ADHD and addiction

For most people seeking help with ADHD and addiction, outpatient treatment is the right starting point. Through our outpatient programmes, Castle Health provides in-person sessions across clinics in the UK, Ireland, and Europe, structured around your schedule.This ensures you can stay connected to your daily life. 

The clinical work is still, however, substantial. When ADHD is part of the clinical picture, consistency and pace are key considerations. Sessions are designed to work with attention patterns, never against them. 

If attending a clinic regularly isn’t practical, online treatment runs to the same clinical standard through secure video sessions. Sessions are clinician-led and structured. 

For people with ADHD, removing the logistical and transitional demands of regular travel can make sustained engagement more achievable.

Online treatment works best when there is a reliable routine around it. Our team will help you build that routine from the start.

When the level of need calls for a more intensive setting, Castle Craig Hospital in Scotland and Smarmore Castle in Ireland offer residential treatment programmes. 

Both settings have extensive experience with dual diagnosis, including ADHD and addiction. Since the risk of substance use disorders can be twice as high in people with ADHD, and four times as high when ADHD co-occurs with conduct disorder, residential settings provides round-the-clock clinical presence and additional structure.

Some substances cannot be stopped without medical supervision. Alcohol, benzodiazepines, and opioids carry withdrawal risks that can’t be safely be managed at home. 

The US National Library of Medicine sets out the key timelines:

• Short-acting opioid (e.g. heroin, fentanyl) withdrawal typically begins within 8 to 24 hours of the last dose and can continue for up to 10 days.
• Benzodiazepine withdrawal generally begins within 1-7 days and may continue for 2-8 weeks or longer.
• Alcohol withdrawal may carry significant risk, and in cases of heavy use should be carried out under the support of a medical team

Cocaine does not typically produce visible physical withdrawal symptoms. But MedlinePlus documents the significant psychological effects that can follow stopping. These are intense cravings, depressed mood, anxiety, fatigue, and, in some cases, suicidal thoughts.

A review of the literature found that medication alone is not helpful at addressing substance dependencies, but still advocates for supervised pharmacological management of ADHD. The general consensus is that using structured behavioural and psychological treatment is central to managing ADHD and addiction together. 

This can help people to understand how the condition affects their daily functioning and develop practical coping strategies.

Cognitive Behavioural Therapy (CBT) can help effectively manage symptoms of adult ADHD, compared to medication alone, with modified approaches like structured skills training, producing measurable symptom reduction.

Dialectical Behaviour Therapy (DBT), individual therapy, group therapy, and family therapy are all part of the Castle Health offering. These therapies work better when adapted for how an ADHD brain actually engages with sessions. Pacing, structure, and working with stimulation patterns rather than against them are not accommodations. They are good clinical practice for this population.

In most cases, yes. Your medication will be reviewed as part of your assessment. Our clinical team will work with you and, where appropriate, with your prescribing psychiatrist to ensure your ADHD is managed safely throughout treatment. We don’t make changes to your medication without your knowledge and involvement.

No. Many people who come to us with a suspected ADHD and addiction presentation have never received a formal diagnosis. You can begin treatment without one. If a formal assessment would be clinically useful, we will refer you to an external psychiatrist and explain how that fits with your treatment plan.

You don’t need to know. Most people cannot say with certainty, and clinically it matters less than addressing both together. Our assessment will give us a clearer picture of your history and what treatment looks like for you specifically.

Costs depend on the type and length of treatment. Please contact our team directly for a clear breakdown based on your situation. We will give you a straightforward answer with no obligation to proceed.

Yes, though pathways and waiting times vary. If you are weighing up your options, our team can explain the differences between NHS and private care clearly and without pressure. We are happy to help you work out the right route, even if that turns out not to be with us.