SINGAPORE: 35-year-old Matt was taking cocaine weekly before he discovered he had ADHD, as experts warn some neurodiverse Australians are turning to the black market to self-medicate.

It comes as new government data reveals treatment for cocaine use is at a 10-year high.

There were 3385 treatment episodes for cocaine and MDMA use reported in 2025 – a figure that has grown since ten years ago, when there were 1917 treatment episodes reported.

Alcohol continues to be the most common drug that led Australians to receive treatment, with 87,632 episodes reported last year.

Nationally, cocaine is the second most used illicit drug – behind only marijuana – while Australians are among the world’s highest per-capita consumers of cocaine, according to the UN World Drug Report 2025.

Psychotherapist Pettina Stanghon said she has seen a rise in cocaine addiction over her almost two decades running rehabilitation centre Noosa Confidential, with younger people in their 20s to 40s most affected.

She said it is “very common” for these people to also have ADHD, as cocaine is a stimulant and acts in a similar way to regulated prescription drugs such as dexamphetamines.

“Ultimately what we’re talking about is dopamine chasing,” Ms Stanghon said.

“You’re three times more likely to have addictions if you’re ADHD because you’re hardwired to chase dopamine, and cocaine helps with stimulation and can have a focusing effect just like dexamphetamine does.”

Ms Stanghon said the accessibility of cocaine – coupled with the difficulty to obtain ADHD medication prescriptions due to shortages and long wait times to see a qualified professional – is contributing to this trend.

But ADHD specialist Dr Alison Poulton warned drugs like cocaine are not an adequate substitute for prescription medications.

“They both bind with the dopamine receptors in the central nervous system,” said Dr Poulton, who specialises in ADHD research at the University of Sydney and has over 30 years’ experience working with people with ADHD.

“But cocaine enters the central nervous system much more rapidly and that can lead to the sensation of euphoria which is what people tend to chase.

“Prescription stimulants for ADHD bind more slowly and have a more gradual and sustained onset.”

Dr Poulton – who is a board adviser to ADHD Australia – suggested that methamphetamine more closely mimics ADHD medication, but is much more dangerous in terms of its addictive potential, and said prolonged and uncontrolled use can have serious long-term health and mental health consequences.

“Illicit drugs are far more dangerous and there is no quality control as to what it’s made of and there’s no dose control for users,” she said.

“If ADHD isn’t treated, someone could have difficulty at school and work and that might lead them to the fringes of society.

“If you have ADHD, you are likely more impulsive and not focusing on the consequences of your actions, and so the risk of substance abuse is higher.”

35-year-old Matt understands this experience first-hand.

The NSW resident said he was first introduced to cocaine by a friend at 23, and used it recreationally until he started buying it for himself at 25.

His dependence increased over the next decade, but got “really bad” in the past two years when he would take cocaine weekly.

“I was a happy user but the days after I would feel depressed and I thought everyone was against me,” said Matt.

“There were times when I would go to bed and it’s like I couldn’t breathe because my nose couldn’t cope anymore – I started to feel ashamed and like I was a loser, but it’s so hard to control.

“It affected my relationship with everyone in my life, especially my wife.”

Matt did not know it at the time, but he had undiagnosed ADHD.

He said he was not aware of neurodivergence growing up, but when somebody suggested he might have it, he saw a specialist who confirmed the diagnosis and prescribed him medication.

He also sought support for his cocaine addiction through the Southern Highlands Addiction Retreat at the start of this year.

Matt said the accessibility of cocaine made it “very easy” to fuel his addiction, but learning about his ADHD helped him better understand and control the patterns of behaviour that contributed to his substance use, such as impulsivity.

“I didn’t think I had it but everything I do shows that I have ADHD, I have all the symptoms, and I know people with ADHD are very likely to use cocaine,” Matt said.

“Cocaine made me feel calmer, it made my brain stop thinking about a million things in the same second.

“I’ve got an addictive personality and unfortunately it’s easier to buy cocaine than it is to buy water.”

Craig Martin – Alcohol and Drug Foundation’s evidence and innovation lead – said he is “concerned” about the overrepresentation of people with ADHD that use drugs and alcohol, and that more research is needed to understand this overlap.

“For those that seek treatment for substance dependence, it was found that 32 to 45 per cent – so approaching half – had symptoms indicative of adult ADHD, which shows a significant overrepresentation,” Mr Martin said.

“That relationship is not completely understood, however there are probably some clues.

“People with ADHD may have more impulsivity and that may lead them to experiment with drug use, particularly young people.

“These drugs can also provide short-term relief for common ADHD symptoms such as restlessness, negative emotions, depression, anxiety, sleeping challenges, and racing thoughts.

“But we also know that ADHD in adults, especially when it’s not treated, is associated with poorer outcomes and increased disadvantage across people’s lifetime, so it is very concerning.”

ADHD Foundation Australia director Christopher Ouizeman said his non-profit’s information and support helpline has received ongoing calls from Australians who are struggling to get an ADHD diagnosis or treatment, and are looking for alternatives for support.

He said shortages of some ADHD medications and long wait times to see a psychiatrist can turn a small group of people to illicit substances.

“People with ADHD – diagnosed or not – who weren’t able to access medication tend to go to the black market to see what they can source,” said Mr Ouizeman, noting that not all ADHD treatment involves stimulants.

Mr Ouizeman said this behaviour is a result of systemic pains, including medication shortages stemming from increased demand and global supply chain issues, as well as the difficulty accessing a qualified practitioner for a prescription.

“It’s a small group of people who go to the black market but people really should shy away from it because the drugs found there are not going to do what you think,” he said.

“The physiological impacts could be permanent, and the black market does not replace the advice and knowledge of a health professional.”

Ruth Limkin, founder and CEO of rehabilitation centre The Banyans, said she has also seen a rise in people using cocaine to self-medicate their ADHD and believed this was due to a greater awareness and understanding of the condition.

“If someone has ADHD or a mental health condition that hasn’t been diagnosed or isn’t being well managed, they will reach for whatever helps them,” Ms Limkin said.

“What we’re seeing is people in their 40s and 50s (who use cocaine) who didn’t experience neurodivergence being well-understood when they were growing up, and so they’ve only ever known their current condition as normal.

“There was just never the opportunity for them to realise their ADHD was something they could get help with and they’re coping in the best way they know how to.”