Unique Motivations and Patterns of Substance Use in Individuals With ADHD

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CONFERENCE REPORTER

Individuals with attention-deficit/hyperactivity (ADHD) show distinct motivations and patterns of substance use. Additionally, treating ADHD symptoms does not decrease an individual’s likelihood of misusing substances.

The poster, “Substance Use Motives and Patterns in People With and Without ADHD,” presented at the American Professional Society of ADHD and Related Disorders 2024 conference sought to understand motivations and patterns of substance use in individuals with ADHD compared with controls.¹

Investigators recruited 404 participants between the ages of 18-65, and of that 404, 175 self-reported ADHD. The ASRS-v1.1 and ASSIST were used to assess ADHD and substance use, respectively, along with additional scales such as the GAD-7 and an updated Substance Use Motives Measure (SUMM). Participants were also assessed via brief questionnaires that inquired about usage patterns. Then, data were analyzed through correlation and regression models. Results confirmed different substance use motivations and patterns between the ADHD and control groups. Investigators identified distinctive patterns in the ADHD group, such as paradoxical reactions, solitary usage, and heightened susceptibility to cues. However, gender, age, and anxiety levels were not significant mediators. Furthermore, treatment of ADHD did not decrease the likelihood of participant substance misuse, especially among participants with severe ADHD symptoms. For those with ADHD, motives were primarily linked to “coping, social interaction, and performance.”

This aligns with the self-medication hypothesis, which posits that “suffering (not pleasure seeking) is at the heart of addictive disorders.”² While this hypothesis holds weight, it is important to note that in a previous study seeking to examine ADHD and self-medication, investigators surveyed participants and found that only 36% of used substances for self-medication, while 25% used to get high, and 39% had unknown motivation.³ Separate research found that adolescents with ADHD are highly likely to have a comorbid substance use disorder, potentially self-medicating, and the most commonly misused substances are marijuana, alcohol, or the combination of the two.^4,5 New research also indicates individuals with ADHD may use caffeine to self-medicate as well.⁶

In order to develop targeted psychotherapy interventions and healthier coping strategies for individuals with ADHD, more knowledge and understanding of these motivations is needed.

References

1. Sergeeva M. Substance use motives and patterns in people with and without ADHD.

2. Khantzian EJ. The theory of self-medication and addiction. Psychiatric Times. February 21, 2017. https://www.psychiatrictimes.com/view/theory-self-medication-and-addiction

3. Wilens TE, Adamson J, Sgambati S, et al. Do individuals with ADHD self-medicate with cigarettes and substances of abuse? Results from a controlled family study of ADHD. Am J Addict. 2007:16 Suppl 1:14-21; quiz 22-3.

4. Zulauf CA, Sprich SE, Safren SA, Wilens TE. The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Curr Psychiatry Rep. 2014;16(3):436.

5. Wilens TE, Martelon M, joshi G, et al. Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. J Am Acad Child Adolesc Psychiatry. 2011;50(6):543-553.

6. Ágoston C, Urbán R, Horváth Z, et al. Self-medication of ADHD symptoms: does caffeine have a role? Front Psychiatry. 2022;13:813545.