This reinforces dependence, creating a cycle that makes recovery difficult.

ADHD: Impulsivity

Individuals with ADHD often struggle with emotional regulation, where stress, frustration, and even boredom can feel overwhelming. Tie this with a core symptom of ADHD, impulsivity, and doing anything would feel better than how you currently feel. 

 “In the moment, reaching for a substance may feel like an escape, but it often makes emotions more difficult to manage,” adds Dr. Takahashi.

The only way to numb daily life is with daily use. If you become so accustomed to dulling your daily life, dealing with daily emotions without substances becomes unbearable, almost painful. Again, an individual with ADHD is forced to look for an outlet for their emotions, and they’ve already found a shortcut once.

Breaking the cycle

Effective treatment starts by addressing both ADHD and substance use. Medication, therapy, and supportive care are a few tools a psychiatrist may use to help manage symptoms. Building healthier coping strategies is the ultimate goal of all treatment plans.

“When we treat ADHD and substance use together, we help people reclaim stability and move forward,” says Dr. Takahasi.

Understanding how the two are connected can empower individuals. It can help many realize that there is something bigger than them, and with help, it can be managed. 

At SIU Medicine, we believe in treating the whole person, not just the condition. Our care teams bring together clinical expertise and compassion to help patients regain control.

If you enjoyed this read, you might also enjoy our other blog, Navigating relationships with ADHD.

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