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Does alcohol make ADHD worse?
Reviewed by Charles Li, MD
December 24, 2022
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Alcohol can worsen some of the symptoms of ADHD.
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Alcohol can also interact with ADHD medication, making it harder to treat ADHD.
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Individuals with ADHD are at a higher risk of developing alcoholism.
Alcohol and ADHD have some effects that overlap. For example, both are associated with reduced inhibitions.
One of the effects of ADHD is greater impulsivity. Alcohol similarly lowers our ability to inhibit ourselves from acting on our impulses.
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Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. Alcohol makes it harder for the brain areas controlling balance, memory, speech, and judgment to do their jobs, resulting in a higher likelihood of injuries and other negative outcomes.
NIAAA NIH
ADHD, alcohol, and focus
ADHD and alcohol also affect your ability to focus and pay attention. Those with ADHD have a “deficit” in their ability to pay attention. When we’ve had too much to drink, we can also have difficulty focusing on tasks such as driving.
It turns out that there’s a biological reason behind this effect. Alcohol affects the “focus” signal in your brain, mediated by norepinephrine.
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When we want to focus on something, or when we stand up from a chair and become active, a brain stem nucleus releases a chemical called norepinephrine. Acute exposure to alcohol inhibits this signal in the brain
This same signal also happens to be a target for a treatment of ADHD, atomoxetine.
Interaction between alcohol and ADHD
There’s evidence that those with ADHD are affected differently by alcohol.
The effects of alcohol don’t just “add” on to the effects of ADHD, they might be enhancing them as well in some cases.
One small study on alcohol and ADHD tested the ability of participants to perform tasks and inhibit themselves when given alcohol.
Increased Sensitivity to the Disinhibiting Effects of Alcohol in Adults with ADHD
The study found that those with ADHD had far more trouble inhibiting themselves than those without ADHD when given alcohol.
Alcohol amplified the differences between those with ADHD and those without ADHD when it comes to inhibition and self-control.
Alcohol makes ADHD harder to treat
Alcohol can also make it harder to treat ADHD. Many with ADHD take medications to help them function normally at everyday tasks.
Unfortunately, many of these medications can potentially interact with alcohol.
For example, if someone takes Ritalin and later drinks alcohol, their body produces a potentially toxic metabolite called ethylphenidate as it processes the alcohol.
While not much is known about ethylphenidate, it has been linked to several cases of severe illness and death, which is one of the reasons why individuals are cautioned not to drink too much if they are taking Ritalin.
ADHD can also make drinking worse
ADHD can also increase the risk of alcoholism. The greater impulsivity and higher susceptibility to addiction that comes with ADHD can lead to higher rates of alcoholism in those with ADHD.
One study estimated that around a third of those with an alcohol use disorder may also have adult ADHD.
Do Alcoholics Have ADHD? A study estimated that many chronic today may have ADHD as adults, and may have had it when they were children as well.
Experiences with alcohol and ADHD
Reddit users with ADHD generally recognized that they were more susceptible to addiction.
Two of the users below reported having to give up alcohol to keep themselves from developing drinking problems. These experiences are consistent with the medical literature.
Interestingly, it seemed that many felt that alcohol helped alleviate their ADHD symptoms, allowing them to interact and function more normally.
While this effect hasn’t been scientifically tested, it may be a factor in alcoholism and ADHD, as those with untreated ADHD may self-medicate with alcohol.