ADHD: Medications, Alcohol, and Marijuana

Medically Reviewed by Smitha Bhandari, MD on July 13, 2022
Written by Alexandra Benisek
5 min read

Experts know that attention deficit hyperactivity disorder (ADHD) can make you more likely to misuse substances like alcohol and marijuana. Half of adults with ADHD have had some form of a substance use disorder. Some ADHD medications may also mix with alcohol or marijuana and cause harmful side effects. It’s important that you know about the risks involved with ADHD medicines and these substances.

There are a few factors that link ADHD to substance misuse. You may be more likely to use marijuana or alcohol due to:

Mental health issues. It’s important that doctors review your mental health history, especially if you have ADHD. Over a fourth of people with ADHD also have, or have had, depression. This rate is much higher than people without ADHD.

Experts notice that ADHD-related substance misuse goes down if a person’s doctor is able to help them control their depression and anxiety. If you have an untreated mental health condition, you may be more likely to self-medicate. This means that, instead of proper medications, you may use alcohol or marijuana to cope with the symptoms of anxiety and depression.

Childhood abuse. Many people with ADHD have had some kind of childhood trauma. Over a third of young adults with ADHD said they were either physically or sexually abused before they turned 16.

There’s also a link between childhood abuse and substance misuse. If you went through trauma at a young age, it may have affected the development of your brain and emotions. Later on in your life, this can cause you to be more likely to form a substance disorder.

Accelerated gateway hypothesis. In young adults with ADHD, alcohol is the number one misused substance. Marijuana is the next most common drug used in this group. Some experts believe that substance misuse is higher in adults with ADHD because of the “accelerate gateway” hypothesis. This assumes that people with ADHD begin substance use at a younger age. This can lead to riskier situations with substances and more substance-related issues in adulthood.

People used to believe that ADHD medications, like methylphenidate (Ritalin), made someone more likely to use or abuse alcohol and drugs. Experts looked at data from 15 studies and found no link between ADHD medication use and drug or alcohol abuse later in life. ADHD drugs didn’t make a person more or less likely to try substances.

Many people with ADHD state that marijuana helps with the condition. There’s limited research on any possible benefits, but experts have studied the opinions of those with the condition who use weed. They found that at least three times as many people stated that marijuana helped their ADHD symptoms, compared with those who said it was harmful or not effective.

Those who believed it was helpful stated that marijuana helped with their inattentive symptoms from ADHD. Some people even said that marijuana had medicinal benefits, like ADHD treatment. But there’s still very little data on how weed affects ADHD. It’s best to stick to your ADHD medication until experts learn more about marijuana for this condition.

You may wonder if alcohol or marijuana use will affect your ADHD medication regimen. Studies found that severe side effects are uncommon when you take stimulants such as methylphenidate, dexamphetamine (Dexedrine Spansule, ProCentra, Zenzedi), or atomoxetine (Strattera) by mouth and drink alcohol. But they can still happen.

Stimulants and alcohol use together can lead to drinking more alcohol than usual. In turn, this puts you at a higher risk for short-term and long-term alcohol-related health issues.

In a review of multiple studies, experts also found that side-effects got slightly worse when a person took ADHD medications with alcohol. Just like with any medication, it’s crucial that you check the label or ask your doctor about alcohol use with your ADHD medications. If you don’t know if it’s safe to drink with your medicine, it’s better to stay away from alcohol.

Mixing alcohol with ADHD medications can lead to a number of complications:

  • Your ADHD medication may not work as well.
  • You may think that your medication or the alcohol isn’t working as much when you mix them. This could cause you to overdose if you take more.
  • Dangerous effects, like seizures, can happen if you mix alcohol with ADHD medications.
  • You could develop a substance abuse disorder around both alcohol and your ADHD medication.

Since marijuana is illegal in the United States, it’s hard for experts to study its effects on ADHD medications. There are only a few studies about the possible interactions between these treatments and weed.

One study looks at marijuana and the ADHD drug, methylphenidate. Experts found that the drug reacts with weed and can cause strain on your heart.

Marijuana use can also affect your brain. Studies show that long-term use of the drug can lead to neurological, or brain function, decline.

This is especially important to note if you have ADHD. Studies have shown that people with the condition tend to have weaker brain function and structure in their frontal lobe. If you smoke weed and have this condition, you’re at a higher risk for delaying your brain development even further.

Experts have also found that marijuana may lessen the effects of your stimulant medications. If you smoke weed while on a stimulant for ADHD, you may cause the treatment to not work as well.

If you have ADHD, you’re already at a higher risk for suicide than those without the condition. Smoking weed might put you even more at risk for this. But experts need to study the link between marijuana and suicide more.

It’s important to remember that help is always available. If you think you’ve developed an unhealthy relationship with your ADHD medications, alcohol, and/or marijuana, you should get help as soon as possible. You can find help online through organizations like American Addiction Centers or Substance Abuse and Mental Health Services Administration (SAMHSA).

If you notice any changes in your behavior or symptoms, tell your doctor about them. They’ll be able to check to see if they’re normal or if they’re from mixed ADHD medicine, alcohol, and/or marijuana.

It’s a good idea to know the signs of an overdose. An alcohol overdose could include:

  • Mental confusion
  • Trouble staying conscious, or fully conscious
  • Seizures
  • Lack of response or if someone isn’t able to wake up or to be awakened
  • Irregular or slower breathing
  • Slower or stopped heart rate
  • Very low body temperature
  • Bluish or pale, clammy skin

A stimulant overdose includes symptoms like: