The Complex Relationship Between ADHD and Alcohol
May 22, 2023, 7 min read
Living with ADHD can mean adapting certain things in life to fit your individual needs, and drinking alcohol may be one of them. Whether you have been living with ADHD long-term and noticing symptoms related to alcohol that you want to explore further, or you have just been diagnosed and want to make sure you stay healthy, we are shining a light on the relationship between ADHD and alcohol.
At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about ADHD, alcohol or anything else, we’re here to help.
From the ADHD traits that can cause excessive drinking, to the possibility of alcohol making ADHD worse, to its interference with ADHD medications, there are many interesting links between the two. Here’s everything you need to know…
What is ADHD and what are the symptoms?
In adults, symptoms may include difficulty focusing for long periods of time, impulsiveness and inattentiveness. Some people find it interferes with their learning, studying, working or just getting tasks done throughout the day, like organising things, remembering things, following through on instructions, and managing their time.
Children with ADHD may struggle to play quietly, to take simple instructions without getting distracted, and can be hyperactive (i.e. running or climbing things a lot). ADHD can present differently in girls than boys — girls are often less hyperactive and present more inattentive features of ADHD.
What ADHD traits can cause excessive drinking?
When it comes to drinking alcohol, it is important to understand the links between this and ADHD, and the risks involved. According to a 2021 study, 36% of young adults with ADHD had a lifetime alcohol use disorder compared to just 19% of those without ADHD.
Some of the main symptoms of ADHD in adults include issues with following instructions, social interactions, coping with stress, restlessness, and impulsivity. When combined with alcohol, these traits can increase the risk involved with drinking and could potentially cause a person with ADHD to drink more than they should.
If you suffer from ADHD, you might find yourself drinking to cope with stress in a particular situation, drinking past your limit due to impulsivity, and using alcohol as a crutch during social interactions. Being aware of these tendencies is important.
Is there a link between ADHD and alcohol issues?
Yes. Firstly, it’s important to note that drinking alcohol always comes with health risks whether you have ADHD or not, but if you do have ADHD, the risks are higher as you may have an increased sensitivity to the effects. A 2009 study found participants with ADHD were more likely to show signs of alcohol impairment, and may experience more severe ADHD symptoms like heightened impulsiveness, difficulty focusing, issues with decision-making, and more.
A 2011 review also reported childhood ADHD is a significant risk factor in the development of alcohol use disorder in adulthood. In fact, other studies have found links between ADHD and the early onset of alcohol use. One found that at the age of around 14, 40% of children diagnosed with ADHD had used alcohol, in comparison with only 22% of the control group.
Looking at the comorbidity between ADHD in adults and alcohol/drug dependence, the diagnosis of ADHD seems to increase the risk of alcohol/drug dependence, but this does also fall in line with the risks of other conditions like depression and anxiety.
Why is there a link between ADHD and alcohol issues?
The reasons for the link between ADHD and alcohol issues is not yet known, though there are a number of theories indicating brain chemicals such as dopamine could play a role.
Some clinical neuroscience studies (supported by brain scan research) have identified possible links between ADHD and alcohol use due to the role of the medial forebrain dopamine system; it is thought low levels of dopamine in the forebrain can cause issues with executive functions related to attention and impulse control. This theory is supported by the fact that many ADHD drugs will raise dopamine levels in the brain.
This also supports the common theory that some people with ADHD can have a lower threshold for alcohol and drug-related problems due to a low baseline level of impulse control. This would mean they may experience the inhibiting effects of alcohol after consuming less alcohol than someone without ADHD.
Can drinking alcohol make ADHD symptoms worse?
Drinking alcohol can make ADHD symptoms worse in the short term. One 2009 study found participants with ADHD were more likely to show signs of alcohol impairment (which could be anything from mild impairments to speech and memory, to loss of consciousness), which could aggravate the common symptoms of ADHD like impulsiveness and trouble focusing.
Long-term alcohol use has been associated with cognition issues, decision-making abilities, memory and speech, so if you have ADHD and drink alcohol, you may notice your symptoms (like distractibility and impulsiveness) increase.
Can alcohol interfere with ADHD medication?
If you have ADHD, you may be wondering if drinking alcohol can affect the ADHD medication you take. In short, yes, alcohol and ADHD medications can interact with each other depending on the type of medication you are taking.
Stimulants are some of the most commonly prescribed medications to treat ADHD, and they do so by increasing the activity in your central nervous system. Conversely, alcohol will decrease the activity in your central nervous system. You may be thinking this will simply cancel out the effects of your stimulant medication, but this is usually not the case.
Instead, alcohol changes the way your body processes it, which can lead to an increase in physical side effects like a racing heart rate, high blood pressure and trouble sleeping, as well as mood issues such as depression and anxiety.
Mixing alcohol and ADHD medications can also put you at a higher risk of alcohol poisoning and overdose, so it is important to discuss your drinking habits with your prescribing doctor or therapist so they can help you manage this, or prescribe you an alternative. It is thought that nonstimulant ADHD medications could be safer, with studies finding nausea to be the only side effect in heavy drinkers who also took atomoxetine to treat ADHD. Keep in mind, the drug manufacturer does not recommend mixing it with alcohol.
As well as whether you are taking stimulant or nonstimulant medications, some other factors can determine how your body reacts to mixing ADHD medication and alcohol, such as the dose you are on, and whether you are taking short-acting or long-acting medication. As a general rule, you should avoid drinking alcohol — especially heavy drinking — while taking ADHD medication, but speak to your doctor or prescribing therapist for more details as it may be fine to enjoy a drink every now and then.
Are all people with ADHD at risk of alcohol issues?
No. Just because you have ADHD does not mean you are automatically at risk of developing alcohol issues. Everyone is different, and everyone reacts to alcohol differently. It is good to be aware that up to 43% of people with ADHD develop alcohol use disorder, which refers to a number of conditions such as alcohol abuse, alcohol dependence, alcohol addiction, and alcoholism. Remember, of this 43%, not all will have an addiction.
Some of the symptoms of ADHD — like hyperactivity, impulsivity and disrupted emotional functioning — can play a role in the development of alcohol issues, so studies recommend those who are diagnosed with both alcohol use disorder and ADHD should receive treatment addressing both their ADHD and alcohol issues.
Although alcohol issues can be a problem for those with ADHD, it doesn’t mean you are destined to experience them yourself.
I have ADHD. Should I be drinking alcohol?
It is important to understand the risks that come with alcohol use when you have ADHD, but having it does not mean you must never enjoy a drink of alcohol.
Get to know how your body handles it, and make your own decision on how much you should be consuming — a good general rule is to drink in moderation. If you are unsure of your limits, speak to your doctor who can give you advice, and ensure nothing interacts with your ADHD medication.
How can I manage my risk of alcohol issues?
Whether you have ADHD or not, everyone should be mindful of their limits when drinking alcohol. Everyone has a unique tolerance level, so learn to understand your own limits.
If you have worries about drinking or think you need help with your ADHD symptoms or alcohol consumption, you may find it helpful to speak to a therapist. This allows you to talk openly about any concerns you have and start to work through the thoughts and feelings you have about alcohol. If you have ADHD, seeking therapy can be beneficial in managing the symptoms long-term and avoiding any alcohol issues in future.
Where can I find support to manage my ADHD?
You do not need to manage your ADHD symptoms or alcohol issues alone — help and support is always available, no matter how mild or severe you think the issues may be. If you believe you may have either ADHD or an alcohol issue, or both, reach out to a professional who can help you start to understand your condition and manage it.
Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from a private ADHD assessment or review, to broader mental health care: join us today.