Exploring the Science of Drinking With ADHD

Life can feel like navigating a teeming city, bustling with activity, dazzling lights, and swarms of people. Those of us living with attention-deficit/hyperactivity disorder (ADHD), however, experience this city without a guide or map. Each day can feel like a constant exploration of a busy metropolis marked by uncharted routes and unexpected detours.

What happens when we throw alcohol into the mix, though? Well, quite a bit — and the relationship between the two can be cyclic. Does alcohol make ADHD worse? Is there a link between ADHD and alcohol abuse, or ADHD and drinking? As it turns out — yes. Alcohol can exacerbate ADHD symptoms, and living with ADHD can increase the risk for alcohol misuse. And what about ADHD medications: can you mix Atomoxetine and alcohol? And can you drink on Strattera? If you’re living with ADHD (or know someone who is), read on to understand the complexities and how to prioritize well-being. 

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that typically shows up in childhood and can persist into adulthood. The nature of this disorder is intricate, enveloping a person's cognitive, emotional, and behavioral dimensions.

According to recent data, up to 5% of American adults, or over 8 million people, are currently living with ADHD. Alarmingly, a vast majority of these adults remain undiagnosed, keeping them unaware of the root cause behind their struggles. 

The hallmark characteristics of ADHD are not just limited to distractibility, they extend to impulsivity and hyperactivity. These symptoms manifest uniquely in each person. For some, the challenge might be an inability to focus on tasks, leading to incomplete projects or frequent errors. Others might grapple with impulsivity, making hasty decisions without considering the consequences, or hyperactivity, exhibiting constant restlessness.

The strategies employed to handle ADHD vary widely: including behavioral therapies that focus on coping mechanisms, lifestyle changes that include structured routines, and medications that aid in enhancing focus and reducing impulsivity. Each person finds their unique combination to navigate life efficiently.

But like everyone else, people with ADHD also find themselves in situations where alcohol plays a significant role. But adding alcohol to the ADHD equation, it creates various complexities that require further examination. 

ADHD and Alcohol: What Are the Effects?

Clinical research points towards a robust connection between ADHD and an escalated risk of alcohol misuse, as well as misuse of other substances. But why is this link so significant, and how does alcohol use affect people with ADHD? To answer these questions, let's delve deeper into the science to uncover ways this interaction impacts individuals with ADHD.

Exacerbation of Symptoms

ADHD inherently complicates the cognitive and behavioral processes of those affected.

Alcohol heightens existing ADHD symptoms, which makes it a potentially detrimental choice for those living with the condition. After consuming alcohol, people with ADHD might experience amplified issues concerning concentration, impulsivity, and hyperactivity, adding an additional layer of complexity to their already-challenging daily lives.

What might this look like? Imagine you've spent the previous evening at a social gathering where you enjoyed a few drinks. The next day, as you sit down to work, you realize your concentration is even more fragmented than usual. You're more impulsive in your choices, perhaps cutting off your colleagues mid-sentence instead of hearing them out. Your thoughts race and your mind is chattering incessantly. Focusing on any single task is an uphill battle — and because you can’t seem to concentrate on anything, you barely finish any of your day’s assignments. This is a glimpse of how alcohol can exacerbate the symptoms of ADHD, adding fuel to the fire of an already intricate condition.

Increased Risk of Substance Misuse

Studies have indicated that people with ADHD may be more susceptible to falling into patterns of substance misuse — and often, alcohol is the gateway.

Impulsivity, a core symptom of ADHD, is a key player in this risk. It can steer individuals towards risky behaviors, including binge drinking or alcohol dependence. The lure of immediate gratification can be especially strong for someone with ADHD, and resisting the allure of alcohol is daunting.

Interference With ADHD Treatments

Alcohol's impact on ADHD is not just limited to amplifying symptoms or escalating the risk of substance misuse. Many people rely on a combination of therapies, including behavioral techniques and prescribed medications, to manage their ADHD symptoms. Adding alcohol to the mix can potentially hamper the effectiveness of these interventions.

When it comes to mixing medications such as Atomoxetine or Strattera and alcohol, it’s better to err on the safe side. Alcohol can be a bit unpredictable in this combo, possibly causing drowsiness or making ADHD symptoms worse.

Furthermore, mixing alcohol with Ritalin (a prescription medication commonly used to treat ADHD) can increase heart rates to dangerous levels, disrupt sleep patterns, and potentially worsen mood. Ritalin is a stimulant and alcohol is a depressant; since they counteract each other’s effects, the combination can lead to an increased risk of misuse of both substances. 

ADHD and Alcohol: What Can We Do?

By adopting proactive measures, those of us with ADHD can strike a balance. Here are seven ways to do so:

1. Seek Knowledge 

Before addressing the interaction of ADHD and alcohol, it's imperative to have a clear understanding of the potential implications. Recognizing the nuances of how alcohol affects ADHD symptoms and any medications can be pivotal in making informed decisions. The good news is that by reading this blog, you’re doing just that! 

This can also mean immersing ourselves in research to build a solid foundation. We can do this by actively seeking out literature, articles, or scientific papers that delve into the topic. ADDitude is an excellent resource for catching up on current events relating to ADHD, as well as for finding additional ways to manage symptoms. 

This form of self-education illuminates the potential risks, such as how alcohol might counteract or reduce the efficacy of ADHD medications or intensify ADHD symptoms.

2. Drink Mindfully

ADHD increases impulsivity, as we’ve discussed. This trait can sometimes spur decisions without thorough forethought, especially in social settings where alcohol is involved. Impulsive drinking can exacerbate ADHD symptoms or lead to other undesirable outcomes — accidents, violent behavior, and other regrettable choices. 

Embracing mindfulness is the key. It entails being acutely aware of the present moment and our choices. Before lifting that glass, take a deep breath, and consider the repercussions. Is the thrill of an intoxicated evening worth the long-lasting repercussions? 

Pre-determining a drinking limit can be helpful. For instance, we might choose to have one alcoholic beverage and then switch to mocktails after. This way we don’t completely deprive ourselves, but we also don’t fall into the adverse effects. We may also choose to have alcohol-free days throughout the week to avoid falling to habitual alcohol use (i.e., drinking a beer after work or pouring a nightcap before bed). 

By setting these boundaries ahead of time, we give ourselves tangible guidelines to follow, curbing overindulgence. 

3. Consult With Healthcare Providers

Medications play a pivotal role in managing ADHD for many. However, these medications can have complex —often unpleasant! — interactions with alcohol. This interplay might dilute the medication's efficacy, amplify side effects, or even pose severe health threats.

Open communication with our healthcare providers is the cornerstone here. Before indulging in any alcoholic beverages, a candid conversation with our doctor or pharmacist is essential. Acquainted with our medical history and the intricacies of ADHD medications, these experts can provide guidance tailored to our unique needs. Whether it's suggesting safe consumption limits or recommending complete abstention while on certain medications, their advice is instrumental in ensuring our safety and well-being.

4. Opt for Non-Alcoholic Alternatives

Social scenarios — parties, dinners, or simple gatherings — often feature alcohol as a centerpiece. In these situations, there's often an implicit pressure or a natural inclination to partake to feel included. This can be especially challenging for someone with ADHD, who might already grapple with impulsivity. 

Thankfully, today’s beverage market is full of non-alcoholic alternatives that mimic the taste, look, and feel of alcoholic drinks. Mocktails, for instance, are crafted with the same care and artistry as cocktails but without the alcohol. Non-alcoholic beers and wines have seen significant advancements in flavor profiles, making them almost indistinguishable from their alcoholic counterparts. There are even alcohol-free champagne and tequila options! 

Choosing non-alcoholic drinks allows us to participate in the social ritual of drinking without alcohol’s potential pitfalls. Furthermore, these alternatives keep us from feeling deprived or out of place.

5. Establish a Support System

We all sometimes need a sounding board, a guide, or just a listening ear. For someone with ADHD, a reliable support system can be a game-changer, especially regarding alcohol-related choices.

We can do this by opening up to a close friend, family member, or trusted loved one. We may also choose to join a support group (we have several in the Reframe app Forum!), making the other participants aware of our goals and apprehensions. This established network acts as a safety net, providing advice, a second opinion, or even gentle reminders, helping in navigating social situations that involve alcohol.

6. Avoid Binge Drinking

Binge drinking is detrimental to everyone, regardless of age, gender, or health status. However, drinking to excess can accentuate ADHD symptoms. The aftermath — the exacerbated impulsivity, heightened distractibility, and potential emotional disturbances — can make prioritizing our well-being challenging.

In this case, a prevention plan is crucial. Decide on a drink limit and adhere to it. Alternate alcoholic beverages with water or other non-alcoholic alternatives. Spacing out drinks reduces the risk of rapid intoxication. Furthermore, we can decide what we will do if we encounter our strongest drinking triggers or experience cravings. In this case, finding a healthy form of distraction, such as exercising, calling a friend, or grabbing a healthy snack, is paramount. 

With an action plan in place, we create more barriers between ourselves and the desire to drink. Over time, these healthier alternatives can become habitual and replace the urge to consume alcohol excessively. 

7. Seek Therapy or Counseling

Often, the lure of alcohol for those of us with ADHD isn't just about social pressure; it might be a form of self-medication, an attempt to cope with ADHD symptoms. Examining these underlying motivations is key to establishing a healthy relationship with alcohol, and ourselves.

Professional therapy or counseling can be invaluable. Therapists, especially those specializing in substance misuse or ADHD, can offer insights into the motivations behind certain choices. Cognitive-behavioral therapy (CBT) is particularly effective in instilling coping strategies, managing impulsivity, and improving decision-making. Therapy provides a non-judgmental space to explore, understand, and address concerns related to alcohol and ADHD.

Living with ADHD presents unique challenges, but proactive strategies can help us make informed choices when it comes to alcohol. By taking the action steps above, those of us with ADHD can lead balanced lives, celebrating social engagements without detrimental alcohol-related consequences.

Mental Health Matters

It’s evident that alcohol use can complicate the ADHD journey. 

However, these effects don't require complete abstinence from alcohol or social isolation. Instead, it highlights the importance of drinking mindfully and consulting a healthcare provider before choosing to imbibe if we live with ADHD. 

Additionally, we should point out that ADHD isn't a solitary journey — it's a shared exploration involving healthcare professionals, support groups, family, and friends. We are not defined by ADHD. It's a part of our journey, but it isn’t our entire identity. Our dreams, our strengths, our accomplishments, our relationships — they all contribute to who we are!