The Relationship Between ADHD and Substance Use Disorder in Adults

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is often comorbid with Substance Use Disorder (SUD), creating a complex challenge for clinical management. Individuals with ADHD are at high risk of developing SUD, driven by neurobiological dysfunctions, such as dopaminergic dysregulation, and psychosocial factors, such as the use of substances for self-medication. This study offers a narrative review of the existing literature on the prevalent relationship between ADHD and Substance Use Disorder (SUD) in adults. This intersection requires an integrated therapeutic approach, which combines pharmacological interventions, such as psychostimulants, with psychotherapeutic approaches aimed at the management of impulsivity and inattention. Studies highlight that early screening for ADHD in patients with SUD, and vice versa, is essential to improve clinical outcomes. Treatment programs that simultaneously address both disorders can significantly mitigate the impact of these conditions, providing a more favorable prognosis. In addition, it is important to consider that pharmacological treatment may require adjustments, such as higher doses of psychostimulants in patients with comorbidity, due to the neuroadaptation caused by substance use. The complexity of the relationship between ADHD and SUD, evidenced by the high prevalence of co-occurrence and therapeutic challenges, underscores the need for comprehensive and personalized interventions to improve patients' prognosis and reduce the risk of associated complications.