Addiction & ADHD

What is Addiction?

Addiction is a chronic disease. People with addictive disorders can be aware of their problem but are unable to stop it even if they want to.

Misuse is different from addiction. Substance misuse does not always lead to addiction, while addiction involves regular misuse of substances or engagement in harmful behavior.

Many people experience both mental illness and addiction. The mental illness may be present before the addiction. Or the addiction may trigger or make a mental disorder worse.

Symptoms

Symptoms of addiction often include declining physical health, irritation, fatigue, and an inability to cease using a substance or engaging in a behavior.

The addiction may cause health problems as well as problems at work and with family members and friends. The misuse of drugs and alcohol is the leading cause of preventable illnesses and premature death.

Substance Use in Youth

There is no single reason why young people use alcohol and other drugs, and there is no simple way to prevent use and abuse of alcohol, other drugs or gambling activities.

There are both risk factors and protective factors that play a role in determining whether young people will experience harmful effects from substance use or gambling. Family factors such as effective parenting practices are among the strongest predictors and protective influences for alcohol and drug use among youth.

People who start using drugs at a young age suffer the most when they rely on drugs to help them cope with the challenges of growing up: making friends, facing fears, sexual pressures, and the need to perform well at school, at work or in sports. They miss out on the chance to develop life skills, and when they want to quit, they have to catch up with their peers before they can have a normal drug-free life.

ADHD & Substance Use

Many people with untreated ADHD try to self-medicate to improve functioning. Adults with ADHD smoke more and have more trouble quitting. Children with ADHD start smoking younger and smoke more.

A common myth about ADHD is that use of stimulant medications may lead to substance abuse. In fact, untreated ADHD is a significant risk factor for substance abuse in adolescence and adulthood, whereas ADHD medication is associated with an 85% reduction in risk for substance use disorders in youth with ADHD.

Behavioural Addictions

Non-substance related addictions involve being unable to stop certain activities, such as gambling, eating, shopping, sex, work, and excess use of the internet or video gaming. In these circumstances, a person has a behavioral addiction.

Behavioural addictions are not currently diagnosed as mental health conditions under the DSM-5. However, there is growing evidence that these are addictive conditions that cause impairment in normal functioning and share similarities with substance addictions including tolerance and withdrawal.

Video Gaming

At least 8% of youth show harm from playing video games, which means a higher proportion of youth experience harm from gaming than adults do from alcohol, other substance abuse, or gambling. Games can be a positive way to socialize, escape, relieve stress, experience excitement and challenge, and explore identity and creativity.

Although it is rare for players to have problems as a consequence of gaming, it is common to see an increased preoccupation towards playing which can create concern for parents.

Excessive gaming becomes a serious concern when youth neglect important tasks, argue with family members, struggle to reduce or take a break from play, or withdraw from other interests. In such cases, gaming may contribute to poor social skills, isolation, lower grades, weight gain, and time away from family, studies, and interests.

The Canadian Pediatric Society recommends no screen time for children under 2 years of age, under 1 hour per day for children age 2-4 years, and under 2 hours daily for most others.

Gaming is only addictive for some people, not everyone; in fact, 92% of gamers do not meet the clinical criteria for problematic gaming. Youth who are non-aggressive, are prosocial, have positively developed ethical frameworks, have good focus in social and academic spheres, and have boundaries set by/with parents are at reduced risk of gaming abuse.

Youth who are aggressive/pre-aggressive, have narcissistic tendencies or poor social skills, have anti-social or violent tendencies, or have ADHD are at increased risk for gaming abuse.

Internet Gaming Disorder, an emerging diagnosis, most commonly co-occurs with ADHD, anxiety and depression.

Youth with a mental health disorder use 2-3 times the screen time compared to the general population.

Treatment for gaming addiction involves addressing the untreated mental health issues or history of trauma that predisposes the youth to gaming abuse, not the gaming itself.

Hyperfocus: ADHD youth can “hyperfocus” on games because they are highly stimulating and trigger the dopamine system (the brain’s reward system).

Video games do not train ADHD youth how to better sustain attention for long periods; rather, the youth play for long periods because the game is designed to provide constant distraction that is stronger than other (real world) distractors and keeps them focused on the game. Over time, tolerance develops and the player needs a “bigger hit.”

Treatment Options for Youth

There are many treatment options for young people and their families in Alberta. Options include group counselling, a support group, regular visits with an addiction counsellor (outpatient treatment), or more intensive treatment such as detoxification or residential treatment programs.

Youth detox provides stabilization and support to help youth withdraw from substance use and get ready for treatment.

Youth residential treatment offers intensive live-in programs for substance abuse and related issues.

There are also many treatment opportunities for families.

Resources

For more information and to find an addiction services office in Calgary, please call the 24-hour Helpline at 1-866-332-2322.