17. Addiction problems with ADHD
Author: Ulrich Brennecke
Review: Dipl.-Psych. Waldemar Zdero
Substance-related addiction problems are a possible symptom of untreated ADHD. Alcohol addiction increases the risk of ADHD in young men by 5.3 times. There may be a self-medicating component to cannabis use, but medical cannabis is only a suitable treatment option in rare cases. The medical usability of non-medical cannabis is questionable due to the fluctuations in the active ingredients.
In the area of non-substance-related addictions, increased video game time is shown to be a consequence, but not a cause of ADHD. Internet addiction and cell phone addiction are associated with increased ADHD symptoms. There is a correlation between excessive cell phone use and impulsivity as well as a number of other mental illnesses.
ADHD medications significantly reduce the risk of addiction.
17.1. Substance-related addictions in ADHD
17.1.1. Alcohol addiction with ADHD
Short-term alcohol consumption reduces stress symptoms. Long-term alcohol consumption, on the other hand, increases them.
If there was another substance-related addiction in addition to alcohol addiction, the probability of comorbidity with ADHD was 5.3 times higher in young men.1
A senior physician at an addiction clinic told us that around 70% of all addiction patients on her ward are diagnosed with ADHD.
The German S3 guideline “Screening, diagnosis and treatment of alcohol-related disorders” already provides for ADHD screening as a standard measure.
17.1.2. Cannabis use and ADHD
Cannabis can have a self-medicating component in ADHD. This already occurs at doses that have no intoxicating effect (microdosing). Nevertheless, non-medical cannabis is not an appropriate treatment and medical cannabis is only a possible medication in very rare constellations.
Dosages that cause an intoxicating effect are of no serious medical significance. The medical usability of non-medical cannabis is fundamentally questionable due to the high fluctuations in the active ingredients.
More on this at ⇒ Cannabinoid medicines for ADHD And ⇒ Substance abuse with self-medication effects in ADHD.
17.2. Non-substance-related addictions
17.2.1. Video game addiction with ADHD
ADHD appears to trigger more video game time, while more video game time does not cause an increase in ADHD.2
Internet gaming addiction and ADHD appear to exhibit the same reduced functional connectivity between PFC and subcortical brain regions, each of which declined after 1 year of drug treatment.3
One study found a link between internet gaming addiction and inattention. It also found that this relationship was reinforced by a vertical individualistic cultural orientation with no significant gender difference.4
17.2.2. Internet addiction and ADHD
Of 650 boys at a high school, 12 to 15% showed a pronounced internet addiction. This was accompanied by increased ADHD symptoms.5
Internet addiction was differentiated into two subtypes by one study: one subtype that correlated with impulsivity and ADHD-HI and another subtype that correlated with compulsivity.6
One study found that internet addiction in ADHD correlated with motivational dysfunction, but not executive dysfunction.7
17.2.3. Cell phone addiction with ADHD
Excessive cell phone use correlates with impulsivity8 and affected 20.1% of the participating student test subjects.
Excessive cell phone use continued to correlate with higher levels of
- Alcohol consumption
- Sexual activity
- PTSD/PTSD
- Anxiety disorders
- Depression
Cell phone addiction correlated directly with ADHD, depression, anxiety and stress in one study, but not with sleep duration.9
Marmet, Studer, Lemoine, Grazioli, Bertholet, Gmel (2019): Reconsidering the associations between self-reported alcohol use disorder and mental health problems in the light of co-occurring addictions in young Swiss men. PLoS One. 2019 Sep 30;14(9):e0222806. doi: 10.1371/journal.pone.0222806. eCollection 2019. n = 5516 ↥
Stenseng.,Hygen, Wichstrøm (2019): Time spent gaming and psychiatric symptoms in childhood: cross-sectional associations and longitudinal effects. Eur Child Adolesc Psychiatry. 2019 Sep 6. doi: 10.1007/s00787-019-01398-2. n = 791 ↥
Han, Bae, Hong, Kim, Son, Renshaw (2019): Resting-State fMRI Study of ADHD and Internet Gaming Disorder. J Atten Disord. 2019 Oct 23:1087054719883022. doi: 10.1177/1087054719883022. ↥
Stavropoulos, Baynes, O’Farrel, Gomez, Mueller, Yucel, Griffiths (2020): Inattention and Disordered Gaming: Does Culture Matter? Psychiatr Q. 2020 Jan 3. doi: 10.1007/s11126-019-09702-8. ↥
Choi, Huh, Kim, Suh, Lee, Potenza (2019): Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys. Psychiatry Investig. 2019 Jun;16(6):433-442. doi: 10.30773/pi.2019.04.02.1. ↥
Tiego, Lochner, Ioannidis, Brand, Stein, Yücel, Grant, Chamberlain (2019): Problematic use of the Internet is a unidimensional quasi-trait with impulsive and compulsive subtypes. BMC Psychiatry. 2019 Nov 8;19(1):348. doi: 10.1186/s12888-019-2352-8. ↥
Zhou, Zhang, Li, Xue, Zhang-James (2020): Motivational but not executive dysfunction in attention deficit/hyperactivity disorder predicts internet addiction: Evidence from a longitudinal study. Psychiatry Res. 2020 Jan 25;285:112814. doi: 10.1016/j.psychres.2020.112814. PMID: 32036155. ↥
Grant, Lust, Chamberlain (2019): Problematic smartphone use associated with greater alcohol consumption, mental health issues, poorer academic performance, and impulsivity. J Behav Addict. 2019 Jun 1;8(2):335-342. doi: 10.1556/2006.8.2019.32. n = 3.425 ↥
Selçuk, Ayhan (2019): The relationship between smartphone addiction risk and sleep duration and psychosocial comorbidities in health professional candidates. Perspect Psychiatr Care. 2019 Dec 20. doi: 10.1111/ppc.12465. n = 408 ↥