Abstract
BackgroundAlthough the prevalence of substance use disorder (SUD) with co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. A recent study reported met- and unmet needs for several life domains regarding these patient groups. To improve treatment, it is necessary to identify the everyday life consequences of SUD and co-occurring ADHD or ASD in adult patients.MethodsQualitative study using in-depth interviews. 11 SUD + ADHD and 12 SUD + ASD patients participated in the study. The interview transcripts were coded and analysed according to the seven steps for descriptive phenomenology by Colaizzi.ResultsBoth patients with ADHD and patients with ASD can get caught in a jumble of thoughts and emotions which can often lead to agitation and impulsivity in the case of ADHD or passivity and melancholia in the case of ASD with co-occurring SUD in both cases. Initially substance use ameliorates the symptoms and related problems, but both patient groups can later experience even greater problems: difficulties with the structuring of daily life due to a lack of planning (SUD + ADHD) or due to a lack of initiative (SUD + ASD). Both groups indicate that structure helps them function better. They also recognize that substance use disorganizes their lives and that an absence of structure contributes to substance use in what becomes a vicious circle which needs to be broken for effective treatment and care.ConclusionsThis study provides insight into the daily life consequences of SUD with a co-occurring ADHD or ASD. Substance use is reported to solve some ADHD- or ASD-related problems in the short run but have negative consequences in the long run (i.e., contribute to already impaired cognitive functioning). Insight is provided into what clinicians can do to break this vicious circle and thus help ADHD patients to refrain from action and ASD patients to take action.
Highlights
The prevalence of substance use disorder (SUD) with co-occurring attention deficit/ hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses
Insight is provided into what clinicians can do to break this vicious circle and help ADHD patients to refrain from action and ASD patients to take action
With regard to the everyday life consequences of SUD with co-occurring ADHD or ASD, it can be concluded that the underlying mechanisms appear to differ for the groups but that the everyday life consequences of having a dual disorder are similar: both groups get caught in a vicious circle of symptoms and substance use
Summary
The prevalence of substance use disorder (SUD) with co-occurring attention deficit/ hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) is relatively high in adult patients, there is hardly any knowledge about these dual diagnoses. Mental disorders can frequently co-occur with a substance use disorder (SUD) or some other disorder. Such cooccurrence is often referred to as a dual diagnosis, which can itself refer to either life-time co-occurrence or current co-occurrence. The co-occurrence of SUD with attention deficit/ hyperactivity disorder (ADHD) has been examined quite extensively. A recent meta-analysis of the prevalence of attention-deficit hyperactivity disorder in substance use disorder patients showed 23% of all patients with SUD to meet the criteria for adult ADHD [6].
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