The Connection between ADHD and Alcohol - why it matters

Did you know that up to 43% of people with ADHD will experience an alcohol use disorder? No, neither did I until I got diagnosed in 2022, having struggled with alcohol for decades.

So, as it’s ADHD Awareness Month and Sober October, I thought I’d write about this in case it’s not something that’s come across your radar yet.

I’m currently seeing a great deal of my grey area drinking clients in their 40s, 50s, and 60s being diagnosed. As are many of my friends in recovery from alcohol, drugs or food - and retrospectively it’s evident that many of my family who have struggled similarly are neurodivergent (ADHD is 80% heritable, and part of the neurodivergent ‘family’ of conditions like autism, dyslexia, dsypraxia and Tourettes).

You see, the 43% is JUST alcohol and with the amount of diagnoses we’ve seen in the last few years I believe we will see this number is actually much greater.

Additionally there are many other addictions/dependences that are significantly higher in people with ADHD than the general population.

Substance addictions are like booze, drugs (illicit or prescribed) and nicotine, as well as process addictions like eating disorders of any kind, sex/porn, gaming, compulsive spending, shopping, the internet, social media etc.

Why do people with ADHD experience so much more alcohol misuse than the general population?

It’s because we are deficient in certain neurotransmitters (brain/body chemicals) like dopamine and norepinephrine. We are chemically wired to seek out things that will increase our dopamine levels to a baseline of ‘neurotypical’ people (aka ‘normal’ brains).

This means that we get a much higher reward from engaging in substances, behaviours, processes that are stimulating to us and will increase our dopamine (the reward and motivation chemical). Essentially, the pay off is much bigger in our brains and bodies. This reinforces a reward loop that means we are more likely to keep engaging in said behaviour.

In other words, there are some pretty high odds that if we have ADHD we’ve likely struggled with addictive behaviour of some kind. 2 - 4 times more likely than the general population.

And it’s not our fault; the way our brains are wired is causing us to struggle with many things that lead to addiction.

So much so that the first ever Australian evidence-based clinical guidelines for the treatment of ADHD released in 2022 recommended (a) routine screening for ADHD in all alcohol and drug settings and (b) routine screening for substance use disorder in ADHD patients in mental health settings. These guidelines have been developed in conjuction with, and endorsed by, the full suite of psychology, psychiatry and medical bodies in Australia.

Yep, that’s how big the link is.

But it’s not just the brain chemistry, there’s a heap of ADHD related reasons why …

We're essentially:
🧩 self-medicating
🧩 trying to quieten our racing brain
🧩 using it to sleep
🧩 seeking instant gratification, feel bored or have an urge to rebel

🧩do the same things over and over again because we forget what the outcomes were last time
🧩 managing overwhelm and over stimulation
🧩 dopamine seeking.

We get addicted to stuff easier than most. We tend to be very impulsive, risk takers with biiig emotions. And that's not our fault, again, it's the way our brains are wired.

And it’s hard being a neurodiverse person trying to navigate a neurotypical world.

We have a LOT of internalised shame for:
⚡️not being able to do the things others make look easy,
⚡️not having control over our behaviours and emotions,
⚡️over sharing and blurting,
⚡️struggling to adult and burn out cycles,
⚡️repeatedly failing at things like jobs, relationships, finances, goals, dreams, making poxing instagram reels,
⚡️And for probably having been told that overtly since we were children, too - by teachers, employers, friends, peers.

“Hmm, some of this is sounding quite familiar to me. What actually is ADHD then?”

Well, I’ll be writing a lot more on the topic as I have added ADHD and Anxiety to my suite of coaching specialisations. I’d love you to check out my website here and let me know what you think!

Often these 3 A’s - Alcohol, Anxiety, ADHD - go hand-in-hand, but my clients may come to see me about just one of these, or they may have all 3 going on (like me!).

If you want the low down on ADHD, I’ve written an article here with the basics, to get you started.

“I don’t have ADHD so this doesn’t apply to me”

Excellent! Thanks for still being interested in enough to read this far.

It’s still useful to know because it speaks to the fact that are MANY underlying reasons we struggle with booze. All of us.

And like ADHD a lot of these also:

💡relate to the impact on our brains (either of our pasts, or our alcohol use)

💡involve trauma or unhappy childhood beliefs and patterns

💡involve our mental health

💡involve us trying to fit in and belong somewhere

💡involve highly dysregulated nervous systems and emotions

💡involve trying to manage lives that are unmanageable, which we may not yet be ready to fully admit to ourselves (e.g chronic workloads and stress, unhappy relationships, unsatisfying work, difficult family lives or friendships)

Just like ADHD, many of these reasons are not our fault. They’re often part of our genetic lottery. And holding compassion for ourselves while we’re trying to navigate our challenges with alcohol is important, particularly when we hold a lot of shame, regardless of our brain wiring.

Sources:

May T, Birch E, Chaves K, et al. The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder. Australian & New Zealand Journal of Psychiatry. 2023;57(8):1101-1116. doi:10.1177/00048674231166329

ADHD Guideline Development Group. Australian evidence-based clinical practice guideline for Attention Deficit Hyperactivity. Melbourne: Australian ADHD Professionals Association; 2022. Australian Evidence-Based Clinical Practice ADHD Guideline (aadpa.com.au)

Luderer, M., Quiroga, J. A. R., Faraone, S. V., Zhang-James, Y., & Reif, A. (2021). Alcohol use disorders and ADHD. Neuroscience & Biobehavioral Reviews, 128, 648-660.