ADHD is a neuro-developmental disorder and is thought to be largely genetic but also can be acquired due to damage or injury to the structure and function of the brain. This can be caused by traumatic brain injury, repetitive concussions from playing contact sports or even damage due to substances including alcohol and other drugs. It is a misconception that patients need to be hyperactive to have ADHD.

ADHD results in a reduction of blood flow to the prefrontal cortex of the brain which is responsible for controlling your executive functions. This part of the brain requires two main neurotransmitters which are called dopamine and adrenaline.

Brain SPECT CT imaging can be a useful modality for assessing the underlying function of your brain https://www.amenclinics.com/services/brain-spect/ 

Your executive functions include:

• Regulating emotions (getting anxious and having panic attacks)
• Impulse control (impulse buying, spending, eating or trouble controlling emotional outbursts)
• Short term memory (losing keys/phone/wallet, forgetting names, forgetting appointments)
• Organisation and time planning
• Distractibility
• Impaired self-regulation
• Poor focus and concentration

Dopamine, Adrenaline and Addiction

Many people with ADHD develop addictions. The lack of dopamine and adrenaline in the brain causes patients significant symptoms. Up to 80% of patients with ADHD will have at least one associated mental health condition, with the most common being anxiety, depression and difficulty sleeping. 

Childhood ADHD is a predictor for later substance use disorders. It was linked with the development of nicotine use disorder as a teenager and later to alcohol, cannabis, combined alcohol and psychoactive Substance Use Disorders (SUDs).

Often, people who suffer from ADHD will resort to drugs and medications which increase dopamine and adrenaline to treat ADHD's underlying symptoms.

If you have ADHD, you are more than 3x as likely to be dependent on substances than the general population. Only 30% of people surveyed said that they used substances to get high. 70% were using these substances to help relieve the symptoms associated with untreated ADHD.

"Abuse isn't about how much you're doing or how often it happens. It's about how your use affects your relationships, health, work, school, and your standing with the law" - Wendy Richardson.

Up to 50% of patients presenting to clinics for cannabis use disorder had a diagnosis of ADHD.

Other conditions and addictions associated with ADHD include:

• Gambling addiction
• Food addiction (binge eating disorder, obesity)
• Porn and sex addiction
• Computer gaming addictions (includes computer, console and mobile gaming)
• Social media addiction

Untreated ADHD is linked to premature death and increased rates of suicide. It is estimated to cost Australians over $20 Billion per year.

If you think you might have ADHD, please speak to your doctor or visit https://www.adhdaustralia.org.au/ to find out more.

Take an online screening test for ADHD https://www.additudemag.com/adhd-symptoms-test-adults/

Resources:

• https://www.additudemag.com/the-truth-about-adhd-and-addiction/
• https://www.additudemag.com/cannabis-use-disorder-marijuana-adhd/ 
• https://www.additudemag.com/complex-adhd-symptoms-diagnosis-treatment/ 
• https://pubmed.ncbi.nlm.nih.gov/21156266/ 
• https://aadpa.com.au/the-social-and-economic-costs-of-adhd-in-australia/ 
• https://www.continuingedcourses.net/active/courses/course082.php 

Written by Dr. Bryce Joynson (MBBS, FRACGP)
CEO - Executive Function Consulting Agency
Member Australian ADHD Professional Association, World Federation of ADHD, RACGP Specific Interest group (ADHD, ASD and neurodiversity)
Member Australian Medical Cannabis Association (AMCA), Society of Cannabis Clinicians(SCC), Australian and New Zealand College of Cannabinoid Practitioners (ANZCCP)