When people think of prescription drug addiction, their minds are most likely to first turn to prescription opioids, and with good reason, as overdoses from prescription opioid abuse continue to rise. However, opioid prescriptions are unfortunately not the only prescription medications that are seeing an upward trend in addictions and abuse.
According to the 2015 National Survey on Drug Use and Health, roughly 2.5 million adults aged 18 to 25 were reported to have misused prescription stimulants like Adderall. Within that age bracket, those abusing prescription stimulants are overwhelmingly young adults and college students. Students will often engage in prescription stimulant abuse largely in an attempt to increase their academic performance, but also sometimes to suppress the effects of alcohol so that they can drink more or even to aid in weight loss.
Part of the issue is that, compared to opioids, whose dangers are dominating the news, there is a much lower stigma surrounding drugs like Adderall in the sense that they are seen as “safe” to misuse, particularly for the sake of studying. Another contributor to widespread prescription stimulant abuse in college is that this is where many students have their first experiences as “adults,” and are responsible for themselves and free to do things they couldn’t before. This is only exacerbated by how readily accessible drugs like prescription stimulants are on college campuses.
In fact, non-prescription use of prescription stimulants is so common during college that taking even dangerously high amounts of medications like Adderall to stay up all night working on papers or cramming for exams is seen by many students as part of the normal college experience, an ordinary situation that carries no serious consequences. As of 2014, about one in five students at Ivy League universities were reported as abusing prescription stimulants.
Of course, prescription stimulant abuse has plenty of negative consequences, including addiction, heart problems, an increased risk of alcohol poisoning, brain damage, and much more. This is why it is so important to understand the dangers of prescription stimulant addiction and be able to spot the signs of abuse and dependency in time, so someone who is struggling with prescription stimulant addiction can seek out treatment before it’s too late and permanent damage has occurred.
In general, the term stimulant refers to a class of drugs that increase alertness, energy, and feelings of euphoria, as well as boost metabolism and mask the effects of depressants like alcohol.
Some stimulants have established medical uses, and while they are sometimes prescribed to treat the symptoms of sleep disorders like narcolepsy or even obesity, they are mainly used in the treatment of Attention-Deficit/ Hyperactivity Disorder (ADHD).
ADHD is a neurodevelopmental disorder that was, even as recently as 40 to 50 years ago, a controversial diagnosis.
But as more studies and research were devoted ADHD, it became clear that it was a real disorder affecting millions of people. In fact, in 2015, it was estimated that at least 51 million people were living with ADHD.
Ritalin was among the first prescription stimulants to be prescribed by doctors to treat the symptoms of ADHD, along with Concerta, a different brand that is essentially the same substance. Today; however, Adderall, the brand name for a combination of four different amphetamine salts, has largely become the drug of choice for counteracting the effects of ADHD, with newer drugs like Vyvanse also growing in popularity for use as ADHD treatment.
When taken as properly prescribed by those that require them, prescription stimulants can be extremely beneficial. Unfortunately, these stimulants are all Schedule II drugs, meaning that while they have proven medical usage, they carry a high risk of addiction and potential for abuse.
Many people without ADHD may abuse prescription stimulants recreationally for the effects of increased euphoria and energy, seeing them as a safer alternative to illicit stimulants like cocaine.
Research on ADHD has shown that people who have been diagnosed with the disorder have extremely low levels of dopamine and norepinephrine in their brains. This can significantly impair several different key brain functions and is the root cause for many of the symptoms associated with ADHD.
Dopamine is a neurotransmitter that regulates what is commonly referred to as the brain’s “pleasure center,” controlling not only pleasure but also emotion, cognition, and, most importantly in the case of ADHD, our motivation and reward system. Norepinephrine, also a neurotransmitter, is responsible for controlling how the brain responds to outside events in terms of reaction speed and the ability to pay attention.
Adderall, Ritalin, Concerta, and Vyvanse all work in similar ways in that they increase the levels and general activity of dopamine and norepinephrine in the central nervous system. The norepinephrine makes the user more alert and aware by speeding up brain activity, and the dopamine provides a small amount of euphoria to create a greater sense of motivation and can actually make the brain pay more attention to tasks by literally perceiving it as more interesting.
They do this in two different ways, which also marks the major difference between these substances. The first way is by activating dopamine and norepinephrine receptors in the brain to create more of these neurotransmitters. The second is by blocking a process known as “reuptake.”
Normally, the brain will release a certain amount of a brain chemical and then, when it feels the effects these chemicals produce are no longer needed, reabsorbs them. This is the reuptake process and is how the brain regulates the amount of a given neurotransmitter remaining in the brain and central nervous system and how long it stays there.
While Ritalin and Concerta produce amphetamine-like effects, they are not amphetamines and function solely as “reuptake inhibitors”. This blocks the reabsorption of dopamine and norepinephrine and allows them to instead build up in the synapses and reach much higher levels, causing the sharp increase in feelings of alertness, energy, and euphoria.
Adderall and Vyvanse, conversely, are both amphetamines and considered to be both stronger and more stimulating than their non-amphetamine counterparts. These substances have the double effects of blocking reuptake and increasing dopamine and norepinephrine.
As with any substance that alters the brain’s dopamine levels, if regularly abused, the brain begins to stop making dopamine on its own in order to balance out the high levels of dopamine that are being artificially produced. This is why, after an extended period of regular prescription stimulant abuse, when someone tries to suddenly stop taking it, the body crashes and is unable to function on its own.
This crash can be especially intense if the person misusing prescription stimulants does not have ADHD and is unused to dealing with low dopamine, creating the cycle of abuse and dependence that leads to addiction.
The physiological effects of prescription stimulants mirror those of illicit stimulants like cocaine but tend to last much longer. Because of this, there is a good deal of medical controversy surrounding the use of amphetamines as prescription medication and whether or not the benefits outweigh the potentially harmful side effects and risk of dependency and addiction.
When prescriptions stimulants are abused in excess or taken in unintended ways to create a more intense high, such as by snorting or injecting crushed pills, the short-term effects include:
At extremely high doses, prescription stimulants can also have extremely serious health effects such as:
When someone becomes dependent on prescription stimulants to the point of addiction, there are many signifiers of increasing abuse and dependency that manifest physically, mentally, and behaviorally. Some common signs of prescription stimulant addiction include:
And as obtaining and using prescription stimulants becomes the most important thing in someone’s life as well as the driving force behind the majority of their decisions, certain common behavioral signs serve as markers not only for prescription stimulant addiction but substance use disorders in general.
These warning signs include:
If you’ve experienced these symptoms or have observed them in someone you know, they are indicative of prescription stimulant addiction and require the aid of professional help and treatment as soon as possible.
The first step in prescription stimulant addiction treatment is detoxification, flushing out the substances from the body to counteract their negative effects and ensure that an individual is fit to enter into a recovery program.
Prescription stimulant withdrawal and detox is rarely ever a life-threatening process, and can sometimes be handled on an outpatient basis for non-amphetamine medications like Ritalin, as well as if the addiction is not particularly severe. However, whether it is through an outpatient detox program or a more heavily monitored inpatient program, detox should always be carried out under the care and supervision provided by a professional medical detox center.
And in the case of severe prescription stimulant addictions, especially amphetamines, someone undergoing detox can experience intense depression, violent mood swings, insomnia, and suicidal thoughts, which can create a high risk of self-harm or even attempted suicide. There is also a risk of seizures, which can be potentially deadly without medical intervention and monitoring.
A doctor at a medical detox center can also prescribe different medications to help ease the symptoms associated with prescription stimulant withdrawal. Some common medications used specifically during prescription stimulant addiction treatment include:
Anticonvulsant medications are often used to help avoid the dangers of seizures that can occur during the initial crash phase of withdrawal.
Mild sedatives and sleep aids can be administered to help induce sleep for those experiencing withdrawal symptoms such as exhaustion, restlessness, and insomnia.
Antidepressants are also frequently utilized to help minimize the often intense feelings of depression and suicidal thoughts.
Anti-anxiety medications are also used to lessen the chances of panic attacks and lower stress levels in general.
Detoxing at a medical detox center ensures that you have a safe withdrawal process that avoids any unnecessary discomfort and the potential for relapse.
The next step in prescription stimulant addiction treatment once detox has concluded is transitioning into a recovery treatment program. Otherwise all detoxing will have accomplished is putting a bandage on the problem. In order to properly address the issues at the heart of an individual’s addictive behaviors, an addiction rehabilitation treatment is essential.
Undergoing rehabilitation treatment and therapy will help provide the tools and skills to help someone manage their addiction in the long-term, as well as provide a network of support that can make all the difference in not only getting on the path to recovery but also staying on it.
While there are many different treatment options available, from standard therapies like individual counseling and 12-step programs as well as holistic options, treatment plans will vary based on what is deemed most helpful for an individual patient based on assessment and evaluation.
As previously mentioned, prescription stimulants are widely considered safe for misuse and abuse in contrast to illicit stimulants or even other prescription medications such as opioids. But this is not the case, there is no such thing as “safe substance abuse,” and prescription stimulants are no exception.
Because many people are unaware of the dangers posed by prescription stimulant addiction, they are less wary of becoming addicted as well as taking too much at one time and overdosing. Some may not realize that it’s even possible to overdose on drugs like Adderall.
Prescription stimulant overdose symptoms most commonly include:
And even when taken at regularly prescribed doses, these stimulants can cause sharp increases in blood pressure, heart rate, and body temperature, as well as a decrease in appetite and sleep. When abused in the long-term, prescription stimulant addiction can lead to stroke, blockage of blood vessels, and serious cardiovascular problems.
In addition, there is the danger posed by mixing prescription stimulants with alcohol or other drugs. While some may engage in polysubstance use with a variety of sedatives, the most common secondary drug used in combination with prescription stimulants, especially Adderall, is alcohol.
College students, in particular, will frequently mix prescription stimulants with alcohol in order to drink more without feeling the effects of intoxication. This not only places a significant strain on the heart but leads to over-drinking, which can have serious consequences like:
All of which have the potential to end someone’s life if help is not sought in time.