ADHD and substance use: evidence and help in New Jersey

By the time many adults ask about ADHD, alcohol, cannabis, nicotine or other substances are already part of the story. Some are in recovery and worry that treatment could put it at risk. Others are using now and are unsure whether to say so. This page sets out what the research shows, how New Jersey's rules shape treatment when both are present, and where to get substance use help in the state. It is general information as of October 2026, not advice about anyone's own care.

How often ADHD and substance use disorders occur together

The Kessler estimate comes from a modest sample of adults aged 18 to 44 and should be read as approximate. These studies show that the two conditions travel together. They do not show why, and they do not show that one causes the other. No New Jersey-specific figure for the overlap was found.

Why the overlap complicates diagnosis

Intoxication, withdrawal and heavy regular use can all disturb attention, memory, sleep and mood. The National Institute of Mental Health notes that adults diagnosed with ADHD must have shown symptoms starting before age 12, and a careful evaluation also asks whether something else explains them better. For a person with a substance use history, a careful evaluation leans on two questions: what childhood looked like before any use began, and how attention holds up during periods of abstinence or reduced use. The symptoms guide's article on ADHD or the effects of substances goes into this further.

Being open helps. New Jersey's rules already expect the question: when starting a controlled substance, N.J.A.C. 13:35-7.6(b) requires the practitioner to take a thorough history that reflects the patient's history of substance use, make a reasonable effort to get prior records, and check the New Jersey Prescription Monitoring Program (NJPMP). A clinician who knows about current use can separate its effects from ADHD and choose treatment with the full picture.

What the research says about treatment

A large US study by Quinn and colleagues, published in 2017 in the American Journal of Psychiatry, followed nearly 3 million commercially insured adolescents and adults with ADHD. Comparing each person with themselves, months on ADHD medication carried 35% lower odds of substance-related events (emergency department visits tied to substance use) for men and 31% lower odds for women than months off medication. The authors were careful about limits: because clinical trials have been mixed, they said the results should not be read as supporting ADHD medication as a treatment for substance problems, and the study could not address diversion or misuse outside treatment.

The other side of the ledger is just as real. The 2025 study by Han and colleagues found that among adults with prescription stimulant use disorder, 72.9% used only their own prescribed stimulants, and misuse was about three times as common among people taking amphetamines as among those taking methylphenidate. Every prescription stimulant carries an FDA boxed warning about abuse, misuse and addiction, updated across the class in May 2023, which directs prescribers to assess each patient's risk before prescribing and monitor during treatment.

How that plays out in practice

• A substance use history does not automatically rule out ADHD medication. It changes the questions the prescriber asks and how closely treatment is followed.
• Non-stimulant options exist. A 2024 review in American Family Physician lists non-stimulants, such as atomoxetine and viloxazine, for situations where stimulants are contraindicated, not tolerated or ineffective. The same review advises considering controlled-substance agreements and prescription monitoring checks.
• Coordination helps. With your consent, your ADHD prescriber and any addiction counselor or program can talk to each other.

Which medication suits a person in recovery, and whether a stimulant is appropriate at all, is a decision for the prescriber and patient together. Background on the medication classes is in stimulant vs non-stimulant ADHD medication and ADHD medication misuse and addiction risk.

New Jersey rules that add structure

• Prescription monitoring. Pharmacies report controlled-substance dispensing to the NJPMP, and prescribers check it when starting treatment. See the NJPMP and ADHD medication.
• Supply limits. N.J.A.C. 13:35-7.6(c) generally limits a Schedule II prescription to a 30-day supply. Federal law bars refills, so each supply needs a new prescription.
• Telehealth. For adults located in New Jersey who are prescribed a Schedule II stimulant through telehealth, P.L.2026, c.40 requires an in-person visit within 30 days of a telehealth first exam, a contact every three months and an in-person visit at least once a year.
• Sharing is a crime. Giving or selling a controlled medication to someone else is illegal; see sharing ADHD medication and New Jersey law.

None of this signals distrust of a particular patient. It is how controlled medications are managed for everyone. The full set of rules is in New Jersey's rules for ADHD medication. Cannabis raises its own questions; see ADHD medication and cannabis in New Jersey.

Where to get substance use help in New Jersey

The details below were read on state and nonprofit pages on October 19, 2026. Numbers and hours change, so confirm before relying on them.

• ReachNJ: 1-844-732-2465, 24/7. The Department of Human Services describes it as the central call-in line for New Jersey residents seeking help with a substance use disorder. Each call is answered by a live person within the first 30 seconds. Staff screen callers, refer them to supportive services and connect them to a local treatment provider. ReachNJ serves residents of all ages regardless of insurance status or ability to pay.
• Family and friends: the Mental Health Association in New Jersey lists a line for people concerned about a loved one's substance use, 855-652-3737, weekdays 8 am to 8 pm and weekends 10 am to 4 pm.
• Peer Recovery Warmline: 877-292-5588, weekdays 8 am to 10 pm and weekends 5 to 10 pm, for ongoing peer telephone support for people living with mental health conditions, according to the state's hotline list.
• Crisis: for suicidal thoughts or a mental health or substance use crisis, call or text 988. For an overdose or other emergency, call 911. County crisis options are in mental health crisis resources in New Jersey.

These services treat substance use. They do not provide ADHD evaluations or ADHD prescriptions, though a treatment program may screen for ADHD and refer you.

Talking to a prescriber about substance use

• Say what you use, how much and how often, including alcohol, cannabis, nicotine and caffeine.
• Describe any past treatment and how long you have been in recovery.
• Mention any time you took a prescription differently from how it was written.
• Ask how the prescriber monitors controlled medications and what is expected of patients.
• Ask about non-stimulant options if you would rather avoid a controlled substance.

Dr. Shershow is a psychiatrist who focuses on adult ADHD and is licensed in New York and New Jersey. The evaluation covers health history, including medications, sleep and substances, and considers other explanations for symptoms. The treatment page describes how medication management works when medication is appropriate. The New York version of this page is ADHD and substance use in New York.