Adderall Addiction: Signs, Side Effects, and Treatment

Adderall is a prescription stimulant medication formulated as a combination of dextroamphetamine and amphetamine. It is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy—an illness characterized by uncontrollable episodes of deep sleep.¹ Stimulant medications are drugs that increase activity in the central nervous system (CNS) to help with alertness and attention, boost energy, and improve focus. When prescribed by a doctor and taken as directed, Adderall is legal to use, but Adderall may also be illegally obtained and misused.

People sometimes misuse Adderall for the rush of euphoria (i.e., the “high”), or to feel that they move faster, are more alert and can be more mentally and physically active when taking them.²

Misuse of stimulant medications can be dangerous and lead to dependence and addiction Adderall is known as a “study drug” or a performance enhancer, since some people will use it to help them stay awake to study for a test or perform better in sports.² Misuse of Adderall can lead to addiction, particularly when people start to use higher amounts, so

it’s important to understand the potential for misuse, particularly if you or someone you know is struggling with Adderall addiction.²

This article will further explain:

• What Adderall is.
• How it works.
• Adderall side effects, including health risks.
• Signs of Adderall addiction.
• Symptoms of Adderall withdrawal.
• Treatment for Adderall addiction and stimulant use disorders.

What is Adderall?

Adderall is the brand name for a prescription medication that combines dextroamphetamine and amphetamine. It is classified as a central nervous system (CNS) stimulant.³ It is often prescribed as a part of a treatment plan to help control symptoms of both pediatric (age 6 and older) and adult ADHD, which can include distractibility, short attention span, hyperactivity, and impulsivity.^1,3 It can also be prescribed for narcolepsy in adults and children over 6 years old.³

The U.S. Drug Enforcement Administration (DEA) classifies Adderall as a Schedule II controlled substance which means it has a high potential for misuse and dependence.³

Adderall XR, an extended-release formulation of dextroamphetamine/amphetamine, is currently the only brand name formulation available; however, the medication is also available as a generic drug in both extended-release and immediate-release formulations. Extended-release formulations reach their maximum effect at around 7 hours while immediate-release formulations reach maximum effect in the body at around 3 hours.⁶

Prescription stimulants like Adderall are sometimes misused by high school and college students looking to achieve higher levels of energy, enhance memory or focus, and boost school or athletic performance.⁹ In 2018, among college-age students in the U.S., about 11.1% reported misusing the drug compared to 8.1% of non-college peers.⁵

How Does Adderall Work?

Amphetamines and other prescription stimulants increase the activity of two neurotransmitters: dopamine, which is involved in the reinforcement of rewarding behaviors; and norepinephrine, which activates the sympathetic nervous system and affects things like blood pressure, pulse and breathing.³

Studies have shown that prescription stimulants like Adderall can be effective at decreasing impulsivity and distractibility in children and adults with ADHD, while also increasing cognition, reaction time, and short-term memory.⁸

People misusing Adderall for non-therapeutic reasons may feel different effects, such as:^{2, 9}

• Feelings of joy and euphoria (i.e., a “high” or “rush”).
• Feelings that things are extremely clear.
• Feeling more in control and self-confident.
• Feeling more sociable.
• Having increased energy and the need for less sleep.

What Are the Side Effects of Adderall?

When Adderall is taken as prescribed and directed by a physician for the treatment of ADHD, it can lead to a drastic reduction in symptoms such as distractibility and an inability to focus.⁸ Yet, amphetamines like Adderall also have the potential for adverse side effects that can include:⁸

• Insomnia.
• Decreased appetite.
• Weight loss.
• Headaches.
• Dry mouth.
• Nervousness.

Other side effects can be more serious, but leading people to discontinue using this medication as prescribed. These include:⁸

• Development of tics.
• Seizures.
• Psychosis.

Other Health Effects of Adderall

Adderall and other amphetamines may cause mild increases in blood pressure and heart rate (pulse), although it is typically mild when used as directed by a doctor at therapeutic dosing levels. Misusing the medication at higher doses, however, puts a person at increased risk of experiencing both short- and long-term adverse health effects. These may include:^{7, 16}

• Heart problems, including a rapid or irregular heart rate (pulse), stroke, myocardial infarction (heart attack), and even sudden death (typically seen in people with pre-existing heart abnormalities).
• The worsening of undiagnosed psychiatric conditions.
• Long-term suppression of growth in children.
• Worsening of certain vascular conditions, like Raynaud’s Phenomenon.

Other harmful adverse health effects of chronic amphetamine use, especially if misused in high doses, include:²

• High body temperature and skin flushing.
• Memory loss, problems thinking clearly, and even strokes.
• Mood problems and increased aggressiveness or violent behavior.
• Depression and suicidal thoughts.
• Psychosis and ongoing hallucinations.
• Tooth decay.

Signs and Symptoms of Adderall Addiction

Studies have indicated that individuals who use stimulant medications like Adderall as prescribed by a doctor, are at no increased risk of developing a substance use disorder at a later time.¹⁷

Misusing Adderall may lead to addiction or a substance use disorder (SUD). Misuse can include taking Adderall at higher doses, taking someone else’s medication, using it to get high, or attempting to take it in a way other than directed, such as crushing and snorting it or dissolving it in water and injecting it into a vein.⁹

Stimulants like Adderall have the potential to lead to significant tolerance and physiological dependence, especially when misused consistently at higher-than-recommended doses.

Tolerance occurs when the body has adapted to the presence of a drug, and it takes increasing amounts of the drug to feel the same effects.⁹

Dependence is characterized by the presence of withdrawal symptoms after a person stops or significantly reduces their intake of a drug.

Over time, tolerance and dependence can contribute to a person developing an addiction or substance use disorder. A person who has a substance use disorder is unable to control their substance use and they continue using a drug regardless of negative consequences, such as health problems, issues at work, school, home, or with social relationships.⁹

Only a medical professional can diagnose a substance use disorder, however, it can be helpful to know the criteria doctors use so that you can more easily recognize potential signs and symptoms of an SUD in yourself or a loved one. The Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition, contains the diagnostic criteria for various SUDs. A person who has at least two of the following symptoms within a 12-month period could be diagnosed with a stimulant use disorder:¹⁰

• Takes a stimulant drug in larger amounts or over longer periods of time than intended.
• Persistent desire or unsuccessful effort to cut down or control stimulant use.
• Spending more time in activities necessary to obtain, use, or recover from effects of stimulants.
• Having Adderall cravings or a strong desire to use Adderall or other stimulant drugs.
• Failure to meet obligations due to recurrent use of stimulants.
• Continued use of stimulants despite negative effects in social or interpersonal relationships.
• Giving up important social, occupational, or recreational activities due to stimulant use.
• Continued use of stimulants in physically dangerous situations (such as driving a car or operating machinery).
• Using stimulants despite having persistent or recurrent physical or psychological problems.
• Developing tolerance to stimulants, meaning that increased amounts of a stimulant are required to feel the same effects.
• Physiological dependence, which is characterized by the development of withdrawal symptoms after stopping or significantly reducing stimulant use.

Symptoms of Adderall Withdrawal

Stimulants in the amphetamine class like Adderall are addictive and misuse can lead to the development of stimulant use disorder.² Physiological dependence is one of the criterion for a stimulant use disorder. A person who has a physiological dependence on Adderall or other stimulants will experience adverse effects when trying to stop using or significantly reducing their use. These adverse effects are known as withdrawal symptoms.²

Symptoms of Adderall withdrawal and its severity can differ from person to person, and may include:²

• Strong cravings for Adderall.
• Mood swings that can range from feeling depressed, agitated, and anxious to even feelings or thoughts of suicide.
• Feeling fatigued.
• Inability to concentrate.
• Hallucinating or psychosis.
• Headaches, aches and pains, increased appetite, and not sleeping well.

Symptoms of an Adderall Overdose

When someone has overdosed by taking too much Adderall, the effects will depend on the amount taken and whether it was taken with any other medication or drugs.¹² Regardless, if you or a loved one is experiencing an overdose on Adderall or any medication, you should contact 911 immediately. Some of the general signs and symptoms to look for when someone has overdosed on Adderall or other amphetamines include:¹⁸

• Pupil dilation.
• A fast or irregular heartbeat that may lead to feeling lightheaded or dizzy or fainting.
• Restlessness and feelings of panic and agitation.
• Aggressive or combative behavior.
• Tremors.
• Overactive or over-responsive reflexes.
• Paranoia.
• Confusion or hallucinations.
• Seizures.

Adderall Addiction Treatment

Addiction is a chronic medical condition that can be effectively treated. Detox may be an important first stage in recovering from a stimulant use disorder. This is especially true for those with long-term amphetamine misuse, since withdrawal symptoms can be more severe, especially if a person expresses suicidal thoughts or attempts to act on them.¹¹

Continuing treatment after detox will include the use of behavioral therapies combined with education and other supportive services. This may occur in either inpatient or outpatient settings. Currently, there are no FDA-approved medications to treat stimulant use disorder, although studies in this area remain ongoing.¹³

A treatment plan for stimulant use disorder will be tailored to a person’s individual needs and may include individual or group counseling, behavioral treatments, and support or mutual-help groups, like 12-step groups.¹³ If needed, treatment plans may also address co-occurring mental health disorders.

People may undergo treatment in inpatient or outpatient settings:

• Inpatient treatment means a person lives at a facility during treatment to receive 24/7 care. Inpatient treatment can last anywhere from a few weeks to months.
• Outpatient treatment can vary in intensity and frequency, and main difference vs. inpatient is that a person lives at home and travels to a facility to receive outpatient treatment.¹⁴

Treatment methods useful in treating stimulant use disorders include:¹⁵

• Cognitive-behavioral therapy (CBT). This helps people identify and change unhelpful or negative thoughts and behaviors that led or contributed to the addiction.
• Contingency management. This is designed to help increase a person’s motivation to change by providing positive reinforcement (usually as incentives like vouchers for tangible items) for not using drugs.
• Self-help or mutual help groups. This may include 12-step groups like Narcotics Anonymous.

If you or a loved one are struggling with Adderall or stimulant addiction,

American Addiction Centers (AAC) is here to help. Our compassionate navigators are available 24 hours a day to listen and understand your situation to help you choose the right treatment. Contact us today to verify your benefits and learn more about treatment options tailored to you.

 

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2. S. National Library of Medicine (2020). Substance use – amphetamines.
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5. National Institute on Drug Abuse. (2019). Drug and Alcohol Use in College-Age Adults in 2018.
6. Food and Drug Administration. (2007). Medication Guide Adderall XR.
7. Food and Drug Administration. (2007). Medication Guide Adderall.
8. Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., & Hechtman, L. (2008). Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatric disease and treatment, 4(2), 389–403.
9. National Institute on Drug Abuse. (2018). Prescription Stimulants Drug Facts.
10. Stimulant Related Disorders. Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
11. Shoptaw, S. J., Kao, U., Heinzerling, K., & Ling, W. (2009). Treatment for amphetamine withdrawal. The Cochrane database of systematic reviews, 2009(2), CD003021.
12. National Capital Poison Center. Poison Control. ADHD Drugs
13. National Institute on Drug Abuse. (2020). How Can Prescription Drug Addiction be Treated?
14. National Institute on Drug Abuse. (2014). Treatment Settings.
15. National Institute on Drug Abuse. (2014). Behavioral Approaches.
16. Sinha A, Lewis O, Kumar R, Yeruva SL, Curry BH. (2016). Adult ADHD Medications and Their Cardiovascular Implications. Case Rep Cardiol.
17. Humphreys KL, Eng T, Lee SS. (2013). Stimulant Medication and Substance Use Outcomes: A Meta-analysis. JAMA Psychiatry.
18. Spiller, H.A., Hays, H.L. & Aleguas, A. (2013). Overdose of Drugs for Attention-Deficit Hyperactivity Disorder: Clinical Presentation, Mechanisms of Toxicity, and Management. CNS Drugs.