The phrase "addictive personality" is thrown around a lot in the addiction world, but what--and whom--does it refer to exactly? A sensation-seeking hedonist who is drawn to things that feel good? Sure. A person with a mental illness? Yes, people with mental or developmental disorders make up the bulk of the addiction population. Someone with a history of trauma and negative memories lingering in their head that they're itching to escape with drugs? Absolutely. The link between trauma and addiction is stronger than the link between obesity and Type II diabetes.
I'd like to hone in on these claims with a theory of my own: that the ADHD personality is the penultimate addictive personality type, eclipsing even the depressed, bipolar or traumatized population in their tendency to self-medicate with drugs. Hear me out.
When most people think of ADHD, they tend to think of mere hyperactivity, daydreaming or ditzyness. But it goes way, WAY deeper than that. People with ADHD have a dysfunctional dopamine system. Dopamine is the pleasure/reward chemical. Humans get little bursts of it throughout the day as we do things like eating a warm meal, completing a chore, exercising or spending time with our children. In the ADHD brain however, dopamine production is insufficient or otherwise dysfunctional, meaning sufferers feel nothing or feel even WORSE after attempting to complete any task that requires sustained effort--even tasks that make others feel rewarded and accomplished.
As a result, we walk around in a state of perpetual boredom and under-arousal that feels like purgatory. Doing almost anything other than our narrow set of hobbies is torture, including just getting out of bed in the morning. This leads to a vicious cycle of getting less accomplished than our peers, causing us to feel terrible about ourselves in an endless loop of underachieving and self-hatred. Our outer lives are often awash in clutter, poor hygiene, low self-esteem, forgetfulness, miscommunications, missed opportunities & more. Our minds run laps around our bodies & are never truly at rest. Depression is an ever-present companion.* How could it not be? By the time an un-medicated child reaches adulthood, they've incurred many traumatic memories due to the difficulty of living without the aid of proper treatment. This puts them in several of the categories from the first paragraph of this article (escapism, depression, childhood trauma), making them a prime contender for addiction.
Thus, the first time someone with ADHD tries a substance like opiates, stimulants, weed or any other drug that stimulates dopamine, it's like a nearsighted person putting on glasses for the first time. Everything snaps into focus; they feel "normal". This is particularly true with stimulants like amphetamine or cocaine but applies to any drug really. Dopamine is the key. The more the better. If the person is undiagnosed and doesn't know much about drugs, this is where addiction can really sink its teeth in. Not everyone knows right away that more isn't necessarily better.
As an ADHD sufferer myself, I always disliked being 'fucked up' and out of control--I just wanted enough energy and motivation to not lay around all day and feel worthless. But when you resort to trying street drugs without the aid of a doctor, you come across substances that lend themselves to abuse like research chemicals which are often insanely addictive (see: mephedrone). I know for an absolute fact that if I'd had Adderall or a similar medication in my youth, my drug experimentation would've been drastically reduced. Maybe I would've never tried anything other than weed. Instead, I've been self-medicating for the last 17 years and have tried every class of drugs except inhalants as well as 23 psychiatric medications--mostly anti-depressants--to no avail.
And it doesn't stop with drugs: activities like gaming, social media addiction, porn, gambling, shopping, binge eating & other dopamine-stimulating activities are frequent vices for the ADHD sufferer. Anything that offers an instant high or rush. The "reward" chemical is intricately connected to this disorder due to our impulsivity and lack of endogenous supply of it.
To Medicate or Not to Medicate?
Unsurprisingly, studies show that untreated ADHD in adults increases the risk of drug abuse exponentially. One-fourth (25%) of substance abusers fit the clinical criteria for ADHD. You can probably think of several celebrities who were diagnosed and ended up self-destructing with drugs (Kurt Cobain & Bradley Nowell of Sublime come to mind but there are many others who've come out as having the condition) which makes one wonder how many undiagnosed drug addicts are walking around. Worse, there are parents right now who are denying their kids medication because they think it will actually increase the risk of drug addiction later or don't want them to be "dependent on a pill" because it's stigmatizing.
While the decision to medicate is a big one with many benefits and drawbacks, these particular reasons are counter-intuitive as studies show you actually increase your child's risk of addiction by leaving them un-medicated. Part of this is likely due to the trauma you're putting them through by allowing them to struggle as they flail through life without the supports needed to succeed academically, socially or otherwise. (Remember the statistic about childhood trauma causing addiction mentioned above?) It's akin to denying your disabled child a wheelchair or refusing your hearing impaired child a hearing aid. This is not hyperbole. While there are behavioral, dietary and other interventions that can and should be explored, ADHD is a neurological disorder at its core and requires a biological approach in the vast majority of cases.
Do you honestly think the draconian DEA/FDA would allow stimulants to be prescribed to children if they hadn't been shown to work for ADHD, and produce dramatic results at that? Uhh, no. It's one of only two conditions they're FDA approved to treat, the other being narcolepsy. (Vyvanse is also approved for Binge Eating Disorder but that's the exception). You get the point. Stimulants work for ADHD and are safe when taken in prescribed doses by people who need them. They're not new medications either: they've been in use since the 1920's so the long-term effects are well studied. This ain't Vioxx or Fen-Phen here.
Where's the Outrage?
So why isn't more made of this shocking link between ADHD and addiction? Our society is positively plagued by addiction in all forms; it would seem wise to address the underlying causes. We wring our hands about childhood diseases like autism while practically throwing kids with ADHD to the wolves. Girls & poor kids in particular. Like autism, ADHD is not merely a childhood disease that one grows out of--it's a lifelong neurological disorder that affects the core of a person's being. Everything from career & academic prospects to relationships, family & social life are affected by it. Even one's risk of falling into the criminal justice system or dying prematurely by accidents.
Yet ADHD medication is inaccessible for a lot of people & those who can get it have to jump through flaming hoops due to strict government regulations, high costs & other factors. This often causes people to resort to the only alternative available: street drugs. Meth, cocaine, MDMA, opiates & all the adulterants therein. In the age of fentanyl, this has never been a more deadly game. The abstinence-only rehab industry chews us up and spits us out, "clean and sober" and at a higher risk of overdose and death than before we went in due to a reduced drug tolerance. If they don't understand this basic tenet--that we will never be truly free of addiction without treating our underlying ADHD--they're doing more harm than good.
It's long past time for evidence-based drug rehabilitation tailored to meet the needs of the individual: neurodivergence and all.
*Note: I'm speaking mostly of the inattentive subtype of ADHD from which I suffer. There are other subtypes with other predominant symptoms. I'm not a medical professional (duh) and don't presume to know what's best for you or your kid so talk to your doctor and do some serious introspection if you're a parent agonizing over whether to medicate.
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