ADHD and Substance Use: What Adults in New York Should Know

Alcohol, cannabis, nicotine and other substances are part of many adults' history by the time they ask about ADHD. Some are in recovery and worry that a stimulant prescription would put it at risk. Others are using now and are unsure whether to say so. This page covers what is known about the overlap, how it affects treatment, and where to find help in New York. It is general information and not advice about any individual's care.

How often ADHD and substance use disorders occur together

Two figures frame the overlap.

• Among adults with ADHD: about 15.2% had a substance use disorder in the previous 12 months, according to the National Comorbidity Survey Replication, published in 2006. That estimate comes from a small sample of adults aged 18 to 44 and should be read as approximate.
• Among people in addiction treatment: 23.1% met criteria for ADHD in a 2012 meta-analysis of 29 studies. That is close to one in four.

The second number is the more striking. ADHD is common in addiction treatment settings, where inattention, restlessness and impulsivity can be hard to separate from the effects of substance use or withdrawal. The National Institute of Mental Health notes that ADHD often co-occurs with other mental disorders and can make them harder to treat.

These studies show that the two conditions travel together. They do not show why, and they do not show that one causes the other.

Why the overlap complicates diagnosis

Intoxication, withdrawal and heavy regular use can each impair attention, memory, sleep and mood. The diagnostic criteria require the clinician to judge whether another condition better explains the symptoms, and they require several symptoms before age 12. For someone with a substance use history, the evaluation therefore leans heavily on two things: what childhood looked like before any substance use began, and how attention holds up during periods of abstinence or reduced use.

Honesty helps the person being evaluated. A clinician who knows about current use can separate its effects from ADHD and can choose treatment with the full picture. Information shared with a treating clinician is protected health information. For who can see what, read who can see your ADHD diagnosis and prescriptions in New York.

Treatment when both are present

A substance use history does not automatically exclude ADHD medication. It changes the questions.

What labels and reviews say

• Every prescription stimulant carries an FDA boxed warning about abuse, misuse and addiction, updated across the class in May 2023. The warning directs prescribers to assess each patient's risk before prescribing and to educate patients about safe storage and disposal.
• A 2024 review in American Family Physician advises physicians to consider controlled-substance agreements and prescription monitoring program checks.
• The non-stimulants atomoxetine and viloxazine are FDA-approved for adult ADHD and are not controlled substances. The same review lists non-stimulants for cases where stimulants are contraindicated, not tolerated or ineffective.

Drug names are examples of classes. Which medication suits a person in recovery, and whether a stimulant is appropriate, is a decision for the prescriber and patient together, often in coordination with an addiction treatment provider.

What monitoring looks like in New York

New York already builds oversight into every stimulant prescription. Most prescribers must check the state Prescription Monitoring Program registry (I-STOP) before prescribing a Schedule II drug, prescriptions are sent electronically, and no refills are allowed, so each supply needs a new prescription. Some practices add a written treatment agreement or more frequent visits. None of that signals distrust of a particular patient. It is how controlled medications are managed. The rules are explained in New York's rules for ADHD stimulant prescriptions.

Prescription stimulant misuse: the data

Two details from the 2025 study are worth knowing. Of people with prescription stimulant use disorder, 72.9% used only their own prescription, so the problem is not confined to diverted pills. And misuse was about three times as common among people using amphetamines as among those using methylphenidate.

"Misuse" in these surveys is broad. It includes taking a medication more often or in larger amounts than prescribed, or taking someone else's. The practical points follow directly: take medication only as prescribed, tell the prescriber if you find yourself taking extra, store it where others cannot reach it, and do not share it. New York's Penal Law defines selling a controlled substance to include giving it to another person, as sharing or selling ADHD medication explains.

Where to get help in New York

The New York State Office of Addiction Services and Supports (OASAS) oversees addiction prevention, treatment and recovery services. The details below were read on OASAS pages on October 13, 2026. Phone numbers and services change, so confirm them on the OASAS site.

• HOPEline. Call 1-877-8-HOPENY (1-877-846-7369) or text HOPENY to 467369. OASAS describes it as free and confidential, open 24 hours a day all year, and answered by professionals trained in addiction, mental health and crisis support. It offers crisis intervention and referrals to treatment, recovery support groups and peer and family support. Callers can ask to speak with someone who has personal experience of substance use or gambling. OASAS lists staff languages that include Spanish, Bengali, Traditional Chinese, Haitian Creole, Korean and Russian, with interpreters for others.
• Treatment finder. OASAS runs an online Provider and Program Search of all certified programs, searchable by county, city or ZIP code and by program type: crisis services, inpatient, residential, opioid treatment programs and outpatient services.
• Ability to pay. OASAS states that OASAS-funded treatment providers cannot turn a person away for an inability to pay.
• Insurance problems. CHAMP, the behavioral health ombudsman program, helps New Yorkers with insurance obstacles, denials and appeals for addiction and mental health care. Its line is 1-888-614-5400.
• Regional supports. OASAS lists Open Access Centers that operate around the clock for assessments and referrals, Recovery Centers offering non-clinical support, and Peer Engagement Specialists and Family Support Navigators. It advises calling ahead before visiting a facility.
• Crisis. For suicidal thoughts or a mental health crisis, call or text 988. Call 911 for an overdose or other emergency.

Talking to a prescriber about substance use

• Say what you use, how much and how often, and include 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 the practice expects of patients.
• Ask about non-stimulant options if you prefer to avoid a controlled substance.
• If you have an addiction counselor or program, ask whether the two clinicians can communicate, with your consent.

The practice's treatment page describes how medication management works there, and the site's overview of non-stimulant options gives background on that class. The comparison to read next is ADHD medications approved for adults in 2026, which sets out which medications are controlled substances and which are not.