In my previous post, I discussed the risks associated with individuals taking ADHD medication while working on construction sites due to the potential adverse side effects of these drugs. As a follow-up, I wish to highlight additional risks related to the combination of ADHD medication and illicit substances such as cannabis. While these risks are not exclusive to individuals with ADHD, they are particularly relevant as those correctly diagnosed with the condition typically have lower levels of dopamine in the brain.
Dopamine plays a crucial role in concentration and focus—both essential for safety on construction sites. It also enables feelings of pleasure and enjoyment, whether from the sight of a beautifully finished structure, a good film, or a favourite meal. This deficit in dopamine function explains why individuals with ADHD often experience sadness, irritability, and feelings of disconnection from others. Research suggests that up to 53% of people with ADHD also suffer from depression. However, it is important to distinguish between depression as a common consequence of ADHD and clinical depression as a separate condition. An individual may suffer from both simultaneously, exacerbating symptoms and increasing overall risk.
While ADHD medications may help reduce the likelihood of depression, they can also contribute to it, as discussed in my previous post. This, in turn, may drive some individuals towards substances such as cannabis, which is widely available. Cannabis, like other drugs, triggers an increase in dopamine release, temporarily creating a sense of well-being that may be lacking in those with ADHD. There is a common misconception that cannabis helps to manage ADHD symptoms, including anxiety, rejection-sensitive dysphoria, and sleep disturbances. However, research suggests that cannabis use exacerbates cognitive impairments already present in individuals with ADHD.
According to ADDitude, a specialist ADHD publication, the negative effects of cannabis are particularly harmful to developing brains. Numerous studies indicate that cannabis use before the age of 25 is linked to poorer long-term outcomes. Research published in The Lancet Psychiatry in March 2019 found that smoking potent, ‘skunk-like’ cannabis significantly increases the risk of serious mental illness. The study estimated that around one in ten new cases of psychosis may be associated with high-strength cannabis use, based on findings from various European cities. In locations such as London and Amsterdam, where much of the cannabis sold is of high potency, the risks are believed to be even greater. The study also found that daily cannabis use of any kind increases the likelihood of developing psychosis.
A tragic example of these risks is the case of Pietro Addis, a young man from Brighton who was diagnosed with ADHD in 2018 and prescribed Lisdexamfetamine under its brand name, Elvanse. One of the potential side effects of Elvanse is heightened anxiety. Although the medication initially appeared beneficial, in 2019, Addis became a heavy user of cannabis. Emails from his aunt, with whom he was living, to his doctor raised concerns about his behaviour while taking both Elvanse and cannabis. In January 2021, Addis carried out a frenzied attack, stabbing his aunt 17 times, resulting in her death. His defence team argued that he had been suffering from paranoia and anxiety. He was sentenced to 15 years for manslaughter.
Beyond the risks associated with substance use, ADHD itself does not directly cause anger or violent behaviour, but there is a recognised connection. Individuals with ADHD tend to become more easily frustrated, and their responses to challenging situations may be more intense. This can lead to impulsive reactions, which, in high-risk environments such as construction sites, could have serious consequences.
By understanding the vulnerabilities of employees with ADHD and the potential for substance use to exacerbate these risks, construction companies that embrace neurodiverse hiring policies must take proactive steps. It is essential to ensure that employees with ADHD are fully aware of these dangers while also educating the wider workforce. A well-informed team fosters a safer and more supportive working environment for all.
Anthony Hegarty MSc
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