Prescription Stimulants (Adderall, etc.) Methods of Use

Prescription stimulants refers to a large group of medications recommended for the treatment of several mental and physical health conditions like attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Stimulant medications boost a person’s energy and ability to focus. This makes them effective medications for the conditions they treat but also desirable drugs of abuse for some individuals.1

People often misuse stimulants to get high or to try to improve their academic or physical performance. This may result in mental or physical health issues and may lead to addiction.1

One in 6 people who use prescription stimulants nonmedically in any way will develop an addiction at some point. 2

Types of Prescription Stimulants

Ritalin pills

Many prescription stimulants known by various generic and trade names exist, but they all work very similarly in the brain to produce similar effects. The most commonly abused stimulants include:3

  • Dextroamphetamine (e.g., Dexedrine).
  • Dextromethylphenidate (e.g., Ritalin, Concerta, and Focalin).
  • Dextroamphetamine and amphetamine combination product (e.g., Adderall).

Regardless of the type, many people seek out and abuse prescription stimulants every year. Stimulants prescribed for ADHD are misused by about 10% of patients for whom they are prescribed.2 According to the 2019 National Survey on Drug Use and Health, nearly 5 million people aged 12 or older misused prescription stimulants in the past year.4

Short-Term Effects of Prescription Stimulants

Prescription stimulants such as Adderall and Ritalin enhance the effects of two very important neurotransmitters in the brain, dopamine and norepinephrine. Dopamine is associated with feelings of pleasure and is a key component of the brain’s reward system, while norepinephrine plays a critical role in mobilizing the brain and body to action (e.g., the fight-or-flight response).5

Misuse of stimulant medications can bring about an initial euphoric rush, as well as short-term effects include:1,5

  • Feeling more awake and staying awake longer.
  • Increased alertness.
  • Energy boost.
  • Increased attention.
  • Decreased hunger.
  • Rise in heart rate and blood pressure.
  • Rise in blood sugar.
  • Decreased blood flow
  • Opening up of the breathing passages.
  • Increased breathing.

Changing the route of administration can change the way the body responds to a substance. A person who smokes, snorts, or injects a prescription stimulant may expose themselves to greater risk or additional risks compared with taking the drug orally.6,7

Health Effects of Abusing Prescription Stimulants

Unwanted and potentially dangerous consequences come along taking higher doses of prescription stimulants Some of the short-term health effects of misusing stimulants include:1,8

  • Irregular heartbeat.
  • Dangerously high body temperature.
  • Decreased quality and quantity of sleep.
  • Increased risk of seizures and heart failure.

As abuse continues and the person consumes the drugs at high doses more often, the risk of dangerous health effects increase. Common long-term health effects from prescription stimulant abuse include:1,8,9

  • Heart problems.
  • Hostility, anger, and aggression towards others.
  • Psychosis and paranoia.

Perhaps the most dangerous effect of prescription stimulant abuse is overdose. If a person consumes enough of the drug, the stimulant will overwhelm the body, which may result in death.1

Why and How Do People Abuse Prescription Stimulants?

Stimulants are often called “uppers” because they are effective at keeping people energetic and awake. These effects are appealing and lead many people who don’t have a medical need for these drugs to abuse them.

Stimulants can also make people may feel more productive, confident, and intelligent. In fact, misuse of prescription stimulants by high school and college students is driven by a motivation to get better grades under the misconception that these drugs can improve your academic performance or your memory.1,10,11 In reality, there is little evidence to support this.3

People may also misuse these drugs as a way to lose weight, since side effects include appetite suppression.1,11

What Is Prescription Stimulant Abuse?

Ritalin on book
  • Taking someone else’s medication.
  • Using more than the recommended dose.
  • Mixing the medication with alcohol or other drugs to change the effect.
  • Taking the medication for a reason other than prescribed, like to “get high.”
  • Using the medication in a way other than prescribed such as by snorting it.3

Methods of Use and Abuse

Prescription stimulants are generally prescribed in pill or tablet form for oral consumption. People typically abuse them by swallowing the pill but some people abuse them by changing the route of administration. With stimulants, people may consume them by:9

  • Snorting
  • Smoking
  • Injecting

The route of administration can affect the experience a person has when misusing the substance. Using an alternative route of administration is often done in an effort to get the drug into the system as quickly as possible and intensify its effects.12

Health Risks of Snorting, Smoking, or Injecting Prescription Stimulants

The risks of snorting, smoking, or injecting stimulants are serious. Ignoring the risks can lead to severe health problems.

Method of administration is also linked to addiction risk.  Smoking and injecting are indicative of an escalation of drug use and thereby these routes may also be associated with a higher risk of becoming addicted than oral and nasal administration.2,12


Snorting may seem harmless to a user, but intranasal use of stimulants can result in damage to the nasal septum, including deviated septum.2,13

Snorting Adderall or other prescription stimulants may also result in loss of smell and recurring nosebleeds.13

Snorting also results in a much quicker onset of the effects of Ritalin (15-30 min vs. 45-60 min), which can increase the drug’s abuse and addiction potential.14


By crushing oral medications into a fine powdery substance, users may attempt to smoke or vaporize prescription stimulant medications. Not only is smoking Adderall or other prescription stimulants related to increased addiction potential but it may also bring lung and airway damage, including lung toxicity.2,13,15 Symptoms that may arise from smoking drugs illicitly include:16

  • Coughing.
  • Wheezing.
  • Shortness of breath.
  • Chronic bronchitis.


Whether the substance is heroin, cocaine, or prescription stimulants, intravenous drug injection is arguably the most dangerous route of drug administration. When injecting drugs, sharing paraphernalia can spread life-threatening infectious diseases like HIV and hepatitis.1

Injecting prescription stimulants into the veins forces ingredients (which includes pill binders and fillers) from the tablets into tiny blood vessels, which can result in blocks blood vessels. Depending on the blockage, injections can damage the heart and other organs.3

Other risks of injecting drugs include:17

  • Skin infections and abscesses.
  • Scarring at the injection sites that may last for more for years.
  • Endocarditis, an infection of the heart’s lining.

Prescription Stimulant Overdose

In situations when the person consumes too much of a prescription stimulant, overdose may occur. The signs of overdose on prescription stimulant medications include physical and mental health effects like:1

  • Confusion.
  • Aggression.
  • Restlessness.
  • Panic.
  • Hallucinations.
  • Tremors.
  • Overactive reflexes.
  • Quickened breathing.
  • Fever.
  • Pain.
  • Weakness.
  • Irregular heart rate and increased heart attack risk.
  • Extreme increase or decrease in blood pressure.
  • Nausea, abdominal cramping, vomiting, and diarrhea.
  • Convulsions.

In severe cases, overdose from prescription stimulants may be fatal. 1 Drug overdose deaths involving psychostimulant drugs with abuse potential (e.g., Ritalin, Adderall, and methamphetamine) increased by an average of 30% each year from 2012 to 2018.18

Treatment for Stimulant Addiction

A stimulant addiction, or stimulant use disorder, occurs when a person’s stimulant use begins to significantly interfere with their health and/or other areas of their life.

Signs of a stimulant use disorder include:

  • Spending a lot of time trying to get and use stimulants and recover their effects.
  • Craving stimulants when none are available.
  • Trying to cut back or end your use without success.
  • Having legal, academic, social, physical, or mental health problems triggered by stimulants.
  • Needing to take stimulants in higher doses or more frequently to achieve the desired effects.

The above are not the only signs a professional will use to determine if a stimulant use disorder is present. The main criteria for a stimulant use disorder is that you are unable to quit even when using is causing problems for you. If you feel you have a problem with prescription stimulants and it is causing distress in your life, a professional can complete a full assessment to determine the extent of the problem and make treatment recommendations.

Depending on your treatment needs, the evaluator may recommend inpatient or outpatient care. Fortunately, Recovery First’s treatment center in Hollywood, Florida offers both. From inpatient medical detox and live-in rehabilitation to day treatment and intensive outpatient, Recovery First offers an appropriate level of care for your, wherever you are in your recovery journey.

At Recovery First, we know that making the decision to seek help for a stimulant use disorder is not easy, but your recovery is possible. Put yourself first and call us today at 754-228-5136.


  1. National Institute on Drug Abuse. (2018). DrugFacts: Prescription Stimulants.
  2. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  3. National Institute on Drug Abuse. (2020). Prescription Stimulant Medications (Amphetamines).
  4. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  5. National Institute on Drug Abuse. (2020). Misuse of Prescription Drugs Research Report.
  6. Weyandt, L. L., Oster, D. R., Marraccini, M. E., Gudmundsdottir, B. G., Munro, B. A., Rathkey, E. S., & McCallum, A. (2016). Prescription Stimulant Medication Misuse: Where Are We and Where Do We Go From Here?. Experimental and Clinical Psychopharmacology, 24(5), 400–414.
  7. Teter, C. J., McCabe, S. E., LaGrange, K., Cranford, J. A., & Boyd, C. J. (2006). Illicit use of specific prescription stimulants among college students: prevalence, motives, and routes of administrationPharmacotherapy26(10), 1501–1510.
  8. National Institute on Drug Abuse. (2020). Commonly Used Drugs Chart.
  9. Department of Justice/ Drug Enforcement Administration. (2020). Drug Fact Sheets – Stimulants.
  10. Kennedy S. (2018). Raising Awareness About Prescription and Stimulant Abuse in College Students Through On-Campus Community Involvement ProjectsJournal of undergraduate neuroscience education : JUNE : a publication of FUN, Faculty for Undergraduate Neuroscience17(1), A50–A53.
  11. Arria, A. M., & DuPont, R. L. (2010). Nonmedical prescription stimulant use among college students: why we need to do something and what we need to doJournal of addictive diseases29(4), 417–426.
  12. Kelly, B. C., Vuolo, M., Pawson, M., Wells, B. E., & Parsons, J. T. (2015). Chasing the bean: prescription drug smoking among socially active youth. The Journal of adolescent health : official publication of the Society for Adolescent Medicine56(6), 632–638.
  13. Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020.
  14. Lile, J. A., Babalonis, S., Emurian, C., Martin, C. A., Wermeling, D. P., & Kelly, T. H. (2011). Comparison of the behavioral and cardiovascular effects of intranasal and oral d-amphetamine in healthy human subjectsJournal of clinical pharmacology51(6), 888–898.
  15. Tseng, W., Sutter, M.E. & Albertson, T.E. (2014). Stimulants and the Lung. Clinical Reviews of Allergy and Immunology, 46, 82–100.
  16. Government of South Australia. (n.d.). The risks of using drugs.
  17. Semel Institute for Neuroscience and Human Behavior. (n.d). Potential Complications Of IV Drug Use.
  18. Centers for Disease Control. (2020). Drug Overdose Deaths in the United States, 1999–2018.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More

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