Adderall Abuse
The Biological & Mental Impact of a "Socially Accepted" Stimulant

What is Adderall?

Adderall is the trade name of one of the most relevant drugs of the last decades among American College students. It is a mixture of four different amphetamine derivatives, a stimulant drug used as a formal treatment for attention-deficit hyperactivity disorder (ADHD) and narcolepsy.

In 1971, six years after the FDA limited the use of the drug to prescription-only patients, over 30% of American students were using it illegally to boost their mental status and study faster, better, and have excellent results.1

Although this rate subsequently dropped, there was another one that rose amidst the peace: the rate of abuse. Unfortunately, amphetamines are extremely addictive drugs, which have an important component on the central nervous system, creating a kind of cycle from the alteration of several receptors in our brain.

The abuse of amphetamines is a serious public health problem today. The worst characteristic of this drug is that those affected are usually adolescents and young adults, making it the second most widely used illegal drug.2

Even so, it seems that in recent years the number of older adults who use these drugs has increased by up to 700% in just 7 years. 3

The Origin of Abuse

There are several factors that encourage or promote the abuse of stimulant drugs such as Adderall and are important, as they are also part of the treatment and rehabilitation of these patients. We will discuss each of them later, however, there is one thing that is more interesting and worth highlighting above all else: false expectations. 

All people who use this drug do so thinking that the stimulants will enhance their neurocognitive ability, assuring them of better performance and achievement in their academic activities, which seems not entirely true.4 The biggest problem is that most of them tend to relapse into abuse, and this has a severely negative impact.

Many studies have been devoted to testing the effect of Adderall abuse, and all have shown direct results: no long-term benefits. Rather, it brings severe complications that must be managed by specialists. One of the first, just to give an example, is insomnia, and lack of sleep not only prevents the fixation of knowledge (since sleep is crucial for memory) but also interferes with our reasoning, processing, logic, etc.5

adderall

Although the first time a patient uses Adderall he will feel a kind of “hype” that will help him to concentrate, the bill will be too expensive. The next time he uses it the effect will not be the same, moreover, if it is a university student using it to improve his academic performance, it is likely that by the time of the test he will only be extremely tired and uncontrollable.

That brings us to the first point, or the first reason, that creates the abuse: the pressure to succeed. In an article written by Matthew D. Varga for the Journal of Evidence-Based Social Work,6 the 4 most relevant reasons inciting people to consume Adderall were published. The first, and most prominent, was the pressure to succeed.

Pressure for Success:

The desire to succeed is something that lies in almost all of us. It can work as an excellent intrinsic motivator, but it can also consume us if we don’t manage it properly. For a student, there is no choice but to succeed, although the degree of importance may differ from person to person. There are several factors that can contribute to this point, such as parental, school, college, and personal pressure.

Social-Cultural:

The other problem is the social and cultural perception of the use of Adderall. Its consumptions has become normalized, especially among university students who see it as a “recreational” or “necessary” to concentrate and pass the corresponding exams. For them, this is not a “real” drug, as cocaine or heroin would be. Also, some students believe that because it is a “prescription” drug it is not illegal. This illogical thinking is very dangerous and leads to the consensual use of the drug.

Collegiate Lifestyle:

As we mentioned, young adults are the most relevant population at risk. Among them, university students are the most affected and where this drug is most frequently found. The “typical” lifestyle of a college student acts as a catalyst for Adderall use. They need a booster that allows them to party all night, but also to present very important evidence the next day. Some even believe that college is the best place and time to try drugs.

Accessibility:

The last relevant point is the easy accessibility that students have to the Adderall. According to Matthew Varga, the lack of regulation by the institutions towards this problem seems to collaborate with the ease with which students can acquire various drugs. They have even studied the symptoms of attention deficit disorder and they go to a specialist pretending to have them, only to be prescribed Adderall.

Over time, continued use of Adderall will only cause an effect known as “tolerance”, our bodies will get used to it and create a kind of “need” for the drug, and that is where dependent, uncontrollable abuse begins. The worst part is that this drug causes early and permanent effects on our body, and the only way to prevent this is to act in time.

The Biological Effect of Adderall

Amphetamines primarily affect our central nervous system. The brain is the most affected organ, although it’s not the only one. Usually, drugs or medications that affect the CNS usually have an impact on our whole body, since the nerve impulse is transmitted from the brain to our fingertips. Let’s evaluate the impact of Adderall a little.

Neurotoxicity

Every scientist knows that any high dose of amphetamines is lethal. This drug can alter the secretion of neurotransmitters fundamental to the correct functioning of our brains, such as dopamine and serotonin. 7,8 This causes serious mental disorders, such as the appearance of generalized anxiety disorders, depression, and even psychosis.

In addition, the same alteration in neurotransmitters (especially dopamine) can alter our metabolism by interfering with the production and secretion of various hormones (such as tyrosine hydroxylase). Some studies claim that it can cause cerebral hemorrhagic events at high doses.

Abuse of Adderall destroys our brain from within. During the period that you use the drug, your basal requirements increase greatly; it is as if you must eat 10 times a day to maintain function. Since that doesn’t happen, there is latent damage in almost every area that your brain is constantly trying to compensate for 9.

It’s as if you damage one region of your body in order to partially recover another. At the end of the period, all that’s left is an obsolete brain, with a ridiculous consumption of glucose and other nutrients just to try to survive.

Do you have any idea what it means that your brain cannot control its energy expenditure? At first, it only affects its functioning, but then it creates structural changes that are almost irreversible 10. The cerebral cortex, the thalamus, the striated nuclei, etc. Everything begins to readjust just to be able to carry the load.

Beyond the Central Nervous System

Just as it affects the basic structures of the CNS, it also affects the rest of our body. This can be expressed in various ways, such as hypertension, tremors, cramps, generalized weakness, insomnia, serious cardiovascular disorders, liver disorders, and a host of other possibilities. 

What would happen if you stopped using Adderall, but were left with high blood pressure or permanent tachycardia? What if the use you consider “safe” ended up causing a fatal arrhythmia? This is the effect that Adderall could have on patients who abuse this drug or not. Maybe there is another solution to overcome the tests, one that does not cause any fatal body alteration.

Symptoms of Adderall Abuse

We already know what happens in the body of an Adderall abuser, but how does that manifest itself? Well, it depends on the dose and the time of exposure to the drug. Among the most frequent signs and symptoms we have11.

 

The most relevant symptoms are born from the alterations we have mentioned such as tachycardia (palpitations) and arterial hypertension.

Some patients experience prolonged muscle contractions or, at least, muscle pain.

As well as the acceleration of the heart, pulmonary ventilation is also frequently accelerated. 

Many often develop pain when urinating, due to the narrowing of the urinary channel, as well as urinary retention, due to the total contraction of the urethra or the bladder trine.

Some general symptoms are severe agitation, confusion, generalized weakness, mydriasis (pupil dilation), fever, and other symptoms.

All of these arise from the frequent consumption and abuse of Adderall. However, in severe cases of overdose, much more serious complications can occur, such as cardiogenic shock, cerebral hemorrhages, circulatory collapse, convulsions, psychosis, rhabdomyolysis (a major cause of acute renal failure), pulmonary edema and hypertension, renal failure, extreme temperature rise, etc.

Adderall Abuse Management

Managing Adderall abuse can be complicated, requiring time and specific techniques to improve the patient’s quality of life and help them get through the stage. The primary approach is to treat the sympathomimetic syndrome that the drug develops (generating activation responses, such as tachycardia, urinary retention, tachypnea, etc.). In addition, certain drugs such as benzodiazepines can be used, but with very close monitoring.

Complete Rehabilitation & Maintenance

The first thing is to decontaminate the gastrointestinal system,12 especially in early overdoses. Our first aid is activated charcoal, a compound that binds to amphetamines and does not allow the Adderall to be removed before it can have a more serious effect on the body. However, it can only be used in patients who are not severely mentally compromised (at least conscious). Once we cleanse the whole system of any pills, capsules, or traces of Adderall left in the system, we can start with physical and mental treatment to overcome the abuse and possible addiction or dependency. Remember, even though they are our loved ones, they are still drug addicts, so we need to watch closely at every step.

Hospitalization & Late Detox

While we clean the Adderall that remains active out of our system early, we must mitigate the effects of the amphetamines that are circulating in our blood, and that can last a few days.13 You need to have a close evaluation; monitor everything you ingest and use some specific medications to decrease the impact of the withdrawal syndrome that this drug can cause.

Also, you need to stay for as long as it takes. Some patients can be rehabilitated within a couple of weeks, while others need months to do so. The brain will experience some sort of dopaminergic “seizure” (one of the neurotransmitters most affected by Adderall), which will cause withdrawal symptoms and cravings.13

Complete Rehabilitation & Maintenance

Educating patients and giving them tools to avoid relapsing into Adderall consumption is crucial. If we do not do this, we diminish the effectiveness of previous therapy and facilitate relapse. To do this, it is necessary to have a specialized team that can provide excellent post-detoxification treatment and follow up with the patient once they leave the institution.

In addition, there are various support groups that can serve as a base for staying away from this drug and creating your path away from it. Remember, the better your reintegration into society, the further away you will be from the Adderall.


Resources

  1. Sumner J. Yaffe, Charles W. Bierman, Howard M. Cann, Arnold P. Gold, Frederic M. Kenny, Harris D. Riley, Irwin Schafer, Leo Stern, Charles F. Weiss, Gregory Chudzik, Harry C. Shirkey, Lester F. Soyka, John C. Ballin, Alan K. Done, Louis Farchione, Jacques Leger, Jean D. Lockhart, Steven Sawchuk and Artemis P. Simopoulos. USE OF d-AMPHETAMINE AND RELATED CENTRAL NERVOUS SYSTEM STIMULANTS IN CHILDREN. Pediatrics. 1973 Feb;51(2):302-5. Retrieved from PubMed
  2. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future national survey results on drug use, 1975-2006: Volume I, Secondary school students. National Institute on Drug Abuse; Bethesda, MD: 2007. Retrieved from Google Scholar
  3. Substance Abuse and Mental Health Services Administration. Detailed Emergency Department Tables From DAWN:2002. National Survey on Drug Use and Health, U.S.Department of Health and Human Services. U.S.Department of Health and Human Services, Substance Abuse and Mental Health Service Administration (SAMHSA), Office of Applied Studies, Drug Abuse Warning Network, 2001 (03/2002 update); 2002. 1-23-2008. Retrieved from Google Scholar
  4. Benson K, Flory K, Humphreys KL, Lee S. Misuse of stimulant medication among college students: a comprehensive review and meta-analysis. Clin Child Fam Psychol Rev. 2015 Mar;18(1):50-76. doi: 10.1007/s10567-014-0177-z.
  5. Weyandt LL, Marraccini ME, Gudmundsdottir BG, Zavras BM, Turcotte KD, Munro BA, Amoroso AJ. Misuse of prescription stimulants among college students: a review of the literature and implications for morphological and cognitive effects on brain functioning. Exp Clin Psychopharmacol. 2013 Oct; 21(5):385-407. Retrieved from PubMed
  6. Matthew D. Varga. Adderall Abuse on College Campuses: AComprehensive Literature Review. Journal of Evidence-Based Social Work. Retrieved from PubMed
  7. Seiden LS, Sabol KE. Methamphetamine and methylenedioxymethamphetamine neurotoxicity: possible mechanisms of cell destruction. NIDA Res Monogr. 1996;163:251-76. Retrieved from PubMed
  8. Seiden LS, Ricaurte GA. Neurotoxicity of methamphetamine and related drugs. In: Meltzer HY, editor. Psychopharmacology: The Third Generation of Progress. Raven Press; New York: 1987. pp. 359–366. Google Scholar
  9. London ED1, Simon SL, Berman SM, Mandelkern MA, Lichtman AM, Bramen J, Shinn AK, Miotto K, Learn J, Dong Y, Matochik JA, Kurian V, Newton T, Woods R, Rawson R, Ling W. Mood disturbances and regional cerebral metabolic abnormalities in recently abstinent methamphetamine abusers. Arch Gen Psychiatry. 2004 Jan;61(1):73-84. DOI: 10.1001/archpsyc.61.1.73
  10. Chang L, Cloak C, Patterson K, Grob C, Miller EN, Ernst T. Enlarged striatum in abstinent methamphetamine abusers: a possible compensatory response. Biol Psychiatry. 2005;57:967–974. Retrieved from PMC 
  11. Spiller HA, Hays HL, Aleguas A (June 2013). “Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management”. CNS Drugs. 27 (7): 531–543. doi:10.1007/s40263-013-0084-8
  12. Henry A. Spiller, Hannah L. Hays, Alfred Aleguas Jr. Overdose of Drugs for Attention-Deficit Hyperactivity Disorder: Clinical Presentation, Mechanisms of Toxicity, and Management. CNS Drugs (2013) 27:531–543 DOI 10.1007/s40263-013-0084-8
  13. John J. Mariani, MD and Frances R. Levin, MD. Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders. Am J Addict. 2007; 16(Suppl 1): 45–56. doi: 10.1080/10550490601082783