ADHD, Trauma, and Complex Care: How GPs Can Support Patients
08 Oct 2025
While this improves access to treatment, managing patients with complex needs or multimorbidity requires careful, team-based approaches.
ADHD and Co-occurring Conditions
ADHD is a neurodevelopmental condition often present from early childhood and can coexist with other conditions such as:
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Autism spectrum disorder
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Learning disabilities
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Alcohol or other drug (AOD) dependency
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Post-traumatic stress disorder (PTSD) or complex PTSD
Patients like the hypothetical case of Paul, who is stable on opioid dependence treatment, may benefit significantly from ADHD treatment. However, multimorbidity adds complexity to prescribing decisions.
The Role of GPs
GPs already:
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Prescribe non-stimulant ADHD medications
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Offer guidance and support
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Co-prescribe psychostimulants with paediatricians or psychiatrists
With the new legislation, GPs can now apply for independent prescribing authority, but this does not obligate them to practice independently, especially in complex cases. A collaborative, team-based approach may be required for patients with multiple health challenges.
Key Considerations for GPs Managing ADHD with Multimorbidity
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Assess stability of co-occurring conditions such as AOD dependency or mental health issues
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Determine if team-based care or specialist support is needed
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Communicate clearly with the patient about the scope of GP involvement and when referral to specialists is appropriate
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Recognise the impact of trauma on patients’ engagement with treatment and care
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Advocate for accessible specialist services for patients with ADHD and comorbid conditions
Practical Implications
For many patients, GPs can safely manage ADHD alongside stable co-occurring conditions. For others with more complex presentations, access to multidisciplinary care ensures safe and effective treatment. The new legislative changes expand access to ADHD treatment while preserving the flexibility for GPs to provide the right level of care for each patient.
Ensuring patients with complex needs benefit from these changes will require thoughtful assessment, ongoing monitoring, and, where appropriate, collaboration with specialist services.
Acknowledgements: Associate Professor John Kramer, Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity, and Dr Hester Wilson, Chair of RACGP Specific Interests Addiction Medicine.
