ADHD and Substance Abuse

Research has shown that children with attention deficit hyperactivity disorder (ADHD) are at high risk for later substance abuse. But only recently have psychologists begun to understand that children with certain types of ADHD are most likely to have problems with substance abuse.

ADHD is not yet well understood. It is not a disease or even a disorder with a single cause. Most scientists today believe that ADHD is a label for types of behaviors that are outside of the normal range for age, persistent (lasting longer than 6 months), and not explained by other medical or psychological factors.

There are three subtypes of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Those children who are predominantly inattentive have trouble sustaining attention or fail to pay attention to details. They may appear not to listen when spoken to and have trouble finishing schoolwork or chores. Organization is a problem and they may forget things such as assignments, clothing or other objects.

Those who are predominantly hyperactive-impulsive have great difficulty sitting still. They are constantly on the go, may talk excessively or out of turn. Behavior can be out of control and disruptive at times.

Children with combined ADHD subtype have characteristics of both inattentive and hyperactive-impulsive ADHD.

As many as 50 percent of those with ADHD also have Conduct Disorder (CD), which consists of a pattern of "externalizing" behaviors. This may be aggressive behavior that causes physical harm to people or animals or non-aggressive behavior such as theft, deceitfulness, property damage or repeated violation of rules.

When looking at all of these variables of ADHD, it is those children with hyperactive-impulsive behaviors and those with co-occurring Conduct Disorder who are more likely to have problems with substance abuse than those with only inattentive behaviors. This may be because those children having behaviors that are disruptive at school and at home may be scolded and punished more often, and begin to develop low self-esteem early in life. Difficulties in learning and problems with social relationships can also contribute to low self-esteem - which can set the stage for early experimentation with tobacco, alcohol, and drugs.

It is important for parents to understand how ADHD can predispose a child to substance abuse problems and to work closely with a therapist for early and continued treatment throughout childhood.