The Complex Relationship Between ADHD and Alcohol Use Disorder: A Narrative Review.

Authors

Valentin Skryabin, Polina Makartseva, Svetlana Sokolova, Giovanni Martinotti

Published in

Journal of psychiatric practice. Volume 32. Issue 6. Pages 320-330. Nov 01, 2026. Epub Nov 01, 2026.

Abstract

The comorbidity between attention-deficit/hyperactivity disorder (ADHD) and alcohol use disorder (AUD) presents significant clinical challenges, with ADHD increasing the risk of early alcohol initiation, more severe drinking patterns, and poorer treatment outcomes. This review explores the epidemiological, neurobiological, and psychosocial mechanisms underlying ADHD-AUD comorbidity, highlighting the role of impulsivity, executive dysfunction, and dopaminergic dysregulation in increasing susceptibility to alcohol dependence. We discuss the challenges of diagnosing ADHD in individuals with AUD, given overlapping cognitive impairments and alcohol withdrawal effects that may mimic ADHD symptoms. We also evaluate current pharmacological and behavioral treatment strategies, emphasizing the need for integrated approaches to care that balance ADHD symptom management with relapse prevention in patients with AUD. Although stimulant medications improve impulse control and executive function, their role in preventing alcohol misuse remains uncertain, necessitating careful monitoring. Nonstimulant options such as atomoxetine and guanfacine, alongside anti-craving agents like naltrexone, offer alternative treatment pathways. Cognitive-behavioral therapy, mindfulness-based interventions, and motivational enhancement therapy show promise in addressing ADHD-related alcohol use behaviors. Given the limited long-term data on ADHD treatment in populations with AUD, future research should focus on longitudinal studies, neuroimaging biomarkers, and personalized medicine approaches to optimize clinical management. Expanding ADHD screening in addiction settings and implementing policy changes to improve treatment access will be crucial for enhancing patient outcomes.

PMID:
43013859
Bibliographic data and abstract were imported from PubMed on 12 Nov 2026.

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