ADHD and Addiction

Abstract

Attention-deficit hyperactivity disorder (ADHD) is characterized by symptoms of inattention and/or hyperactivity and impulsivity. It is frequently present in substance use disorder (SUD) patients; estimates of the prevalence of ADHD vary between 14 % and 23 % in SUD populations. The high comorbidity is partly based on communal underlying neurobiological characteristics such as a shared genetic background of the two disorders. Neuropsychological correlates of both disorders include a dysfunction of the motivational/reward system and impulsivity. In general, patients with this type of comorbidity represent a more severe subgroup of SUD patients with more additional comorbidity and a more disadvantageous prognosis and higher treatment drop-out than SUD patients without ADHD. It is important to detect and treat ADHD in SUD patients, and substance use disorder treatment centers can play an important role in this by screening for ADHD. Treatment options may include medication, although convincing evidence of effect in SUD populations is yet lacking, and cognitive behavioral therapy. As problems of SUD and ADHD can be intertwined, it is appropriate to start ADHD treatment during SUD treatment, ideally after initial stabilization of substance use. As this patient group is characterized by high complexity, further research and development of integrated treatment programs are warranted.