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Prescription drug abuse is considered an epidemic in the United States today, and it’s an issue that is often furthered by loved ones. The National Survey on Drug Use and Health (NSDUH) reports that in 2013, more than half of those who abused prescription medications got them for free from a friend or relative. Around 30 percent of fulltime college students may use prescription stimulant drugs for nonmedical purposes, CNN publishes. Over half of the college students who have a legitimate prescription for prescription stimulants are pressured to share or sell them, and close to 30 percent do so, the National Association of Boards of Pharmacy (NABP) publishes. Abuse of Adderall, a prescription stimulant drug containing both amphetamine and dextroamphetamine, is widespread and often under the radar.
Adderall has many potentially dangerous side effects and long-term consequences, not the least of which are drug dependence and withdrawal. The medication is designed to treat symptoms of attention deficit hyperactivity disorder (ADHD) and can help to control impulses, improve self-esteem, and enhance concentration levels for those afflicted with the disorder. It is often abused as a “study drug,” diet aid, or for its ability to produce a euphoric “high.”
The drug may swallowed, chewed, or crushed and then snorted, smoked, or injected when abused. Adderall is a central nervous system stimulant, meaning that it serves to raise body temperature, blood pressure, and heart rate while decreasing the perceived need for sleep and food. Moods are elevated, and focus, attention, and energy levels are also heightened with Adderall abuse. Levels of dopamine, one of the brain’s chemical messengers related to feelings of pleasure, are increased with Adderall abuse.
When it is used for long period of time, an individual can develop a dependence on the drug, as chemical changes made to brain chemistry become more fixed. Individuals who are dependent on Adderall may suffer from intense withdrawal symptoms when the drug is not active in the bloodstream. The Drug Enforcement Administration (DEA) lists Adderall as a Schedule II controlled substance due to its high level for abuse and potential for dependence.
Adderall is marketed in two different formulations: Adderall and Adderall XR (extended release). Each may stay in the system for differing amounts of time, which can play a role in when withdrawal symptoms may start. Adderall is meant to be taken every 4-6 hours, while Adderall XR is taken once a day, when used as directed, the National Library of Medicine (NLM) reports. This likely indicates that Adderall will wear off and withdrawal will start in 4-6 hours and, for Adderall XR, in 10-12 hours. Adderall withdrawal symptoms often peak within a day or two and the bulk of the side effects may taper off in a week or so.
The makers of Adderall, Shire, publish that the main Adderall withdrawal side effects include sleep issues, extreme fatigue, and depression. Drug cravings may also be common, and a person dependent on Adderall may have trouble feeling pleasure without the drug. Concentration, mood, appetite, and energy levels may be affected, as an Adderall “crash” is often the opposite of an Adderall “high.”
Adderall can have some intense withdrawal symptoms, so it is not recommended to stop taking it “cold turkey,” or suddenly. Instead, Adderall may be weaned off slowly during detox. Medical detox, overseen by medical professionals, can provide a safe outlet for removing Adderall from the body while helping to minimize withdrawal symptoms.
Detox, in general, lasts 5-7 days and is provided at a specialized substance abuse treatment facility that can offer mental health and medical support.
Since no two people are exactly alike, detox may be shorter or longer for different people, depending on their specific circumstances and needs. Detox is intended to help an individual reach a level of physical stabilization that will allow them to safely continue on into a substance abuse treatment program that will address the psychological and emotional issues that led to the substance abuse. Behavioral therapies are often highly beneficial in restoring emotional balance during drug abuse treatment after a level of physical stability has been obtained via detox.
Adderall withdrawal is influenced by how dependent on the drug a person is. The more heavily dependent an individual is on Adderall, the longer and more significant the withdrawal period may be. Drug dependence is created with regular and prolonged use of Adderall, so the more of it a person takes more frequently and for longer overall, the more likely they are to be heavily dependent on the drug.
Drug dependence and withdrawal can also be impacted by biological and genetic factors. Underlying medical or mental health conditions, or a family history of addiction, can also contribute to drug dependence and therefore the withdrawal timeline. A person’s environment, support system, and prior history of abuse or trauma can also be influential in the onset of drug dependence and the overall length of withdrawal.
Polydrug, or multi-drug, abuse can also play a role in how intense drug withdrawal side effects may be and how long they will last. Adderall is commonly abused with other drugs like alcohol, marijuana, prescription tranquilizers and pain relievers, and cocaine, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. In fact, in a study of fulltime college students (between the ages of 18 and 22) who abused Adderall, close to 90 percent reported past-month binge drinking, and more than half were considered heavy drinkers. Additional substances used in conjunction with Adderall can extend the withdrawal timeline and add to the possible complications or side effects.
The method in which Adderall is abused also impacts drug dependence and potentially withdrawal as well. Snorting, smoking, or injecting the drug bypasses the intended method of delivery and sends the entire dosage immediately into the bloodstream at once. This can increase the risk for an overdose as well as more rapidly induce drug dependence.
The age a person starts abusing drugs may also play a role in the onset of a substance use disorder, as drug abuse makes changes to parts of the brain that are underdeveloped in teenagers and young adults, potentially causing long-term damage. The National Institute on Drug Abuse (NIDA) postulates that abusing substances before the brain is fully developed around a person’s mid-20s may increase the risk for problematic drug abuse later on, thereby impacting drug dependence and withdrawal.
Within America, suicide is the 10th leading cause of death, as published by the American Foundation for Suicide Prevention. Suicide attempts and suicidal thoughts are potential extreme side effects of Adderall withdrawal that may follow intense depression and mood swings. These may be caused by low levels of dopamine and other brain chemicals that have been depleted by chronic drug abuse. Other possible complications and side effects that may manifest during Adderall withdrawal can include:
The Drug Abuse Warning Network (DAWN) of 2011 reports that over 45,000 people obtained emergency department (ED) treatment for a negative reaction to a prescription central nervous system stimulant that year.
While there are no medications approved to help treat stimulant dependence, medical detox can still provide an individual with the highest level of care during Adderall withdrawal. Generally performed in a residential setting, medical detox offers support from mental health, medical, and substance abuse treatment providers in a safe and secure facility.
Highly trained professionals monitor vital signs and provide mental health support and supervision around the clock to ensure that the individual does not present a danger to themselves or others during detox. Medications to help specific symptoms of withdrawal, such as antidepressants for low moods, can be helpful. Anti-anxiety medications or sleep aids may be beneficial during medical detox as well. Nutritional supplements and vitamins may help to regulate some of the minerals and natural chemicals that were depleted by drug abuse and malnutrition.
A tapering off schedule can be set up to lower the dosage of Adderall in a slow and controlled manner over a set period of time until the dosage is completely removed during medical detox. Any co-occurring medical or mental health disorders can be addressed and simultaneously treated in a comprehensive addiction treatment program that follows detox.