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Teen Drinking and ADHD: What to Know

Medically Reviewed by Dan Brennan, MD on May 26, 2022

Alcohol is one of the most commonly misused substances in adolescents with attention deficit hyperactivity disorder (ADHD). Teens with ADHD are more likely to drink alcohol, to begin drinking at a younger age and, if they do drink, to develop a substance use disorder (SUD) than people who don’t have ADHD.

Researchers don’t agree on reasons for this. And it doesn’t mean that everyone with ADHD will go on to have alcohol issues during their teenage years. In fact, parents who are aware of the link between ADHD and alcohol – and who have good day-to-day communication with their teens – can play a major role in limiting the risk of their alcohol use.

What Is the Link Between Childhood ADHD and Drinking in Teens?

The exact relationship between childhood ADHD and teen alcohol use is unclear. It could be that certain characteristics of some people with ADHD – like being impulsive, having poor judgment, and struggling in school – may increase the chances your child will drink. There could be a genetic link between having ADHD and being prone to SUD or the habit of self-medicating.

Two-thirds of children with ADHD still have the disorder as teens, when the symptoms of hyperactivity and impulsiveness often decrease. If those symptoms get worse, though, the risk of substance abuse increases.

Teens with ADHD can be drawn to substances that make them feel calm or that distract them from racing thoughts and hyperactivity. Also, certain symptoms of ADHD make teens more likely to use alcohol. One study found that each symptom related to inattention (distraction) increased the chance of using alcohol by 8% to 10%.

Long term, the risk of a person with ADHD developing an SUD is twice as high as people without ADHD.

What Happens When Teens With ADHD Start Drinking?

Alcohol and ADHD don’t mix. When you’re drinking, your ADHD symptoms – impulsiveness and difficulty focusing, for example – may become worse. Drinking also may affect the way your body handles ADHD medications. Most teens with ADHD don’t know about these risks, though.

What Are the Chances That Children With ADHD Will Begin Drinking as Teens?

The risk depends on certain aspects of a child’s ADHD. In one study, teens who experienced more severe childhood ADHD were more likely to begin using alcohol and marijuana earlier and to become heavy users. In another, children with hyperactivity and impulsiveness were at greater risk of early alcohol use.

The sooner you begin treatment, the better. Children treated for ADHD at a younger age are less likely to develop substance abuse disorders, compared with those who begin treatment later. This includes treatments with stimulants. Even though there’s a possibility for stimulants to be abused, one study found that stimulant treatment for ADHD actually reduced the chance of later substance abuse.

Early treatment for any additional mental health issues (like anxiety and depression) also may decrease the risk for substance abuse.

Which Factors Increase or Decrease the Likelihood of Drinking in Teens With ADHD?

The chance of developing a drinking problem as an adult is higher for teens who also have behavioral problems, including criminal behavior, and who experiment with drugs or alcohol at an earlier age.

Another factor is the progression of the ADHD itself – whether symptoms get better or worse over time. For example, if symptoms lessen over time, the risk of substance abuse during the teen years also lessens. And the reverse is true. Children whose symptoms increase are more likely to drink alcohol more frequently during their teens.

In one study, more than half of teens with ADHD who were smokers went on to develop SUD as young adults. One theory is that smoking may lead to changes in brain development that increase the likelihood of SUD.

Lastly, combinations of all these factors can increase the risk of drinking. For example, ADHD symptoms that worsen over time combined with criminal behavior during adolescence are risk factors for binge drinking in early adulthood.

What Can Parents Do to Reduce the Risk of Drinking in ADHD Teens?

They can do a lot. One study found that the risk of alcohol use at age 17 is higher when parents know little about their teen’s activities, friendships, and whereabouts. That risk goes away when parents have a better-than-average awareness of these aspects of their teen’s life.

Ways you can stay alert to your child’s risk factors include:

Educate them. Talk to your young kids and teens with ADHD about the dangers of substance abuse, including alcohol. Set an example by not misusing alcohol.

Communicate with them. Have positive conversations with your kids, including family therapy sessions and behavioral treatments, if needed, to deal with problems.

Be watchful. Parents should see ADHD as a long-term condition. Look for any signs that symptoms are getting worse or new symptoms are happening. Schedule doctor or other provider appointments when needed.

Report changes. Alcohol and drug use can cause symptoms similar to ADHD, such as:

  • Trouble paying attention
  • Difficulty finishing tasks
  • Sleeping issues
  • Little appetite
  • Not wanting to socialize with others
  • No interest in school

If you notice any changes in behavior or sudden differences in their ADHD symptoms, mention them to your child’s doctor.

Schedule “booster” sessions. Think about getting help from your child’s mental health provider during sensitive times such as the transition to middle school or high school.

Show Sources

SOURCES:

Child Mind Institute: “ADHD and Substance Abuse.”

Drugfree.org: “Teens With ADHD or Conduct Disorder May be More Likely to Drink or Smoke.”

Europe PMC: “Associations between childhood ADHD, gender and adolescent alcohol and marijuana involvement: A causally informative design.”

Journal of Abnormal Psychology: “Childhood ADHD and Growth in Adolescent Alcohol Use: The Roles of Impairments, ADHD Symptom Persistence, and Parental Knowledge.”

Current Psychiatry Reports: “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.”

Addiction (Abingdon, England): ”Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent ADHD and delinquency.”

Experimental and Clinical Psychopharmacology: “Increased Sensitivity to the Disinhibiting Effects of Alcohol in Adults with ADHD.”

Cureus: “Risk of Alcohol Abuse in Humans with Attention-deficit/Hyperactivity Disorder Symptoms.”

HealthyChildren.org: “ADHD and Substance Abuse: The Link Parents Need to Know.”

SAMHSA Advisory: “Adults with Attention Deficit Hyperactivity Disorder and Substance Abuse Disorders.”

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