What Is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that typically begins in childhood and affects overall functional capacity throughout life. Its symptoms fall into three main categories: inattention, hyperactivity, and impulsivity. Individuals with ADHD may struggle to focus, complete tasks, and regulate impulses. While hyperactivity is more noticeable in children, adults often experience internal restlessness or intense focus on areas of interest. This impulsivity may sometimes lead to risky behaviours, including substance use. The challenge is not only biological; psychological aspects such as loss of self-esteem, feelings of failure, and inadequacy also deepen the condition. Therefore, ADHD is not merely a problem of attention, but rather a complex imbalance in the brain’s reward system, motivation, and impulse control systems.
What Is Substance Use Disorder (SUD)?
Substance Use Disorder (SUD) is a complex condition shaped by biological, psychological, and cognitive factors. Although individuals are aware of the harm, they continue using substances, as the behaviour becomes driven more by automatic and impulsive processes than conscious decisions. The dual-process model explains this through two systems: the controlled system, which represents conscious decision-making and self-regulation, and the impulsive system, which is driven by instant gratification and instinctive reactions. In addiction, the balance between these systems is disrupted, leading individuals to prioritise short-term relief despite knowing long-term consequences. Impairments in the prefrontal cortex weaken cognitive control while reinforcing impulsive decisions. Additionally, SUD frequently coexists with depression, anxiety, and other psychiatric disorders, complicating the treatment process.
Long-Term Impact Of Childhood ADHD
When ADHD is not recognised and supported early in life, it may create a neuropsychological vulnerability to substance use during adolescence. Weaknesses in impulse control and the reward system lead individuals towards immediate satisfaction. Difficulties in adapting to social expectations and continuous criticism may cause internalised feelings of inadequacy and worthlessness. Eventually, substance use can become a method of emotional regulation and temporary relief. Thus, the relationship between ADHD and substance use becomes a multilayered structure that includes not only biological dysregulation but also emotional coping strategies.
The Vicious Cycle
The vicious cycle between ADHD and substance use disorder is now a well-recognised reality. While ADHD predisposes individuals to substance use through impulsivity and poor self-control, substance use further disrupts the brain’s reward mechanisms and intensifies ADHD symptoms. Alterations in dopamine and other neurotransmitter levels may result in both difficulties in sustaining attention and periods of excessive focus. Eventually, the individual loses both mental balance and internal regulation—addiction and distractibility become two sides of the same neuropsychological process.
Different Perspectives
According to the psychodynamic perspective, impulsivity and restlessness in ADHD represent the expression of suppressed emotions. Substance use serves as a temporary method to soothe these feelings. Cognitive theory suggests that individuals with ADHD attempt to compensate for distorted beliefs such as “I am inadequate” through substance use. Meanwhile, behavioural theory views substance use as a learned response that provides short-term relief.
Conclusion
In conclusion, the relationship between ADHD and substance use disorder is a multilayered process shaped by biological predisposition, emotional vulnerability, and environmental influences. Emotional dysregulation, weakened self-regulation, and impulsivity increase susceptibility to addiction, while social stigma perpetuates the cycle. Understanding ADHD not merely as an attention problem but as part of a neuropsychological pathway toward addiction—choosing empathy over judgement—is the first step toward genuine recovery.
References
Ee, S. S., Humphreys, K. L., Flory, K., Liu, R., & Glass, K. (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: A meta-analytic review. Clinical Psychology Review, 31(3), 328–341. https://doi.org/10.1016/j.cpr.2011.01.006
Özgen, M. H. (2023). Dikkat eksikliği ve hiperaktivite bozukluğu: Yetişkinlere yansıması, belirtilerin dünü ve bugünü. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 30(2), 79–85. https://doi.org/10.4274/tjcamh.galenos.2023.2523
Özgen, M. H., Erermiş, S., Bilgiç, A., & Yüce, M. (2021). Dikkat eksikliği hiperaktivite bozukluğu ve madde kullanım bozukluğu eş tanısı olan ergenlerin taranması, tanısı ve tedavisi için uluslararası fikir birliği beyanı. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 28(2), 79–86. https://doi.org/10.4274/tjcamh.galenos.2021.18291