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Adderall is a prescription stimulant drug that is primarily prescribed to treat attention deficit hyperactivity disorder, or ADHD, which is a common behavioral disorder typically diagnosed in childhood. In those suffering from ADHD, Adderall can help to increase attention, focus, self-esteem, and impulse control abilities.
Nonmedical use of Adderall may temporarily increase work production by improving concentration as well as potentially producing a euphoric “high.” Adderall’s active ingredients, amphetamine and dextroamphetamine, are similar to the illegal drug cocaine in that they are all stimulant drugs that increase heart rate, blood pressure, body temperature, pleasure sensations, and energy levels; and decrease inhibitions, appetite, and the need for sleep.
The National Survey on Drug Use and Health (NSDUH) states that in 2014, around 1 million people in the United States who were at least 12 years old were presently abusing a stimulant drug (not including methamphetamine). Abuse of a prescription central nervous system stimulant medication, such as Adderall, led to over 40,000 visits to an emergency department (ED) in 2011, according to the Drug Abuse Warning Network (DAWN).
Adderall may be abused by taking the drug without a legitimate prescription, taking more of it at a time than prescribed, or by altering the drug (e.g., crushing it) to take it in a way other than intended (e.g., snorting, smoking, or injecting it).
Adderall comes in both an immediate-release and extended-release form (Adderall XR).
When the extended-release format is altered by chewing or crushing and then ingesting, smoking, snorting, or injecting the drug, the intended slow and controlled release mechanism of the drug is bypassed, instead sending the entire dosage of the drug straight into the bloodstream.
This can increase the odds for a toxic overdose wherein the drug overwhelms the system. In the case of an Adderall overdose, blood pressure, body temperature, and heart rate are raised too high, which may result in seizures, heart attack, or stroke. Confusion, tremors, restlessness, fatigue, panic, hallucinations, abdominal upset, vomiting, and an irregular heart rate are all signs of an Adderall overdose.
Adderall is also commonly abused with alcohol or other drugs, which increases all of the possible risks of all substances involved, including the potential for an overdose. Fulltime college students abuse Adderall at very high rates and are also more likely to also abuse other substances along with it, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. For instance, SAMSHA reports that in a study of fulltime college students who misused Adderall, almost 90 percent also stated that they binge drank alcohol in the past month. Marijuana abuse, as well as the abuse of prescription tranquilizers, painkillers, and even cocaine, was also more prevalent in the college students who abused Adderall than in those who didn’t. Abusing more than one substance at a time heightens the chances for a negative adverse reaction and for a possible life-threatening overdose.
Adderall abuse can cause mood swings and erratic behaviors, and even aggression and hostility. The US Food and Drug Administration (FDA) reports that psychosis including paranoia, hallucinations, and mania as well as the potential for bipolar symptoms, depression, and suicidal thoughts may occur with Adderall use, particularly for those with previous history with related mental health issues.
The prescription information published by the makers of Adderall, Shire, warn individuals of the potential for the following additional side effects:
The way Adderall is abused can lead to additional problems as well. For example, injecting the drug can cause infections along the injection site, increase the risk for developing an infectious disease like HIV/AIDS or hepatitis, and cause scarring or “track marks.” Some of the insoluble fillers used in Adderall may block small blood vessels when it is injected as well, NIDA reports. Snorting it may lead to respiratory issues, chronic nosebleeds, and damage to the sinus cavities, while smoking it can cause lung infections and burns to the hands and face. Swallowing it may create gastrointestinal issues or even possibly cause stomach ulcers.
Chronic Adderall abuse can cause cardiac complications and, per Shire, even potentially lead to cardiomyopathy, which is a disease affecting the heart muscle. NIDA also reports that malnutrition and stroke are potential side effects of long-term prescription stimulant drug abuse. Individuals who abuse a drug like Adderall are also more likely to have lower grade point averages in college than their peers who do not abuse the drug, even though Adderall is often thought of as the “smart drug.”
Adderall can also lead to changes in eyesight, increased blood pressure and heart rate, and potentially slow a person’s growth when used for an extended period of time, the FDA warns. Long-term Adderall abuse may cause a person to have difficulty feeling pleasure without the drug and possibly even cause a complete personality shift.
When a drug such as Adderall is used or abused for a long period of time, an individual may become dependent on it. This means that the changes in the brain that are created when Adderall is present become more ingrained. Some of the circuitry of the brain and its natural production of neurotransmitters like dopamine are affected. When Adderall is not present, or is removed, the brain attempts to regain its balance, causing difficult withdrawal symptoms like fatigue, insomnia, depression, trouble concentrating, and suicidal thoughts. Drug cravings may also be a side effect of Adderall withdrawal, causing an individual to lose control over use and leading to addiction.
Addiction is a chronic and relapsing disease of the brain that affected over 20 million American adults in 2014, NSDUH reports. Addiction disrupts many aspects of a person’s life, with negative emotional, financial, physical, behavioral, social, and interpersonal ramifications. If an Adderall addiction takes hold, these effects can be felt in all spheres of life.