ADHD and Alcohol – What’s the Deal?

According to most research, ADHD is a risk factor for problems related to alcohol and for developing alcohol dependence. But what does an increased risk mean? And what causes this heightened risk? 

Is it all the negative attention during childhood? Or is it about adults self-medicating for restlessness and low self-esteem?  In this blog, we will explore the association between ADHD and alcohol. 

We know that adolescents with ADHD, on a group level, are more likely to experiment with tobacco, alcohol and in some cases, illicit drugs at a much earlier age than their peers without the diagnosis.

However, it appears that ADHD and addiction disorders are more prevalent in certain families than others, suggesting a deeper connection between ADHD and addiction beyond mere early or frequent experimentation.

ADHD and alcohol – common genetic risk factors

Today, most agree that our lives are shaped not solely by genetics or environment but rather by a combination of how our hereditary factors (i.e. genes) interplay with our unique environment. 

Children growing up in families where a parent suffers from alcohol problems, not only face the consequences of having a parent who is not well. They also risk “learning” to cope with various difficulties in life through alcohol. 

In some cases, it is theorized that children growing up under difficult circumstances exhibit ADHD symptoms as a response to challenging life situations. 

An alternative interpretation, suggested by several family and twin studies, is that there may be common genetic vulnerability factors that increase the risk of both addiction and ADHD in certain families.

The idea that ADHD and alcohol dependence share common genetic risk factors is supported by the fact that they also share many neurobiological processes. Such as reactions to dopamine in the brain’s reward system. 

Indeed, many with ADHD describe how difficult it is to resist temptations and how easily they succumb to short-term pleasures at the expense of long-term goals in life.

Wired for short-term gains, struggling with long-term goals 

The reward systems are located deep in the middle of the brain and are closely linked to other crucial parts and brain functions. 

While the human brain is much more advanced than most other animals, the reward systems are almost identical across species. It’s as if nature wanted to keep these parts of the brain unchanged throughout evolution, despite the many other developments and changes made over time.

Perhaps this isn’t so surprising either, considering that reward systems govern so much that is essential for our immediate survival. 

Thanks to these systems, we can make lightning-fast decisions that increase not only our individual chances of survival but the survival of our entire species. We see something edible and seize the opportunity to consume it because you never know when the chance will come again. We sense danger and take cover, or feel threatened and go into defense mode.

Each time we engage in activities nature deems beneficial, dopamine is released, giving us a sense of satisfaction without even thinking about why.

This makes us eager to repeat these behaviors and experience that pleasurable feeling again.
Think about your feelings when eating something you really enjoy, after exercising, or during sex!
Nice, right? 

Well, that is because all these things are activities that nature wants you to repeat. You gain energy, stay healthy, and reproduce! Perfect! 

Unfortunately, our reward systems aren’t as reliable when it comes to longer-term goals in life. For that, they need assistance from our more analytical thinking. We need to think about the future, plan for things that haven’t happened yet, and manage the consequences of our choices in both the short and long term.

ADHD -sensitivity to dopamine bursts

So, natural rewards release dopamine and make us yearn and strive for them. 

However, the dopamine rushes from food and sex can’t compare to the levels released when we consume alcohol. Alcohol quickly reaches the brain, triggering a cascade of various neurotransmitters, including dopamine. But, when the brain experiences such intense dopamine release, it starts protecting itself by downregulating its dopamine receptors.

That means that you need to drink more and more alcohol to achieve the same positive effect. This tolerance marks the beginning of developing dependence. 

Individuals with ADHD often struggle to activate their reward systems while simultaneously reacting more intensely when these systems are activated. Many with ADHD describe it as a restless feeling of “nothing is quite right but also not wrong” leading them to constantly search for ways to feel ok or balanced. 

Dopamine plays a central role in both ADHD and alcohol problems, and the risk is that one might develop dependence faster than those without this vulnerability.

This does NOT imply that everyone with ADHD will experience alcohol dependence, however, but rather that you may be more sensitive to it. 

This is crucial knowledge because there are plenty of reasons to take extra care of yourself (and your children) if ADHD is present in your family. 

It’s simply about getting to know one’s brain and reward systems are based on somewhat different circumstances than most others. With knowledge and support, one can navigate through life excellently. 

And many even manage to turn sensitive reward systems to an advantage!

Don’t forget, to check out the Mindhub section of the Letterlife app.
There you’ll find more on how ADHD and alcohol impact each other and common risk factors to crucial considerations regarding assessment and medication.