Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects children and adults in the United States. ADHD can make it difficult to focus and perform in school through childhood, impairing learning and socialization. These issues can carry into adulthood, especially when they’re left unaddressed. ADHD is often treated with stimulant medication, but what if someone with ADHD takes cocaine? Cocaine is a powerful stimulant drug that is seldomly used for medical purposes. It’s more common as a recreational drug, but does it have the potential for use as an ADHD medication? Learn more about cocaine and its effects on someone with ADHD.
How Does ADHD Affect Your Brain?
ADHD is a neurodevelopmental disorder. That means that it’s a disorder that begins early in a person’s life, so it affects the development of the brain. ADHD begins early in childhood, and it is usually first noticed when a child reaches school age.
Neurodevelopmental disorders and other issues affecting the brain are extremely complicated. Researchers don’t know everything about ADHD and how it works in the brain, but there are some compelling explanations for why some people struggle with attention and hyperactivity problems and others don’t.
ADHD affects the brain’s structure and function. While ADHD was thought to be a behavioral problem, it’s actually a disorder that’s rooted in your biology and biochemistry. People with ADHD tend to have smaller frontal lobes, which is the part of the brain responsible for impulse control and inhibitions. Research has also found that people with ADHD go through slower brain development. This may be why children with ADHD often feel like they are behind their classmates.
Those are brain structure differences, but ADHD can also have an effect on brain chemistry. One of the most significant chemicals tied to ADHD is dopamine. Dopamine is a neurotransmitter, a chemical messenger, in the brain that’s involved in reward and motivation. Dopamine is released when you do something or experience something that gives you positive feelings.
When you eat a delicious meal, accomplish a significant achievement, or hear your favorite song, dopamine is released into your brain to bind to and activate its receptors. Those are all noticeable moments where dopamine is released, but you also have dopamine in your system throughout the day that you may not notice. These ambient dopamine levels allow you to maintain motivation to complete everyday tasks. People with ADHD may have lower levels of this ambient dopamine, which makes it difficult to maintain focus and motivation.
Low levels of dopamine can make it so that focusing on a task isn’t providing you with any rewarding sensation. People without attention problems may not feel like staying focused. A mundane task is very rewarding, but people with ADHD know the feeling of fighting through a task their brain isn’t focused on. The lack of focus may come from your brain’s desire to find a reliable source of dopamine. For instance, if you’re studying for a test in your dorm and your brain isn’t releasing enough dopamine, an interesting conversation in the hallway may be irresistible because your brain is seeking a dopamine source.
What Causes ADHD?
Like many issues affecting the brain, ADHD’s causes are complex and not fully understood. However, because ADHD always starts early on in childhood, it’s thought that children are born with the disorder or genetically predisposed to it.
ADHD is thought to have a significant genetic component, which means it can be caused by biological differences in your brain that are passed down from your parents or grandparents. Around 75% of children with ADHD also have a relative with the disorder. ADHD often runs in families. Although a parent with ADHD doesn’t guarantee that you or your kids will have it, your risk factors are increased.
Not having a parent or grandparent with ADHD also doesn’t mean you or your kids won’t have it. There are many factors that contribute to the disorder, and heredity is just one of the most common factors. Plus, ADHD is sometimes underreported in women, so you may have a mom or grandmother who has dealt with ADHD symptoms that were not diagnosed.
While genetics make up a significant portion of your risk factors for ADHD, there may be other factors that contribute to the disorder, including:
- Brain structure. The structure and function of your brain can be factors in ADHD. There are significant differences between the brains of people with ADHD and people without the disorder. These structural differences are usually naturally occurring and may be inherited from your parents.
- Head injuries. It may be possible that significant head injuries during early childhood could contribute to neurodevelopmental issues like ADHD. However, that doesn’t mean every bump and bruise will cause ADHD.
- Premature birth. Premature birth is associated with many developmental problems, including ADHD.
- Prenatal issues. Babies who are exposed to nicotine or other toxins in the womb may be more likely to develop ADHD and other issues.
- Environmental toxins. In some cases, exposure to toxins like lead could cause developmental issues like ADHD. However, these cases are rare.
Other factors have been suggested to cause ADHD like diet, sugar, food additives, allergies, and immunizations, but there is currently no definitive evidence linking those factors to the disorder.
How Is ADHD Diagnosed?
ADHD comes in three types that may present different experiences and symptoms. The first is predominantly inattentive, which is characterized by a lack of focus and difficulty concentrating. The second is hyperactivity, which is characterized by restlessness and the inability to sit still for long periods. Finally, if you experience symptoms from both types, you may have the combined type, which is common in many children.
A doctor, pediatrician, psychiatrist, or psychologist can all diagnose ADHD. When you’re seeking a diagnosis, your doctor will likely use the Diagnostic and Statistical Manual of Mental Disorders (DSM). There are several signs and symptoms for each of the two main types, and you need to experience six or more of them to be diagnosed with ADHD.
The inattentive type has nine common symptoms. To be diagnosed with this type, you need to have experienced six or more symptoms before the age of 16 or five symptoms for those 17 or older. They also need to have occurred for six months. Symptoms can include:
- Struggling to pay attention to details, which can lead to careless mistakes, especially in schoolwork or at work. Missed details may lead to problems in other areas as well.
- You may have trouble maintaining your attention when performing tasks. Children may struggle to keep their attention while playing.
- You may not notice when people are talking to you directly. Others may not think you are listening when talking to you.
- Inattention may cause you to fail to finish schoolwork, workplace responsibilities, or other obligations. You may become sidetracked or miss important instructions.
- Organizational activities may be difficult for you.
- People with ADHD often avoid tasks that require sustained mental effort. Schoolwork or work responsibilities that require you to focus and think for a long time may be frustrating or difficult.
- You may find that you lose things often, especially things that are necessary to complete activities, like certain school supplies. Adults may misplace keys, wallets, purses, and other essential items.
- People with ADHD may be easy to distract.
- You may forget daily activities and miss important events.
The hyperactivity type of ADHD involves problems with fidgeting and the urge to get up and move at inappropriate times. It was thought that this aspect of ADHD could be outgrown. However, adults may experience hyperactivity in different ways than children. Where children may want to run and climb when they shouldn’t, adults may feel restless and uncomfortable in situations when they have to remain still for long periods.
Like the inattentive subtype, children and adolescents under age 17 must experience six of the nine common symptoms of this subtype. People aged 17 and older must experience at least five, and symptoms must be present for six months. Signs and symptoms of hyperactive ADHD include:
- Fidgeting with your hands and feet. This may include taping or squirming in your seat.
- Getting up and leaving your seat when it’s inappropriate. The urge to get up a move.
- Children may want to run or climb when it’s inappropriate. Adults may feel restless when they need to sit still.
- You may be unable to participate in quiet recreation or leisure activities. Children struggle to play quietly.
- You’re on the go constantly, and people may think you have boundless energy.
- Excessive talking is normal for you. You may feel that you often talk too much.
- Impatience while talking, causing you to answer questions before someone’s finished asking.
- It’s difficult to wait your turn, especially for children.
- Interrupts other people and intrudes when it’s inappropriate. This could involve interrupting conversations of activities.
If you have six or more symptoms in both categories, you may be diagnosed with the combined subtype. Many children and adults experience a combination of both symptoms. Some symptoms may be related. For instance, you may have trouble concentrating and completing tasks because of the urge to get up and move around. There are treatment options that can address both subtypes.
How Does Cocaine Work?
Cocaine is a powerful central nervous stimulant, which means it works by increasing activity in your brain and throughout your nervous system. More specifically, it works by influencing the brain’s mesolimbic dopamine system, which is the part of your nervous system that’s responsible for reward. The reward is an important function of the brain because it encourages you to repeat healthy tasks like finding food, water, and comfortable shelter.
When you engage in healthy activities, your brain releases rewarding chemicals like dopamine that make you feel good. Your brain learns sources of those reward responses and encourages you to return to them through cravings and compulsions.
Of course, the reward system can also be misused. A healthy meal can cause a release of rewarding chemicals, but so can a pint of ice cream. Likewise, drugs can manipulate rewarding chemicals like dopamine without any real benefit. Stimulants like cocaine can increase the levels of dopamine in your system. Cocaine does this by blocking a process called reuptake. Under normal circumstances, some stimulus will cause a release of dopamine, it will bind to dopamine receptors, and then it will be removed from your system through reuptake. Reuptake helps to avoid a buildup of dopamine, and it recycles the chemical and its parts.
Cocaine binds to what’s called a dopamine transporter, which blocks it from reabsorbing the chemical. This causes cocaine to build up in your system, binding to more and more of its receptors. As it activates more receptors, it will have a more intense effect than it would naturally, causing excitement, euphoria, alertness, and elation.
But how does this affect ADHD?
ADHD and Cocaine
ADHD is often treated with stimulant medications like amphetamines. But why would you want to give a stimulant to someone who struggles to sit still and focus? The reason stimulants can work to treat ADHD has to do with the way ADHD affects the brain. Since ADHD can cause low dopamine that makes it so that your brain is constantly seeking a better source of dopamine, a drug that can increase the levels of the chemical may be able to help. Stimulants increase dopamine levels in your system by blocking reuptake and increasing focus, alertness, and wakefulness.
But can cocaine do the same thing that stimulant medications can?
Cocaine works similarly to amphetamines and other ADHD medications. It also increases alertness, focus, and wakefulness. It’s possible it would provide some short-term relief from ADHD symptoms. However, cocaine is more intense than prescription medications. Plus, illicit drugs are inherently unpredictable. A cocaine high marked by a rush of exhilaration and euphoria lasts for only a few minutes. The high is followed by a comedown that can be uncomfortable, including anxiety, insomnia, and paranoia. While cocaine may offer some temporary benefits, illicit cocaine is likely to do more harm than good.
Cocaine use problems may also increase your risk of worsening ADHD. ADHD is common in people who seek treatment for substance use issues. People who complete an addiction treatment often need to be treated for ADHD at the same time. A 2018 study found that ADHD symptoms improved in people with cocaine abstinence and that there may be a relationship between ADHD and cocaine dependence. That could mean that cocaine misuse and abuse could make ADHD worse rather than treat it.
Self-Medicating with Cocaine
Self-medication is the use of drugs or alcohol to treat a mental or physical problem without consulting a doctor. In many cases, a person may not set out to self-medicate with an illicit or recreational drug. However, when they find it relieves some of their troublesome symptoms, they continue using it. Alcohol is a common drug for self-medication for mental health issues, such as depression and anxiety. But other drugs may be used for specific ailments. For instance, meth is sometimes used to help a person lose weight. Cocaine may be used to help with fatigue and issues related to ADHD and concentration problems.
There are several signs that your drug use has turned into self-medication. Most people who begin using cocaine do so for recreational purposes. They may take the drug in social settings or experience a euphoric high. However, drug use becomes self-medication when you stop using it to feel good and start using it to feel better. You may feel like you need the drug to get through the day or to mask uncomfortable symptoms. In the case of ADHD, you may feel like you need cocaine to get through tasks that require prolonged mental effort and concentration.
However, self-medication can quickly lead to substance use problems like dependence and addiction. While self-medicating may provide temporary relief, it’s likely to cause serious consequences that make your ADHD worse and produce other problems.
Consequences of Misusing Cocaine
Cocaine misuse also increases your likelihood of developing a substance use disorder. Cocaine is severely addictive. The short-lived high followed by the uncomfortable comedown encourages users to take several doses in a row, which is called a binge. A cocaine binge increases your risk of developing a chemical dependence and addiction to cocaine, especially after long-term use.
Dependence happens when your brain gets used to cocaine’s effects over time. Your brain chemistry will adapt to cocaine and its effects on your dopamine levels. Your brain may produce fewer dopamine receptors or alter your brain chemistry in other ways to balance your brain chemistry. When you stop using cocaine or cut back, you will experience uncomfortable withdrawal symptoms. Withdrawal can cause depression, agitation, restlessness, fatigue, sleep problems, and lethargy. If you have ADHD, cocaine withdrawal can make your symptoms worse, and you might find concentration and focus more difficult.
If you develop a moderate-to-severe cocaine use disorder, you may encounter various consequences affecting your health, relationships, finances, and nearly every aspect of your life. Long-term cocaine addiction also increases your risk of an overdose, which can be fatal. While cocaine shares some similarities with ADHD medications, it’s much less safe, especially when you get it from an illicit source.
Does ADHD Make Me Tolerant to Cocaine?
Because stimulants are used to elevate dopamine levels in people with ADHD that may have low levels of ambient dopamine, it has led to some myths about how cocaine affects people with ADHD. Does ADHD make you tolerant to cocaine? Does it make you immune? The short answer is no.
While low levels of ambient dopamine are a possible explanation for ADHD and why stimulants can help with ADHD, it doesn’t mean you can take a powerful stimulant and be less affected than the average person. If you have ADHD, your dopamine levels may be low when you’re trying to complete meticulous tasks, sit still, or wait for long periods. But you still feel pleasure when you eat your favorite foods or engage in activities you find interesting. A powerful stimulant like cocaine will still have significant effects on you as it increases your dopamine levels.
Treating Co-Occurring Substance Abuse and ADHD
If you realize that you’ve developed a substance use disorder related to cocaine, it’s important to seek treatment as soon as possible. Substance use disorders can take over multiple aspects of your life and worsen issues like ADHD. Substance use disorders commonly occur alongside mental health issues like anxiety and depression. In treatment, both mental health and substance use problems should be addressed at the same time. Ignoring one and treating the other can slow or impede treatment.
ADHD is a developmental disorder, but it can increase your risk for mental health issues like anxiety and depression. In treatment for a substance use disorder, your treatment plan should address underlying issues like ADHD. You may learn to cope with challenges that are caused by ADHD and identify ways ADHD may contribute to substance use problems.
Can You Take ADHD Medications in Recovery?
One of the first-line treatment options for ADHD involves the use of stimulant medications like amphetamines. However, some people in recovery avoid the use of stimulant medications. Though they are relatively safe, the FDA warns that drugs like Adderall have high abuse potential. When you’re in recovery, you will need to weigh the pros and cons of using certain prescriptions with your doctor and therapists. If you determine that taking stimulants for ADHD would risk your sobriety, other nonstimulant medication options are available, including atomoxetine and clonidine.