In his first semester of college, Raphael tried a “study” drug to help him get through finals. Holed up in the library, the stimulant he took – a mixture of amphetamine salts usually prescribed for attention-deficit hyperactivity disorder (ADHD) – had Raphael soon feeling like a “philosopher.” A few years after graduation, Raphael was still taking Adderall each day where he worked as a web developer at an e-commerce company in Los Angeles. Raphael didn’t have ADHD, but he now had an addiction.
Like many other millennials who routinely took stimulants during their childhood and adolescence, Raphael was abusing Adderall to enhance his performance at work. He isn’t the only one looking for a boost. Substance abuse experts say college students, athletes and others in highly competitive professions are taking prescription stimulants at increasingly high rates to achieve perfection and meet unrealistic levels of production. The problem is, once hooked, Adderall isn’t easy to quit.
An increase in the number of children diagnosed with ADHD has been followed by a rise in prescriptions during the past three decades. In 1990, 600,000 children were on stimulants, usually Ritalin, an older medication that often had to be taken multiple times a day. By 2013, 3.5 million children were on stimulants and, in many cases, the Ritalin had been replaced by Adderall, officially brought to market in 1996 as the new, upgraded choice for ADHD, but more effective and longer-lasting.
In the next decade, the number of Adderall prescriptions had jumped to almost 9 million annually. Adults were taking the drug in increasing numbers as well. In 2012, roughly 16 million Adderall prescriptions were written for adults between ages 20 and 39, according to QuintilesIMS, a health care data company. Today, Adderall is the second most abused drug on college campuses, widely taken by students both with and without a prescription.
Designed to disrupt the central nervous system and decrease impulsive behavior, Adderall works fine for people with ADHD who need help focusing. Adderall acts as a sedative to counteract hyperactivity in the brain.
While Adderall does improve concentration, the amphetamine can also cause sleep disruption and serious cardiovascular side effects, such as high blood pressure and stroke. People who abuse Adderall are also at risk for mental health problems, such as depression, bipolar disorder and unusual behaviors including aggressive or hostile behavior.
The abuse among college students is enough to pay attention to. Almost 16 percent say they misuse prescription stimulants, often in the quest for better grades, according to researchers at The Ohio State University. But contrary to their popular belief, these so-called “smart pills” do not provide the brain with any added superpowers.
According to one study, Adderall may even impair working memory performance in college students who do not have ADHD. Even so, Adderall does promise to deliver a euphoric charge, which makes the drug attractive to students who are cramming for tests and looking for the help that another cup of coffee won’t provide.
Adderall is easy to abuse. When prescribed, Adderall is usually taken in the morning as a pill or capsule. Unfortunately, once crushed or opened, the amphetamine can be injected or snorted, which makes a pill or capsule easy to abuse with other drugs. Mixing alcohol and Adderall can be dangerous, especially for those using the stimulant for purposes other than medicinal.
Adderall is available in an immediate-release version; sometimes referred to as “Adderall IR” and an extended-release version, “Adderall XR. Both versions of the drug contain dextroamphetamine and amphetamine, which means they both have a high potential for abuse and dependence and the same side effects.
As a stimulant, either version of Adderall acts quickly, often in less than an hour. The same symptoms associated with other stimulants can be expected from the use of Adderall.
But Adderall is not for everyone. While the drug may make some calm and relaxed, as a performance-enhancer Adderall can also cause:
In a tablet form, Adderall needs to be taken every six hours to maintain effectiveness and every 24 hours for Adderall XR.
The euphoric effects of Adderall IR in a tablet form will peak after four hours and begin to decrease over the next two hours. Adderall XR effects will last a full 10-12 hours.
Any form of Adderall needs time to entirely leave bodily fluids including blood, saliva, and urine.
How long depends on the physiological makeup — height, weight, age, the percentage of body fat, fitness habits and overall health — of the individual taking the medication, frequency of use and stress levels. In most cases, Adderall in immediate release tablets cannot be detected in the body after two days; and three to four days for extended relief capsules.
Misuse of Adderall can lead to unpleasant and severe side effects including:
Adderall use, even among those who have prescriptions and comply with a doctor’s treatment plan, can succumb to physical dependence. When the body is conditioned for Adderall use, more of the drug is required to achieve the desired effects over time.
Although each is unique and may experience a different set of circumstances than another who is dependent on Adderall, early signs of addiction to the stimulant may include:
When an individual goes “off label” and abuses Adderall by either taking too much or begins to snort or inject the drug, the risk of overdose dramatically increases. Signs of overdose include:
Adderall is not impossible to live without. Although some products claim to flush the stimulant from the body, the best way to remove Adderall from the system is to let the drug clear naturally.
If you or a loved one needs assistance with an addiction to Adderall, then the best chance at recovery is to ask for help. A fresh start toward a life without Adderall begins with detoxification, typically at a residential treatment facility. Here, doctors can prescribe medications to alleviate any unpleasant withdrawal symptoms and medical staff can monitor progress to prevent complications.
Behavioral therapies including cognitive behavioral therapy (CBT) and contingency management (CM) can treat those who are addicted to Adderall or dependent on the drug. A central element of CBT is anticipating problems and enhancing a patient’s self-control by developing effective coping strategies, such as:
By modifying a patient’s expectations and the behaviors associated with Adderall, cognitive behavioral therapy can help to manage triggers and stress and eventually prevent abuse. Contingency management provides vouchers or small cash rewards for positive behaviors such as staying drug-free.
National Institute of Drug Abuse. from https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants
American Scientist (May-June 2018). from https://www.americanscientist.org/article/is-drug-addiction-a-brain-disease
U.S. National Library of Medicine (June 2006). from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1524735/