New Zealand’s failure to adequately diagnose and treat ADHD is likely leading to significant drug harm including from alcohol and nicotine, a new report shows.
Released by the NZ Drug Foundation, the report pulls together international evidence on how Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder {ASD} affect people’s drug use and likelihood of suffering substance use disorders.
It showed people with ADHD are “significantly” more likely to use drugs and develop suffering substance use disorders, known as SUDs.
In particular, the NZ Drug Foundation pointed to one study which suggested as many as 50% of adults with ADHD will meet the criteria for suffering a substance use disorder at some point in their lifetime.
“Evidence also shows that people with ADHD and SUD are more likely to die early, especially if their ADHD is untreated or unmanaged.”
However, people who received timely pharmacotherapy had an 85% reduction in risk for developing a SUD compared to those not receiving treatment.
NZ Drug Foundation executive director Sarah Helm said making ADHD diagnosis and treatment more accessible would avoid “significant amounts of harm” and save the health system money.
“ADHD is under-diagnosed and under-treated in Aotearoa,” she said.
“The people we spoke to for this report confirmed the very real barriers they faced when trying to access diagnosis and support.”
One study suggested 0.6% of adults in New Zealand receive pharmacological treatment for ADHD, however, ADHD prevalence in adults could be as high as 2-6%.
ADHD New Zealand spokesperson Darrin Bull said the report highlights how barriers to ADHD treatment can seriously affect people’s lives.
“Untreated ADHD can impact people’s relationships, their employment, and their mental health. Add in a heightened risk of drug harm to that mix and you can see why we need to get serious about making support and treatment more accessible.
“We’ve heard loud and clear from the community that they experience barriers and feelings of mistrust from health services, and this is compounded if they disclose substance use issues – even if their ADHD may be an underlying cause.”
In the report, it shows there is a limited understanding of the relationship between substance abuse and autism.
“However, some studies suggest that people with ASD may be at increased risk of harmful use and may be more likely to engage in problematic drinking,” said a NZ Drug Foundation spokesperson.
The report also published the following 12 recommendations:
- Streamline screening of ADHD in individuals with SUD or substance harm
- Increase access to ADHD diagnosis
- Introduce clinical guidelines for screening, diagnosis and management of ADHD and ASD in adults
- Tailor treatment approaches in the alcohol and other drug (AOD) sector for those with neurodivergence
- Offer training on neurodivergence and substance use for the addiction workforce
- Enhance community-based support
- Ensure approaches to neurodiversity and substance use are equitable, culturally safe and work for Māori
- Avoid requiring abstinence before providing ADHD pharmacotherapy in clients with SUD
- Fund and expand access to lisdexamfetamine
- Trial novel approaches to harm reduction such as stimulant substitution therapy
- Increase research on neurodivergence and substance use in Aotearoa New Zealand
- Tailor existing harm reduction approaches for those with neurodivergence.
