How ADHD Affects Addiction & Impulsivity | Dr. John Kruse & Dr. Andrew Huberman

00:00:00.000 | Is there a relationship between ADHD and addiction because of the impulsivity component?

00:00:08.660 | Yes, and. So the answer is, and these are really rough statistics. Actually,

00:00:14.800 | one of my pet peeves is people who quote, oh, the rate of this is 27.43%. Well,

00:00:21.240 | it might have been in that study, but that's looking at one population at one set.

00:00:26.380 | So I use ballpark figures. The ballpark figure is Americans in the last 20 years,

00:00:32.320 | more than that, about 20% of Americans run into some addiction, substance addiction problem,

00:00:39.080 | either alcohol or drugs. People with ADHD have a rate that's almost double that, and it's

00:00:44.780 | higher in men than in women. Double.

00:00:47.960 | Almost double, almost 40% risk. And that's for substance abuse,

00:00:51.860 | not behavioral addictions. Yeah, that's substance abuse,

00:00:55.920 | and that's looking at abuse, and we can get into the related topic of what's misuse and versus abuse,

00:01:01.060 | and I have pet peeves there. However, kids who are put on stimulant medications when they're

00:01:07.680 | young, and I should say the stimulants themselves do have a small potential for addiction,

00:01:13.320 | but putting kids on stimulants pretty much normalizes their rate of addiction problems.

00:01:21.000 | So it protects them.

00:01:21.820 | This is a really important point that I think maybe we just hover on for a second,

00:01:26.300 | because I think many people, including myself, assume that, well, if you were, you know, putting

00:01:32.240 | these kids on amphetamines, of which, you know, many of the medications for ADHD are,

00:01:37.960 | that we're creating kids that are addicted to amphetamines or to a hyperstimulation period.

00:01:46.100 | But you're telling me it's actually protective to put kids with real ADHD on medication for ADHD.

00:01:53.220 | Yeah, I can say not absolutely every study has found this, but several large meta-analyses have gone back,

00:01:59.960 | and most of them have found this fairly dramatic benefit to being on stimulants as a kid in terms

00:02:07.060 | of specifically reducing substance abuse risk. And some of them that have looked at this, when I said it

00:02:12.900 | was a yes and, it seems to be that it's not just the impulsivity traits, but some of the inattentive ones, too.

00:02:20.180 | You know, if your teacher's lecturing about the risks of alcohol or this and this, and you're zoning out at the window

00:02:26.780 | and looking at the plane flying by, you have less pertinent information on the topics.

00:02:31.620 | You may be less attentive to the negative effects that other kids are seeing among the classmates

00:02:37.600 | who are stoners at this age or X, Y, or Z. So it seems that both the inattentive sets of ADHD symptoms

00:02:45.380 | and the impulsive, you know, thrill-seeking, not weighing the consequences as heavily, are all contributing to this heightened risk.

00:02:55.980 | I have this model in my head that is perhaps completely wrong, maybe partially wrong, and it goes something like this,

00:03:05.960 | that we know that the neural circuits involved in executive control and directing attention and maintaining attention

00:03:14.740 | and avoiding distraction, this kind of thing, use dopamine and epinephrine and norepinephrine, at least to some extent.

00:03:23.620 | And we know that people with ADHD are capable of focus, as you said, it's a failure to direct that focus, maintain, et cetera.

00:03:31.780 | So I've heard from you before this discussion that, you know, people that, you know, tend to drink lots and lots of caffeine

00:03:40.560 | or who can drop into an activity but have a lot of distractibility that, you know, they might have ADHD.

00:03:46.560 | So what I'm imagining here is that the threshold to get dopamine, epinephrine and norepinephrine released is either much higher or more complicated for people with ADHD.

00:03:57.340 | And so what they're seeking is these catecholamines, these three chemicals, dopamine, epinephrine and norepinephrine.

00:04:04.120 | And that if they're given a medication that puts them in that range where they're getting it, then they're good.

00:04:10.120 | They can stop seeking it, so to speak.

00:04:12.120 | And I'm raising this now because we're talking about addiction, addiction is a, you know, pursuit of things essentially.

00:04:19.900 | And I guess what I'm saying is it seems to me that the model of ADHD that we hear about is that, you know, people can't focus, you know, their dopamine circuits are all out of whack.

00:04:32.900 | And then you put them on this dopaminergic drug and, you know, basically you get them addicted to that tunnel vision or something.

00:04:40.100 | But I have this model in mind now that what we are all seeking is to have portions of our day where we are directing our focus towards a meaningful bill.

00:04:49.240 | The things that are, you know, generative in our life, work, school, relationships, et cetera.

00:04:53.560 | And that whether or not it's pharmacology or exercise or what have you, that it's just about getting into this plane of consciousness.

00:05:02.660 | And I say that in no woo or abstract terms.

00:05:05.720 | Is that right?

00:05:06.540 | I mean, are we really talking about here is a failure to access enough of these neuromodulators and these medications, which we're about to talk about, are really about putting us in the realm where those neuromodulators are just more accessible?

00:05:18.880 | - I'll just say I can go with that.

00:05:20.980 | - Okay, well, you're the expert.

00:05:22.380 | I mean, I'm putting this together based on kind of what we're talking about, like getting enough sleep to me is a way of being able to have enough arousal during the day.

00:05:31.520 | You know, exercise or these medications, just different ways of being able to access arousal.

00:05:37.160 | Like if you don't sleep, you can't access arousal during the day.

00:05:39.600 | Like if you don't sleep, you don't sleep, you're going to sleep, you're going to sleep, you're going to sleep.

How ADHD Affects Addiction & Impulsivity | Dr. John Kruse & Dr. Andrew Huberman

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