Neurodivergence and addiction: ‘I found the clinics could be very stigmatising’

Niall, a 50-year-old from Dublin, recounts a childhood where undiagnosed ADHD led to him being labeled "bold, lazy, not trying hard enough." This persistent criticism eroded his self-worth, leading him to seek solace in cannabis at age nine to "quieten my mind" and feel "normal." His struggles continued into adulthood, culminating in heroin use around age 17, which he later transitioned away from due to health complications.

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I was trying hard, but when you are told you are bad enough times as a child, you believe it.

Niall's experience highlights a significant challenge within addiction services: the lack of understanding and accommodation for neurodivergent individuals. He found that clinics, meant to be supportive, often became sources of stigma and judgment. His difficulties with punctuality, anxiety, and maintaining eye contact, all common traits associated with ADHD, were perceived as "bad behavior" under the clinics' rules, further alienating him.

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For me drugs were survival to make me feel normal because when you are told you’re bad, you’re useless – you feel just shame and stigma.

Research from Trinity College Dublin's school of nursing and midwifery confirms Niall's experience is not isolated. The study found that over one in five (21%) individuals accessing addiction services are neurodivergent, presenting with conditions like ADHD, autism, or dyslexia. This group is more likely to use alcohol and heroin, and women with benzodiazepine dependencies are particularly likely to be neurodivergent.

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I found the clinics could be very stigmatising and judgmental.

In response to this "crying need," Trinity College Dublin is launching a free six-hour online course titled "Substance Use and Neurodiversity." Professor Catherine Comiskey, who led the research, emphasized that neurodivergent individuals often face distress in busy clinic environments due to sensory sensitivities or communication differences. Without specific training, service staff learn through trial and error, often failing to meet these clients' needs. The course aims to equip professionals with the knowledge to make simple, yet crucial, changes that can significantly improve treatment access and success for neurodivergent individuals.

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More than one in five (21 per cent) of those accessing these services have ADHD, autism, dyslexia or other neurodivergences.