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Signs of Adderall Abuse

Adderall is the brand name of a prescription stimulant medication designed to treat attention deficit hyperactivity disorder (ADHD) in children and adults as well as narcolepsy—a neurological disorder characterized by daytime sleepiness and uncontrollable episodes of deep sleep.1

Adderall is considered a Schedule II drug by the U.S. Drug Enforcement Agency.2 It’s a combination dextroamphetamine/amphetamine product that increases dopamine and norepinephrine (both neurotransmitters) in the brain, resulting in increased energy and sharper focus.1

The U.S. Food and Drug Administration (FDA) approved Adderall for the treatment of ADHD in 1996, and this medication experienced a surge in popularity in the U.S. in the 1990s as more children received diagnoses of ADHD.3 Among U.S. children and adolescents, the estimated prevalence of diagnosed attention-deficit/hyperactivity disorder increased significantly between 1997 and 2016, from 6.1% to 10.2%.4

The medical understanding of ADHD and how it should be treated has improved a lot over the past several decades. The American Academy of Pediatrics currently recommends a combination of behavior therapy and medication for children aged 6 and older.5

The Recent History of Adderall Abuse

Adderall is misused in an effort to achieve a state of euphoria or a stimulant high.6

In 2018, over 4.6 million people abused prescription amphetamine products—which includes Adderall—in the past year. Young adults—those who fall in the 18 to 25 age group—make up the majority of users (56%) who take prescription amphetamine products for non-medical reasons.7

Many high school and college students believe stimulants like Adderall can be used as a “study drug” to enhance cognitive performance and will help them to do better in school.6

A study of data collected for the National Survey on Drug Use and Health between 2006 and 2011, identified friends or relatives as the major primary source of nonmedically used dextroamphetamine-amphetamine for adolescents (ages 12-17) at 60.2% as well as young adults (ages 18-25), where they were the primary source for 68.3% of nonmedically used stimulants.8

Studies show that children receiving stimulant treatment for ADHD are at no increased risk of developing substance abuse.9

Conversely, research has also clearly shown that children and young adults who misuse stimulants are also more likely to report use of other drugs. Prescription drug misuse has been associated with higher rates of cigarette smoking; heavy episodic drinking; as well as marijuana, cocaine, and other illicit drug use among U.S. adolescents, young adults, and college students.10

In addition to a higher risk of developing a substance use disorder, misuse of stimulants also carries with it other risks of acute and chronic physical harm that can reduce quality of life or lead to overdose and death.10

Effects and Side Effects of Adderall Abuse

People who misuse prescription stimulants such as Adderall often will take enough to produce a “rush” of euphoria. Along with this rush, comes other physical effects of the drug:10

  • Increased blood pressure and heart rate.
  • Increased breathing and opened-up breathing passages.
  • Decreased blood flow.
  • Increased blood sugar.

Even when taking Adderall as prescribed it’s possible to experience side effects of the medication. With increased doses, these side effects will likely intensify. Common side effects include:11

  • Agitation.
  • Headaches.
  • Stomachache.
  • Nervousness.
  • Difficulty sleeping.
  • Decreased appetite.
  • Dry mouth.
  • Constipation.
  • Diarrhea.
  • Nausea/vomiting.
  • Weight loss.
  • Grinding teeth.

The effects of long-term use of Adderall, even at therapeutic doses, hasn’t been studied; however, a person is more likely to develop an increased tolerance to the drug with repeated use. This means an individual will need to take larger or more frequent doses of Adderall to feel its effects, which could increase the cumulative risk of experiencing a serious adverse side effect, which includes sudden death.

  • Multiple empty pill bottles
  • “Losing” prescriptions or frequently needing refills
  • Doctor shopping for multiple prescriptions
  • Lying about the drug
  • Acquiring it online or on the black market
  • Stealing the drug from friends or family with a prescription
  • Poor decision-making
  • Changes in academics or work performance
  • Less social interaction with friends or family
  • Appearing high, energetic, or jittery much of the time
  • Changes to sleeping and eating habits
  • Becoming defensive or aggressive when asked about the drug
  • Experiencing financial or legal problems because of the substance

Adderall Dependence & Withdrawal

After taking Adderall for a long enough period and at high enough doses, the body may develop a physical dependence to the medication, resulting in experiencing withdrawal symptoms that may include:11

  • Feelings of sadness and depression.
  • Fatigue.
  • Vivid, unpleasant dreams.
  • Insomnia or excessive sleepiness.
  • Increased appetite.
  • Slowed or altered physical and emotional reactions, including speech and affect.

Adderall Addiction

For Adderall abuse to be diagnosed as a stimulant use disorder, a person must demonstrate at least two of the following symptoms within a 12-month period:12

  • Takes larger amounts of Adderall over a longer period than originally intended.
  • Expresses a persistent desire or is unsuccessful in efforts to cut back the use of Adderall.
  • Spends a lot of time trying to get, use, or recover from using Adderall.
  • Craves Adderall.
  • Constantly uses, resulting in a failure to fulfill major role obligations at work, school, or home.
  • Continues to use despite having reoccurring interpersonal problems caused or exacerbated by the effects of Adderall.
  • Gives up important social, occupational, or recreational activities because of Adderall use.
  • Uses Adderall in situations where it’s physically hazardous.
  • Continues using Adderall despite knowing of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by use.
  • Develops a tolerance to Adderall.
  • Experiences withdrawal from Adderall.

Professional Help to Overcome Abuse of Adderall

Professional help to Overcome Abuse of Adderall

Adderall addiction can be effectively managed, but it requires attention from medical professionals who understand addiction to stimulants.

Getting supervision to ease the physical discomfort of withdrawal is the first step; after detox has been successfully completed, a comprehensive rehabilitation program can help one to recognize the underlying causes of addiction and personal triggers. Fortunately, there is a lot of help available from addiction specialists to stop abusing Adderall.

References

  1. National Institute on Drug Abuse. (2018). Prescription Stimulants.
  2. U.S. Department of Justice, Drug Enforcement Administration, Diversion Control Division. Controlled Substance Schedules.
  3. Elia, J. (2005). Attention Deficit/Hyperactivity Disorder: Pharmacotherapy. Psychiatry, 2(1):27-35.
  4. Xu, G., Strathearn, L., Liu, B., Yang, B., & Bao, W. (2018). Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016JAMA Network Open1(4).
  5. Subcommittee on Attention-Deficit/Hyperactivity Disorder & Steering Committee on Quality Improvement and Management. (2011). ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128 (5), 1007-1022.
  6. U.S. National Library of Medicine. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.
  7. Center for Behavioral Health Statistics and Quality. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health(HHS Publication No. PEP19‑5068, NSDUH Series H‑54).
  8. Chen, L.-Y., Crum, R. M., Strain, E. C., Alexander, G. C., Kaufmann, C., & Mojtabai, R. (2016). Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants. The Journal of Clinical Psychiatry, 77(03), e297–e304.
  9. Lakhan, S. E., & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: Misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661–677.
  10. Humphreys, K. L., Eng, T., & Lee, S. S. (2013). Stimulant Medication and Substance Use OutcomesJAMA Psychiatry70(7), 740–749.
  11. National Institute on Drug Addiction. (2018). Drug Facts: Prescription Stimulants.
  12. U.S. Food and Drug Administration. (2019). Adderall XR Drug Label and Prescribing Information.
  13. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

 

About The Contributor
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