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ADHD and Addictions: A Holiday Nightmare You Can Avoid
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By Dr. Sam Pirozzi


Blown BulbApproximately sixty percent of individuals with substance use disorders also have a mental health disorder.  Co-occurring disorders are very common and the link between Attention Deficit Hyperactivity Disorder, cigarette smoking, alcohol, marijuana, cocaine and other substance use is very strong.  The reliance upon substances often begins when ADHD youngsters are at greatest risk, during their teens and their use becomes an unhealthy coping skill that often impairs learning healthier skills.  Of the total number of adults who abuse substances, about twenty percent have ADHD and over fifty percent of adult alcoholics had childhood ADHD.  The relationship between ADHD and substance abuse is complex although with the proper treatment you can learn how to manage these disorders especially under time of high risk.


The stress of the holidays can create uncomfortable circumstances for countless ADHD adults, making the holidays an especially risky time for those who have a history of relying upon excessive food and alcohol, illegal substance abuse or excessive or risky behaviors to calm their uneasiness, particularly in social environments.  Having fun at office parties and family gatherings may result in over-eating and drinking to excess as ADHD adults deal with overwhelming holiday stress.  Advance planning, support and good decision-making make a significant difference between a happy holiday season and regretful season.  


Self-knowledge, simply learning from your past, allows you to capitalize on negative and positive experiences and develop a plan to manage your personal risks factors. When you know the source of your discomfort (a particular family member always pushes your buttons, or perhaps you’re fine with anyone as long as they are in small groups, but a house full of people or a large company party really jangles your nerves), you can take steps to manage it.  Avoiding excess stress is critical for a successful season as holiday stress may trigger impulse control tendencies that have been managed successfully during the year can now place you at risk.  The correct use of this knowledge potentially allows you to be more resilient.


During the holidays, people are mindful of the fatalities that occur on New Year’s Eve.  The National Highway Traffic Safety Administration reports that more people are likely to die in alcohol-related traffic crashes on New Year’s Eve between 6:00 PM and 5:59 AM, New Year’s Day than during the same period any other day of the year.  However, often people are less thoughtful during the rest of the holiday season.  Preventive measures will prevent you from needing to make last minute decisions about potentially excessive behaviors like the use of alcohol.  


It is important to recognize some general facts about alcohol.  If you decide to drink, personal planning to minimize risk is essential.  For example, some people believe they can reduce their intake of alcohol and still drive.  This thinking can lead to tragedy.  Remember, you will fail to recognize that your critical driving skills and decision-making abilities are diminished long before you feel intoxicated.  During a night of drinking, it is easy to misjudge yourself.


Some simple facts about alcohol that you may want to know are that; one standard drink is 12 ounces of regular beer, 8.5 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80 proof spirits.  However, keep in mind that at a house party these standards often do not apply.


If you plan on drinking alcohol, double check that it is safe to drink while taking your prescription medications.  If it is safe, pace yourself.  Have no more than one drink an hour and no more than four drinks in a day for a man and three drinks in a day for a woman. Consider alternating alcohol drinks with non-alcohol drinks such as water, soda, or juice.  Do not drink on an empty stomach and most of all know how to say "No, thanks.”


If you or someone you care about is in recovery from alcohol or other drugs, know that the holiday season places them at high risk for relapse.  Awareness of risk factors and having a relapse prevention plan that can be executed with confidence is essential.  Have a conversation in advance with your support network about the holidays.  A frank discussion now about relapse prevention can make a big difference.  


Finally, if you are seeing a psychotherapist, coach or attending a support group, taking time off for the holidays is not recommended.  Simply stated; having a plan and a support network will provide a sense of self-efficacy and security that are the ingredients for a healthy, happy, and safe holiday season for all.


Dr. Sam (Saverio) Pirozzi is a New Jersey licensed clinical drug and alcohol counselor with over 30 years of experience. He has worked in outpatient mental health and chemical dependency treatment, inpatient treatment centers, hospitals, universities and in private practice. Learn more at

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