'I thought my 14-year-old was struggling with his ADHD medication. Then I found the videos on his phone.'

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When Sophie's* 14-year-old son said he was done with his ADHD medication, she thought it was about side effects. He told her it made him feel sick and "too skinny."

Months later, Sophie discovered the truth.

She found videos on his phone of bongs and other THC-infused products, along with late-night calls urging him to sneak out. Sophie was devastated, scared and felt completely out of her depth.

"I was devastated, scared and felt completely out of my depth," she told Mamamia.

"As a mother, I was heartbroken, I felt that I had failed my son in some way."

Her son had been diagnosed with ADHD at 11. The diagnosis came after years of concern from educators.

It was a long road that included a sub-threshold diagnosis, an anxiety diagnosis and even a school exclusion. After starting medications, Sophie said her son told her it felt like "the static radio background noise in his brain had been shut down."

Listen: Are ADHD and addiction linked. Post continues below.

But during the COVID-lockdown, everything changed. Sophie's son stopped taking his medication with online learning and less movement.

By halfway through Year 8, Sophie began to suspect he was using marijuana and other THC products to self-medicate and help him sleep.

Over time, his drug use escalated, ultimately contributing to expulsion at the end of Year 9.

Sophie's story, while confronting, is not an isolated one.

According to the Australian ADHD Professionals Association (AADPA) ADHD Treatment Guidelines, people with ADHD are almost three times more likely to be nicotine-dependent and about 50 per cent more likely to develop a drug or alcohol use disorder compared with people without ADHD.

Rachel's* story played out very differently to Sophie's. Her son was calm, affectionate and academically strong.

Teachers praised his attention in early years, and in Year 10 he received awards, and was being considered for prefect. But in Year 11, his marks began to drop, and teachers said he often went "off on tangents."

Just before Year 12, Rachel learnt he had been sneaking out to nightclubs.

"He was sneaking out to get dexamphetamines," she told Mamamia.

He was just 16 years old.

He told his parents he had avoided opioids and meth because they were addictive, and marijuana because he worried it would slow him down.

Eventually, Rachel's son was diagnosed with ADHD.

For Rachel, the diagnosis was both relief and shock: relief that there was an explanation that came with prescribed medication, and shock because he had been so well-behaved, she'd never even considered ADHD.

Why ADHD brains seek substances.

According to ADHD coach Caroline Beresford, the ADHD wired brain chases dopamine, because it calms the mind and makes a person feel good.

"It's rather easy to fall into drug use, particularly marijuana," she said.

Beresford said Australian medication access and supply difficulties only add to the risk of those with ADHD turning to drugs and alcohol in an attempt to self-medicate.

"Boys tend to self-medicate with marijuana, whilst for girls, alcohol is more widely used."

Clinical psychologist, Dr Alissa Knight, said there are many warning signs of substance abuse, but each child responds differently.

"Each child will respond to the effects of substance use differently depending on their individual characteristics, personality, and temperament," she explained.

"If you notice that your child has all of a sudden, started to act out of character and started to show more externalising behaviours, such as: anger or agitation, lashing out against the world, acting defiantly towards you or others, yelling, screaming, self-harming. Or, perhaps the opposite, with more internalising behaviours: Extreme anxiety, lower appetite, losing weight… withdrawing from friends and wanting to stay in their bedroom, not wanting to go to school.

"These are all signs that your child may be maladaptively using drugs to self-medicate."

How to start a hard conversation.

How parents open a conversation around self-medication matters, Knight said.

"It really comes down to making your child feel safe enough to have this type of conversation with you, knowing they are going to feel scared about losing your trust, respect, and being reprimanded for behaviour," she said.

"I would encourage parents to go in with more of a curious lens and open mind into, what has led my child to need to use drugs, as opposed to straight out judging them for poor decisions."

In her clinical work with adolescents who have ADHD, Knight has found that once teens see they are not being judged as a person, they'll often open up, giving parents and clinicians the chance to help.

Beresford agreed, and said the most effective response is calm, informed support.

""The best interventions are being under the care of a paediatrician or child and adolescent psychiatrist who have an interest in treating ADHD for prescribing and management of appropriate ADHD medication," she said.

"Therapy with an ADHD informed psychologist, and ADHD coaching with a coach who has ADHD themselves and can provide a neuro-affirming space."

Watch: Understanding the relationship between dopamine and ADHD. Post continues after video.

Beresford added that schools need to play a role too, especially when it comes to early response and understanding of early warning signs.

"If a teen's behaviour starts to change, if their grades drop, or if they are late and unmotivated, start being aware, and perhaps reach out to the teen's parents to start a conversation," she encouraged.

She explained that punitive measures alone miss the chance to identify ADHD-related distress and substance-use risk.

Understanding how ADHD can present in males and females is also crucial.

Beresford explained that masking can look different by gender and ADHD subtype; boys often adopt the class clown role, while girls are more likely to be quiet and well-behaved.

Both Sophie and Rachel experienced late diagnosis, but for different reasons.

Sophie's son's hyperactivity in preschool was flagged, but the path to a formal diagnosis took six years and included a school exclusion.

In contrast, Rachel's son was compliant and academically strong, with his ADHD presenting as tangential thinking and intense interests.

For parents like Sophie and Rachel, empathy has been as powerful as treatment.

"I've learnt so much about ADHD, and it makes me so upset when people call it a fad," Sophie said.

"When it's not managed well, it can cause chaos and make life really hard. But when you understand it, and when your child understands it, it's not a weakness, it's a strength. I just want him to know he can still do incredible things."

Rachel agreed but says early intervention is critical.

"I'll always wish I'd recognised it sooner," she says. "But I can't change that. What I can do now is be the safe parent he can talk to and make sure his siblings get the help they need early. I've seen how much difference that makes. It's life-changing."

*Names have been changed for privacy.

Read these next stories for more ADHD content:

• 'My 6-year-old son has ADHD. It's nothing like you think it is.'

• 'My partner has ADHD. Here are 5 things we've had to do differently since his diagnosis.'

• 'How do I know if I have ADHD?' Your questions about adult ADHD, answered by medical experts.

Feature image: Getty.