ADHD and Alcohol: Why the Link, and What Helps

Short answer: Alcohol and other drug problems are more common in people with ADHD. A meta-analysis of more than 5,400 people found those with ADHD were 50% more likely to develop a drug or alcohol disorder than people without it.¹ ADHD involves impulsivity, which in adults can show up as risk-taking and addiction,² and alcohol itself can make concentration, mood and sleep worse.³⁴ The Australian ADHD Guideline says stimulant treatment for ADHD doesn’t increase the risk of substance use disorders,¹ and confidential support for drinking is available to anyone who’s worried.⁵

How common are alcohol and drug problems with ADHD?

Substance misuse is one of the problems adults with ADHD may experience, alongside anxiety, depression and difficulties at work and in families.⁶ The Australian ADHD Guideline describes a childhood diagnosis of ADHD as an established risk factor for substance use disorders in adolescence and adulthood.¹

The main figures come from meta-analyses, which pool the results of many studies:

• One meta-analysis of more than 5,400 people found those with ADHD were almost three times as likely to be dependent on nicotine as people without ADHD, and 50% more likely to develop a drug or alcohol disorder.¹
• Looking from the other direction, a meta-analysis of people with substance use disorders found that 23.1% also met the diagnostic criteria for ADHD.¹

When the two occur together, ADHD is linked with starting addictive use earlier, heavier use, more hospital admissions and higher relapse rates.¹ Given how common this overlap is, the guideline recommends routine screening for problematic substance use when ADHD is treated in public and mental health settings.⁷

These figures are averages across large groups, not predictions for any one person.

Why are ADHD and alcohol linked?

There’s no single explanation, and different factors matter for different people.

Impulsivity and the pull of the moment

ADHD involves impulsivity, a tendency to act on what’s in front of you without weighing up the risks and consequences, which in adults can show up as risk-taking, overspending, conflict and addictions.² People with ADHD may also prefer smaller rewards now over bigger rewards later.²

A drink offers something pleasant straight away, while the costs come later. Alcohol also reduces inhibitions,⁸ so the limit you set at the start of the night can be harder to stick to after the first couple of drinks.

Drinking to cope

You’ll often hear the idea that people with ADHD “self-medicate” with alcohol, drinking to quieten a busy mind, take the edge off restlessness or wind down at night. Whatever the reason, using alcohol as a way of coping with anxiety, depression, trauma or stress is one route into alcohol dependence.⁹ Alcohol is a depressant, and long-term use increases the risk of depression, anxiety and other mental health conditions.⁴

Sleep

Sleep problems are common with ADHD: studies report insomnia in 43–80% of adults with ADHD.¹⁰ A nightcap can seem to help because alcohol can make you drowsy, but it often worsens the quality of your sleep in the second half of the night.⁴ healthdirect advises avoiding alcohol for at least 4 hours before bed.¹¹ For more on this, see ADHD and sleep.

Anxiety, depression and other conditions

Many people with ADHD also have anxiety or depression.⁶ Drinking can change the balance of chemicals in your brain and make depression or anxiety worse,³ so alcohol and these conditions can feed into each other. Read more in ADHD and anxiety.

What does alcohol do to ADHD symptoms?

Alcohol is a depressant that slows the messages travelling between your brain and body, and even when you feel fine it can affect your concentration and reaction time.³ As your blood alcohol level rises, it impairs judgement and reduces inhibitions, which can lead you to behave in ways you normally wouldn’t.⁸

Those effects land on areas ADHD already affects: sustaining attention, acting without thinking, and managing emotions and mood.¹² So drinking can add to difficulties you already live with, both on the night and the next day. A hangover can bring tiredness and anxiety,³ which doesn’t make a day of organising, remembering and focusing any easier.

It works the other way too: an ADHD assessment includes checking whether alcohol or other drug use might be contributing to the difficulties you’re having.¹²

Australia’s alcohol guidelines

To reduce the risk of harm, Australia’s alcohol guidelines, released by the National Health and Medical Research Council (NHMRC) in December 2020, advise healthy adults to drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.¹³ A standard drink contains 10 g of pure alcohol.¹⁴ The guidelines also say women who are pregnant or planning a pregnancy should not drink alcohol, and that not drinking is safest for women who are breastfeeding.¹³

These are upper limits, not targets: the less you drink, the lower your risk of harm from alcohol.¹⁴

Signs that drinking may be becoming a problem include strong urges to drink, struggling to stop, and having a hard time controlling how much you drink.⁹

Can you drink alcohol on ADHD medication?

Ask your doctor or pharmacist about your specific medicine. General information like this can’t tell you whether a particular combination is safe for you.

In general, alcohol can interact with many medicines, making side effects worse, making a medicine less effective or, in some cases, causing a serious reaction.¹⁵ healthdirect’s advice is not to drink alcohol while taking a medicine unless you’ve checked that it’s safe.¹⁵

A few other points:

• Be open with your doctor about how much you drink. A history of alcohol or other drug problems doesn’t automatically rule out ADHD treatment, but it does affect which treatment is chosen.¹
• Be careful with energy drinks as mixers. The caffeine in them can hide some of the effects of alcohol.¹⁶ See ADHD and caffeine.
• Don’t stop a prescribed medicine on your own. Talk to your doctor first.¹⁷

Does treating ADHD help with drinking?

Some people worry that ADHD medicines will lead to substance problems. The Australian ADHD Guideline says there is robust evidence that stimulant treatment for ADHD does not increase the risk of substance use disorders, compared with people with ADHD who don’t take stimulant medicines.¹ For people who also have a substance use disorder, it notes that stimulant treatment can lead to positive outcomes, including reduced substance use.¹

A large population study points the same way. In this US study, using insurance claims from almost 3 million adolescents and adults with ADHD, emergency department visits related to substance use were less likely during months when people were taking ADHD medicine than during months when they weren’t: 35% lower odds for men and 31% lower for women.¹⁸ Studies like this show an association, not proof that the medicine caused the difference.

The guideline also notes a lack of high-quality evidence on treating ADHD in people with substance use disorders, and for people with both conditions it recommends combining medicine with cognitive-behavioural therapy approaches.¹ More broadly, long-term studies link ADHD treatment with better outcomes than no treatment.¹⁹ If untreated ADHD might be part of why you drink, an assessment could be worthwhile. The drinking still needs support in its own right.

Getting help

If you’re worried about your own drinking or someone else’s, you don’t have to wait until things are serious.

• Your GP can talk through your drinking with you, help you cut down, and help manage any withdrawal symptoms.⁹
• National Alcohol and Other Drug Hotline: 1800 250 015. Free, confidential information and support, 24 hours a day, 7 days a week (8.30am to 10pm for callers in South Australia).⁵
• Lifeline: 13 11 14. 24-hour crisis support by phone, or text 0477 13 11 14.²⁰
• If someone’s life is in danger, call 000.²⁰

If you’re physically dependent on alcohol, stopping can cause withdrawal symptoms such as nervousness, sweating, confusion and seizures.⁹ Talk to your doctor before you stop.

If you think ADHD might be part of the picture, raise it with your GP too. Adult ADHD is often underdiagnosed,²¹ and the Australian ADHD Guideline stresses that picking up ADHD early in drug and alcohol services is critical.¹ See ADHD in men and ADHD symptoms in adults.

Frequently asked questions

Is alcohol bad for ADHD?

Drinking as an adult doesn’t cause ADHD, but it can make ADHD harder to manage. Alcohol affects concentration, lowers inhibitions and disrupts sleep, and long-term drinking increases the risk of anxiety and depression.

Are people with ADHD more likely to have problems with alcohol?

On average, yes. A meta-analysis summarised in the Australian ADHD Guideline found people with ADHD were 50% more likely to develop a drug or alcohol disorder than people without ADHD. That’s a higher risk, not a certainty.

Can you drink alcohol on ADHD medication?

Ask your doctor or pharmacist about your specific medicine. Alcohol can interact with many medicines, making side effects worse or a medicine less effective, so don’t assume a combination is safe until you’ve checked.

Does ADHD medication make substance use problems more likely?

The Australian ADHD Guideline says there is robust evidence that stimulant treatment for ADHD does not increase the risk of substance use disorders. A large study has linked periods on ADHD medicine with fewer substance-related emergencies, although that kind of study shows an association rather than proof.

Where can I get help for drinking in Australia?

Your GP is a good place to start. You can also call the National Alcohol and Other Drug Hotline on 1800 250 015 for free, confidential support, or Lifeline on 13 11 14 if you’re in crisis. In an emergency, call 000.

Next steps

Read is ADHD medication addictive? and how to get an ADHD assessment in Australia, or start with the free ADHD self-assessment.

This article is general information only and is not medical advice. Only a qualified health professional can diagnose ADHD. ADHD GP is a private telehealth clinic staffed by AHPRA-registered Australian GPs.

Book your ADHD assessment

References

1. Australian ADHD Professionals Association. Australian ADHD Guideline — co-occurring substance use disorders. 2022. adhdguideline.aadpa.com.au — Providing stimulant treatment for ADHD does not increase the risk of substance use disorders.
2. Australian ADHD Professionals Association. About ADHD (Australian ADHD Guideline). 2022. adhdguideline.aadpa.com.au — ADHD affects 6–10% of Australian children and 2–6% of adults; heritability 70–80%; symptoms begin before 12 though diagnosis may come later; 60–86% persist into adulthood; inattentive presentation most prevalent; up to 80% of adults have another mental health condition; describes executive-function, brain-maturation and dopamine differences.
3. healthdirect (Australian Government). How alcohol affects your health. 2026. www.healthdirect.gov.au — Alcohol is a depressant that slows messages between brain and body and can affect concentration and reaction time; drinking can worsen depression or anxiety; hangovers can bring tiredness and anxiety.
4. healthdirect (Australian Government). Food, drink and mental health. 2024. www.healthdirect.gov.au — Caffeine can increase anxiety and change sleep patterns, and regular users can get withdrawal symptoms such as tiredness; alcohol is a depressant that often worsens sleep in the second half of the night.
5. Department of Health, Disability and Ageing. National Alcohol and Other Drug Hotline. 2026. www.health.gov.au — Free, confidential information and support on 1800 250 015, 24 hours a day, 7 days a week (8.30am–10pm for SA callers), for anyone concerned about their own or someone else’s alcohol or drug use.
6. healthdirect (Australian Government). Attention deficit hyperactivity disorder (ADHD). 2025. www.healthdirect.gov.au — ADHD is a neurodevelopmental condition that begins in early childhood; around 1 in 20 people in Australia has ADHD; it is partly genetic; an adult diagnosis requires evidence that symptoms began in childhood; learning difficulties can occur alongside it.
7. Australian ADHD Professionals Association. Australian ADHD Guideline — summary of recommendations. 2022. adhdguideline.aadpa.com.au — Medication is the most effective treatment for core symptoms, with non-medication treatments adding support (3.1.1); diagnosing clinicians should be registered and trained in ADHD assessment (2.1.1); the diagnosis must be confirmed before starting medication (5.1.2); CBT should be offered to adults (4.2.11); stimulants are first-line for impairing adult ADHD, with heart rate, blood pressure, weight, sleep, mood and anxiety monitored during titration; co-occurring conditions get best-practice treatment.
8. Department of Health, Disability and Ageing. What are the effects of alcohol?. 2026. www.health.gov.au — Alcohol slows down the brain, impairs judgement and reduces inhibitions, which can lead people to behave in ways they normally wouldn’t; drinking while taking medicine can be risky.
9. healthdirect (Australian Government). Alcohol dependence (alcoholism). 2026. www.healthdirect.gov.au — Signs of dependence include strong urges to drink and difficulty controlling drinking; it can follow using alcohol to cope with anxiety, depression, trauma or stress; withdrawal can include seizures.
10. Wynchank D, Bijlenga D, Beekman AT, Kooij JJS, Penninx BW. Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Insomnia: an Update of the Literature. Current Psychiatry Reports. 2017. PubMed PMID 29086065 — Studies report insomnia in 43–80% of adults with ADHD.
11. healthdirect (Australian Government). Sleep. 2023. www.healthdirect.gov.au — Most adults need about 7 to 9 hours of sleep; avoid alcohol for at least 4 hours before bed, and tea, coffee and caffeinated soft drinks for at least 3 to 7 hours before bed.
12. Better Health Channel (Victorian Government). ADHD — adults. 2026. www.betterhealth.vic.gov.au — About 7 in 10 children continue to experience ADHD symptoms as adults; treatment can include education, psychological support, coaching, practical strategies and medication.
13. Department of Health, Disability and Ageing. Australian Alcohol Guidelines revised. 2020. health.gov.au — NHMRC released revised guidelines on 8 December 2020: healthy adults should drink no more than 10 standard drinks a week and 4 on any one day; women who are pregnant or planning a pregnancy should not drink.
14. Department of Health, Disability and Ageing. How much alcohol is safe to drink?. 2026. www.health.gov.au — Healthy adults should drink no more than 10 standard drinks a week and no more than 4 on any one day; a standard drink contains 10 g of pure alcohol; the less you drink, the lower your risk of harm.
15. healthdirect (Australian Government). Medicines and alcohol. 2024. www.healthdirect.gov.au — Alcohol can interact with many medicines, worsening side effects, making a medicine less effective or causing serious reactions; never drink alcohol with a medicine unless you have checked it is safe.
16. healthdirect (Australian Government). Caffeine. 2025. www.healthdirect.gov.au — Caffeine stimulates the brain; effects start in about 30 minutes and last up to 6 hours; healthy adults can safely have about 400 mg a day; a 250 mL energy drink has about 80 mg; caffeine can mask alcohol’s effects.
17. healthdirect (Australian Government). ADHD medicines — children and adults. 2025. www.healthdirect.gov.au — Stimulants adjust dopamine and noradrenaline; short-acting forms work soon after a dose and long-acting forms last longer; common side effects include reduced appetite, weight loss, anxiety, irritability and insomnia, and stimulants can raise blood pressure; prescribing is tightly controlled and there is a risk of dependence if not taken as prescribed.
18. Quinn PD, Chang Z, Hur K, et al. ADHD Medication and Substance-Related Problems. American Journal of Psychiatry. 2017. PubMed PMID 28659039 — In claims data from almost 3 million adolescents and adults with ADHD, months on ADHD medication were associated with lower odds of substance-related emergency visits (35% lower in men, 31% in women).
19. Shaw M, Hodgkins P, Caci H, et al. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Medicine. 2012. PubMed PMID 22947230 — Treatment of ADHD was associated with improved long-term outcomes compared with no treatment.
20. Lifeline Australia. Lifeline home page. 2026. www.lifeline.org.au — Lifeline offers 24-hour crisis support on 13 11 14 (or text 0477 13 11 14); if life is in danger, call Triple Zero (000).
21. Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Primary Care Companion for CNS Disorders. 2014. PubMed PMID 25317367 — Review of the evidence that adult ADHD is substantially underdiagnosed.

Sources were last checked on 5 October 2026. See all sources used on this site on our Sources page.