ADHD and Addictions: A Holiday Nightmare You Can Avoid

By Dr. Sam Pirozzi

Approximately 60% of individuals with substance use disorders also have a mental health disorder. Co-occurring disorders in general are very common, given the complex nature of the brain. The link between Attention Deficit/Hyperactivity Disorder and substance use is very strong. In fact, of the total number of adults who abuse substances, about 20% have ADHD. Those with ADHD, on average, experiment with substances at an earlier age than those without the condition and are at a greater risk of substance abuse because of tendency towards impulsive behaviors. The relationship between ADHD and substance abuse is complex, though with the proper treatment you can learn how to manage these disorders, especially under times of high stress and high risk.

The stress of the holidays can create uncomfortable circumstances for countless ADHD adults, making this an especially risky time for those who have a history of relying upon excessive food and alcohol, illegal substance abuse, or excessive or risky behaviors to calm their uneasiness. Having fun at office parties and family gatherings may result in over-eating and drinking to excess as an attempt to deal with overwhelming holiday stress. Advance planning, support, and good decision-making make a significant difference between a happy holiday season and regretful season for those prone to over-indulgence or substance use.

Know yourself.

Self-knowledge, simply learning from your past, allows you to capitalize on negative and positive experiences. Once aware of your strengths, vulnerabilities, and needs you can develop a plan to manage your personal risks factors. When you know the source of your discomfort, you can take steps to manage it and prioritize your needs. Perhaps a particular family member always pushes your buttons, or you’re fine in small groups but a house full of people or a large company party really jangles your nerves. Take control of these situations before you find yourself stuck in them by setting boundaries and coming up with a plan of action. It’s important to navigate these situations based on what you need most.

Manage stress.

Managing excess stress is critical since stress can trigger impulses and old, unhelpful coping strategies. This can make it hard to stick to the strategies that have helped you maintain stability over the course of the year, putting your hard-earned success at risk. Applying what you know about yourself and your old patterns helps you be more resilient during times of stress.

Don’t minimize risks.

Approaching New Year’s Eve, we are reminded of the unfortunate fatalities related to excess alcohol use. The National Highway Traffic Safety Administration reports that more people are likely to die in alcohol-related traffic crashes on New Year’s Eve between 6:00 PM and 5:59 AM New Year’s Day than during the same period any other day of the year. However, often people are less thoughtful during the rest of the holiday season. Preventive measures will prevent you from needing to make last minute decisions that could put you in risky situations.

Be realistic about problems and solutions.

If you decide to drink, realistic consideration of obstacles and appropriate planning are essential to minimize risk. For example, some people believe they can reduce their intake of alcohol and still drive. This thinking can lead to tragedy. Remember, you will fail to recognize that your critical driving skills and decision-making abilities are diminished long before you feel intoxicated. During a night of drinking, it is easy to misjudge yourself. Be honest with yourself and think through possible risky scenarios.

Know your limit.

Some simple facts about alcohol that you may want to know are that; one standard drink is 12 ounces of regular beer, 8.5 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80 proof spirits. However, keep in mind that at a house party these standards often do not apply. Be aware of how much you have consumed and know your limit. Drink plenty of water, and don’t assume that just because you don’t feel intoxicated you are below the legal limit of blood alcohol level.

Be mindful of medication.

If you plan on drinking alcohol, double check that it is safe to drink while taking your prescription medications. If it is safe, pace yourself. Have no more than one drink an hour and no more than four drinks in a day for a man and three drinks in a day for a woman. Consider alternating alcohol drinks with non-alcohol drinks such as water, soda, or juice. Do not drink on an empty stomach and most of all know how to say “No, thanks.”

Be mindful of your triggers.

If you or someone you care about is in recovery from alcohol or other drugs, know that the holiday season places them at high risk for relapse. Awareness of risk factors and having a relapse prevention plan that can be executed with confidence is essential. Know your triggers and have a plan for how you will avoid or manage them.

Seek support.

Have a conversation in advance with your support network about the holidays. A frank discussion now about relapse prevention can make a big difference. If you are seeing a psychotherapist, coach or attending a support group, taking time off for the holidays is not recommended.

Simply stated; having a plan and a support network will provide a sense of self-efficacy and security that are the ingredients for a healthy, happy, and safe holiday season for all.

Dr. Sam (Saverio) Pirozzi is a New Jersey licensed clinical drug and alcohol counselor with over 30 years of experience. He has worked in outpatient mental health and chemical dependency treatment, inpatient treatment centers, hospitals, universities and in private practice. Learn more at www.drsampirozzi.com.