The prescription drug Adderall is made to do just one thing: help people with Attention-deficit/ Hyperactivity Disorder (ADHD) enhance their sense of focus. For people who have ADHD, Adderall can mean the difference between completing a simple task in a few minutes or a few hours.
Since 1990, sales of prescriptions like Adderall have risen 400 percent, according to an article in the Journal of Law and Education. That rise can’t be attributed solely to a rise in the number of people with ADHD. Instead, it’s often attributed to a rise in the number of people who abuse the drug.
People who don’t have ADHD but who take Adderall may also experience a boost in focus. They may also experience a sense of intense happiness and joy. That combination of joy and focus can keep people taking the drug even though the substance is remarkably damaging.
Adderall is particularly damaging to the heart. Understanding the risks that come with this particular type of drug abuse could help some people to understand that abusing Adderall, even occasionally, just isn’t safe.
Each Adderall pill contains a mixture of two substances, both closely related to amphetamine. Researchers writing in Columbia Science Review explain that Adderall’s chemical structure is similar to the structure of the natural brain neurotransmitters epinephrine and norepinephrine.
Adderall molecules attach to brain receptors for epinephrine and norepinephrine, and they block the action of other chemicals that would render these substances inert. That means levels of both substances are artificially elevated within the brain.
Epinephrine and norepinephrine are involved in our “fight-or-flight” responses. As an article in the Huffington Post explains, when these chemicals are active within the body, the heart beats faster and some blood vessels shrink. This allows us to have quick reflexes and fast movements, so we can assess and/or get away from a threat that is close by. It’s this response that allowed our ancestors to survive in a world full of predators.
For someone with ADHD, an elevation in these neurotransmitters would result in an enhanced sense of focus. They may have a deficiency in these neurotransmitters naturally, so the medication helps to replace what isn’t there. But the way the substances work on the body, especially the heart, can cause intense harm.
In a report published in the journal Case Results in Cardiology, the authors highlight that amphetamines like Adderall can increase resting heart rate by about 5.7 beats per minute, and they can increase systolic blood pressure by 1.2 mmHg. The authors point out that these are increases that seem small, but they can have a huge impact on overall health.
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Blood pressure is a measurement of the strength of blood pressing on the walls of blood vessels with each beat. The American Heart Association reports that high blood pressure causes the arteries that serve the heart to clog up with plaque deposits. Normally, these deposits would whisk away through larger openings, but when things are tight and closed, there is no way for them to move out.
Arteries tight and closed with plaque can lead to blood clots. A clot can block blood flow to a portion of heart muscle, and that blocked portion can die off. Death or damage to the muscle as the result of a block is known as a heart attack. Someone who has a heart attack may experience the classic symptoms of passing out while clutching an arm, but a subtle heart attack may come with smaller symptoms, such as:
Since Adderall is known to raise blood pressure scores, there is a link between use of this drug and risk of heart attack.
When measuring heart health, doctors do more than assess blood pressure. They also assess how quickly the heart is beating. Heart rate is important, according to Harvard Medical School, because the heart’s work is vital to survival. When the heart beats at an optimal level, it can deliver oxygen and nutrients to all cells within the body. When the heart isn’t beating properly, the entire body could be at risk for issues.
A normal heart rate is between 60 and 100 beats per minute, Harvard Medical School says. Since Adderall can increase heart rate, it puts the entire body at risk. Some people with a fast heart rate may notice the difference, and they may feel tense or worried. Others may experience rapid heart rates intermittently while feeling normal beats most of the time.
People who take Adderall typically take doses between 5 mg and 60 mg each day, according to an article in Topics in Companion Animal Medicine. Most research done on the heart dangers of Adderall have been performed with people taking this recommended amount of the substance. Even at this level, dangers have been spotted.
The National Capital Poison Center reports that the dangers are so real that some doctors choose to perform heart tests on their patients before they prescribe Adderall. They may assess the speed and regularity of heart rate, or they may take images of the heart. If they find irregularities in these screening tests, they may choose a different medication for those patients struggling with ADHD.
Doctors who perform these tests aren’t overreacting. But studies performed on the link between healthy people and Adderall have come back with some reassuring news.
In one of the largest studies of the issue, published in JAMA, researchers found that there was no strong link between supervised Adderall use and the risk of serious heart problems (like heart attacks) in young people. Even so, this study came with some limitations that could be vital for people who abuse the drug.
Researchers in this study were focused on people who had a prescription for Adderall and were taking that prescription as directed. They did not perform what’s known as a “dose-dependent analysis” to determine if the risk of problems was related to the amount that people took. They did not include people who had taken Adderall without a prescription.
Someone who abuses Adderall may take two or even three times as much of the substance as prescribed. This person may take the drug at different times of day and in different doses each time. That means a drug user like this is very different than someone using the drug for therapeutic purposes. The amounts, and the damage done, could be very different.
People with an Adderall addiction may take the drug for a very long period of time, and that also can be dangerous.
A doctor interviewed for ADDitude reports that increases in blood pressure and heart rate caused by stimulants can build up. This cumulative damage can lead to a larger amount of damage in time. The longer people have taken the drug, he says, the more they need testing for heart issues.
In addition to causing damage to the heart, Adderall can damage other vital systems throughout the body. According to the National Institute on Drug Abuse, Adderall intoxication can lead to anger, paranoia, or psychosis. People who overdose on Adderall can develop:
These early symptoms can intensify into seizures, and those who develop seizures require immediate medical attention and medication in order to survive.
Medical treatment for Adderall overdose involves restoring blood flow, reducing body temperature, and stopping seizures. When people feel well after overdose, the work isn’t done. Next, people need to address their triggers for substance abuse and learn how to gain control of those triggers.
People who abuse Adderall may need programs that address addictions to multiple substances. In research published in the Journal of American College Health, researchers report that people who abuse Adderall were more likely to abuse other substances (such as cocaine, alcohol, or opiates) when compared to people who used Adderall with a prescription and didn’t abuse it.
In a program designed for people with complex addictions, therapists help their clients to understand their personal triggers for drug use. For some, that might be social situations. For others, it might involve stress. Therapists can help their clients to dig deep into the people, places, and things that tend to spark their urge to use. They can help clients build up their skills, so they won’t use when they encounter these triggers. These programs are remarkably effective.
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Adrenaline, Cortisol, Norepinephrine: Major Stress Hormones, Explained. (April 2013). Huffington Post. from https://www.huffpost.com/entry/adrenaline-cortisol-stress-hormones_n_3112800
Adult ADHD Medications and Their Cardiovascular Implications. (August 2016). Case Results in Cardiology. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992783/
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Cardiovascular Screening and ADHD Meds. ADDitude. from https://www.additudemag.com/cardiovascular-screening-and-adhd-meds/
Prescription Stimulants. (June 2018). National Institute on Drug Abuse from https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants
Characteristics of College Students With Attention-Deficit Hyperactivity Disorder Symptoms Who Misuse Their Medications. (April 2011). Journal of American College Health. from https://www.tandfonline.com/doi/abs/10.1080/07448481.2010.513073