The risks of substance abuse are higher for teens with ADHD

Teenagers with ADHD (attention-deficit hyperactivity disorder) often have difficulty wrestling with school grades, social activities and sports, sexuality and dating, and relationships with friends and families. Another issue that troubles many teens with ADHD is drug and alcohol abuse.

The fact that teens with ADHD have more problems with substance abuse has been well documented. A 2007 report in the Archives of General Psychiatry confirmed that having ADHD was a predictor for drug and tobacco use among teenagers; even among kids who had just one symptom of ADHD, there was an increased rate of substance abuse. A 2003 study also found that teens with ADHD experience more alcohol-related problems.

Estimates vary, but roughly 13 to 21 percent of teenagers with ADHD abuse alcohol or drugs. They also tend to start using these substances at a younger age than teens without ADHD. Cigarette smoking, too, tends to start earlier among teens with ADHD, and they're more likely to make it a habit than are other teenagers.

Researchers are unsure why the link between ADHD and substance abuse exists, though some have speculated that it may be related to other conditions—including conduct disorder, antisocial personality disorder or oppositional defiant disorder—that often occur with ADHD.

Other researchers believe the link between ADHD and substance abuse might be related to a family history of alcoholism or drug abuse, or perhaps even social influences that kids with ADHD often face. For example, poor academic performance often leads kids to gravitate toward "non-conformist" peer groups where smoking and substance abuse are accepted or, in some cases, encouraged.

ADHD Medication and Drug Abuse

Many parents are concerned that their teens who are taking stimulants or other medications for ADHD might become dependent on them. But the National Institute on Drug Abuse (NIDA) has reported that adults who were treated with stimulants for ADHD when they were young children have roughly the same rates of substance abuse as adults who were never diagnosed with ADHD.

And though adults with ADHD, according to the NIDA, who had started on stimulant therapy as older children or teenagers had somewhat higher rates of substance abuse than adults without ADHD, researchers contributed that increase to co-occurring disorders like antisocial personality disorder.

There is, however, some evidence that ADHD medications—especially stimulants—are abused by those who were not prescribed the drugs: up to 29 percent of teenagers and young adults with ADHD report that they are asked to give, sell or trade their medication to others.

If you have a teenager with ADHD, you already know that treatment, including appropriate medication, can help your teen manage everyday life. But you should also know how to approach the issue of drugs and alcohol with your teenager.

Be Aware of Some of the Signs of Drug Use in Teens

According to the American Academy of Child and Adolescent Psychiatry, these can include:

  • Fatigue
  • red or glazed eyes
  • a lasting cough
  • personality or mood changes; irritability; arguing
  • depression
  • withdrawal from friends, family, sports or other activities
  • a drop in grades
  • problems with the law
  • discipline problems

Talk About It: Stopping Drug Abuse

If you think your teenager is using alcohol or drugs—whether they have ADHD or not—try the following tips for communicating with your teen about the issue:

  • Before you have a conversation, try to prepare yourself. Avoid negative feelings like anger and betrayal; they may result in your child tuning out. Organize your thoughts and decide what you want to say.
  • Open the discussion by expressing your love and concern for your teen. Let your teen hear your understanding of the facts: you found drug paraphernalia in their room, your teen has violated curfews, etc.
  • After discussing the facts as you see them, ask your teen for his or her response. Listen actively to your teen and try to understand what he or she is saying.
  • Discuss the shared information. This may be difficult, since you and your teen may respond angrily. Be calm and consistent in your approach.
  • Make it clear that you will not tolerate drug or alcohol use by your teen. Identify the consequences if they do use drugs or alcohol.
  • Let your teen know that they are accountable for their actions, and that there will be consequences for not following the rules such as loss of privileges or restricting their curfew. Also consider offering incentives or rewards.
  • Don't be surprised if your teen walks away in anger. Let everyone cool down and prepare to have the conversation again. Find a time when you and your teen can have the next talk. Talking to your kids about drugs and alcohol is a process, not an event. If needed, seek professional help.


American Academy of Child and Adolescent Psychiatry

"Prospective Effects of Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, and Sex on Adolescent Substance Use and Abuse." Irene J. Elkins, PhD; Matt McGue, PhD; William G. Iacono, PhD. Archives of General Psychiatry. 2007;64(10):1145-1152.

Molina, BSG et al. Childhood Predictors of Adolescent Substance Use in a Longitudinal Study of Children With ADHD. Journal of Abnormal Psychology. 2003, Vol. 112, No. 3, 497–507.

National Alliance on Mental Illness

National Institutes of Health

National Institute on Drug Abuse

Parents: The Anti-Drug

Publication Review By: the Editorial Staff at

Published: 08 Feb 2011

Last Modified: 27 Aug 2015