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Dr Rachel V Gow Inside ADHD > ADHD > ADHD in adults > ADHD and the risk of addiction

ADHD and the risk of addiction

Nicotine

ADHD and the risk of addictionTobacco use, and indeed a greater likelihood of addiction to cigarettes, is also elevated in individuals with ADHD by approximately double compared to controls [63]. This pattern persists irrespective of gender [64]. Smoking cessation failure is associated with a diagnosis of ADHD in childhood [65] and individuals with ADHD have an earlier onset of smoking, higher rates of use and greater difficulty with abstinence [66]. Adults with ADHD are also less likely as a group to be successful in quitting compared to the general population [67].

Both nicotine and traditional pharmacological medications for ADHD operate as a psycho-stimulant. This shared functionality is consistent with the hypothesis that nicotine is used as a type of self-medication in these patient groups [68, 69]. The temporary effects of nicotine have been documented to enhance memory, reduce anxiety and tension, and improve symptoms of impulsivity, alertness, concentration and attention in adults with ADHD. All of which are considered to play a reinforcing role in the relationship between ADHD and smoking [65]. These transient improvements are likely to be due to the way nicotine acts on the release of neurotransmitters especially dopamine, serotonin and acetylcholine [68, 70]. The argument of substance dependence by way of self-medication is, as previously mentioned, known as the “gateway hypothesis” [70]. Reducing the symptoms of ADHD using psychostimulant medication (e.g., methylphenidate) impacts on the dopamine transporter (DAT) and has been found to significantly delay the onset of smoking in young adults [71, 72]. The variety of noradrenergic and dopaminergic drugs such as bupropion and moclobemide are both nicotine effective and also beneficial in the treatment of ADHD [70, 73].

Mum says it is always good to remind myself what I enjoy doing and what I am good at. She says everyone is good at something. Today, I thought about this and decided that I am good at running and jumping. I’m nearly always 1st, 2nd or 3rd at sport’s day. I am good at gymnastics and trampolining too. And, I can walk on my hands the length of the playground without falling down. But most of all I’m brilliant at art and computer games and when I grow up I want to be a computer games designer and make really cool games better than tomb raider. Lots and lots of people will want to buy my games, and I’ll be more successful than Richard Branson or Bill Gates or what’s that man called the one who invented IKEA? – Him anyway. I’ll buy a Ferrari because I’ve always wanted one – yes that’s what I’ll do. But most of all, it won’t matter if I have ADHD, ‘cos nothing will stop me.

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