1 in 4 patients with addictions have undiagnosed ADHD
- People with Attention Deficit Hyperactivity Disorder (ADHD) are more vulnerable to developing an addictive disorder.
- Cannabis and tobacco are the substances most frequently consumed by adults and adolescents with ADHD.
- At least 5% of Spanish teenagers have ADHD disorder and half of them will maintain their diagnostic into adulthood.
- When children are adequately treated for their ADHD there is a lower risk of developing a dual pathology and they are less vulnerable to the potential consumption of substances, therefore reducing likeliness of failing at school or experiencing social and clinical problems in general.
Attention Deficit Hyperactivity Disorder (ADHD) is a risk factor to be considered into account when assessing the potential development of an addictive disorder. Experts meeting at the III International Congress on Dual Pathology consider that neuro-development disorders, such as ADHD, which begin in children development stages, generate alterations of a clinical, personal functioning, social and academic nature. Among all disorders to be linked to a greater vulnerability towards substance abuse and, therefore, dual pathology, ADHD leads the ranking.
Patients with ADHD exhibit a greater prevalence of substance-use disorders’ problems and, in turn, patients with addictive disorders are frequently diagnosed with ADHD. According to Dr. José Martínez-Raga, psychiatrist at the Doctor Peset University Hospital in Valencia, “there is a clear relationship between ADHD and disorders caused by the use of substances. This pathology is a clear and significant risk factor for the development of an addictive disorder. In fact, any given patient with attention deficit has twice the possibilities of developing an addiction than an individual who does not suffer from such a disorder”.
As clearly stated during the Barcelona Congress, ADHD increases the risk of developing a substance use disorder, doubling the pace at which minor abuse becomes a serious dependency and duplicates the duration of consumption before a final ceasing of use. Furthermore and according to experts, some of the undiagnosed patients use drugs as a form of “self-medication” to fight the discomfort and complications provoked by the symptoms of their mental disorder.
Clinical practice provides with enough evidence about the link between ADHD and a dependence on tobacco, alcohol and other drugs such as cannabis, cocaine or heroin. Percentages of patients complying with ADHD criteria: around 31-75% of patients with alcohol dependency, 35% of cocaine addicts and 17% of patients undergoing detoxification treatment with methadone and a significant and growing number of those dependent on cannabis. “An overview reveals that the prevalence of addictive disorders among patients with attention deficit is, approximately, double than that observed among general population”, Dr. Martínez-Raga states.
Early detection and action
The scenario found among patients with neuro-development disorders becomes even more complicated if the fact that psychiatric assessment is usually done when the patient is already an adult and has not been diagnosed at childhood or youth is taken into account. “ADHD has been considered exclusively as an infant disorder. However, research has shown that not only it is the most frequent neuro-biological disorder in infancy, but also a chronic development disorder that persists into adulthood in more than half of patients, if it is not adequately treated. Only 25% of adults with ADHD are diagnosed during childhood”, Dr. Nestor Szerman, President of the Spanish Dual Pathology Society (SEPD) says.
According to experts meeting at the Congress, there is a notable lack of childhood-stage learning disorders and other problems such as AHDH in Spain. Approximately 5% of teenagers suffer from AHDH, and it is an age and a pathology that multiplies the risk of vulnerability towards the abuse of substances. ”Adolescence is the time when one starts to experiment with drugs and when a greater prevalence of addictive disorders is recorded”, Dr. Martínez-Raga states. “If, in addition, there is another mental disorder, there is an increased vulnerability and a bigger danger of suffering a dual pathology”.
Cannabis and tobacco are the drugs that are most frequently abused of by teenagers and adults with ADHD. Cannabis presents an added problem, since it has linked effects to problems on attention, concentration and recent memory, a fact that significantly complicates deficit attention symptoms and makes diagnosis more difficult.
One of the greatest challenges mental health professionals face consists on achieving an early diagnosis and implementing a correct and timely treatment of ADHD, aiming to lessen addiction and dual pathology itself. According to Dr. Szerman, when children with ADHD are adequately treated, their vulnerability to the consumption of substances is reduced, as are the potential development of dual pathology and the chances of experiencing academic failure.
Finally, Dr. Martínez-Raga considers that another milestone in the field of Mental Health relies on the development of specific programmes for adolescents with one form or another of dual pathology, including an appropriate transition from infant to adult psychiatry -15 to 18 years old, depending on the Spanish region in which the psychiatric treatment is being administered.
III International Dual Pathology Congress
Elena Moreno/ Cristina García
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