Understanding Adderall Abuse, Addiction, and Treatment

Adderall is a powerful prescription medicine made up of the central nervous stimulants amphetamine and dextroamphetamine. Used for the treatment of attention deficit hyperactivity disorder (ADHD) primarily and narcolepsy, Adderall raises the levels of certain neurotransmitters, especially dopamine and norepinephrine.[1,2]

The medicine is increasingly recognized for the potential of misuse and addiction, however, despite its potential therapeutic benefits. The stimulant properties can lead to addiction and physical dependence.

Short-Term Adderall Effects

When a person takes Adderall, it helps improve focus, attention, and impulse control. It enhances cognitive performance and concentration, making tasks requiring sustained attention more manageable.[2,3] Through boosted dopamine levels, Adderall creates a feeling of euphoria or well-being and users also often experience wakefulness and heightened alertness.

Adderall stimulates the cardiovascular system in the short term, leading to elevations in blood pressure and a more rapid heartbeat. Stimulants tend to suppress appetite, and the wakefulness the medicine creates can disrupt normal sleep patterns.

Long-Term Adderall Effects

There are both physical and mental long-term Adderall effects. Chronic use can cause psychological dependence and addiction, characterized by compulsive, out-of-control use and cravings.

Over time, a user may find they need bigger doses to achieve the same effects, increasing the potential for overdose.

Long-term Adderall use and misuse can also worsen depression, anxiety and other mental health disorders.

Physically, prolonged Adderall use can lead to chronic high blood pressure and irregular heartbeats, as well as a greater risk of stroke or heart attack. Because of ongoing appetite suppression, significant weight loss and nutritional deficiencies can occur.[4,5]

Long-term use of Adderall can cause major disruptions to sleep patterns.

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Why Is Adderall Addictive?

Adderall’s primary mechanism that makes it addictive is the influence on the reward system in the brain. The amphetamine compounds that are contained in Adderall raise amounts of dopamine and norepinephrine in the brain.

Dopamine is linked to pleasure and reward. Norepinephrine is associated with attention and response actions. The release of these chemicals at high levels can increase energy and euphoria, which can be reinforcing, leading to the repeated use of the drug.

Initial use of Adderall can be medical or non-medical. The initial use, whether it leads to addiction or not, can start under medical supervision. The goal of medical use is to manage symptoms effectively.

Non-medical use might occur if someone uses the drug recreationally to improve focus, help them stay awake longer or enhance their performance at school or work.

From those initial uses, over time, with regular use, the brain gets used to the presence of Adderall. Higher doses are needed to get the same effects—this is tolerance.

As tolerance builds, a person might increase how often they’re using Adderall or the amount they’re using without medical guidance.

As the brain develops a reliance on increased dopamine levels, cravings might start happening. The need to achieve or maintain desired effects can lead to compulsive drug-seeking behaviors, where getting and using Adderall is a primary focus.

From Abuse to Addiction

Adderall abuse starts when it’s taken outside of how a healthcare professional prescribes it. This could include taking higher or more frequent doses or through methods that aren’t approved, such as crushing up tablets and snorting them. Taking Adderall to get high, enhance performance or for weight loss are also considered abuse.

The transition to addiction often occurs as someone starts losing control over their Adderall use and taking it compulsively even though there are negative consequences.

Physical dependence forms when the body is adapted to the presence of the drug, leading to withdrawal symptoms when not using it.[6]

A person who’s beginning to develop an addiction to Adderall will prioritize its use over other responsibilities and relationships. This can have a major impact on behavior and daily functioning.

Key signs of Adderall addiction, along with increased tolerance and withdrawal symptoms, include failed attempts to quit, ignoring other responsibilities, and continued use despite problems.

Other signs and symptoms of an addiction to Adderall can include:

• Doctor shopping to get more prescriptions or try to refill prescriptions early.
• Hiding or lying about use or being defensive when asked about it.
• Isolation from friends and family.
• Physical symptoms like weight loss, insomnia, or extreme fatigue during times without drugs.
• Changes in mood, such as extreme highs and lows, increased anxiety or general feelings of unease.
• Being obsessed or preoccupied with getting and using Adderall.
• Paranoia or suspicion of others.
• Impaired judgment is often related to getting or using the drug.
• Decreased cognitive function in tasks requiring mental effort without using Adderall.
• Declining performance at school or work.
• Strained relationships or conflict.
• Legal issues related to addiction behaviors or illegal activities to attempt to get the drug.

Treatment Approaches for Adderall Addiction

There are different ways to treat Adderall addiction.

The first step might be supervised medical detoxification. Medical detox is a process where your body clears itself of Adderall while managing withdrawal symptoms. Medicines can be used as needed to minimize withdrawal symptoms and manage cravings.

Cognitive-behavioral therapy, or CBT, helps with recognizing and altering negative thought patterns and behaviors linked to addiction. This can be part of an inpatient or outpatient treatment program. CBT also provides coping strategies to handle stress and triggers. Another form of therapy that can be used for treating Adderall addiction is called contingency management, which uses positive reinforcement to encourage sobriety.

Whether it’s an inpatient or outpatient rehab, other treatment approaches that could be integrated include:

• Individual counseling and group therapy.
• Participation in support groups consisting of 12-step or non-12-step programs.
• Holistic therapies include mindfulness, meditation, exercise and nutrition, yoga, and acupuncture.
• Dual diagnosis treatment integrates mental health care at the same time as the addiction is being treated.
• Educational and vocational support, such as programs to teach life skills.
• Aftercare and relapse prevention can include continued therapy, transitional living environments and prevention planning.

Successfully treating Adderall addiction is multifaceted and uses a combination of methods. Personalization of treatment plans is also necessary to address specific challenges and circumstances.

Adderall addiction is complex, requiring a personalized, comprehensive treatment approach. Through combined medical, psychological and holistic therapies, individuals can address their addiction effectively and work towards long-term recovery.

References:

1. Food and Drug Administration (FDA): Adderall
2. Oxford Academic International Journal of Neuropsychopharmacology: Efficacy of Adderall and methylphenidate in attention deficit hyperactivity disorder: a drug–placebo and drug–drug response curve analysis of a naturalistic study
3. National Institute of Health (NIH): Amphetamine
4. National Institute of Health (NIH): Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review
5. JAMA Network: Long-Term Cardiovascular Effects of Medications for Attention-Deficit/Hyperactivity Disorder—Balancing Benefits and Risks of Treatment
6. Johns Hopkins University: Adderall abuse on the rise among young adults, Johns Hopkins study suggests