(166) Reddit Discussions About Stimulant Use and ADHD Symptoms

Background & Introduction: Almost one quarter (23.1%) of all patients with Attention-Deficit/Hyperactivity Disorder (ADHD) have a substance use disorder (SUD) diagnosis[1]. It is known that prescription stimulants such as d-amphetamine and methylphenidate are helpful in treating ADHD and preventing the development of SUD[2]. The self-medication hypothesis posits that patients may use non-prescribed and illicit stimulants to manage ADHD symptoms[3]. Patients with SUD and ADHD may encounter stigma when discussing the use of therapeutic and illicit stimulants with a physician. Anonymous forums such as Reddit may be a resource for people with ADHD who use illicit stimulants to discuss their experiences. This study analyzes posts from Reddit users with ADHD or self-reported ADHD who report cocaine and methamphetamine (meth) use to assess the intersection of illicit stimulant use in patients with ADHD. The objective of this study is to identify the self-reported benefits of non-prescribed and illicit stimulants for ADHD symptoms and analyze the complex relationships between ADHD and the use of illicit and/or prescribed stimulants.

Methods: This is a qualitative study of data from four stimulant-related online forums on Reddit (r/meth, r/cocaine, r/drug, r/addiction) from January 2024 to September 2025. We retrieved publicly available data from the subreddits and filtered subsets of these posts relevant to stimulant drugs and addiction using natural language processing (NLP). Using medical toxicology expert-specified keywords (cocaine, meth, ADHD, prescription, medicate/medication, and adderall), we computed stimulant mention frequencies from the posts retrieved from the subreddits. We further conducted thematic analyses of these posts to characterize the information identified. A sample of 34,235 posts identified by NLP as having content related to stimulant use and ADHD were reviewed by authors to identify relevant codes into which the posts could be classified. Codes were then applied to the larger set of posts in order to identify themes.

Results: We identified 32,245 posts in the stimulant forums and excluded posts that did not mention the keywords. Of all posts, 2,754 (8.54%) mention the key words, and 1,383 (4.3%) specifically mention ADHD. Among specific forums, 767 of 12,395 (6.19%) posts in r/meth, 270 of 6,824 (3.96%) posts in r/cocaine, 402 of 3,211 (12.52%) in r/addiction, and 1,312 of 9,807 (13.38%) posts in r/drugs mentioned ADHD-related topics.

Within the ADHD-mentioning posts, 28.8% in the meth and 50.74% in the cocaine subreddit make a direct reference to using illicit stimulants to ameliorate ADHD symptoms. A common theme among these posts was using illicit stimulants to achieve a sense of calm, focus, or normalcy. For example: “In Adhd, so unfortunately cocaine has an extremely positive affect one me (relaxed, empathetic, calm... yes,.really).” This theme was present in 23.2% of meth posts and 24.4% of cocaine posts. Adverse and unintended effects such as psychosis or “tweaking” are mentioned in 6.13% of meth and 9.26% of cocaine posts. For example, one post describes experiencing hallucinations with meth: “maybe by some miracle this just psychosis, but my hallucination don’t stop and have been worsening (it’s not bad, like i know it’s fake it’s just perceptively weird). i also started having audio hallucinations (whispers, short tender sounds, etc, whistles, scratches, etc).” Posts that describe a progression from prescribed stimulants for ADHD to illicit stimulant use were rare (fewer than 1%); 3.33% of cocaine related posts describe a progression from prescription stimulants for ADHD to cocaine use. For example: “I really just like how my brain functions on it and it helps me maintain productivity at work and in lectures. I also fucking love drugs and the euphoria aspect of taking a high dose. Are there any easier to get alternatives that aren’t scripts? From what I know that pretty much leaves me with speed and meth.” Many Reddit users describe using meth (5.61%) or cocaine (2.59%) because they are unable to obtain prescription stimulants due to concerns about dismissal or judgement from a clinician; for example “my psychiatrist will no longer prescribe Adderall, so I’m looking at replacing my script with very low doses of high purity meth for getting work done.”

Conclusion & Discussion: Reddit authors with diagnosed or self-described ADHD report use of stimulants such as meth and cocaine to manage ADHD symptoms, sometimes due to lack of access to prescribed stimulants. Some fear disclosing their history of stimulant use to a clinician who may be dismissive of their symptoms or perceive them to be “drug-seeking.” Many users report feeling beneficial effects of illicit stimulants- leading to calm, and enhanced concentration rather than euphoric feelings of being “high” or negative feelings of “tweaking” that are often mentioned amongst people who use stimulants and do not report ADHD symptoms. There does not appear to be a lot of chatter regarding prescribed stimulants for ADHD later leading to illicit stimulant use. Rather, users talk about using illicit stimulants such as meth or cocaine in order to treat their ADHD symptoms if they are unable to obtain a prescription for stimulants. While ADHD and SUD often co-occur, there is uncertainty about the intersection of these diagnoses. Overall these posts describe a complex relationship between ADHD, illicit stimulant use, and prescribed stimulant use.

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