ADHD and Addictions 5 more Clinical Studies

Post from: Adult ADD Strengths

As a follow up to my last post,

Here are 5 more studies on the well known (among those familiar with ADHD) links between ADHD and Addictions.

Or 5 more reasons why governments should start properly diagnosing and treating adults and children with ADHD now, or pay 100 times the price later in addictions and all the associated costs; crime, incarceration, additional health care costs, career costs, family damage, etc. And I’m not even mentioning the links between ADHD and tobacco and marijuana, which are the #1 and #3 most popular drugs for children and adults with Attention Deficit Hyperactivity Disorder to abuse.

You can also look at my check 3 part series of posts on ADHD and Crystal Meth Part One as well as Part Two and Part Three.

1. 35% of Cocaine Abusers had ADHD

Comprehensive Psychiatry. 1993 Mar-Apr;34(2):75-82

35% of 298 treatment-seeking cocaine abusers met DSM-III-R (the previous version of DSM IV)
criteria for childhood ADHD. Those that had ADHD were 78% male, 93% had conduct disorder and 47% had antisocial personality disorder and report a history of conduct disorder in first-degree relatives.

Cocaine abusers with childhood ADHD were younger at presentation for treatment and reported more severe substance use, earlier onset of cocaine abuse, more frequent and intense cocaine use, intranasal rather than freebase or intravenous use of cocaine, higher rates of alcoholism, and more previous treatment. This pattern of cocaine use is consistent with clinical descriptions of self-medication of residual symptoms of ADHD in cocaine abusers. Data from this study suggest that there may be more cocaine abusers with a history of ADHD than previously recognized in clinical samples of cocaine users, and that these individuals may differ in clinically meaningful ways from those without childhood ADHD. Moreover, the poorer outcome of subjects with ADHD in this sample underlines the importance of identifying and treating residual symptoms of ADHD in cocaine abusers.

2. 24% of Psychoactive Substance Abusers had ADHD

J Clin Psychiatry. 2000 Apr;61(4):244-51

Two hundred one participants were selected randomly from 2 chemical dependency treatment centers

Forty-eight (24%) of the participants were found to meet DSM-IV criteria for ADHD. The prevalence of ADHD was 28% in men (30/106) and 19% in women (18/95; NS). Seventy-nine participants (39%) met criteria for conduct disorder, and 34 of these individuals also had ADHD. Overall, individuals with ADHD (compared with those without ADHD) were more likely to have had more motor vehicle accidents. Women with ADHD (in comparison with women without ADHD) had a higher number of treatments for alcohol abuse.

CONCLUSION: A significant overrepresentation of ADHD exists among inpatients with psychoactive substance use disorders. Over two thirds of those with ADHD in this sample also met criteria for conduct disorder. Our sample had a very large overlap between ADHD and conduct disorder, and the major comorbidities identified here were attributable largely to the presence of conduct disorder. Individuals who manifest conduct disorder and/or ADHD represent a significant proportion of those seeking treatment for psychoactive substance use disorders. They appear to have greater comorbidity and may benefit from a treatment approach that addresses these comorbidities specifically through medical and behavioral therapies.

3. 32% of Cocaine Users and Alcoholics had ADHD

American Journal of Drug Alcohol Abuse. 1999 Aug;25(3):441-8

Of 136 inpatients with an SUD (substance use disorder) diagnosis (cocaine vs. alcohol vs. cocaine/alcohol) 32% had ADHD.

There were no significant differences in the percentage of ADHD between the SUD+ groups divided by drug choice…. Patients with cocaine use were more likely to have ADHD in childhood only when compared to the alcohol or cocaine-alcohol groups. The findings of this study indicate that ADHD is prevalent in treatment-seeking substance users without difference in prevalence or subtype by drug choice.

4. 70% of Crystal Meth (Methamphetamine) Inpatients had ADHD

Journal of  Addiction Disorders. 2005;24(3):133-52.

Methamphetamine-dependent inpatients (N = 51) were screened for childhood attention deficit hyperactivity disorder (ADHD) using the Wender Utah Rating Scale upon admission to 30-day inpatient treatment. Baseline assessments included neuropsychological tests of executive function, memory, information processing, verbal fluency, attention, motor skills, and the Brief Symptom Inventory (BSI), a measure of psychiatric symptomatology. The thirty-six participants (70.6%) screening positive for ADHD reported significantly more frequent methamphetamine use prior to baseline. Baseline cognitive functioning was similar between groups, but the presumptive ADHD participants exhibited significantly worse psychiatric symptomatology. At three-week follow- up, 41 participants (80.4%) repeated the neuropsychological battery and BSI. All 10 non-completers screened positive for ADHD. The entire sample improved with abstinence in most neuropsychological domains except memory. The presumptive ADHD group failed to improve on tests of attention. All participants demonstrated significant reductions in psychiatric symptoms with abstinence.

Methamphetamine-dependent individuals with ADHD symptoms are common and pose a significant treatment challenge.

5. 83% of Inhalant Abusers and 55% of Methamphetamine Mbusers in Japan had ADHD.

Psychiatry Clinical Neuroscience. 2005 Feb;59(1):102-5.

They examined the childhood histories of 54 methamphetamine users and 12 inhalant abusers in Japan using the Wender Utah Rating Scale.

The inhalant abusers experienced initial drinking at a younger age than methamphetamine abuser…83.3% of inhalant and 55.6% of methamphetamine abusers had higher scores than the cut-off for ADHD. These findings suggest that drug abuse is associated with childhood ADHD, and that inhalant abusers have a higher incidence of childhood ADHD than methamphetamine abusers.

There’s more on the links between ADHD and addictions on this page of my 100+ ADD resource website

Study 20% of Alcoholics had ADHD

Post from: Adult ADD Strengths

A study in the Journal Alcohol and Alcoholism looked at 91 adults with alcohol dependence and 61 adults with multiple substance addiction and they determined if these patients were affected by ADHD.

RESULTS: 20.9% WURS-k (Wender Utah Rating Scale) 23.1% (DSM-IV diagnostic criteria) of the alcohol-dependent patients showed evidence of retrospective ADHD affliction in childhood. With the help of CAARS, (Conners’ Adult ADHD Rating Scales) ADHD was proved to be persistent in 33.3% of the adult patients.

But Adults with ADHD are only 5% of the population.

In the group of substance-addicted patients 50.8% (WURS-k) and 54.1% (DSM-IV) presented with diagnostic criteria for ADHD in childhood and 65.5% (CAARS) showed evidence of ADHD persisting in adulthood.

Again Adults with ADHD are only 5% of the population.

CONCLUSIONS: These results reveal that habit-forming illnesses can be associated with a high comorbidity with ADHD, expressed in the form of alcohol abuse and also in consumption of illegal drugs. The results underline the great importance of early and adequate diagnostics and therapy of ADHD for the prevention of habit-forming illnesses.

While adults with ADHD are only 5% of the population, ADDers are dramatically over represented in people who are addicted to alcohol and drugs, the SMALLEST numbers I’ve seen on ADHD and addiction are 20-25% in peer reviewed clinical journals in Pub Med, (a service of the U.S. National Library of Medicine indexing articles from MEDLINE and other life science journals for biomedical articles) and I’ve frequently seem much larger ones. If adults with ADHD aren’t diagnosed and treated, and 85% of them aren’t, they will find ways to treat themselves or self medicate. Some will self medicate in positive ways with exercise, work or hobbies they enjoy, meditation and sex. Others will self medicate with alcohol and drugs, tobacco, food, and gambling, because they all boost dopamine, the brain chemical ADDers are short of and that the ADHD medications increase.

So at a minimum, adults with Attention Deficit Disorder are 4 times more likely to abuse drugs and alcohol, there’s no controversy at all about those numbers by those who know ADHD. But in the media, government, the health bureaucracies and the education systems often seem to be totally oblivious of this. Even if you don’t care about us as human beings, the financial costs of NOT diagnosing and treating adult ADHD are huge. And we’re not even talking about the higher rates of eating disorders, depression, dsythemia and anxiety, let alone crime (also off the charts) among Adults with ADHD. But on the flip side there are billionaires with ADHD, and also many strengths associated with ADHD, properly managed.

Here’s some articles and blog posts on the links between ADHD and addictions.

There is a huge problem in my hometown Vancouver BC Canada with drug and alcohol abuse and trafficking and associated crime, violence and homelessness, we’re in the middle of a civic election and yet no one is mentioning the connection between ADHD and these problems. No politician, no one in the media is talking about it. Peter Ladner candidate for the NPA isn’t talking about it, Gregor Robertson, candidate for Vision Vancouver. Or COPE. I searched on their websites for ADHD and found nothing. We really need a full time adult mental health advocate at city hall. Even though mental health is a provincial jurisdiction, Vancouver often pays the biggest cost of the provincial government’s inaction on mental health. There is no BC provincial adult mental health advocate, there should be one.

It’s hard to find someone in BC to diagnose and medically treat ADHD, so few are trained in it because it’s not being adequately taught in our medical schools, and I get people emailing me and phoning me to find out where to get diagnosed for ADHD several times a week. The BC Liberal (really neo-conservative) government closed down down the only provincial Adult ADHD clinic at childrens hospital because it had a 1 year wait list, which was politically embarrassing. Kill the wait list, avoid bad media coverage about long wait lists. I contacted the NDP (the left wing opposition) repeatedly to help raise the issue in question period but I kept getting shuffled around, promises were continually made and nothing happened. We got coverage on BCTV but no other media outlet and the BC adult ADHD clinic is still dead and the patients are still abandoned.

So diagnose and treat ADHD in children and adults now, or pay a hundred times the price or more in financial terms and in human suffering later, your choice citizens. You’ll be paying the cost one way or another.