Part 4: Alcohol & Substance use and the role they play in ADHD

So while researching other parts of ADHD, I came across one tiny little sentence that said something along the lines of, research shows that alcoholism and substance use by grandparents may be linked to ADHD. That sentence was then embedded in my brain, never to be forgotten for some reason. Obviously, I was going to have to research it more, so down that research abyss I went. Here's what I found...

ADHD and substance use disorders (SUD) are closely linked through shared genetic factors that can be inherited across generations, including from grandparents. Research indicates that these conditions often "co-segregate" in families, meaning the same genetic predisposition can manifest as ADHD in one family member and substance abuse in another. I tell ya, the brain is a crazy thing, isn't it?

Why did this topic interest me? Those who know me personally know that neither of my parents are alcoholics or drug users However, I do have a family history on my mother's side. Both of her parents were alcoholics, as was her grandfather on her mother's side. Knowing this is a particular reason that my mother chose to abstain from alcohol and drug usage. It obviously had a direct effect on her life growing up, and she wanted better for my brother and me. For that, I am very thankful. Sadly, it doesn't necessarily mean that no damage was done. If my research is correct, then the effect of my relatives has had a direct effect on my brain, resulting in ADHD as an adult, and thanks to those impulsivity issues and constantly looking for those dopamine hits, I went through a phase in my life where I actively used drugs and drank.....a lot, and sadly it started early on for me

. Again, if either of my parents are reading this, I apologize for my younger self, how I acted, and how I treated you guys. I was having a hard time, and I now know why.

Genetic & Hereditary Links

Shared Genetic Basis: ADHD and alcoholism (or other substance use) share common genes. Studies have identified specific genetic markers, such as variations in the CADM2 and LPHN3 genes, that are associated with both ADHD symptoms and a higher likelihood of using addictive substances.

Transgenerational Risk: The risk is not limited to parents. If a grandparent has a history of substance abuse or ADHD, there is an increased statistical risk for grandchildren to develop ADHD.

First-degree relatives (parents/siblings) of someone with ADHD have a much higher risk (roughly 2x) of substance abuse.

Second-degree relatives (grandparents/uncles) also show an elevated risk, though it is typically lower than that of first-degree relatives.

Heritability Rates: ADHD has a high heritability rate of 75%–91%, while alcohol dependence has a heritability of over 50%. According to Medline Plus (Heritability Rates) are defined as: Heritability is a measure of how well differences in people’s genes account for differences in their traits. I told you you would learn something new from me. I certainly do every time I look into anything.

Mechanisms of the Connection

Impulsivity: A core symptom of ADHD is impulsivity, which is also a major risk factor for initiating and maintaining substance use.

Self-Medication: Individuals with ADHD may use substances like alcohol (a depressant) to "self-treat" hyperactivity or restlessness. Looking for a way to make the brain a bit quieter, if you will.

Dopamine Deficiency: Both ADHD and addiction involve the brain's reward system and dopamine transmission. People with ADHD may seek the "dopamine hit" from substances to compensate for natural deficits in reward processing.

You can see how this could/would be a problem, at least I can. It was most certainly an issue for younger Carissa. Thankfully, my mother constantly went on about how alcoholism ran on her side of the family, and I really needed to be careful if I didn't want to become one myself. I hit my lowest point when I was going through my divorce and had started bartending to make extra cash. I saw people daily who had lost their jobs due to alcohol, yet here they were in the bar I was working at, charging drinks onto a credit card they couldn't afford to pay, and it hit me....This was going to be me if I didn't make some changes, like really quickly. So, I quit that job, decided to put the alcohol behind me, and I haven't looked back since. Like I need any more difficulty in my daily life. LOL

Environmental & Epigenetic Factors

According to the Cleveland Clinic, Epigenetics is the study of how our environment influences our genes by changing the chemicals attached to them.

Genetic Nurture: Beyond direct DNA inheritance, the environment created by a relative with a substance use disorder (e.g., household instability) can influence the expression of ADHD traits in children.

Prenatal Exposure: Exposure to substances like nicotine or alcohol during pregnancy—which may be more common in families with a history of substance abuse—is a known environmental risk factor that can increase ADHD symptoms in offspring.

Does any of this sound familiar to you? If so, are you wondering what you can do to try to prevent it from happening going forward? Well, here's what I found on that. Since you’ve noticed a pattern, it can be helpful to see how these traits often "travel" together. When ADHD and substance use run in a family, it usually stems from a shared struggle with impulse control and dopamine regulation.

Here are the most effective preventative steps and ways to manage that inherited risk:

1. Early Identification & Treatment

Treat ADHD First: Research shows that effectively treating ADHD (through therapy or medication) significantly reduces the risk of future substance abuse. It stops the need to "self-medicate" those restless or chaotic feelings.

Psychoeducation: Helping the individual understand why their brain seeks stimulation can take the shame out of the struggle and make them more cautious of "quick fix" substances. Wish I had known this sooner.

2. Focus on Executive Function

External Structures: Since ADHD affects the brain's "manager," use tools like planners, alarms, and routines to reduce the stress that often leads to drinking or drug use as a coping mechanism.

High-Stimulation Outlets: Channel the need for dopamine into healthy, high-energy activities like working out, sports, martial arts, or creative hobbies.

3. Open Communication & Environment

Honesty about History: Knowing that "Grandpa struggled with this" isn't a "doom" sentence—it’s a roadmap. It allows the individual to recognize their own vulnerability early. Again, thank you, Mom, for trying to help here. I'm sorry I didn't listen sooner.

Stress Management: Since stress is a major trigger for both ADHD symptoms and substance cravings, learning healthy regulation (like exercise or mindfulness) is a vital shield. Too bad I was ninety to nothing earlier in my life. So much stress, all the time.

4. Professional Support

Dual-Diagnosis Specialists: If someone is already struggling with both, it’s best to see a professional who specializes in co-occurring disorders. Treating one without the other often leads to relapse.

*Lastly, I feel the need to say it again for those who are distracted or in the back. I am not a licensed professional, other than Chairapy, so this is intended for informational purposes at most. Always consult a licensed healthcare professional when needed.

Much Love,

Carissa