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Treatment for Dexedrine Addiction

Dextroamphetamine is the generic active ingredient in the branded drug Dexedrine. Like Adderall (a combination of dextroamphetamine and amphetamine), Dexedrine is a central nervous system stimulant that belongs to the amphetamine class of drugs. It’s indicated for the treatment of narcolepsy and  attention deficit hyperactivity disorder (ADHD) helping to alleviate the following ADHD symptoms:1,2

  • Trouble maintaining focus or concentration.
  • Impulsive, hyperactive behavior.
  • Susceptibility to distractions.
  • Forgetfulness regarding day-to-day things and responsibilities.

Researchers remain uncertain as to the precise biological cause of ADHD, although brain imaging studies have helped scientists better understand the underlying brain networks and subsystems that contribute to the disorder’s complexity; and these studies also reveal how Dexedrine and other ADHD drugs work to correct some of the atypical brain functioning.3

Amphetamine analogs, such as Dexedrine, are safe and effective first-line treatments for both childhood and adult ADHD.2 Dexedrine is addiction-forming and has a Schedule II designation under the Controlled Substances Act. In other words, it’s accepted for medical use, but it also has a high potential for abuse.4

About Dexedrine Addiction

According to the 2018 National Survey on Drug Use and Health, about 12.2 million individuals reported using prescription amphetamines such as Dexedrine, and nearly 5.3 million individuals reported misusing prescription amphetamines at least one time in the last year.5 The 2018 Monitoring the Future Survey reported that 8.6% of high school seniors have used some type of stimulant (including prescription amphetamine analogs such as Dexedrine, illicit methamphetamine, and Ritalin).6

College students are at higher risk of non-medical use of CNS stimulants like amphetamines, with increased risk associated with the following:7

  • White male.
  • GPA less than 3.5.
  • Use of alcohol and/or marijuana (often alongside methylphenidate).
  • Member of sorority or fraternity.

High school and college students cite academic motivations as their primary reason for misuse of amphetamines and other CNS stimulants. Weight loss and trying to achieve a “high” are other reasons for abusing these medications.7

Although the evidence supports that those without ADHD may experience some cognitive benefit from using a CNS stimulant, it is also associated with a lower GPA, which suggests it actually hinders academic performance in students without ADHD.7

An individual can get started on Dexedrine abuse—or the abuse of other prescription stimulants—through a number of known pathways. In some instances, individuals who are lawfully prescribed this drug for a diagnosed condition like ADHD may begin to take too much of the drug, such as taking high doses during a short period or frequently taking smaller doses. In other instances, individuals may not have a diagnosis for which Dexedrine is indicated but may obtain this drug from doctors through subterfuge or from friends, neighbors, or the illicit street drug market.

When Dexedrine is taken as prescribed by a physician there’s less potential that the patient will develop an addiction to this drug. The patient may develop a physical dependence, but this condition is not synonymous with a psychological addiction.

Individuals who take Dexedrine under the care of a prescribing doctor aren’t immune from abusing the drug in an attempt to feel a “high,” although studies show it is rare.8 Diversion of the medications from patients to their classmates and colleagues, however, remains a problem.8,9 Diversion is when medication prescribed for one individual is sold, given to, or taken by another individual.9

Signs and Symptoms of Dexedrine Use and Addiction

If a person takes Dexedrine or any prescription amphetamine for any reason not related to its clinically proven therapeutic effects for certain health conditions, there’s a considerable risk of addiction in addition to a host of life-threatening side effects that the individual wasn’t screened for by a physician. For example, structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems combined with CNS stimulants—even at therapeutic levels—is a known cause of sudden death.1

Initial effects (usually desired) after taking 5-60 mg of Dexedrine include:1,2

  • Increased energy, alertness, and sociability.
  • Elation or euphoria.
  • Decreased fatigue.
  • Decrease in appetite.

Adverse side effects that may be experienced after taking Dexedrine include:1,2

  • Headache.
  • Dry mouth.
  • Insomnia.
  • Restlessness.
  • Depression, anxiety, or agitation.
  • Involuntary muscle movement or tics.
  • Dizziness.
  • Diarrhea or constipation.
  • Changes in sex drive.
  • Palpitations.
  • Elevated blood pressure.
  • Rapid heart rate.

Rare but serious adverse effects include:1,2

  • Seizures.
  • Psychosis.
  • Heart attack or stroke.

Adverse reactions are more likely to occur with continued misuse of Dexedrine. Chronic users may increase their dosage to dangerous levels and could experience signs and symptoms of a Dexedrine overdose:1,2

  • Extreme restlessness and tremor.
  • Irritability, panic, confusion and difficulty concentrating.
  • Rapid breathing.
  • Delusions or hallucinations.
  • Dark, reddish-colored urine (rhabdomylosis).
  • Muscle aches, spasms, and tics.
  • Feeling aggressive and prone to violence.
  • Irregular heart rhythms or blood pressures (high or low) leading to circulatory system collapse.

Long-term misuse of dextroamphetamine (Dexedrine) and other amphetamines has been shown to damage dopaminergic nerve terminals.10 Although this damage may not be permanent, it may result in long-term cognitive deficits and mood disorders such as depression.11

Polydrug Use and Addiction

Although some people misuse Dexedrine in an effort to increase attention or improve concentration in order to study, nonmedical use often occurs in conjunction with alcohol and other substances (with males more likely than females to engage in instances of polydrug use).2

Some common signs of addiction to prescription stimulants such as Dexedrine as well as to other substances are:

  • “Doctor shopping,” (going to multiple doctors for different prescriptions to the same or other drugs of abuse).
  • Not eating, displaying poorer nutritional habits than usual, or weight loss.
  • Filling prescriptions at various pharmacies.
  • Poor dental health or possibly decayed teeth.
  • Missing school or work.
  • Borrowing money or stealing items from home, work, or school.
  • Poor performance of familiar tasks.
  • Making excuses to protect the drug use.
  • Substandard grooming or poor hygiene.
  • Recognition that it’s time to stop using the drug but being unable to do so.

There are often many stakeholders involved in a person’s health, such as family, friends, employers, colleagues, and classmates. In some instances, concerned individuals may have an intuition or actual evidence that substance abuse is occurring, but they may not know which exact drugs are being abused. A recognition of substance abuse, even short of knowing which substances are involved, signals the need that somebody may be struggling with addiction. It is good to know the treatment options available to you, your friend or your loved one.

Treating Dexedrine Addiction

Abuse of Dexedrine and other amphetamines is associated with tolerance—or, the body’s need to use increasing doses of medication to feel its effects—and strong psychological dependence that’s difficult to treat. Reducing the dose or stopping use is associated with withdrawal, which generally produces fatigue, depression and social disability.11

Medical management of withdrawal, often referred to as “detoxification” or “detox” is typically the first stage of treating an addiction to Dexadrine and other amphetamines. This is followed by primary treatment and aftercare.

Medical management of stimulant intoxication, overdose and withdrawal is mostly supportive.2 Symptoms may be medically managed using medications, however, there are currently no FDA-approved drugs for treating addiction to CNS stimulants.2

The supervising medical staff may prescribe palliative medications, such as sedatives, muscle relaxers, or other psychiatric medications to help ease withdrawal symptoms, control cravings, and alleviate any feelings of anxiety, depression, or aggression.2

If a co-occurring mental health disorder is also present, additional medications may be prescribed for longer-term use.

Amphetamine addiction can be responsive to a host of evidence-based therapy approaches that will provide a person with healthy coping mechanisms and ways to deal with any psychological components that underlie a substance use disorder.

Typically, a treatment center that offers comprehensive services will provide clients with one-on-one counseling as well as group counseling. The therapist involved in the individual or group sessions may employ a variety of evidence-based therapies. Therapy modalities that may be used for individuals recovering from Dexedrine or other amphetamine addiction include but are not limited to:

Although therapy is a main pillar of treatment there are many supporting beams in the treatment framework. The following are supportive services that a substance abuse treatment program may offer:

  • Treatment that accommodates a dual diagnosis (such as dual treatment for substance use disorder and depression, eating disorders, or other mental health disorders).
  • Onsite or off-site peer/group recovery meetings.
  • Family therapy, family drug education, and social events.
  • Expressive arts therapy.
  • Wellness treatments (such as yoga, acupuncture, and massage).
  • Support for identity-based groups (such as LGBT group meetings).
  • Drug education for the recovering person.
  • Psychoeducational groups.
  • Aftercare services.

Recovery doesn’t end when a person completes a structured substance abuse treatment program. Engaging in aftercare services, such as ongoing counseling and participation in group recovery meetings (e.g., Narcotics Anonymous or SMART Recovery), not only helps recovering individuals to avoid a relapse but also helps them build the infrastructure for a drug-free and fulfilling life.

References

  1. U.S. Food and Drug Administration. (2017). Dexedrine.
  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. Cary, R. P., Ray, S., Grayson, D. S., Painter, J., Carpenter, S., Maron, L., … Fair, D. A. (2016). Network Structure among Brain Systems in Adult ADHD is Uniquely Modified by Stimulant Administration. Cerebral Cortex, 27(8), 3970–3979.
  4. U.S. Drug Enforcement Administration. (2017). Amphetamines.
  5. Center for Behavioral Health Statistics and Quality. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables.Substance Abuse and Mental Health Services Administration, Rockville, MD.
  6. National Institute on Drug Abuse. (2019). Monitoring the Future national survey results on drug use, 1975-2018: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan.
  7. Faraone, S. V., Rostain, A. L., Montano, C. B., Mason, O., Antshel, K. M., & Newcorn, J. H. (2019). Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies. Journal of the American Academy of Child & Adolescent Psychiatry, Aug. 26, 2019, [ePub ahead of print].
  8. Heal, D. J., Smith, S. L., Gosden, J., & Nutt, D. J. (2013). Amphetamine, past and present – A pharmacological and clinical perspective. Journal of Psychopharmacology, 27(6), 479–496.
  9. Sembower, M. A., Ertischek, M. D., Buchholtz, C., Dasgupta, N., & Schnoll, S. H. (2013). Surveillance of Diversion and Nonmedical Use of Extended-Release Prescription Amphetamine and Oral Methylphenidate in the United States. Journal of Addictive Diseases, 32(1), 26–38.
  10. Berman, S., Oneill, J., Fears, S., Bartzokis, G., & London, E. D. (2008). Abuse of Amphetamines and Structural Abnormalities in the Brain. Annals of the New York Academy of Sciences, 1141(1), 195–220.
  11. Berman, S. M., Kuczenski, R., Mccracken, J. T., & London, E. D. (2008). Potential adverse effects of amphetamine treatment on brain and behavior: A review. Molecular Psychiatry, 14(2), 123–142.
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