One-in-five people who use alcohol and other drugs have symptoms of ADHD

Posted on: 28 February 2025

A new research report shows that one-in-five people using drugs and alcohol have symptoms of ADHD and that this rate increases to over one-third amongst people using benzodiazepines. The report – launched at a seminar this morning in Dublin’s Wynn’s Hotel – also shows that the highest rates of ADHD overall were found amongst women using these drugs.

The research was carried out for Citywide Drugs Crisis Campaign – a national network of community activists and organisations involved in responding to issues of drug use – by a team from Trinity's School of Nursing and Midwifery led by Professor Catherine Comiskey.

Professor Comiskey explained that the aim of the study was to provide up-to-date estimates of the prevalence of neurodiversity among people accessing addiction services in Ireland and internationally and to identify the risk and protective factors to inform appropriate service responses.

Professor Catherine Comiskey said:

“Our team reviewed evidence from 32 countries around the world from 1997 to 2024 with a total sample of almost 57,000 people. Our review of this data revealed that the overall estimate of the prevalence of ADHD within the population of people using drugs and alcohol was 21%. When comparing rates of prevalence across substances, the data showed that over one third of benzodiazepine users display ADHD symptoms.

“Our research also involved a study of qualitative interviews with service providers and we found that the majority of them did not have any formal education or training in neurodiversity. In fact, managing the needs of neurodiverse service users has been learned ‘on the job’ using a trial-and-error approach.” 

Research highlights

Professor Comiskey highlighted some other issues that emerged from the research with service providers:

• Working to meet and understand the needs of neurodivergent people provides major challenges for service provider staff;
• Some service users with neurodiverse conditions can take years to find an effective treatment programme that addresses their needs;
• The lack of a formal referral pathway in the Irish health system for adults seeking a formal diagnosis of neurodiverse conditions is a barrier to effective treatment;
• Providing appropriate support for service users with neurodiverse conditions who also have mental health and alcohol problems has been found to be a major challenge.

In terms of addressing these issues, Professor Catherine Comiskey and her team set out a number of recommendations.

“It’s important that all services and settings for people using drugs and alcohol address the issue of neurodiversity as part of their comprehensive assessment process. In addition, immediate training needs to be provided to staff at all levels in these services  and this training should be extended to ’ family members’. To ensure that such training is sustainable, it is recommended that a module on neurodiversity be provided in all relevant educational programmes in health and social care.”

Recommendations from the report

• The processes and practice of services for people using drugs and alcohol need to be modified to ensure that they adopt a neurodiverse informed and non-stigmatising approach;
• The HSE needs to provide appropriate assessment, screening and interventions for people with ADHD and this needs to be coordinated with addiction services;
• There is an ethical onus on the Department of Health and professional bodies to disseminate and implement the care recommended by the international consensus statements on the diagnosis and treatment of people using substances and who have ADHD.

Ken Kilbride CEO ADHD Ireland added:

“On behalf of ADHD Ireland, I would like to highly commend Citywide for commissioning this research, which highlights the severe impact ADHD can have across someone’s lifespan when not suitably supported.”

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