Comorbidity of ADHD with Substance Use Disorders: A Review of Diagnostic and Therapeutic Considerations

Comorbidity between ADHD and substance use disorders (SUDs) is an area that has attracted the attention of clinicians, researchers, and public health in recent years. The aim of this study was to investigate the most basic issues related to epidemiology, screening, and therapeutic interventions for ADHD co-occurring with substance use disorders. Using the research method of reviewing data related to the use of keywords Attention Deficit Hyperactivity Disorder, substance use disorders, and comorbidities in Google Scholar and PubMed search engines as well as in NOORMAGS, SID, and Irandoc databases were searched. The data showed that ADHD is a risk factor for SUDs and the prevalence of ADHD is significant among adolescents and adults with SUDs, especially in inpatient settings. Comprehensive ADHD + SUD assessment by a trained clinician in the areas of addiction, differential diagnoses of ADHD, and specific populations, conducting a standard diagnostic interview for a complete clinical history of ADHD before and during withdrawal, and also, a general history of mental and physical health and psychosocial functioning are suggested guidelines for assessing ADHD + SUD. While pharmacotherapy is the first line and the most effective treatment for ADHD, various psychosocial interventions can be performed in combination with medication, including CBT, psychoeducation, metacognitive education, mindfulness training, coaching, and behavioral modification, as well as motivational interviewing. Overall, the evidence suggests that treating ADHD in early childhood can reduce the risk of later substance use at older ages.