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What assessment tools detect ADHD in people with addiction? 

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Updated
ByMy Patient Advice
Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Identifying ADHD in people who also live with addiction can be challenging. According to NICE and NHS England, symptoms of ADHD often overlap with the effects of alcohol, stimulants, cannabis, or opioids, so using the right combination of tools, timing, and collateral history is essential for accurate diagnosis. 

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Screening tools that help identify ADHD risk 

Two screening questionnaires are widely used in UK addiction services: 

  • ASRS-v1.1 (Adult ADHD Self-Report Scale) 
  • CAARS (Conners’ Adult ADHD Rating Scales) 

Both tools are recommended in RCPsych guidance and national ADHD reports because they reliably flag adults who may need a full diagnostic assessment. However, they are screening instruments only, and NICE warns that results may be distorted if used during intoxication or withdrawal. 

Structured diagnostic interviews 

NICE NG87 highlights that diagnosis must be based on structured interviews and developmental history. The most used tools include: 

  • DIVA-5 (Diagnostic Interview for ADHD in Adults) 
  • Barkley Adult ADHD Rating Scale 
  • ACE+ (ADHD Child Evaluation Plus) for developmental history 

These interviews help clinicians distinguish lifelong ADHD patterns from temporary substance-related symptoms. The Royal College of Psychiatrists stresses the importance of using them alongside information from parents, carers, teachers, or medical records, essential when substance use blurs the clinical picture. 

Digital tools improving accuracy 

Digital measures are increasingly used in dual diagnosis pathways. The QbTest, a computer-based assessment of attention, activity, and impulsivity, is recognised by NICE and referenced in the NHS England ADHD Taskforce. Evidence suggests it can: 

  • improve diagnostic confidence 
  • reduce waiting times 
  • help identify ADHD in complex cases, including those with substance use disorders 

While helpful, QbTest is an adjunct tool that is never a standalone diagnostic method. 

Using tools safely in addiction settings 

NICE and RCPsych recommend using screening or diagnostic tools only after substance stabilisation, since intoxication and withdrawal can produce false positives or mask symptoms. Multidisciplinary assessment, involving addiction teams, neurodevelopmental clinicians, and family or collateral informants is considered best practice across the NHS. 

Integrated models and digital pathways 

New NHS neurodevelopmental data hubs and integrated assessment models are being rolled out to improve early detection in adults with substance use disorders. These approaches combine screening tools, digital testing, structured interviews, and shared-care reviews to reduce diagnostic delays and misinterpretation. 

Private assessment services such as ADHD Certify use similar multi-method models, supporting people who need structured diagnosis and medication reviews alongside NHS pathways. 

Takeaway 

Screening tools like the ASRS and CAARS can spot ADHD risk, but accurate diagnosis in people with addiction relies on structured interviews, collateral history, digital tools, and multidisciplinary assessment, always applied after substance stabilisation to ensure clarity and safety. 

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. 

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