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ADDITIONAL INFORMATION
13 Minutes
CONTENTS
Have you ever wondered why it is so common for someone with ADHD to get tangled with cocaine? What may seem like a coincidence to you has multiple theories backing up the strong relationship between the two.
With a mixture of impulsivity, hyperactivity, and inattention, ADHD can easily lead you down a tricky path, often involving drugs like cocaine. Known for its highly euphoric and intensely addictive nature, cocaine can become a quick fix for anyone with ADHD. But many don’t realise this combination often makes them pay a hefty price.
Let’s discuss more about the complex relationship between the use of cocaine and ADHD, exploring how they overlap, the associated risks, and how to co-manage both issues.
Attention deficit hyperactivity disorder or ADHD is a psychiatric disorder with overlapping patterns of hyperactivity-impulsivity and inattention. This frequent overlap significantly interferes with daily functioning and development. [1]
ADHD can be categorised into the following three primary presentations:
ADHD often begins in childhood and easily persists into adulthood, negatively affecting social, occupational, and academic functioning. The primary cause involves a complex blend of neurobiological, environmental, and genetic factors that mess with the brain’s dopaminergic transmission to alter the levels of dopamine hormone.
Derived from the coca plant, cocaine is a stimulant drug, famous for its immediate euphoric effects and high risk of addiction. It stops serotonin, norepinephrine, and dopamine from rebabsorping into the system, increasing their blood concentration. With a high concentration of these neurotransmitters in the brain, your brain activates the reward pathway and produces intense feelings of pleasure, heightens your alertness levels, and boosts energy. [2]
Most effects of cocaine described above are short-lived. Yet, its continued use can lead to significant health risks, such as neurological damage, cardiovascular issues, and psychological problems like addiction, paranoia, and anxiety. The short-lived effects also leave you craving for more, and repeated use quickly leads to addiction.
Approximately 8.7 per cent of adolescents and 4.4 per cent of adults currently live with attention deficit hyperactivity disorder. Research closely monitoring this population has so far revealed that they are at a higher risk of acquiring a substance use disorder than the rest of the population.
A research study performed in 2017 found that 23.1 per cent of people with an underlying substance use disorder also had ADHD. While the choice of substance for the participants was highly variable, many were reportedly misusing cocaine, too. [3] More recent investigations focusing on ADHD and its relationship with substance use disorder support the findings. Another trial performed in 2023 aiming to calculate the estimated prevalence of ADHD in adults with substance use disorder found it to be 19% for people actively misusing cocaine. [4]
Another study exploring the relationship between ADHD treatment and stimulant misuse has also offered some interesting insights. It revealed that adolescents are much more likely to misuse stimulants and cocaine than the rest of the population. This prevalence of stimulant and cocaine misuse was more prevalent in adolescents who had received treatment for ADHD in the past. [5]
Research indicates that people with underlying ADHD are more likely to acquire substance use disorders, such as cocaine addiction than those without this psychiatric illness. Several factors can add to this risk, such as the following:
Let’s look at these factors in more detail in the following sections.
Neurobiologists have been working for years to unravel the relationship between cocaine use and ADHD in terms of how the brain works. So far, many vital mechanisms have been proposed that supposedly facilitate this connection. [7]
Continued research on the relationship between ADHD and cocaine use has revealed multiple social and psychological factors contributing to this connection. Some of these factors include the following:
Since cocaine has stimulating properties, it can cause euphoria and increased energy in people without diagnosed ADHD. However, in people labelled with this psychiatric disorder, it has a paradoxical calming effect. The drug acts on their dysfunctional dopaminergic transmission and boosts dopamine levels. With these effects, you may feel an improvement in your ADHD symptoms, such as restlessness, inattentiveness, and impulsivity.
Inside your body, cocaine can directly affect multiple brain structures, including the following:
Cocaine use also reduces the reuptake of serotonin, norepinephrine, and dopamine. What this means is it ensures that these happy hormones remain in the blood. In people with ADHD, this causes hyperarousal, hyperalertness, increased vigilance, and euphoria. However, if you have been diagnosed with ADHD, it can calm the behavioural and executive dysfunctions that you commonly experience.
In short, you may:
While these effects may seem desirable, they are short-lived and can make you crave more cocaine just to keep experiencing them. This dangerous cycle can propel you down the road of cocaine addiction, which comes with hazardous risks.
The misuse of cocaine in individuals with ADHD can lead to severe risks and potentially damaging consequences. Adopting a comprehensive, multidisciplinary approach is critical to avoiding these negativities.
Because ADHD and cocaine abuse are two distinct issues, addressing their co-occurrence requires a comprehensive treatment plan that manages them both together. Such plans are known as integrated plans and can be more effective than treating both issues separately.
Following are some fundamental approaches that an integrated plan can include:
Getting a diagnosis of ADHD early on and pinpointing your growing cocaine use can be highly beneficial in managing both issues. This early awareness allows you to start planning on treatment with a greater compliance rate.
Attention Deficit Hyperactivity Disorder treatment typically involves the use of stimulant medicine, such as amphetamines and methylphenidates. These first-line drugs work by boosting the levels of norepinephrine and dopamine, which, in turn, keep impulsivity and inattention under control. In some cases, particularly when you have a previous history of substance abuse, experts often resort to non-stimulant drugs, like guanfacine and atomoxetine. Ensuring that you get these medications prescribed and take them regularly is imperative, as doing so will keep your symptoms well-managed, reducing the need to self-medicate with cocaine.
Cognitive behavioural therapy and other similar interventions are a primary component of treatment for ADHD and cocaine abuse. These therapies can help you acquire healthy coping strategies, reduce impulsivity, and improve executive functioning.
Seeking awareness and education regarding a problem you are actively facing is crucial before you can start treating it. This awareness also helps you adhere to your ongoing treatment plan and empowers you to make good decisions while saving yourself from pitfalls.
Following initial treatment, you must ensure continuous monitoring and support to keep up adherence while addressing any issues that emerge with time. For this purpose, you must regularly attend follow-up appointments and actively participate in support groups.
ADHD and cocaine are two different realms with a high tendency to intertwine. Understanding their association is similar to untangling a badly knotted ball of yarn. The process can be messy and highly complex, leaving people scratching their heads. But with the right level of awareness and support in the community, getting on top of this mess is definitely possible.
From impulsive tendencies to self-medication, many factors can lead you down risky paths, creating vulnerabilities that ultimately lead to cocaine use and addiction. However, this blame game cannot help you or anyone else treat the underlying issue. The actual management involves identifying your challenges, developing an understanding, and seeking support.
With an intricate web of psychology, neurobiology, and social dynamics pushing a person with ADHD toward cocaine use, it becomes clear that the solution to this issue should be multifaceted. Ultimately, combining medical interventions with behavioural therapy and support from the community is the key to success.
Yes, both share a link in a way that if you have ADHD, you are at a higher risk of using cocaine than the rest. This increased risk can arise from multiple factors, such as sensation-seeking behaviours, the constant urge to self-medicate, and impulsive behaviours.
Many people with attention deficit hyperactivity disorder turn to cocaine to self-medicate. In my experience, cocaine helps them alleviate specific ADHD symptoms, including impulsivity, hyperactivity, and inattention. Because cocaine is a stimulant, it can also temporarily elevate their mood and focus while reducing the challenges associated with the disease.
You may find cocaine alleviating some of your ADHD symptoms initially, mainly because of its stimulant properties. However, its continued use may cause neuroadaptive changes in your brain, worsening the symptoms over time. Additionally, using cocaine can also lead to other negativities, such as psychiatric comorbidities and addiction.
Cocaine is highly addictive that can make anyone misuse. People with ADHD are particularly at a higher risk of abusing it due to their impulsive tendencies. The co-existence of these issues can lead to many issues, such as relationship problems, financial difficulties, and mental health struggles. In the long run, cocaine use alone can also negatively affect the health, causing:
Inflammation of the heart muscles
Psychosis
Weight loss
Increased risk of seizures and stroke
Unchecked cocaine use also puts a person at a higher risk of overdose, which can easily prove fatal.
Stimulant medications, such as amphetamines and methylphenidate, typically manage ADHD. Their regular use, as advised by a medical professional, can reduce cocaine cravings and use in some people struggling with both issues at the same time. However, the efficacy of this can highly vary based on individual factors.
To reduce your risk of abusing cocaine, consider seeking professional management to keep your ADHD under control. Seeking help from support networks and using therapy to develop healthy coping strategies can help you tackle stress and impulsivity without relying on cocaine use. I also advise people struggling with cocaine and ADHD to avoid environments where cocaine use is expected.
If you suspect that a loved one diagnosed with ADHD has been using cocaine, you may be tempted to help them get over this problem as soon as possible in whatever way is needed. However, I strongly advise everyone in this situation to deal with the situation with concern and empathy. Encourage them to get professional help for their struggles and offer them your support in whatever way possible. For instance, you can help them shortlist professionals to seek help from, help them with daily chores if they are struggling, or agree to drive them to treatment sessions. Never push them to seek treatment by force, as this can worsen the situation for them.
Experts offer integrated treatment programs to address both cocaine addiction and ADHD simultaneously. While the exact structure of these programs can vary, most include a combination of behavioural therapy, pharmacotherapy, support groups, and psychoeducation.
I recommend people struggling to manage ADHD with underlying cocaine use disorder seek therapy. Some forms of treatment, such as cognitive behavioural therapy, can help people acquire positive coping mechanisms and address all underlying issues contributing to their cocaine addiction. Regular treatment can also equip you with tools to keep your cravings under control while distancing yourself from common relapse triggers.
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