ADHD and Substance Use: Signs Families Should Know and Treatment

Written by the medical team at Day One Rehabilitation Center, Nakhon Nayok, Thailand · Medically reviewed by Dr. Pichayut Kasemphakdeephong (Psychiatrist)

Forgetting things often, leaving tasks unfinished, getting distracted easily, being unable to sit still, having a short temper, or acting without thinking are behaviors many people experience — especially during periods of poor rest or high stress. But when these symptoms have been present continuously since childhood and affect school, work, relationships, or life management, they may be related to ADHD.

ADHD isn’t only seen in children. A number of adults continue to have symptoms, though the pattern may shift from hyperactivity or restlessness to poor time management, procrastination, frequent job changes, impulsivity, difficulty controlling emotions, or a constant need to be doing something.

When substance use is also present, assessment becomes more complex, because some substances can change attention, memory, sleep, mood, and self-control. On the other hand, some people with ADHD may start using alcohol, cannabis, or stimulants to try to calm themselves, focus, work longer, or escape from stress and a long-accumulated feeling of failure.

Families shouldn’t be quick to conclude that the person is simply “irresponsible” or that all the symptoms come from the substance alone. What matters is assessing when the attention and impulsivity symptoms first appeared, whether they existed before substance use began, and what role the substance is currently playing in the person’s life — so that treatment can address both ADHD and the substance use problem together.

What Are the Symptoms of ADHD, and Can Adults Have It?

ADHD is a condition involving the ability to regulate attention, behavior, and impulsivity, with symptoms starting in childhood — even though some people aren’t diagnosed until adulthood.

Having ADHD doesn’t mean someone has “no attention at all.” Some people with ADHD can focus for long periods on things that interest them, but struggle to regulate their attention when facing tasks that are boring, repetitive, require multi-step planning, or offer delayed rewards.

Symptoms families may notice include:

Getting distracted easily by outside stimuli
Starting many things but not finishing them
Forgetting appointments, losing things, or misplacing items often
Difficulty prioritizing tasks
Procrastinating until work piles up
Poor time management or frequent lateness
Trouble listening to others for long, or interrupting
Making quick decisions without considering the consequences
Spending impulsively or having trouble controlling spending
Getting bored easily and needing new stimulation
Feeling restless or needing to always be doing something
Getting irritable or having trouble controlling emotions in certain situations
Inconsistent performance at school or work despite having the ability
Relationship problems from forgetfulness, not listening, or impulsive decisions

However, having some of these symptoms doesn’t automatically mean someone has ADHD. Stress, depression, anxiety disorder, bipolar disorder, insufficient sleep, and substance use can all reduce concentration and self-control as well.

The key point in assessing ADHD is therefore looking back at symptoms since childhood and their impact across multiple areas of life — not diagnosing based on concentration problems that only appeared after substance use began.

Why ADHD May Occur Alongside Substance Addiction

The relationship between ADHD and substance use doesn’t stem from a single cause. Some people are highly impulsive and decide to try a substance with less thought about the consequences. Some get bored easily and want excitement. Others accumulate problems at school, work, or in relationships until stress builds up, and turn to substances to cope with those feelings.

Another group may use substances to try to manage their own symptoms — for example, feeling calmer after drinking alcohol, thinking less after using cannabis, or feeling more alert and able to work longer after using a stimulant.

This pattern is substance use as an attempt at self-medication, but the short-term feeling that “it’s helping” doesn’t mean the substance is treating ADHD.

For example, someone may regularly struggle to start and finish work on time. When they find that a stimulant keeps them awake and able to keep working for long stretches, they may start using it only during busy periods. Once this repeats, they may gradually come to believe they can’t work without the substance — moving from occasional use to increasing frequency or amount.

Some people may use alcohol or cannabis to quiet racing thoughts or help them sleep. But with repeated use, these substances can affect memory, sleep, motivation, and self-control — making the original problem they were trying to solve more complicated than before.

Impulsivity can also make it harder to stop using a substance. When cravings arise or triggers appear, the person may decide to go back to using quickly, with less time to think through the long-term consequences.

Treatment therefore shouldn’t stop at telling someone to “have more discipline” — it needs to help the person understand how attention problems, self-control, mood, sleep, and substance use are connected to one another.

How Can You Tell ADHD Apart From Concentration Problems Caused by Drugs?

This is one of the important issues, because many substances can cause symptoms that resemble ADHD.

Yaba, ice, and other stimulants can cause excessive alertness, excessive talking, restlessness, insomnia, a short temper, or trying to do many things at once. With continued use or severe sleep deprivation, concentration and decision-making can worsen further, and paranoia or psychotic symptoms can also occur.

After stopping stimulants, some people may feel very tired, lack energy, have reduced concentration, low mood, or sleep excessively. Symptoms during this period shouldn’t immediately be concluded to be ADHD.

Cannabis can affect attention, memory, and learning ability while its effects are active. Frequent users may therefore present with problems like forgetfulness, unfinished tasks, or reduced performance at school and work.

Alcohol, too, can affect decision-making, behavioral control, memory, and sleep — especially with continued or heavy use.

Assessment therefore needs to look back at whether the person had problems with distraction, losing things, missing deadlines, impulsivity, or school problems before starting to use the substance; whether the symptoms occur across multiple situations; and whether family members or childhood records reflect the same pattern of symptoms.

If attention problems only appeared after starting to use a substance, after continuous sleep deprivation, or alongside emotional problems, these causes need to be evaluated as well. ADHD medication should not be bought and self-administered just because someone feels it “helps them work better.”

How Is ADHD Occurring Alongside Substance Addiction Treated?

Treatment should address ADHD, substance use, sleep, mood, and life problems together, since each area can affect the others and can act as a trigger for returning to substance use.

Thoroughly Assess Childhood Symptoms and Substance Use History

Diagnosing ADHD in someone who uses substances requires particular care. The treatment team will ask about symptoms since childhood, school and work history, time management, impulsivity, and impact across multiple areas of life.

Information from family can be helpful, especially when the person themselves can’t recall childhood details — for example, whether teachers ever noted distractibility, whether they often lost things, whether they often failed to turn in complete assignments, or whether impulsive behavior existed before substance use began.

At the same time, the type of substance, frequency, amount, reasons for use, when use began, and symptoms when not using must all be assessed, in order to separate the pre-existing symptoms from the effects of the substance as much as possible.

Build Life-Management Skills Instead of Relying on Willpower

A number of people with ADHD aren’t lacking in intention — they struggle with starting tasks, breaking large tasks into steps, prioritizing, and maintaining consistency.

Treatment therefore helps build systems that make life rely less on memory and willpower — such as scheduling, breaking tasks into smaller pieces, using reminders, reducing distractions, and creating repeatable routines.

For those with substance addiction, these skills must also be connected to relapse prevention — for example, if a backlog of work is a trigger for going back to using yaba to work through the night, treatment must help manage work, rest, and sleep before the person reaches the point of feeling they need the substance again.

Treat Impulsivity and Triggers for Returning to Substance Use

Some people with ADHD know that using substances has negative consequences, but when cravings arise they may decide quickly. Treatment must therefore help create a gap between the craving and the action, so there’s an opportunity to choose a different response.

People in treatment learn to recognize which situations carry a high risk of substance use — for example, work stress, arguing with family, boredom, being with the same group of friends, having money on hand, or several nights of sleep deprivation.

Once the pattern becomes clearer, they can plan ahead, reduce access to the substance, and build other ways of coping instead of making decisions based on short-term emotion.

Motivational conversations also help the person see both what they feel the substance helps with in the short term and its real long-term consequences, without relying on blame or argument as the main tool.

Can ADHD Medication Be Used If There’s a History of Substance Addiction?

ADHD can be treated with medication, but for people with a history of substance addiction, a psychiatrist must assess individually which medication is appropriate and safe.

ADHD medications include both stimulant and non-stimulant types. The choice depends on the clarity of the diagnosis, the type of substance previously used, the pattern of addiction, the risk of the medication being misused, co-occurring conditions, and the person’s ability to follow up with treatment.

Having a history of addiction doesn’t mean ADHD can’t be treated with medication, but it does require proper assessment and monitoring. Medication should never be bought, borrowed from someone else, or self-adjusted in order to read, work, or stay awake longer.

On the other hand, if a person genuinely has ADHD and the symptoms are affecting their life, leaving it unmanaged can make life management and recovery from addiction more difficult. Treatment must therefore balance symptom control with each person’s safety.

A Family Member Has ADHD and Uses Substances — How Should You Help?

Families of people with ADHD may go through a long history of conflict before learning that a condition lies behind it — repeatedly forgetting appointments, leaving work unfinished, spending without thinking, or promising to do something but ultimately not following through. When substance use is added on top of this, feelings of disappointment and distrust can intensify further.

Understanding ADHD doesn’t mean the family has to accept every behavior, but it helps distinguish which are symptoms that need treatment and which are behaviors that still require boundaries and accountability.

Instead of saying “you’re lazy,” “you’re irresponsible,” or “you could do it if you tried,” it may help to reflect what’s actually happening — for example: “I’ve noticed you have a lot of work piled up lately, you’re staying up late, and you’ve gone back to using the drug to get work done — I’m worried it’s cycling back to how it was before.”

If the person says the substance helps them concentrate, there’s no need to rush into arguing that it doesn’t. Instead, you might ask: “How did it help at first, and what happened after that to your sleep, mood, work, or the amount you needed to use?”

Questions like this help the person see the whole picture of their substance use, rather than focusing only on how they feel while the substance is active.

Families should set clear boundaries around money, access to the substance, and behavior that causes damage. They shouldn’t fix the consequences of substance use every single time, to the point that the person never has to face the results of their decisions — but at the same time, they should offer support once the person agrees to an assessment and treatment.

If the patient isn’t ready for treatment yet, the family can start by consulting a professional first, to understand the problem and plan an appropriate way to communicate, without needing to wait until the patient accepts that they have every problem first.

When ADHD Occurs Alongside Substance Use, Where Should You Start Seeking Help?

If the main problem is ADHD symptoms, and there is only occasional drinking, cannabis use, or use of other substances without a clear pattern of addiction — or if the patient isn’t ready for treatment yet and the family wants guidance first — you can start by consulting at Piti Clinic, our outpatient mental-health clinic in Bangkok (Pradiphat Road, Saphan Khwai), to assess ADHD symptoms, mood, sleep, and the relationship between these symptoms and substance use, as well as help the family plan how to talk with and encourage the patient to enter appropriate treatment.

But if there is already repeated substance use that can’t be controlled, use of the substance to study, work, sleep, or manage emotions on a regular basis, increasing amounts, repeated relapse after stopping, withdrawal symptoms, or substance use that’s affecting school, work, finances, and relationships, addressing the substance addiction seriously should be the priority.

Especially when impulsivity, friend groups, or the same environment make it easy to return to substance use, residential treatment at Day One Rehabilitation Center can help create distance from the substance and its triggers, while managing ADHD and any co-occurring psychiatric conditions during the same period.

Treating ADHD and Substance Addiction at Day One Rehabilitation Center

For those with substance addiction alongside ADHD, Day One Rehabilitation Center places importance on treating both problems together, because if the substance is stopped but problems with time management, impulsivity, sleep, and emotional control remain unaddressed, these factors can become triggers for using the substance again.

Conversely, if substance use continues, assessing and managing ADHD symptoms can also be difficult, because the substance can change attention, mood, sleep, and behavior.

Residential treatment helps reduce access to the substance and its triggers early on, allowing the treatment team to continuously monitor post-cessation symptoms, sleep, mood, attention, impulsivity, and cravings.

A psychiatrist can assess how clear the ADHD symptoms are, whether depression, anxiety disorder, bipolar disorder, or other psychiatric conditions are present alongside it, and consider medication use as appropriate, taking the history of substance addiction into account.

Individual therapy and group therapy help people in treatment see the relationship between boredom, stress, impulsivity, life-management problems, and substance use, while practicing skills they can bring back into real life.

Relapse prevention helps plan how to handle situations that have previously been problematic — such as a backlog of work, pressure from school, sleep deprivation, family conflict, the same friend group, or times of boredom and craving excitement.

The goal, then, isn’t only to improve concentration — it’s to help the person in treatment manage their life, control their decisions, and cope with stress without needing to go back to relying on a substance.

Frequently Asked Questions About ADHD and Substance Use

Can adults have ADHD?

Yes. ADHD symptoms begin in childhood, but for some people they continue into adulthood. The pattern of symptoms may shift from hyperactivity to problems with time management, distractibility, procrastination, impulsivity, or difficulty juggling multiple tasks.

Does poor concentration after using drugs mean someone has ADHD?

Not necessarily. Substance use, sleep deprivation, withdrawal, depression, and other mental health issues can all reduce concentration. Diagnosing ADHD requires looking at a person’s symptom history going back to childhood, not just the period when they were using or had just stopped.

Do yaba or ice help someone with ADHD concentrate better?

Yaba or ice should not be used to self-treat ADHD. Even though some users feel more alert or able to work longer at first, these substances carry risks of addiction, insomnia, mood problems, cardiovascular effects, and psychosis. ADHD treatment should be evaluated and monitored by a physician.

Are people with ADHD more likely to develop substance problems than others?

ADHD is one of the factors associated with a higher risk of substance use problems, especially when impulsivity, emotional-regulation difficulties, or other psychiatric conditions are also present. That said, it doesn’t mean everyone with ADHD will become addicted to a substance.

Can cannabis help treat ADHD?

Cannabis should not be used to self-treat ADHD. It can affect attention, memory, and learning while its effects are active. Anyone who feels they need cannabis to calm down, sleep, or manage their thoughts should be evaluated for both mental health and substance use patterns.

Are ADHD medications addictive?

There are several types of ADHD medication with differing levels of risk. Some are stimulants and require careful monitoring of use. A psychiatrist must weigh the benefits and risks, especially for people with a history of substance use — medication should never be borrowed from someone else or self-adjusted.

If I’ve had a yaba addiction, can I still be treated with medication for ADHD?

Treatment can still be considered, but it needs to be evaluated individually by a psychiatrist. A history of yaba addiction doesn’t mean ADHD can’t be treated with medication, but it does affect which medication is chosen, how it’s monitored, and how risk is managed.

If someone has ADHD and a substance problem, which should be treated first?

In many cases both problems should be treated together, in a connected way — prioritizing safety and addressing intoxication or withdrawal first, then monitoring ADHD symptoms once the person’s physical condition and substance use have become more stable. Neither issue should be left unaddressed.

What should I do if my child or family member won’t admit they have a substance problem?

You don’t need to start by forcing them to accept the word “addicted.” Families can start from the problems the person themselves can see — unfinished work, inability to sleep, running out of money, relationship problems, or feeling they need the substance just to function — and then invite them to get an evaluation based on that. If they’re not ready, the family can consult a professional first.

Do ADHD and substance use always require going to a treatment center?

Not for everyone. If the main issue is ADHD and substance use is only occasional, without a clear pattern of addiction, starting with a mental health assessment may be enough. But if there is repeated use that can’t be controlled, reliance on the substance to study, work, sleep, or function, relapse after stopping, or withdrawal symptoms, residential addiction treatment at Day One Rehabilitation Center is an option that should be seriously considered.

ADHD and Substance Addiction Should Be Treated Alongside Building a New Life System

Having ADHD doesn’t mean someone is lazy, irresponsible, or not trying. Many of the problems stem from difficulty regulating attention, planning, controlling impulsivity, and doing things that require long-term consistency.

When substance use is added on top of this, things the person once used to help themselves stay awake, work, calm down, or sleep can gradually become another problem that makes attention, mood, sleep, and daily life worse than before.

Appropriate treatment must therefore distinguish which symptoms existed before substance use, which arise from the effects or withdrawal of the substance, and what need the substance is currently meeting for the person — while treating ADHD and substance addiction in a connected way.

For families, there’s no need to wait until the person accepts every problem before starting to seek help. Once you begin to see repeated, uncontrollable substance use, or a need to rely on the substance to study, work, sleep, or manage life, serious assessment and treatment can help reduce the chance that the two problems reinforce each other further — and help ensure that recovery isn’t limited to stopping the substance, but includes returning to managing life more steadily.