Cocaine and ADHD: Everything you should know

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder. People with ADHD typically present with symptoms of inattention, impulsivity, and hyperactivity. These individuals may have low dopamine levels in the brain, which makes tasks more challenging.

ADHD is common in the United States. In 2019, almost 9% of children aged 3–17 years had received a diagnosis of the condition. Although some children outgrow ADHD, it affects about 2.5% of adults.

Research has identified a strong association between ADHD and substance use disorders, including cocaine use. Cocaine is a stimulant prone to misuse and addiction. Alongside other effects, it can improve concentration, potentially making it appealing to someone with ADHD. However, cocaine also has potential risks, including severe side effects such as heart attack, stroke, and seizures.

This article looks at the link between cocaine use and ADHD and the risks that come with using the drug.

As cocaine is a stimulant drug, it can cause feelings of increased energy and euphoria in people without ADHD.

However, in people with ADHD, cocaine may have a calming effect, as it increases dopaminergic transmission, which is functional in ADHD. Dopamine is a neurotransmitter involved in pleasure, motivation, and learning. Cocaine may, therefore, help people with ADHD manage symptoms of impulsivity, restlessness, and inattentiveness.

The drug affects certain brain structures, including the:

  • accumbens and ventral pallidum, which form the reward system
  • amygdala and hippocampus, which are responsible for working memory
  • orbitofrontal and subcallosal cortices, which play a role in volition
  • prefrontal cortex and cingulate gyrus, which are important for executive control

It inhibits the reuptake of dopamine, norepinephrine, and serotonin, meaning that more of these “pleasure chemicals” remain circulating in the blood.

The effects in people without ADHD include increased arousal, euphoria, and increased vigilance and alertness. However, individuals with ADHD may experience relief from the executive and behavioral dysfunctions that occur with the condition.

People with ADHD might be more susceptible to cocaine use disorder and other substance use disorders. For example, a 2014 review notes research in which 23% of young adults with substance use disorders also had ADHD.

In a 2021 Canadian study Involving 6,872 people aged 20–39 years, the participants with ADHD were significantly more likely to have a substance use disorder than those without the condition.

When considering cocaine specifically, some studies indicate that the prevalence of cocaine use among adults with ADHD is about 26%, with 1 in 10 individuals developing cocaine use disorder. Comparatively, in the general population, 1.9% of people aged 12 years and older will have used the drug in the last year.

There are many reasons why people with ADHD may “self-medicate” with cocaine. However, the primary reason is that the effects of cocaine on the brain may help alleviate some of the symptoms associated with ADHD.

Cocaine acts in a similar way to prescription medications on the systems that do not function as they should in people with ADHD. Using cocaine causes a surge in dopamine, making up for the lack of the chemical.

Cocaine use in ADHD may not produce the classic “rush” and high energy state that people without the condition often experience. Instead, those with ADHD may find that cocaine provides more focus and calm. This can be appealing to people who can feel as though they cannot keep up with the world around them.

However, a person should never consider cocaine use as a treatment for ADHD because of the associated risks of this illegal drug.

Cocaine is a substance that is prone to misuse, and people with ADHD may be more sensitive to developing cocaine use disorder. This disorder can lead to many problems, including financial difficulties, relationship problems, and mental health issues.

Cocaine use over an extended time can also have negative health outcomes, including:

  • psychosis
  • increased risk of stroke and seizures
  • inflammation of the heart muscle
  • significant weight loss

Using the drug can even lead to death in some cases.

Young adults with ADHD are more likely than people without ADHD to use substances, including drugs and alcohol. Children with ADHD may also feel attracted to substances that have a calming effect, and their brains could be more sensitive to drugs and feel the effects more strongly.

It is likely that drugs, alcohol, and other substances provide quick relief from the symptoms of ADHD, calming the mind and reducing racing thoughts.

For example, cocaine may increase attention in the short term, while cannabis can provide mild sedation and euphoria.

In addition to ADHD symptoms, other risk factors can increase a person’s likelihood of turning into drugs or alcohol. For example, people with ADHD may also have mental health problems, such as anxiety or depression, which can also increase the risk of substance use.

Using ADHD medications does not increase the likelihood of substance use. In fact, the opposite might be true. A 2016 analysis involving 150,000 young people with ADHD found that those who took ADHD medication were 7.3% less likely to develop a substance use disorder than those who did not. Therefore, it seems that treating ADHD effectively could protect against substance misuse.

There is no single effective treatment for ADHD, and people with this condition may use various strategies to manage their symptoms and improve functioning. These strategies can include:

  • Medications: Stimulants such as methylphenidate (Ritalin) are established ADHD medications, and up to 80% of children with ADHD have fewer symptoms when using them. Doctors may also recommend nonstimulant medications that have a longer lasting effect.
  • Therapies: Cognitive behavioral therapy (CBT) and child therapy can help strengthen positive behaviors and reduce problematic ones. Parent training in behavior management involves a therapist working with the parents or caregivers to help them manage the child’s behavior.

Individuals may also benefit from training to improve their organization and time management skills. This training may help them complete tasks and meet deadlines more easily.

Learn more about medication and natural remedies for ADHD.

Anyone experiencing symptoms of ADHD should seek a diagnosis from a qualified doctor. The doctor can rule out other potential causes of the symptoms and put an appropriate treatment plan in place.

Without treatment, many people with ADHD may find it difficult to manage their symptoms. These individuals could have an increased risk of developing substance use disorders as a coping strategy.

An ADHD diagnosis involves a comprehensive assessment of the person’s symptoms, their family history, and the presence of any other health conditions. Although the specific approach may vary among doctors, diagnostic protocols generally include:

  • Diagnostic interview and medical history: This standardized set of questions covers a broad range of topics and determines how many of the diagnostic criteria apply to the individual. The interview can also help doctors determine whether the individual may have other psychiatric disorders that could mimic ADHD.
  • Information from other individuals: The doctor may also interview family members or significant others to fully understand the individual’s symptoms and behaviors.
  • DSM-5 symptom checklists: The standardized behavior rating scales from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) allow a comparison between people with ADHD and those without. Although they are not diagnostic in themselves, they help the overall evaluation process.
  • Additional testing: Depending on the findings of the assessments, a doctor may use additional psychological or learning disability tests.
  • Medical examination: A thorough physical examination can help rule out other medical causes of symptoms such as thyroid problems or seizures.

Learn more about untreated ADHD in adults.

Some people with ADHD may feel tempted to use cocaine to alleviate their symptoms. Cocaine mirrors the effects of prescription stimulants because, like them, it causes a rush of dopamine. However, there are significant risks associated with using illegal cocaine.

People with ADHD are more likely to develop substance use disorders. Therefore, anyone experiencing ADHD symptoms should seek a diagnosis and treatment.

The treatment of ADHD typically involves both medication and therapy. These interventions can help an individual manage their symptoms and reduce their risk of developing problems with cocaine and other substances.

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