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Adderall, a Schedule II drug, is a combination of dextroamphetamine and amphetamine. It’s a central nervous system (CNS) stimulant medication used to treat symptoms of attention deficit hyperactivity disorder (ADHD) as well as narcolepsy.1,2 Stimulant use disorders, such as Adderall addiction, are seen in high school and college-aged youth.2,3 Knowing some of the Adderall addiction signs and symptoms, such as delirium, psychosis, and physical exhaustion, can help save your life or the life of someone you know.3
Is Adderall Addictive? Adderall Addiction Signs and Symptoms
Yes, Adderall is addictive, but the onset is slower with a longer duration.3 Something is addictive when the substance repeatedly triggers strong urges to continue using or engaging in it, even when it causes harm or negative consequences. Addictive substances or behaviors typically affect your brain’s reward system, making you feel pleasure, relief, or temporary escape, which reinforces the desire to repeat the activity.
Prolonged stimulant effects from Adderall are caused by a larger percentage of the substance that remains unchanged in your body, and therefore stays in the nervous system longer.3
The pills can be taken orally, smoked, snorted through the nose, or injected.2 When misused, it is typically associated with a binge pattern of use where the person sporadically consumes large doses over a short period, which causes a sensation referred to as a “rush” or a “flash.”2
Should you or someone you know chronically misuse Adderall, you may notice psychosis-like symptoms that resemble symptoms of schizophrenia. These symptoms can include skin picking, paranoia, a preoccupation with your own thoughts, and visual and/or auditory hallucinations.3 If you or someone you know does use Adderall chronically, you may notice an increase in violent and erratic behavior.3 Relatively benign signs and symptoms of Adderall misuse can also include:1
- Weight loss
- Nervousness
- Nausea
- Headache
- Diarrhea
- Changes in sex drive and/or ability
- Constipation
- Painful menstrual cramps
- Dry mouth
- constipation
More serious signs and symptoms of Adderall misuse are:1,3
- Hoarseness
- Slow or difficult speech
- Difficulty breathing or swallowing
- Dizziness
- Eyes, face, tongue, or throat swelling
- Numbness or weakness in the arms or legs
- Seizures
- Itching
- Motor or verbal tics
- Hives
- Teeth grinding
- Skin peeling or blistering
- Depression
- Rash
- Believing things are not true
- Unexplained wounds on fingers or toes appearing
- Feeling unusually suspicious of others
- Hands or feet feeling pain, numbness, burning, or tingling sensations
- Hallucinations (hearing or seeing things that are not there, and others cannot see)
- Agitation, fever, sweating, confusion, tachycardia, shivering, loss of coordination, vomiting, severe muscle stiffness, or twitching
- Changes in vision or blurred vision
- Mania (abnormally excited mood or frenzied)
- In children, adolescents, or adults with heart defects or serious heart problems, this medication may cause sudden death. If you or your child experiences signs of heart problems (e.g., chest pain, shortness of breath, or fainting), discuss the risk of taking this medication with your doctor.
- Delirium
- Psychosis
- Physical exhaustion
Who Is at Risk of Being Addicted to Adderall?
As a cohort, high school and undergraduate college-aged youth have a greater risk for misusing Adderall than other populations.2,3 More specifically, multivariate analysis indicated that white male college students who were a part of a fraternity or sorority earned lower grade point averages, and were more likely to use other substances like alcohol, cigarettes, marijuana, cocaine, ecstasy, exhibited other risky behaviors, and had higher prevalence rates.2 Additionally, colleges that were based in the northeast regions of the United States and had more competitive admissions criteria had higher rates of Adderall use among their students.2
Another subpopulation of college-aged youth that was found to misuse Adderall was dental and dental hygiene students.2 A survey was sent to these students and found that:2
- 12.4% were using a stimulant without a prescription.
- 17% felt like obtaining the medication was easy.
- 17% thought stimulant use was a problem with the institution they were attending.
- 70% were taking the stimulant to increase their attention and/or concentration.
- 77% were taking Adderall.
- 87% got the medication from a friend.
- 90% started using it in college.
A third sub-population of college-aged youth found to misuse Adderall were medical students.2 The same study that detected the Adderall misuse rate in dental and dental hygiene students administered a similar survey to 388 medical students and found:2
- 10% of the medical students used stimulants to improve their academic performance.
- 72.2% of students were diagnosed with ADHD after the age of 18.
Risk Factors for Developing an Adderall Addiction
Many different biological and environmental risk factors can contribute to the propensity to misuse Adderall and potentially develop a stimulant use disorder including:3,4,5
- Low perceived self-efficacy
- Lack of enjoyment in coursework
- The school you attend does not appropriately accommodate special needs.
- Over-reliance on external validation to generate a sense of self-worth (e.g., a professor complimenting you on your analysis of character development in a paper you wrote)
- Having a lower grade point average. Many who choose to use Adderall that was not prescribed to them believe that using Adderall will correlate with an increase in their GPA.
- Experiencing a mental health issue
- Using stimulants such as Adderall increases the release of the neurotransmitter dopamine into the brain and disrupts the normal communication patterns between the brain cells, thus increasing the risk of addiction.
- Personality characteristics of general deviance (e.g., using Adderall to rebel against authority, awareness of substance use prohibition leads to an increased desire to use)
- Using a CNS stimulant that was not prescribed to you puts you at risk of developing an alcohol use disorder and/or an eating disorder.
- Anxiety
- A lack of social support
- Not feeling empowered
- Lack of knowledge about the effects
- Previous history of substance use or withdrawal in the last 12 months
- Being raised in a home where caretakers use substances
- Living in neighborhoods and going to school where substance use is common
- Associating with peers who use substances
- Aggressive behavior in childhood
- Lack of parental supervision
- Low peer refusal skills
- Community poverty
- Genetics
- Gender
- Abuse and/or trauma (sexual, verbal, physical, emotional)
- How a substance is taken (snorted, inhaled, orally, injected, smoked)
How to Treat Adderall Addiction
Treatment for an Adderall addiction is similar to treatment for other substances. First, you undergo an assessment by a mental health professional or certified drug and alcohol counselor who will use the results of the assessment to determine your level of required care at that time, detoxification, inpatient, or various outpatient settings.6
If you are acutely intoxicated, you may be immediately referred to a detoxification facility so that the medical staff can manage your level of intoxication and withdrawal to prevent what would otherwise be life-threatening complications.7 The detoxification process can include three parts:7,8
- Evaluation: During the evaluation process, staff determine whether traces of the substance are in your bloodstream, how concentrated the traces may be, and whether any physical or mental health concerns also need to be addressed.
- Stabilization: A series of medical and psychosocial interventions is deployed to help you manage acute withdrawal symptoms until you are medically stable and your system is free of substances. Medication-assisted treatment (MAT) may be used at this stage.
- Preparation for treatment: Staff will help you manage your treatment expectations, familiarize you with the overall process, and discuss how various interactions contribute to the recovery.
Assessment is ongoing and determines the level of treatment you may need. As such, you may enter an inpatient or residential facility or an outpatient setting that offers treatment in a less restrictive environment. If you are acutely intoxicated, you will likely go to detoxification first before going to an inpatient or outpatient setting. If you are not acutely intoxicated, an evaluation helps determine if you require inpatient or outpatient treatment and detoxification.
Your recommended level of care is predicated on the information revealed during the assessment, which can include:6
- Your social functioning, substance use, symptoms, and experienced level of impairment
- Whether you are currently intoxicated
- Method of use (e.g., snorting, huffing, intravenous, oral consumption)
- Frequency of use
- Dosage
- Periods of sobriety and their duration
- Duration of substance use
- Immediate medical needs such as withdrawal and/or complicated withdrawal histories
- History of mental health concerns
Aftercare and Ongoing Support
Whether you are discharged from an inpatient or an outpatient setting, aftercare is the next step. Aftercare provides you with opportunities to integrate what you learned in treatment to help you more effectively manage triggers to relapse and re-engage in your life.9 Aftercare can take many forms, such as:8
- Addressing any legal concerns (e.g., meetings with Child and Family Services, requirements of probation or parole, restitution)
- Making and keeping a structured routine
- Enrolling in groups that would address other identified areas of concern while in treatment (e.g., parenting classes, co-dependency classes, domestic violence classes)
- Maintaining, identifying, and establishing boundaries
- Finding or maintaining meetings with a sponsor
- Continuing participation in self-help groups
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Resources
- MedlinePlus. (2019). Dextroamphetamine and Amphetamine.
- Lakhan, S. & Kirchgessner, A. (2012). Prescription Stimulants in Individuals with and without Attention Deficit Hyperactivity Disorder: Misuse, Cognitive Impact, and Adverse Effects. Brain and Behaviors, 2(5), 661-667.
- U.S. Department of Justice: Drug Enforcement Agency. (2017). Drugs of Abuse: A DEA Resource Guide.
- Abelman, D.D. (2017). Mitigating Risks of Students’ Use of Study Drugs Through Understanding Motivations for Use and Applying Harm Reduction Theory: A Literature Review. Harm Reduction Journal, 14(68), 1-7.
- National Institute on Drug Abuse. (2020). What is Drug Addiction?
- Stallvik, M., Gastfriend, D.R., & Nordahl, H.M. (2015). Matching Patients with Substance Use Disorder to Optimal Level of Care with the ASAM Criteria Software. Journal of Substance Use, 20(6), 389-398.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Substance Use Disorder Treatment Options.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2006). Detoxification and Substance Abuse Treatment.
- Carvalho, A.F., Heilig, M., Perez, A., Probst, C., & Rehm, J. (2019). Alcohol Use Disorders. The Lance, 394(10200), 781-792.
