Prescription stimulants include drugs like Adderall, which is a combination of amphetamine and dextroamphetamine. This medication was approved by the Food and Drug Administration (FDA) in 1960 to treat attention deficit hyperactivity disorder (ADHD). Adderall has also been prescribed as a weight loss treatment, although it is not used for that purpose anymore, and it can sometimes be prescribed to treat daytime drowsiness associated with sleep disorders like narcolepsy.
There are several formulations of Adderall, both brand name and generic; most of these are either immediate release (IR) or extended release (XR). It is rarer for a doctor to prescribe immediate-release Adderall because the medication needs to treat symptoms of ADHD or off-label conditions for several hours. This means that extended-release versions of the drug make more sense in most applications.
Immediate-Release vs. Extended-Release
Extended-release drugs typically contain more of the active medication than immediate-release versions, but there are several additives that allow for the slow release of Adderall over up to 12 hours. This allows Adderall XR to double the stimulant’s effective duration for people who struggle with ADHD, so they do not have to take as many pills and can focus on living their lives.
However, XR versions of pills, including stimulants like Adderall, are subject to abuse. Some people may crush these drugs and snort them as a method of consuming a lot of Adderall very quickly. Snorting drugs also gets them into the bloodstream faster, so they bind to brain receptors more rapidly.
Both XR and IR versions of Adderall are Schedule II substances, according to the Drug Enforcement Administration (DEA). This means that Adderall in all its forms has the potential for abuse, even though it has important medical uses.
What are the Risks?
There are many risks associated with snorting drugs, including prescription medications like Adderall. Many people mistakenly believe that abusing drugs by snorting them is somehow safer because there is no needle sharing, so there’s supposedly less risk of infection, but the chemicals still hit the brain quickly. Many people mistakenly believe that abusing prescription stimulants is safer than abusing illicit ones because there are fewer harmful additives like fentanyl or PCP.
Snorting prescription drugs is extremely dangerous, and can lead to addiction, overdose, chronic health problems, and death. Typically, snorted drugs hit the brain faster because they are absorbed quickly through the thin mucous membranes in the nose; however, snorting Adderall is not as effective as taking it orally because the drug was designed to move through the digestive system to get to the bloodstream. Abusing this prescription drug by crushing and snorting it means that less of the stimulant enters the bloodstream, so cravings for the drug may become more intense because less of it is bioavailable, which could lead to bingeing the drug.
Some of the effects of snorting Adderall include:
- Harm to the nasal passages and nostrils
- Intense euphoria or high
- Rapid crash and depression, physical side effects, and withdrawal
Physical and Psychological Effects
The effects associated with snorting Adderall may be like those of crushing and snorting Ritalin, or snorting cocaine. People who crush and snort prescription drugs like stimulants are abusing the drug because there is no medical reason to snort these substances. They are intended to be taken orally, with oversight from a doctor.
In addition to headaches, addiction, and shaking or tremors, abusing Adderall may damage the nasal passages, like cocaine does. When snorted, cocaine damages the mucous membranes in the nostrils, which may cause them to erode over time. Eventually, this will lead to damage to the underlying cartilage, and that can cause nasal perforation, or a hole between the nostrils that grows if drug abuse continues. When this damaged is severe, the nose may collapse. Damage to this part of the body is not reversible, but rebuilding the nasal bridge with cosmetic surgery may be possible.
Ongoing drug abuse may also lead to a similar effect in the roof of the mouth, called palatalperforation. This kind of damage is also not reversible, but it can be treated with cosmetic surgery if appropriate.
Other harms from snorting drugs include infections in the upper respiratory system, damage to the lungs and throat, and even pulmonary embolism (a clot in the lungs). Particles from the surrounding environment like dust or dirt can get into the crushed pills and cause infection; snorting off unclean surfaces can cause infection; and inflammation of the nose, mouth, throat, and lungs can increase the risk of infection, especially serious infections like tuberculosis and pneumonia.
Abusing high doses of stimulants can also lead to cardiovascular damage, which may lead to a heart attack or chronic heart problems. High blood pressure may become chronic and contribute to these health issues. Rapid weight loss from a large dose of stimulants like Adderall can also lead to malnutrition, osteoporosis and osteoarthritis, teeth and gum disease, heart problems, gastrointestinal damage, and other harms.
Taking a prescription medication via a method that is never prescribed is a sign of abuse of that substance because the person is attempting to get a greater effect, faster. Abusing stimulants like Adderall increases insomnia, anxiety, and depression. There is also an increased risk of psychosis, which can be treated in a hospital setting. For many people, Adderall psychosis will go away with treatment, but for people who have a pre-existing mental illness or a higher risk of developing this condition, the problem may become permanent, and they will need ongoing mental health treatment.
Signs of psychosis include:
- Delusions of paranoia or grandeur
Addiction to Adderall or other stimulants must be treated because long-term damage to the brain can lead to memory loss, cognitive trouble, and mood disorders.
Getting Treatment for Addiction
With help from an evidence-based detox and rehabilitation program, it is possible to overcome addiction to Adderall. This can reduce harm from chronic abuse of the drug, and some problems, like memory issues or psychosis, may be reversible.