Adderall and Ritalin are household names, often seen as innocuous medications used to treat attention deficit disorder (ADHD or ADD). When used to treat the condition, they are, and actually decreasing the risk for substance abuse. But their prevalence on college campuses, along with a reputation as performance enhancers, is leading to dangerous misuse of prescription drugs and drug diversion—that some say is reaching epidemic proportions.
Stimulants ≠ performance enhancers
According to a study published in the Journal of Addictive Diseases, there are many outlets purporting misinformation about nonmedical prescription stimulant use by creating enticing ideals of “performance enhancers for the brain” to teenagers, young professionals, and students. These young men and women—who are often struggling with final examinations and other situations of intense academic pressure—are inundated with headlines and rumors referencing “smart drugs” and “smart doping” from friends, online forums, and media outlets.
“Hello, I’m just tried methylphenidate for the first time because I have a huge placement test I’m studying for and needed some help with my busy schedule. I only bought 4 pills… I’m being very careful to not get addicted. I fully intend to put the drug down once this test has passed.”
Taking a pill to get better grades, do well at work, or to fit in is an appealing solution to stresses that many of us face. It defies normal taboos of addictive behavior and problematic drug use. “When I was in college, people did drugs to check out. Now, people do drugs to check in,” Dr. Anjan Chatterjee, chair of neurology at the University of Pennsylvania, remarks early in the Netflix original documentary Take Your Pills—which addresses prescription stimulant abuse on college campuses.
“While we were shooting the film, people who use Adderall, Ritalin, these drugs regularly—I was surprised how many young people would say, ‘So, you’re working on this film—does it work?’ Take Your Pills director Alison Klayman told NPR. “And what’s amazing is that one of the effects of Adderall—which is, you know, amphetamine, mixed amphetamine—is that it makes you feel like you are doing better. But the idea that these are ‘smart pills’ or that they’re cognitive enhancers is a little bit misguided.”
And that’s what makes the issue of prescription stimulant abuse a scary problem. This attitude is increasingly common. According to a study published in the American Journal of Psychiatry with data taken from the 2015 and 2016 National Survey on Drug Use and Health, 5 million Americans are illegally using prescription stimulants, with the majority seeking to boost their concentration and mental stamina. A study published in the Journal of American College Health found that 17 percent of 179 surveyed men and 11 percent of 202 women reported illicit use of prescribed stimulant medication. Forty-four percent of surveyed students stated that they knew students who misuse stimulant medication for both academic and recreational reasons.
What constitutes misuse of prescription drugs?
The World Health Organization defines misuse as “the use of a substance for a purpose not consistent with legal or medical guidelines.”
“Hey, I’m a college student and I was wondering how to get Adderall prescribed. I don’t have ADHD or ADD, sometimes I have trouble focusing but I wouldn’t consider myself to have either… I took my first 20mg freshman year of college. Got it from my buddy, and within 2 weeks I scheduled an appointment with a pysch and got my own prescription. Used it safely for about 6 months, but I started to become dependent on it and eventually talked my doc into reaching 80mg a day. Abused it for another year and eventually cut myself off as it was doing more harm than help…“
That definition of misuse covers young men and women are turning to Adderall, Ritalin, Vyvanse, or other prescription stimulants to help them focus, stay awake longer, and perform better. And while they see their intentions as good, what they most likely don’t realize when they take a pill from a friend or seek out a prescription themselves is that the potential benefits of using prescription stimulants to enhance performance are more limited than many realize.
The dangers of prescription misuse
Research shows that prescription stimulant users who aren’t taking them to treat a medical condition typically have lower grade point averages than non-users. This suggests that academically successful students are not likely to use prescription stimulants nonmedically. Additionally, nonmedical prescription stimulant users are more likely than other students to be heavy drinkers and users of other illicit drugs.
Plus, taking these meds can be physically harmful, not just bad for your grades. All bottles of Adderall come flagged with a “black box warning” from the FDA—which is the highest level of alert the FDA puts on medications. The FDA considered the warning necessary because of prescription stimulants’ potential to increase users’ heart rate and blood pressure, as well as raise risks of aneurysms, heart attack, and/or stroke. These medications cause cardiovascular aging. They come with the danger that users can become physically and psychologically addicted or dependent on the drug. Other Adderall side effects include insomnia, hyperactivity, irritability, and changes in personality.
But despite the negative possibilities, prescriptions for stimulants are more popular than ever. ADHD is an increasingly common diagnosis, and prescription stimulants are the first-line treatment. It’s now accepted that ADHD continues to adulthood, so more and more teens go to college with medication—creating a larger opportunity for those who have no prescription to obtain the medication, and creating stigma and difficulty for those who responsibly use stimulants to treat ADHD and ADD. According to the National Institute on Drug Abuse, 16 million U.S. adults are taking prescription stimulants.
To help limit the availability of Adderall, Ritalin, Vyvanse, and other stimulants, many medical practitioners and general physicians are being encouraged by research and experts in the field to refer patients to psychiatric professionals rather than risking misdiagnosing cases of ADD and ADHD themselves.
Raising awareness for misuse of prescription drugs
Authors of the study published in the Journal of Addictive Disease also outline the importance of raising awareness on college campuses of the potential signs, symptoms, and risks of prescription stimulant abuse. But to fully address the competitive pressures that drive a lot of Adderall abuse, wider cultural changes and more open discussions about what misuse and abuse looks like between families, friends, and peers are needed.
“Today, many parents are unaware that their college-attending children are using prescription stimulants nonmedically, or, even worse, many parents appear to be enabling the problem by turning a blind eye or encouraging the behavior,” author Dr. Amelia A. Arria wrote in the study. “Fueled by their concerns about maximizing their child’s academic performance, these parents are highly susceptible to the myths…that, at best, nonmedical use of prescription stimulants might help their children earn better grades and that, at worst, it is harmless. …Parents must be encouraged to discuss these popular myths with their children and emphasize that attending class, completing assignments on time, and keeping up with schoolwork on a regular basis is the most likely—albeit difficult and even boring—strategy to achieve superior academic performance. A useful and appropriate analogy can be drawn with weight management strategies. The healthy way to long-term success involves regular exercise and healthy eating habits.”
Signs of Adderall abuse
When a medication is given to or taken by any person besides whom it was prescribed to, it’s called drug diversion. It’s dangerous, and—unfortunately—it’s all too common. What many don’t realize, it’s also a serious crime. When kids with ADHD cave to peer pressure and give pills to friends, they could be arrested and charged with a felony. And that will stay with them long after the glow of all A’s for a semester fades. If you think your teen might be abusing Adderall, watch for these warning signs:
- Talking more than normal, or having incomplete thoughts
- Seeming unusually excited, aggressive, impulsive or mania
- Eating less than usual
- Withdrawing socially
- Declining personal hygiene
- Having more relationship issues
- Sleeping more or are tired more often
- Missing class or work
- Developing secretive behaviors or seeming paranoid
- Need money more often or go through it more quickly
- Disorientation or memory loss
- Excessive weight loss
- Over-concentrating or overworking leading to exhaustion
If you have a child, family member, friend, or a student who has expressed or shown signs of stimulant abuse, you should take it seriously. Talk to them about the 3Rs of prescription use, recommends the Substance Abuse and Mental Health Services Administration (SAMHSA). Explain that stimulants are harmful—not beneficial—and that using prescription drugs is not and safer than experimenting with illegal drugs. Regard it as a marker for other possible health problems with substance abuse or mental health—which should always be addressed by health care professionals.
Adderall side effects and withdrawal
Most people taking this medication to treat ADHD do not experience any of these side effects. Side effects often fade after taking the medication for a few weeks.
The most common Adderall side effects, according to the U.S. National Library of Medicine, include:
- Changes in sex drive or ability
- Painful menstrual cramps
- Dry mouth
- Difficulty sleeping
- Exaggerated and/or quickly changing emotions
- Weight loss
- Decreased appetite
Talk to your doctor if you experience any of these side effects. Other serious Adderall side effects include:
- Slow or difficult speech
- Weakness or numbness of an arm or leg
- Motor or verbal tics
- Teeth grinding
- Believing things that are not true
- Feeling unusually suspicious of others
- Elevated blood pressure
- Skin sensitive to light
- Urinary tract infection
- Abdominal pain
- Changes in vision or blurred vision
- Paleness or blue color in fingers or toes
- Pain, numbness, burning or tingling in the hands or feet
- Unexplained wounds, like blistering or peeling skin
- Signs of an allergic reaction, like: rash, hives, itching, swelling of the eyes, face, tongue or throat, difficulty breathing or swallowing, hoarseness
If you experience any of these serious side effects, call your doctor immediately, or seek emergency medical treatment. This is not a complete list of side effects, consult the prescription information or a pharmacist before taking any medication.
When Adderall abuse, over a long period of time, can lead to dependence. When that occurs, there can be withdrawal symptoms upon discontinuing the drug. Adderall withdrawal symptoms, according to American Addiction Centers, include:
- Change in appetite
- Mood swings
- Suicidal thoughts
- Drug cravings
- Trouble concentrating
- Lack of motivation
- Muscle aches
- Weight loss
- Fast heart rate
- Panic attacks
- Blurred vision
- High blood pressure
If you suspect Adderall abuse, or that your teen is dependent on Adderall, you may want to set up a weaning schedule with the help of a medical professional to help with symptoms.
Adderall abuse and addiction treatment
Adderall is a Schedule II stimulant, which means it has a high potential for addiction. If you or your teen becomes addicted, you may find it difficult to stop taking Adderall. A combination of medical detox—weaning off Adderall with the help of a physician—and therapy has the best chances of success.
Unsure where to start? Try these Adderall abuse and addiction treatment resources:
- SAMSHA’s national helpline: 1-800-662-HELP
- National Institute on Drug Abuse resources
- American Addiction Center resources