How does ADHD co-occur with alcohol misuse?

PostedNovember 25, 2025

UpdatedNovember 26, 2025

ByMy Patient Advice

Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Attention deficit hyperactivity disorder (ADHD) and alcohol misuse often overlap, and when they do, each can make the other harder to manage. According to NICE guidance on ADHD (NG87), adults and young people with ADHD should always be screened for alcohol and substance use during assessment and treatment, as co-occurrence is common and clinically important.

Why ADHD increases the risk of alcohol misuse

Research consistently shows that people with ADHD are more likely to develop alcohol use disorder (AUD) compared with those without the condition. Large-scale reviews indicate that around 20% of adults in treatment for alcohol problems also have ADHD, while up to 43% of people with ADHD may develop an alcohol use disorder at some point in their lives (PubMed review, 2021).

Experts believe this overlap stems from shared neurobiological and behavioural traits. ADHD is linked to differences in dopamine regulation, reward sensitivity, and emotional control factors that can make alcohol feel temporarily calming or rewarding. For some, this can evolve into self-medication, binge drinking, or dependency. According to NHS advice on ADHD, impulsivity and difficulty managing emotions are common traits that may contribute to risky drinking patterns.

What NICE and NHS guidance recommends

NICE’s ADHD guideline (NG87) advises clinicians to routinely check for alcohol and substance misuse during ADHD assessments, particularly in adults. When both conditions are present, care should be integrated and collaborative, involving both mental health and addiction specialists.

Similarly, NICE NG135: Alcohol Interventions recommends non-stigmatising, early support for people with vulnerabilities such as ADHD or other neurodevelopmental conditions. UK data from the Office for Health Improvement and Disparities (OHID) confirm that alcohol misuse remains the most common substance problem in England, with many individuals also living with ADHD or other mental health conditions.

According to the Royal College of Psychiatrists, joint care plans addressing both ADHD and alcohol misuse together achieve better outcomes than treating them separately.

Managing both conditions safely

Managing ADHD and alcohol misuse in parallel can involve behavioural therapies, mutual-aid support, and, where appropriate, carefully monitored medication for ADHD, such as long-acting stimulants or non-stimulants. NICE and NHS guidance emphasise collaborative, person-centred care and regular review to monitor progress and reduce relapse risk.

Non-medication approaches, such as coaching or behavioural therapy, can also help individuals develop coping strategies. Services like Theara Change provide evidence-based behavioural support for ADHD and mental health, complementing clinical care rather than replacing it.

Takeaway

ADHD and alcohol misuse frequently co-occur, and recognising this link is essential for effective treatment. According to NICE, early screening, joint care planning, and compassionate, integrated treatment give people the best chance of long-term recovery and improved daily functioning.

Victoria Rowe, MSc

Author

Victoria Rowe is a health psychologist with a Master’s in Health Psychology and a BS in Applied Psychology. She has experience as a school psychologist, conducting behavioural assessments, developing individualized education plans (IEPs), and supporting children’s mental health. Dr. Rowe has contributed to peer-reviewed research on mental health, including studies on anxiety disorders and the impact of COVID-19 on healthcare systems. Skilled in SPSS, Minitab, and academic writing, she is committed to advancing psychological knowledge and promoting well-being through evidence-based practice.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.