Adderall prescriptions are on the rise across the nation, and so is the risk of abuse and addiction. How do you prepare yourself for the next wave of addiction?
Adderall is the second most widely prescribed stimulant after Ritalin. There were nearly 13 million Adderall prescriptions between 1992 and 2002. 1 In 2012, Adderall prescriptions surged to 16 million, according to reports consulting firm IQVIA (formerly QuintilesIMS).2
Both prescription and non-prescription use of the drug can cause addiction. Nonetheless, the risk of addiction is quite low when you use it following your doctor’s recommendation.
The National Institute on Drug Abuse for Teens states that dependence and addiction are still possible with the prescription use of certain drugs, such as Adderall.
In the fight against addiction, knowledge is power, and accurate information is key. Read on to learn what Adderall addiction is, how it harms your health, and what you can do to fight it.
Adderall belongs to a class of medications known as central nervous system (CNS) stimulants. It is available only on a doctor’s prescription. Other examples of stimulant medications are Ritalin, Concerta, Dexedrine, Focalin, Metadate, Methylin, and Vyvanse.
Adderall contains four amphetamine salts. They are dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. These ingredients increase the levels of two key brain chemicals: dopamine and norepinephrine (noradrenaline). It increases brain activity, focus, energy, and feelings of well-being.
The US FDA has approved Adderall for the treatment of two conditions: attention-deficit hyperactivity disorder (ADHD) and narcolepsy.
ADHD typically develops during childhood and can continue into adulthood. In children, ADHD can cause hyperactivity and impulsiveness. Adults with ADHD often struggle with anxiety, memory problems, mood swings, and low self-esteem.
Narcolepsy is a rare sleep disorder. It causes excessive sleepiness during the day. Some people may experience sudden episodes of sleep called “sleep attacks.” Other symptoms can include seeing or listening to things that are not there (hallucinations) and sleep paralysis.
Adderall is available in different strengths. They are:
5 mg (white to off-white pills)
7.5 and 10 mg (blue pills)
12.5, 15, 20, 30 mg (yellow pills)
You can also get a generic version of the drug. Before you buy generic Adderall from an online pharmacy, make sure to check its validity. This is critically important because some online pharmacies are known to sell counterfeit products.
British chemist George Barger and physiologist H.H. Dale discovered amphetamine in 1910. Gordon A. Alles, an American chemist, first synthesized amphetamine in 1927.
In 1935, the pharmaceutical company Smith, Kline, and French marketed Benzedrine (the brand name for amphetamine). It was used to treat narcolepsy and mild depression. In 1937, Smith, Kline and French started marketing a more powerful form of amphetamine (d-amphetamine) under the brand name Dexedrine.
In 1994, Richwood Pharmaceuticals purchased a diet pill containing mixed amphetamines, known as Obetrol. Originally developed by Rexar Pharmaceuticals, it was a popular diet pill in the 1960s. Richwood Pharmaceuticals renamed it “Adderall” and began marketing it as a treatment for ADHD.
However, the FDA did not approve Adderall, citing a lack of strong evidence of safety and efficacy. The FDA re-approved Adderall in 1996 for the treatment of ADHD. Interestingly, it was still not clear if the medication was effective in treating ADHD. In 2002, the FDA approved a long-acting, once-daily formulation (Adderall XR).
Adderall also goes by street names such as:
Addys or addies
Vitamin R (this is particularly for Ritalin, another prescription stimulant. However, some may use the term for Adderall as well)
Adderall is a schedule II controlled substance (C-II).4 This means ingredients in Adderall have a high abuse potential. When you use it following your doctor’s instructions, the risk of addiction is low. However, the risk of addiction significantly increases if you abuse the drug. Drug abuse means taking:
More than the recommended dose
Longer than the recommended period
More frequently than recommended
In ways other than recommended (e.g., crushing and snorting oral pills)
If you have been taking Adderall for some time now, you may need larger doses to experience the same effects. This is when you have developed tolerance . Dependence develops when you can no longer function properly without taking the drug.
Some people deliberately take larger doses of Adderall to boost their mental function and experience a high. This is common among college students, athletes, and people who have abused other drugs in the past. Some people call Adderall and other stimulants “study drugs.”
The United States has been struggling with an amphetamine epidemic since the mid-1940s. Medical use of amphetamine has increased by more than five folds since 1995. This is according to the Drug Enforcement Administration (DEA).
According to the US Department of Health and Human Services, methamphetamine abuse. 5
Doubled form 1983 to 1988
Doubled again from 1988 to 1992
Quintupled form 1992 to 2002
2015 National data suggests one in ten college students misused Adderall in 2014. 6 Most notably, Adderall production jumped by nearly 9,008,000% from 1992 to 2002.
The burgeoning production is driven by two factors. First is an increase in the diagnosis of ADHD. Second is emerging Adderall abuse and addiction.
Emergency department (ED) visits involving Adderall and other stimulants have skyrocketed in the last few decades.
According to the 2013 Dawn Report.7
ED visits involving prescription stimulants reached 31,244 in 2010 from 13,397 in 2005
Form 2005 to 2010, ED visits related to nonmedical use of stimulants almost tripled to 15,585
During the same period, ED visits due to serious side effects of stimulants almost doubled from 5,085 to 9,181
A key finding is that ED visits nearly quadrupled among persons aged 18 to 25. On the other hand, ED visits among children younger than 18 remained steady from 2005 to 2010.
A person growing up with friends on prescription stimulants may be at a greater risk of abuse and addiction.
Having a friend or family member on prescription stimulants gives easy access to drugs.
Recreational use of prescription stimulants is considered more acceptable than the use of heroin or cocaine. Some people, especially college students, perceive Adderall as a “soft” drug. According to them, soft drugs allow for pleasure without any significant social or physical risks.
The pressure to fulfill parental and societal expectations often takes a toll on a person’s mental health. Parents want their children to be successful, and society considers parents with successful children as “good” parents. Ultimately, it’s the person who has to cope with the resulting stress.
Stimulants also help improve mental function and performance. Thus, some people may choose to misuse them to succeed and live up to their expectations.
Stimulants provide the much-needed energy required for partying all night or studying hard for an upcoming exam. Many students often misuse stimulants to avoid exhaustion and improve their performance.
Doctors prescribe Adderall for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. The prescription doses range from 5 to 60 mg in total per day.
The starting dose of Adderall for adults is usually 10 mg per day. Depending on the response and individual needs, the doctor may adjust the dose later.
The starting dose for children 6 years and older is 5 mg once or twice a day. In children between 3 and 5 years of age, doctors start at 2.5 mg per day. It is not recommended for use in children younger than 3 years of age.
(Note: The doses mentioned above are of Adderall instant release pills)
Follow your doctor's instructions and directions on the prescription label
Your doctor may adjust doses depending on your needs and response
Avoid sharing your medicine with another person, especially if the person has previously abused the drug
Never take more or less than the recommended doses
Store your medicine in a safe place, out of reach of children and other persons
Talk to your doctor or pharmacist if you have any questions about the use of the drug
Do not crush, chew, beak, or open Adderall XR pills. Swallow intact pills.
Avoid taking stimulants in the late evening, as they can affect sleep
Taking a drug in larger doses more often and for a longer time than recommended is drug abuse. Drug abuse also involves unapproved uses, such as for the euphoric effect.
Some people abuse Adderall to:
Experience a “high”
Boost mental function
They may abuse the drug by:
Taking more than the recommended number of pills.
Injecting its solution into the vein. People who inject Adderall can be at an increased risk of infections, heart disease, and overdose.
Snorting the powdered pill.
Smoking the powder.
Mixing it with other drugs or alcohol. Using a combination of Adderall with other drugs such as Xanax and alcohol can cause fatal complications.
Both short-term and long-term Adderall abuse can cause:
Severe skin rashes
Increased body temperature
Over-breathing that may cause breathlessness
High blood pressure
Loss of appetite
Uncontrollable laughing or crying
People who inject Adderall may be at a greater risk of contracting HIV and hepatitis.
Drug abuse impairs judgment. Impaired judgment and increased tolerance can lead to a potentially fatal overdose.
Adderall can cause withdrawal symptoms when you suddenly stop taking it. These symptoms typically develop within hours to days after the last use.
Withdrawal symptoms are usually more severe if you have abused large amounts of Adderall for prolonged periods. Adderall withdrawal is also known as the “Adderall Crash.”
Too much or too little sleep
Anxiety and irritability
Talk to your doctor if you experience any of these symptoms after stopping your drug.
Adderall overdose can occur if you take large amounts of the drug within a short period. An overdose is more likely if you take the drug in combination with other drugs or alcohol.
The recommended daily dose of Adderall ranges from 5 to 60 mg. According to the Toxicology Data Network, a lethal dose ranges from 20 to 25 mg per kilogram of weight.9 This implies the lethal dose for a person who weighs 60 kg (132 pounds) is about 1,200 mg.
However, not every person who weighs 60 kg will develop overdose symptoms by taking 1,200 mg of the drug. Reports suggest that just 1.5 mg per kg of weight may be toxic in some people.
The tendency to develop overdose symptoms depends on two key factors. First is the amount of drug ingested or injected. Keep in mind that injecting a drug causes rapid absorption into the bloodstream and brain. Second is a person’s physiological traits. Simply put, a low amount of the drug can produce toxic effects in people who are sensitive to stimulants.
The risk of an overdose may be higher in people who take certain medications such as antidepressants, HIV/AIDS medications, and medications to treat irregular heartbeats.
Adderall overdose can cause mild to severe symptoms or even death. These symptoms develop due to abnormally high levels of brain chemicals such as dopamine, serotonin, and norepinephrine.
The symptoms to watch out for include:10
Body temperature 106.7°F (41.5°C) or higher
Anxiety and panic
Breakdown of muscle fibers (rhabdomyolysis)
Nausea and vomiting
Increased breathing rate
High blood pressure
There are no specific antidotes to stimulant overdose.11 An antidote counteracts the effects of a poison such as naloxone (Narcan), which is an antidote to opiate overdose.
Treatments for Adderall overdose are supportive. Medications to control the symptoms of an overdose can include benzodiazepines and antipsychotic medications.
In the case of an overdose, contact the National Poison Center at 1-800-222-1222 right away.
Fact: To call Adderall a “study drug” or “smart drug” would be a misnomer. Stimulants may help to improve your focus, but they will not help you get good grades. Long-term drug abuse can harm your physical and mental health.
Fact: Adderall or any other stimulant is NOT a brain vitamin. They do not nourish your brain or help it function better.12 They affect the levels of brain chemicals and can cause an addiction. Thus, you should avoid taking stimulants without first consulting your doctor.
Fact: In scientific literature, there is no such thing as a “soft” or “hard” drug. The fact is that it is a schedule II controlled substance. This means it carries a high abuse potential and should be used only under medical supervision. Besides, when you take Adderall without a prescription, you may experience unpleasant side effects.
To date, no medications have been approved for the treatment of Adderall addiction.
Treatment begins with detoxification at a rehabilitation center or detox center. It may be done on an inpatient or outpatient basis. Adderall detoxification typically lasts less than seven days.
The detoxification process has two major goals. First is to remove the drug from the body. Second is to prepare a person for long-term rehabilitation.
During detox, a doctor may gradually decrease the dose of Adderall. This is known as dose tapering. Because stimulants are powerful drugs, quitting them cold turkey is not recommended.
Detox involves three steps. They are:
This can involve the use of talk therapy or behavioral therapy to correct a person’s faulty thinking patterns associated with drug abuse.
Cognitive-behavioral therapy (CBT) can help you identify coping skills. CBT not only helps with addiction but can also help relieve anxiety.
You may attend an individual or a group session to learn essential life skills. These life skills help to facilitate your transition to a drug-free life. Your doctor may also recommend joining self-groups or entering sober living homes.
Depending on your response, you may need to continue attending the group sessions after the completion of the treatment. This is known as addiction aftercare.