It appears, then, that the link between ADHD and AODD is most pronounced in people with severe behavior problems.
Assuming that a causal link exists between ADHD and alcohol use, an important issue related to selecting the most appropriate treatment for patients with ADHD and an AODD is that various factors may underlie, or mediate, the relationship between ADHD and AODD.
Appropriate intervention with parents and teachers to provide better social structure and academic support might prevent many problems related to ADHD, including the potential for developing an AODD (Clayton 1992).
Alternatively, low behavioral control related to extreme impulsivity in people with ADHD and comorbid CD may account for elevated AODD problems.
For example, one of the most commonly used approaches in the prevention of AODD is cognitive therapy designed to improve self-control and appropriate problem solving.
If prevention fails, people with ADHD who develop an AODD fare poorly in AODD treatment compared with peers who do nor have ADHD.
Another possible explanation for poor outcomes of patients with ADHD in AODD treatment is that, because of their core deficits of inattention and impulsivity, these patients may respond poorly to standard treatments based on cognitive therapy or semistructured group therapy.
In addition to treating the core symptoms of ADHD, another consideration is the high stress level observed in families of individuals with ADHD and the contribution of poor family functioning to poor AODD outcomes (Clayton 1992).
Clinical researchers and AODD service providers need to be prepared for occurring ADHD and AODD.