ADHD and Addictions

Question

My 19 year old son has ADHD and he is a high school drop-out who is only finally now doing reasonably well working as a mountain bike guide?/instructor and bike mechanic. He was never able to really handle school and I am just so relieved that he found a way to take his passion for biking and turn that into reasonably good paying employment. He is very good at what he does. He has been working full time at the shop for more than a year and he just left home to live with a couple of friends last month. I do not know exactly what is going on but my daughter, who is not one to tattle, came to me today and told me that she say James and his friends using cocaine at his apartment and when she confronted him he said that it wasn’t a big deal and that he had only done it a couple of times. I am very scared by this news and I know that his ADHD puts him at a hugely increased risk to have a problem, especially with drugs like cocaine. I do not think he has a problem yet but I want to make sure that he never does get one. I am still helping him financially and we have a good loving relationship, so I think I can ask/demand that he participate in some kind of addiction prevention program. But I am not sure what kind of program is available. Is there some kind of prevention for young adults program available? I do not think he needs like an addiction program yet, but I want to make sure he never does.

Rev. Christopher Smith · Accepted Answer

As I have not met with you, your son or otehr involved around your situation, please be advised that the answers I am giving are still for a hypothetical case of someone that might be presenting as you have described. Only someone who is able to do a full assessment can reallly answer about your situation.

It is true that some people with ADHD or ADHD-type symptoms will use substances (including cocaine) as a way of self-medicating because of the way that cocaine (and other substances) can make them feel that they are being more focused. Thus, there is reason for concern. There are two aspects that I would suggest that you consider at this point.

The first aspect is where your son is at with respects to treatment of his ADHD. You speak of him as having ADHD but give no indication as to whether he got and is still getting effective treatment for it. The fact that he never really suceeded in school and the nature of his current work would make me wonder if this is being treated well right now. If it is not, then this would be a clear red flag and possible contributor to having or developing a problem with addictions.

The other aspect is that it may be hard for you to determine the degree to which he has a problem with cocaine and/or otehr substances. Your daughter was clearly concerned enough to raise the issue to you, which is out of her character. Her report is that he admits to having used cocaine multiple times (it could be even more than what he reported and his report that it is not a big deal would be no indication that it is not a big deal - just that he does not believe it to be a big deal even if it is causing other problems). The question is what effects are being experienced as a result of his use? The information you provided and probably that you have is not enough to know where he is at on the spectrum of substance use and its associated problems. What is clear is that at this point he is not seeing his use as being a problem. As a result, he may not be ready for assistance - both in terms of being honest enough with a professional to get a real picture of where he is at and in terms of receptiveness to being impacted by the intervention.

While recognizing that the problem is not your problem, you can make gentle inquiries and encouragement to your son. But remember that this is his problem and not your problem at this stage. It would seem to me that the best initial course of action is to address the treatment of the ADHD. If this can be done in a setting or with a clinician who can also assess then address the substance use, this would be preferable. At least basic screening would be helpful at this stage.

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