Ask An Expert / Drugs and Alcohol

How can I protect my son with ADHD from substance abuse?

And why are kids with ADHD at higher risk?

Alan Ravitz, MD, MS

My son was diagnosed with ADHD when he was 12 years old. He is 17 now and a senior in high school. It has not been easy but he has managed to pass each grade. He has taken medications periodically. I've read about ADHD's comorbidity with substance abuse. Why does this happen and how can I help prevent this in my child?

The main reason that kids with ADHD are at high risk for substance use and abuse is that they are impulsive; they don’t think before they act.

But kids with ADHD also tend to have low self-esteem. Often they don’t feel comfortable with higher-functioning kids. Instead, they tend to seek out less accomplished, less socially adept peers, who frequently abuse substances.

Kids with ADHD are also at risk for other psychiatric disorders, especially anxiety and depression, which can get overlooked; kids with ADHD tend to act out and that can mask the symptoms of the other conditions. But these are still there, and some teens use alcohol and other drugs, like marijuana, as a means of self-medication.

What can you do? First, you should encourage your son to take his medication. Although kids with ADHD are at high risk for substance abuse, those who take medication are at much lower risk than those who do not. There is good research that supports this finding.

Second, supervise your son. Get to know his friends. Make sure he keeps you informed of his whereabouts and activities. There is good data to support the fact that parental supervision leads to less behavioral problems.

Third, be on the lookout for comorbid problems such as anxiety and depression, and get treatment for them if necessary.

Finally, spend time with your son. Let him know that you are available to talk with him and support him when he is upset. Let him know that you are interested in him.