Holistic Treatment For ADHD and Dual Diagnosis in Virginia

What Is Attention-Deficit Hyperactivity Disorder (ADHD)?

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning.[1] The condition affects an estimated 4 to 5 percent of adults, though many remain undiagnosed until seeking help for other issues. ADHD manifests differently across individuals, with symptoms ranging from difficulty concentrating and disorganization to restlessness and poor impulse control. These symptoms often lead to challenges in work performance, relationship difficulties, and problems with time management.

ADHD exists in three primary presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined type.[2] The disorder stems from differences in brain structure and neurotransmitter function, particularly involving dopamine regulation. While ADHD begins in childhood, symptoms frequently persist into adulthood, though they may present differently as people age. Adults with ADHD often develop coping mechanisms that mask their symptoms, making diagnosis more challenging and increasing the likelihood of developing secondary conditions like anxiety, depression, or substance use disorders.

Drug/Alcohol Addiction and Its Interaction with ADHD

Adults with ADHD face significantly higher rates of substance use disorders compared to the general population, with studies showing they develop addiction two to three times more frequently.[3] This elevated risk stems from several factors unique to ADHD, including impulsivity, sensation-seeking behavior, and difficulties with emotional regulation. Many people with undiagnosed ADHD turn to drugs or alcohol as a form of self-medication, attempting to manage symptoms like racing thoughts, restlessness, or inability to focus. Stimulants like cocaine or amphetamines may temporarily improve concentration, while depressants like alcohol might calm hyperactivity, creating a dangerous pattern of substance dependence.

The interaction between ADHD and addiction creates a complex problem where each condition makes the other worse. When people use drugs or alcohol, their ADHD symptoms often become more severe, making it even harder to focus, control impulses, or manage emotions. On the flip side, untreated ADHD symptoms make recovery from addiction much more difficult. People with ADHD struggle with planning ahead, waiting for rewards, and controlling their emotions – all skills that are essential for staying sober. This back-and-forth relationship explains why treating just the addiction or just the ADHD rarely works in the long term.

Both ADHD and addiction affect the same parts of the brain, particularly the areas that control reward, motivation, and decision-making.[4] People with ADHD typically have lower levels of dopamine, a brain chemical that helps us feel satisfied and focused. This makes them more likely to seek out drugs or alcohol that temporarily increase dopamine levels and provide relief from their symptoms. Unfortunately, long-term substance use damages these already vulnerable brain areas, creating even bigger problems with attention, self-control, and judgment.

Signs You May Have Undiagnosed ADHD and Addiction

Many adults don’t realize they have ADHD until they seek treatment for substance abuse, as the conditions share overlapping symptoms and often mask each other. Recognizing the signs of co-occurring ADHD and addiction helps identify when specialized dual diagnosis treatment is needed. While everyone’s experience differs, certain patterns commonly emerge when both conditions are present:[5]

• Chronic disorganization despite negative consequences: Consistently losing important items, missing appointments, or failing to complete tasks even when facing serious repercussions from work, relationships, or legal issues
• Self-medication patterns: Using specific substances to manage unnamed symptoms, such as drinking to calm racing thoughts or using stimulants to focus
• Treatment-resistant addiction: Multiple failed attempts at recovery, with relapses often triggered by inability to concentrate, emotional overwhelm, or impulsive decisions
• Emotional volatility: Experiencing intense mood swings, difficulty regulating emotions, or overreacting to minor frustrations, especially when sober
• Substance use starting in adolescence: Beginning drug or alcohol use during teenage years, often to fit in socially or cope with school difficulties
• Family history patterns: Having relatives with diagnosed ADHD, addiction issues, or both conditions
• Persistent restlessness: Feeling constantly “on edge” or unable to relax without substances, with physical fidgeting or mental hyperactivity
• Time blindness: Consistently underestimating how long tasks take, chronic lateness, or losing track of hours when using substances
• Impulsive behaviors beyond substance use: Making rash decisions about money, relationships, or major life changes without considering consequences
• Difficulty with routine tasks: Struggling with basic daily activities like paying bills, maintaining hygiene, or keeping a clean living space, especially when not using substances

How Alpas NOVA Treats Addiction and ADHD

Recognizing that untreated ADHD and substance abuse create unique recovery challenges, Alpas Wellness takes an integrated approach to treatment. The program addresses how ADHD symptoms like impulsivity and emotional dysregulation directly fuel addiction patterns, while substance use worsens attention deficits and executive functioning problems. Rather than treating conditions separately, clinical teams coordinate interventions that manage ADHD and drug abuse simultaneously. Suffering from ADHD and alcohol abuse requires specialized strategies that account for how drinking impacts dopamine systems already affected by ADHD, making comprehensive treatment vital for lasting recovery.

Levels of Care

• Detox Placement: Medical teams monitor withdrawal while evaluating ADHD symptoms that often emerge once substances clear, implementing non-addictive medications to manage attention deficits safely.
• Partial Hospitalization Program: Structured daytime treatment combines ADHD management strategies with addiction recovery, helping patients develop focus and organizational skills crucial for maintaining sobriety.
• Intensive Outpatient Treatment: Flexible scheduling accommodates work and family obligations while providing targeted treatment for both ADHD and drug addiction through integrated therapeutic approaches.

Evidence-Based Treatment Approaches

• Cognitive-Behavioral Therapy: Addresses thought patterns that contribute to both ADHD impulsivity and substance use, teaching practical skills for managing attention difficulties without self-medication.
• Dialectical Behavior Therapy: DBT for ADHD combines mindfulness practices with distress tolerance techniques, helping patients regulate emotions and reduce impulsive substance use behaviors.
• Motivational Interviewing: Explores how undiagnosed ADHD contributed to substance use patterns, building awareness and motivation to address both conditions comprehensively.
• Contingency Management: Provides immediate rewards for positive behaviors, leveraging ADHD brains’ need for quick feedback to reinforce treatment compliance and sobriety milestones.
• Motivational Enhancement Therapy: Helps patients overcome ambivalence about ADHD treatment and sobriety, recognizing how addressing attention issues improves recovery outcomes.
• Experiential Therapy: Incorporates movement and hands-on activities that engage ADHD minds while teaching healthy coping mechanisms to replace substance use.
• Relapse Prevention: Develops personalized strategies for managing ADHD triggers and substance cravings, creating structured plans that address executive function challenges.
• Twelve-Step Facilitation: Adapts traditional recovery principles for ADHD minds, using visual aids and structured formats that improve program engagement and retention.