How Alcohol Abuse Affects ADHD

Alcohol abuse and ADHD are both complex topics, with lots of common misunderstandings and misconceptions.

The two topics are also linked in interesting ways, and if you live with ADHD or suffer from the impact of alcohol abuse, it is important to know how the two intersect and interact.

What is ADHD?

Attention deficit hyperactivity disorder, more commonly known as ADHD, is a cognitive disorder. Like a lot of cognitive disorders and conditions, the exact definition is broad because the experience of ADHD is different from person to person.

However, generally, the condition contributes to a significantly decreased attention span and/or bouts of hyperactivity.

ADHD is often diagnosed in children, adolescents, and young adults during their time in education. This is because teachers can often be the people who spot the signs of ADHD if a young person is having difficulty completing their academic work.

Young people with ADHD can struggle with the rigour of education, and on average have lower rates of university attendance, and decreased academic outcomes such as grades.

This can often lead to frustration among people with ADHD, especially if the cognitive disorder hasn’t been diagnosed because they might feel like they don’t have the ability to keep up with their peers.

Sometimes this frustration manifests itself in the form of defiant behaviour, tantrums, and quick temper, but it’s important to understand that this can be a side-effect of ADHD, but it isn’t actually caused by it.

Due to how it affects a person’s ability and behaviour, ADHD can have a substantial impact on a person’s life outcomes and how they manage their relationships, get through education, and deal with the pressures of a career.

ADHD also has a complex relationship with alcohol and alcohol abuse.

What is Alcohol Abuse?

Alcohol abuse typically refers to an unhealthy, harmful, and negative relationship with alcohol. It can fall under the medical diagnosis of alcohol abuse disorder (AUD) which covers alcoholism, alcohol dependence, alcohol abuse, and the spectrum in between.

Alcohol abuse is recognised as a serious public health risk because alcohol is so accessible in the UK and alcohol is so commonly consumed.

The misuse of the substance leads to short-term and long-term physical and mental health risks, and due to this, it is recommended that alcohol consumption remains within the guidance of the UK’s Chief Medical Officer.

Alcohol Abuse Symptoms

People misuse alcohol in different ways, and it isn’t always easy to spot the signs of alcoholism (also referred to as alcohol addiction) or alcohol abuse. However, there are certain symptoms that, if starting to form a pattern, can indicate that someone could be living with alcohol abuse.

Regular instances of blackouts after drinking: Blackouts are linked with excessive alcohol consumption, and when the blood alcohol concentration (BAC) level exceeds a certain level, it will impair the creation, processing, and storage of memory.

If you experience partial or complete blackouts after drinking alcohol, it is a sign that your relationship with the substance falls under the category of misuse.

• Increasing tolerance for alcohol: There is no set amount of alcohol to get drunk because everyone has their own specific level of tolerance to alcohol based on their height, weight, sex, and other biological factors.

However, the more alcohol you drink over a long period of time, the more your alcohol tolerance increases, and you will have to drink a greater amount of alcohol to get drunk.

• Changes in behaviour: You might notice that someone close to you is becoming more withdrawn, less financially stable, or more erratic with their decision-making.

This doesn’t necessarily mean they are developing an unhealthy relationship with alcohol or becoming dependent on it, but if you also notice that their intake of the substance is increasing (or if you worry that this is the case) then it could be an indicator that they are starting to suffer from alcohol abuse.

• Health-related changes: The impact of excessive alcohol consumption, and alcohol abuse, aren’t just social or psychological – they affect a person’s health too.

Alcoholic drinks are often high calorie, which means that it isn’t uncommon for people struggling with their relationship with alcohol to also struggle to maintain a healthy weight.

A person who is drinking too much over a prolonged period of time could also start to experience health-related problems with their liver, as well as other parts of the digestive system.

Infrequent Excessive Drinking is Still Alcohol Misuse

Sometimes, the misuse of alcohol isn’t indicative of any broader patterns, and just reflects a one-off excessive instance of drinking. Excessive drinking, no matter how rare, is still alcohol misuse – though it doesn’t have the same long-term negative implications on health as prolonged alcohol misuse.

This type of alcohol misuse can be observed through several symptoms that occur within a short space of time.

A lot of the symptoms of excessive drinking can be noticed through careful observation.

The first thing you might notice, if you’ve been excessively drinking, is that your motor ability is becoming impaired. This makes it more likely that you will have an accident, which could put you seriously at risk especially if you hurt your head.

You may also find that you made decisions that you wouldn’t normally make if you drank too much in one sitting. This is because alcohol impacts the part of the brain that is involved in decision-making, the prefrontal cortex.

This can lead to an increase in risky behaviour, without concern for the consequences, and can lead a person to get involved in fights or have unprotected sex, for example.

One of the most serious results of excessive drinking is alcohol poisoning. The signs of alcohol poisoning can include confusion, vomiting, inability to move, and loss of consciousness.

Alcohol poisoning is an extremely serious condition and it can lead to several negative health outcomes.

Finally, you may find that your recollection of your time drinking is a patch or completely absent. This is called fragmentary or en bloc memory lossand is caused when the amount of alcohol in your body becomes so high that it interferes with the formation of memories.

What to Do if You Suspect You’re Suffering From Alcohol Abuse or Misuse?

The best course of action you can take if you believe you could be living with alcohol abuse, or if you believe that you have an increasingly unhealthy relationship with alcohol, is to seek professional medical support and guidance from a local rehab clinic.

If this feels like a step that’s too difficult, too daunting, or too soon, there are other measures you can take to get an indication of whether or not you could be diagnosed with an alcohol use disorder.

There is an online self-assessment questionnaire that can be completed, and this can be used to provide an indication of whether or not you’re living with an alcohol use disorder.

This is called the CAGE questionnaire, and while accessible and quick to complete, it should not take the place of a formal diagnosis.

The Effects of Alcohol Abuse & ADHD

While alcohol is a depressant drug, and consuming it in small amounts can have a relaxing effect. If you drink, for example, a single beer, you might find that you start to become sleepy and feel less stressed, tense, or anxious.

For this reason, it isn’t uncommon to find some people with ADHD using alcohol as a method of reducing their state of hyperactivity.

However, drinking in a moderate amount will actually have the opposite effect, and can make you feel giddy, more energised, more self-confident, and less risk-averse.

This can align with the effects of ADHDand can cause a person to lose self-control and spiral into binge drinking and other alcohol misuses. If this happens with enough frequency, this can develop into a serious issue and can lead to alcoholism or other alcohol use disorders.

Is there a Link between ADHD & Alcohol Use?

Among adults who are treated for alcohol abuseor other forms of substance abuse, approximately 25% either have already been or go on to be, diagnosed with ADHD.

Put simply, the current research suggests that people with ADHD (whether its diagnosed or undiagnosed) are most likely to experience challenges with alcohol abuse during their lives.

However, this correlation isn’t as straightforward as it first seems. The link between the two factors isn’t direct, or in other words, it isn’t the ADHD itself that causes problems with alcohol use.

Instead, it is the consequences of ADHD that act as risk factors for alcohol use disorders.

People with ADHD are more likely to have lower academic achievement, higher rates of financial instability, and higher levels of stress than people who don’t live with ADHD.

It is these factors that are all correlated with the misuse, abuse, and addiction to alcohol, instead of the cognitive impact of ADHD itself.

Alcohol & ADHD Risk Factors

So, even though alcohol doesn’t cause ADHD, we still know that the two are strongly linked. There are several main ways that ADHD acts as a risk factor for an unhealthy relationship with alcohol, and you should be aware of these to help yourself, or others.

Starting alcohol use at an earlier age: research has shown that alcohol use starts at an earlier age in people who have ADHD. When alcohol use starts at an earlier age, people are more likely to develop long-term issues with the substance such as alcohol use disorders or alcoholism.

More likely to binge drink: people who live with ADHD are also more likely to binge drink more often during their early years than people without cognitive disorders.

Binge drinking can lead to serious health related issues, and is linked with a negative future relationship with alcohol.

Heightened symptoms of ADHD: alcohol use can make ADHD symptoms more pronounced, such as risk-taking behaviour and struggling to maintain concentration.

Further to this, long-term misuse of alcohol can also worsen ADHD symptoms because it impairs a person’s decision-making, memory, and cognitive functioning.

Can Alcohol Trigger ADHD?

Alcohol is not in any way related to the onset of ADHD. The condition is a neurodevelopmental disorder, meaning that a person is born with ADHD and can’t develop it in later life.

ADHD is widely acknowledged as having a genetic component, and you are more likely to be diagnosed with ADHD if someone in your family has the cognitive condition too.

Aside from genetics, the causes of ADHD aren’t completely clear, however, there is no research that suggests that drinking alcohol can trigger ADHD in a person.

The only way in which alcohol could impact the development of ADHD is if a mother is consuming the substance while pregnant.

Some evidence does suggest that binge drinking while pregnant is linked with an increased chance of the child going on to be diagnosed with a cognitive disorder.

Alcohol’s Effect on ADHD Medication

There are different types of ADHD medication that a person can take in order to limit the symptoms of the cognitive disorder.

These types of medication can be categorised into stimulants and non-stimulantsand drinking alcohol while using these medications can have a variety of unexpected side-effects.

1. Stimulants

The most common form of pharmaceutical treatment for ADHD is a stimulant-based drug, like Adderall.

Because they are stimulants, they impact the functioning of the central nervous system by increasing the amount of activity. However, consuming alcohol while using stimulant-based medicine is against recommendations.

This is because alcohol is a depressant. A depressant is the opposite of a stimulant, and it decreases the activity of the central nervous system.

Surprisingly, this doesn’t counteract the impact of the stimulant, but it does change the way in which the body processes it and this can lead to a number of side effects:

• Increased heart rate
• Increased and rising blood pressure
• Difficulties with getting to sleep and having restful sleep

In the long term, combined use of the two drugs can lead to pressure and strain on your heart, increasing the chances of a heart attack and/or stroke.

2. Non-stimulants

Non-stimulant pharmaceutical treatment for ADHD, most notably Atomoxetine is less common. However, it is still used by many people with cognitive disorders.

It is still recommended that alcohol is not consumed when taking the medication, however, research has indicated that the side effects of combining the two are less severe.

The research found that nausea was the single side effect that was experienced by people who combined the use of the two substances, however, subsequent future research may uncover more serious health issues in the future.

Alcohol, ADHD & Depression

The misuse of alcohol, ADHD, and depression are all entirely separate issues that can impact people in a wide variety of ways. None of the issues are thought to be directly linked with each other, but research has shown that they share a strong relationship.

We’ve already reflected on the complex links between alcohol misuse and ADHD, explaining that while neither can cause (or trigger) the other, they have often related issues because of the way they interact. The same is true for how the two issues are linked with depression.

Research has shown that people with ADHD are more likely to live with depression, as well as alcohol use issues.

Further to that, research also shows that people with depression are more likely to struggle with alcohol abuse, and people living with alcohol abuse are more likely to be diagnosed with depression. This creates a three-way vicious circle.

Because the relationship between all three is neither linear nor simple, it is important to treat each individual, as well as recognise how it they into the broader relationship. To do this, they need to be recognised as co-occurring disorders.

The Impact of Co-occurring Disorders

A co-occurring disorder is one which is diagnosed alongside another separate (but likely related) disorder. An example of co-occurring disorders is when someone is diagnosed with both alcohol addiction and anxiety.

Co-occurring disorders are difficult to treat because it can be hard to separate the two disorders from one another. If the co-occurring disorder isn’t correctly recognised, it can impact the success of the treatment of the disorder that is being treated.

For example, if you are being treated solely for alcohol addiction, but you also have depression that hasn’t been diagnosed, your alcohol addiction treatment might not be as successful as it could be.

Therefore, it is important that co-occurring disorders are recognised because they can disrupt and derail successful treatment if they aren’t properly assessed and recognised.

ADHD as a Co-occurring Disorder

People who live with ADHD are more likely to also experience alcoholism or alcohol abuse disorders. Therefore, before treatment for alcoholism begins, it is also important to determine whether or not you may have undiagnosed ADHD (if you have displayed any symptoms of the disorder).

This is because, if your addiction to alcohol is treated without taking ADHD into account, your treatment won’t be best adjusted to you and you will find it harder to stick to your future goals. Equally, if ADHD is being treated by medication without taking an addiction to alcohol into account, you could be exposing yourself to the risks of multiple serious side-effects.

Treatment for Addiction to Alcohol & ADHD

Treatment for addiction to alcohol, or other alcohol abuse disorders, will typically begin with a detox. During this detox period, you will be supported as you experience any withdrawal symptoms.

It is important that this is done with the support of a medical professional because withdrawal symptoms from addiction to alcohol can be serious and, in extreme circumstances, life-threatening.

Then, attention will turn to improve your relationship with alcohol, helping you to stay away from the substance, and preventing relapse.

First, you will undergo a period of therapy (typically this therapy will be cognitive behavioural therapy) which will help you to come to terms with your addiction, and recognise the underlying causes that contributed to it.

This will help you to understand your behaviours, and how to change them in the future.

Then, you will create a relapse prevention plan. This will help you to avoid triggers, and when you can’t avoid them, manage them without relapsing back into alcohol use and abuse.

You will also plan for what to do if you do relapseso that it doesn’t risk throwing off your entire progress so far.

Treatment for ADHD is mostly pharmaceutical and will involve choosing the type of medication that is most suited to you.

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References

[1] Alcohol Dependence, Co-occurring Conditions and Attributable Burden https://academic.oup.com/alcalc/article/51/2/201/2888174

[2] Alcohol use disorders and ADHD https://www.sciencedirect.com/science/article/pii/S0149763421003092?casa_token=MiWKb3_Brn4AAAAA:L9Yo9249Ac3Yza_IYkwuXIeAlb4iBN_eqnilfbemweSTVaoXOg9OtVHXPg5DVa0ohUgmTXv-ilU