There are several prescription stimulant medications, like Adderall, that were developed to manage symptoms associated with attention deficit hyperactivity disorder (ADHD), including distractibility, disorganization, hyperactivity, inattention, and impulsivity. Adderall is one of the more popular of these drugs, often discussed alongside Ritalin as a medication to treat this behavioral condition.
Prescription stimulants such as Adderall are an important part of treatment, alongside behavioral therapy, for many children and adults who struggle with ADHD. These medications are occasionally prescribed off-label to treat daytime drowsiness associated with severe sleep disorders like narcolepsy.
Adderall is a brand name combination of amphetamine and dextroamphetamine, which was approved by the Food and Drug Administration (FDA) for prescription use in 1960. There are also generic versions that have since been approved. The combination of amphetamine and dextroamphetamine works by stimulating the release of dopamine, a neurotransmitter associated with increased physical energy and elevated mood.
People who have ADHD are not likely to abuse their prescription drugs because the increase in dopamine improves their mental functioning so they can move normally through the world; this does not trigger addictive behavior. For people who do not have ADHD, though, raising the level of dopamine in the brain also stimulates the reward system, which can lead to abuse of the drug to get high and other compulsive behaviors associated with addiction.
Understanding the Reasons Behind Abuse
Although many people abuse stimulant drugs, from cocaine to crystal meth to Adderall, to get high and have fun, there are different methods of abuse associated with ADHD medications like Ritalin or Adderall. A recent study found that, between 2006 and 2011, non-prescription abuse of Adderall rose among young adults, ages 18–25, by 67%. Emergency room admissions due to harmful effects of abusing this stimulant rose by 156%.
Ritalin and Adderall were both prescribed more often in the 1990s because the medical understanding of ADHD improved, and doctors were better able to treat symptoms with behavioral therapy and doses of new prescription stimulants. However, this meant that more children were receiving ADHD diagnoses, so they had access to stimulant drugs. People with ADHD are not likely to abuse their medications, but they are at risk of sharing these drugs with curious peers who do not have ADHD and who may begin to abuse these substances.
Additionally, as peers without ADHD saw their classmates’ symptoms improve, they often assumed that the drugs were the sole cause. This has led to a boom in stimulant drug abuse as performance enhancers among young people, from students in middle school to young adults. People take these drugs to focus while studying, to stay up all night to finish a paper for college, to perform better on sports teams or during an intense workout, and even to lose weight. One report from 2009 found that fulltime college students were twice as likely to abuse stimulant drugs like Adderall as part-time students or adolescents who did not go to college. More than 90% of these students report that they take Adderall or other stimulant drugs specifically to focus while studying; it is not about the high that can be achieved. The Center on Young Adult Health and Development (CYAHD) reported in 2016 that one-third of college students abused Adderall at least once while they were in school.
The first generation of kids raised around Adderall has graduated college and entered the workforce, and their Adderall addiction has followed them. Adolescents who abused Adderall while in middle school, high school, and college tend to be high achievers, so they tend to seek out competitive and difficult jobs, which means they are under similar stress to perform well for their employers.
Not only is Adderall considered an academic and workplace performance enhancer, but it is also abused to decrease appetite and increase physical energy for longer, more intense workouts at the gym. This stimulant is banned by many sports organizations, including the Olympics, the National Football League (NFL), the National Basketball Association (NBA), Major League Baseball (MLB), the National Hockey League (NHL), and the National Collegiate Athletic Association (NCAA). These organizations ban the use of Adderall even with a prescription.
Research reports that, between 2002 and 2010, there was a 45% increase in the number of stimulant medications prescribed to children. Adderall was the second most-prescribed stimulant drug among these substances.
Again, Adderall and other prescription stimulants are important treatment options for children and adults who have ADHD, but the prevalence of these drugs in homes around the country increases the risk of abuse among adolescents and adults who do not have ADHD.
What are Signs of Intoxication?
Signs of intoxication on stimulants like Adderall include:
- Higher blood pressure
- Pounding heartbeat
- Faster, more shallow breathing
- Increased blood flow to several parts of the body, leading to flushing of the face or feeling warm
- Higher body temperature, almost like a fever
- Wide eyes
- High physical energy, leading to shaking, rapid movements, pacing, a drive to do specific activities like running, and nervousness
- Greater focus which can lead to hyper-focus on specific objects or people, or symptoms associated with obsessive-compulsive disorder (OCD)
- Increased talkativeness and socializing
- Talking faster, louder, or not connecting conversation points
People who abuse Adderall do so for many different reasons, but people who return to the drug over and over do so because of the dopamine rush that stimulates the reward system. The associated intoxicating effects will lead to compulsive behaviors and addiction to Adderall. However, there are harmful short-term and long-term side effects from abusing this drug, too.
Side Effects That Reduce Quality of Life
People who are prescribed Adderall and take it as directed may experience side effects, which can be managed with the help of the psychiatrist or physician who prescribed the medication. Adjusting the dose or switching to a different medication entirely are both options to manage these side effects.
For those who abuse Adderall without a prescription, side effects become more likely, and they are more likely to lead to long-term problems because these issues are not being managed effectively.
Physical Side Effects
Common physical side effects from Adderall include:
- High levels of physical energy
- Shaking or tremors
- Loss of appetite and associated weight loss
- Dry mouth
- Constipation or diarrhea
- High body temperature
- Rapid heartbeat or irregular heart rate
- Heart palpitations
- High blood pressure
- Dilated pupils
- Increased breathing rate
Abusing Adderall can cause long-term harm, too. Damage to the cardiovascular system can lead to heart arrhythmias, stroke, heart attack, blood clots, chronically high blood pressure, damage to the blood vessels, and pulmonary embolism. These issues can lead to death or a lifetime of medical treatment to manage damage to this system.
Rapidly losing weight is also associated with several problems—not just damage to the heart due to stress, but bone density loss and gastrointestinal damage from malnutrition. The muscles may become weaker, and the kidneys and liver could become damaged, too.
Psychological Side Effects
Since Adderall is a psychiatric medication prescribed to treat a specific behavioral disorder, the primary effects are psychological, including changes to attention and mood. Mental side effects from taking Adderall include:
- Euphoria or high
- Temporarily improved sense of wellbeing
- Less drowsiness or sleepiness
- Sleeping less
- Heightened alertness, focus, or attentiveness
- Increased talkativeness and sociability
- Elevated mood
- Insomnia or other sleep problems
- Aggression or hostility
- Increased anxiety or paranoia
- Delusions, both paranoid delusions and delusions of grandeur, including feelings of superiority
One study reported that up to 18% of people who abused stimulants like amphetamines, including in the form of Adderall, experienced at least one episode of amphetamine psychosis every year. People who had underlying psychiatric problems were at greater risk, but even people who had no pre-existing mental health conditions could develop psychotic symptoms with chronic abuse of this potent stimulant.
Long-term mental side effects associated with Adderall abuse include:
- Toxic psychosis
- Other mood disorders, including depression and anxiety
- Memory problems
Need Help Ending Addiction?
Because Adderall releases a flood of dopamine into the brain, people who do not have ADHD can quickly become addicted to the drug, taking larger doses over time, taking more doses per day, and feeling as though they need it to feel normal. Compulsive behaviors, increasing abuse, intoxication, side effects, and withdrawal symptoms are all signs that one may suffer from addiction to Adderall. Fortunately, evidence-based treatment through medical detox and therapy at a rehabilitation program can help someone struggling with Adderall addiction end their physical dependence on the substance, learn to avoid the drug, and lead a healthy, sober life.