Dear Alice,

I've recently been evaluated for ADHD. The doctor kept asking about the amount of alcohol that I used and I must admit that it is a lot. I am a college fraternity boy and alcohol is everywhere so I use it quite often. Now, I've taken Adderall before and it helps me tremendously but I'm scared he won't prescribe me the medicine due to this. Are there any other solutions to my ADHD problem even though I have a history of alcohol abuse?

Dear Reader,

You’re asking two smart questions. The first is about the combination of Adderall (generic name: amphetamine/dextroamphetamine) and alcohol, and the other is concerning alternative treatments for attention-deficit/hyperactivity disorder (ADHD). To answer them in order: drinking heavily while taking amphetamine/dextroamphetamine can lead to higher risk outcomes. This combination of stimulants (amphetamine and dextroamphetamine) increases the activity of neurotransmitters to help with symptoms of ADHD, such as hyperactivity. When used with alcohol, amphetamine/dextroamphetamine may make you feel more energized and less drunk. However, your blood alcohol would continue to rise at the same rate it usually does. Because of this, you may not realize how much you're drinking, which can increase your risk of alcohol toxicity. With that said, amphetamine/dextroamphetamine isn’t the only treatment for ADHD. Many people who have ADHD benefit from a combination of management strategies ranging from dietary changes to cognitive behavioral therapy. Most critical is finding the combination of strategies that work best for you.

ADHD impacts the frontal lobe of the brain, the part associated with decision-making. An adult with ADHD may exhibit symptoms such as inability to multitask, mood swings, and difficulty with time management. Since alcohol also affects the functioning of the frontal lobe, when someone with ADHD uses alcohol, this part of the brain is further impaired. People with ADHD who consume alcohol may be more impulsive, have more unpredictable mood swings, and have more difficulty controlling their behavior. Treatments for adults with ADHD usually include a combination of psychotherapy and medication. If amphetamine/dextroamphetamine works well for you, and you'd like to take it to treat ADHD, you could try to curtail your alcohol intake. There are sources of support to help you reduce your alcohol use. Most colleges and universities offer programs and services that can support students with substance use. Many college students with ADHD struggle with their alcohol use, so you’re not alone.

If living in a fraternity is a priority for you but creates an atmosphere where it's unlikely you could limit your alcohol use, there are alternative treatments for ADHD that don’t rely on medications. Such treatments can take the form of dietary, behavioral, or cognitive approaches. For example, you may consider creating daily routines for yourself, reduce distractions when working, or breaking large tasks down into smaller, more manageable steps. Some other approaches you may take could include: 

  • Dietary changes: One common dietary strategy is eliminating foods that can agitate or over-stimulate the nervous system. Many of these diets are based on the thinking that sensitivity to certain foods may cause or worsen symptoms of ADHD. Such foods commonly include sugar (in the form of candy, cookies, soda, sugary cereal, etc.), artificially added colors, flavors, and preservatives, and foods commonly associated with allergic reactions such as cow's milk, wheat, eggs, soy, corn, chocolate, and yeast. Instead of simple carbohydrates which quickly turn to sugar, a diet consisting mostly of complex carbohydrates (grains and beans), fruits and vegetables, and plenty of protein may improve ADHD symptoms. While these anecdotal approaches haven’t been backed by peer-reviewed research, they may provide symptom relief for some.
  • Nutritional supplementation: Nutritional supplementation is another common dietary approach. It’s based on the assumption that there is a missing component from the diet and that behavior would be improved by providing it. Popular supplements for ADHD are omega-3 and omega-6 essential fatty acids. ADHD is a brain-based disorder where neurotransmitters don't function as expected. Nerve cell membranes are composed largely of fatty acids. Some studies show that supplementing these fatty acids helps improve neurotransmitter functioning. Other popular dietary supplements for ADHD are amino acids, basic vitamins, and herbal and homeopathic remedies. All of these supplements can be bought over-the-counter at a trusted health food store, but it may be smart to consult with a health care provider or registered dietitian for some guidance when choosing a supplement.
  • Behavioral techniques: Some find cognitive behavioral therapy (CBT) useful to strategize about concrete habits and actions to reduce their symptoms. Others prefer talk therapy to work through any patterns in relationships or self-esteem they may have handled throughout their life. In addition to forms of therapy, ADHD coaching is an alternative to therapy that focuses on day-to-day problem solving, such as how to organize and complete daily tasks.
  • Physical activity: Finally, physical activity can be a helpful tool in treating ADHD symptoms. Movement from physical activity helps to boost the neurotransmitters in the brain that support a person’s ability to focus and pay attention.

In the end, each person is unique and what works for one doesn't always work for another. Additionally, if you try many treatments, you increase your chances of finding one that works for you. Whether you use amphetamine/dextroamphetamine and change your drinking habits or try other treatments, it’s ultimately what feels best for you.

Alice!

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