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17. Addiction problems with ADHD


17. Addiction problems with ADHD

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 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

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

Whether video game addiction can lead to ADHD, as is sometimes assumed[^5], is questionable. The adolescents surveyed in this study were between 12 and 16 years old. DSM 5 requires an ADHD diagnosis by the age of 12. If children under the age of 12 develop a video game addiction, this raises the question of parental involvement and socioeconomic status. On the other hand, this could indicate genetic causes that contribute to the parenting behavior of the parents and the ADHD of the children. ADHD is associated with a deviant profile of attention, in which attention is less able to be activated for intrinsically non-interesting things. Since school is usually entirely about extrinsic guidance, it would be conclusive if children with ADHD are at an increased risk of perceiving video games as one of the few elements in life that they find intrinsically interesting. Video games are specifically programmed to increase intrinsic motivation. People with ADHD also find it enjoyable when their attention is working. We further hypothesize that the lower interest for more distant rewards caused by ADHD also triggers a higher affinity for video games, as they often systematically motivate by means of short-term rewards (especially at entry levels)

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
  • Anxiety disorders
  • Depression

Cell phone addiction correlated directly with ADHD, depression, anxiety and stress in one study, but not with sleep duration.9

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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

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