Attention Deficit

Two new studies confirm that ADHD children are more at-risk for alcohol and substance abuse as they grow older. Parental alcoholism and stressful family environments are additional risks. Results of the two studies were published in Alcoholism: Clinical & Experimental Research [April 2007].

• Attention-Deficit Hyperactivity Disorder Moderates the Life Stress Pathway to Alcohol Problems in Children of Alcoholics

• Attention-Deficit/Hyperactivity Disorder Risk for Heavy Drinking and Alcohol Use Disorder Is Age Specific

Brooke Molina, associate professor of psychiatry and psychology at the University of Pittsburgh, and co-author for both studies says that, “Children with ADHD are believed to be at risk for alcoholism because of their impulsivity and distractibility, as well as other problems that often accompany ADHD such as school failure and behavior problems.”

To determine alcohol use, Molina interviewed 364 participants in the larger Pittsburgh ADHD Longitudinal Study and compared it with demographically age matched adolescents and adults as a comparison. “We found that the children with ADHD were more likely than the comparison group to drink heavily and to have enough problems related to their drinking that they were diagnosed with alcohol abuse or dependence,” said Molina. “This means that their drinking caused problems such as fights with their parents or friends, a drop in their grades at school, or difficulty with controlling the amount of alcohol that they drank.”

Drinking problems began around age 15, said Molina. “The 15-to-17-year olds with childhood ADHD reported being drunk an average of 14 times in the previous year, versus only 1.8 times for 15-to-17-year olds in the study who did not have childhood ADHD. Whereas 14 percent of the 15-to-17-year olds with childhood ADHD were diagnosed with alcohol abuse or dependence, none of the 15-to-17-year olds without childhood ADHD were.”

The study indicates that the ADHD-alcohol connection seems to begin in adolescence when children have greater access to alcohol and other substances.

“For example, 42 percent of those children with ADHD who also had serious, persistent behavior problems [later] had alcohol abuse or dependence by the age of 18 to 25,” said Molina.

Molina indicates that little is known about alcohol dependence beyond this age range for ADHD persons. “Most young adults drink less after they settle into jobs and family life,” she said. “We will be following the young adults in the Pittsburgh study to see if this happens or not.”

Molina’s research also indicated that parental alcoholism predicted heavy problem drinking among teenagers in her study. The ADHD/family link may cause increased family stress beginning in early childhood due to lack of parental coping skills and behavioral conflicts. The parent may begin drinking in response to the increased family stress. No genetic proclivity is identified by this study, however, this seems like an essential next step. The study reflects an issue that affects families whether they have and ADHD member or not: if a parent suffers from alcoholism, the child will have an increased risk as well. What is interesting about the research is the fact that stressors like ADHD may drive some parents to drink as a coping mechanism. This, in turn, may begin a similar cycle for the ADHD child.

Bottom line, Molina says, “We need to put these findings in perspective; it is important to recognize that not all children with ADHD will have problems with alcohol.”