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.

When ADHD is part of the clinical picture, consistency and pace matter more, not less. Our approach is built around that. Sessions are designed to work with attention patterns, rather than against them. You stay connected to your daily life. The clinical work is substantial.

If attending a clinic regularly isn’t practical, online treatment runs to the same clinical standard through secure video sessions. For people with ADHD, removing the logistical and transitional demands of regular travel can make sustained engagement more achievable.

Sessions are clinician-led and structured. 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. Inpatient care is the right level of support when outpatient structure hasn’t been enough.

Both settings have extensive experience with dual diagnosis, including ADHD and addiction. Research published in the Journal of the American Academy of Child and Adolescent Psychiatry found that the risk of substance use disorders is twice as high in people with ADHD, and four times as high when ADHD co-occurs with conduct disorder. The residential setting provides round-the-clock clinical presence and the structure that comes with that.

Some substances cannot be stopped without medical supervision. Alcohol, benzodiazepines, and opioids carry withdrawal risks that cannot safely be managed at home. The US National Library of Medicine sets out the key timelines, stating that short-acting opioid 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 one to seven days and may continue for two to eight weeks or longer, depending on the medication involved.

Cocaine does not typically produce visible physical withdrawal symptoms. But MedlinePlus, the US National Library of Medicine’s health information service, documents the significant psychological effects that can follow stopping. These are intense cravings, depressed mood, anxiety, fatigue, and, in some cases, suicidal thoughts. These can be severe, even without the physical symptoms associated with alcohol or opioid withdrawal.

If you are entering treatment with substances that require a medically managed detox, we will tell you that clearly at the start. We will not recommend beginning therapy before it is clinically safe to do so.

Structured psychological treatment is central to managing ADHD and addiction together. Research published in Primary Psychiatry identifies structured behavioural strategies as central to treatment for adults with ADHD. This can help people to understand how the condition affects their daily functioning and develop practical coping strategies.

Research published in Behaviour Research and Therapy found that Cognitive Behavioural Therapy (CBT) reduces symptoms of adult ADHD, 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.

When you first get in touch, you’ll speak with our team confidentially. There’s no pressure to commit to anything in that first conversation. We will listen to what you are experiencing, explain the options that are relevant to your situation, and be clear about what we do and do not offer.

If you need a formal ADHD assessment or diagnosis, we will refer you to an appropriate external psychiatrist and explain how that fits with starting treatment. Our psychiatrists do not provide standalone ADHD assessments. Most providers in this sector aren’t clear about what they offer and what they don’t. We are. Knowing what we offer, and what we do not, helps you make an informed decision.

If your use of alcohol or other substances requires a medically managed detox before therapy can begin, we will explain that at the start. We won’t recommend beginning therapy where it is not yet clinically safe. You can read more about patterns of alcohol use in ADHD on our alcohol page.

Recovery from a dual diagnosis is rarely linear. It is not a programme you complete and then move on from. Our model includes ongoing aftercare and recovery support because the evidence supports longer engagement, and because the challenges of ADHD do not disappear when primary treatment ends.

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.