Misuse of dextroamphetamine-amphetamine (Adderall) is highest among teens and young adults, according to research which indicates these users are typically getting it without prescriptions. Many are using it as a “study drug” to avoid sleeping.

Kiernan J, Reid C, Zavos P. Pulling an all-nighter: current trends of college students’ use of adderall. MOJ Womens Health. 2016;3(1):167‒170.

 

 

Adderall facts

Adderall is a prescription medication that’s classified as a central nervous system stimulant, since it works on the brain’s neurotransmitters (such as dopamine) that affect hyperactivity and impulse control. The FDA approved Adderall in 2001, and it’s currently used to treat ADHD and narcolepsy.

Other prescription stimulants in the same class include methylphenidate (Ritalin), lisdexamfetamine (Vyvanse), methylphenidate extended-release (Concerta), and dextroamphetamine (Dexedrine).

The DEA classifies Adderall as a Schedule II drug, the same as cocaine, indicating its potential for abuse is high. Such stimulant drugs are the most widely used class of illicit drugs worldwide behind cannabis.

Siefried KJ, Acheson LS, Lintzeris N, et al. Pharmacological treatment of methamphetamine/amphetamine dependence: a systematic review. CNS Drugs. 2020;34(4):337–365.

 

A study in the Journal of American Pharmacy found that Adderall is frequently being purchased through online pharmacies without prescriptions.

Penley B, Chen HH, Eckel SF, et al. Characteristics of online pharmacies selling Adderall. J Am Pharm Assoc (2003). 2021;61(1):e103–e109.

These “rough” pharmacies are prevalent in Google search engines, enabling individuals to buy from unsafe sources and potentially misuse this medication.

 

 

Misuse rising among young people

Anecdotal evidence once suggested that Adderall abuse was most prevalent among pre-teens and adolescents. However, research from Johns Hopkins Bloomberg School of Public Health found that Adderall misuse is highest in 18–25 year-olds who obtain Adderall without a prescription, primarily from friends or family members.

Adderall misuse arising among young adults. Johns Hopkins Bloomberg School of Public Health. 2016.

 

“Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying,” said study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School. “We need to educate this group that there could be serious adverse effects from taking these drugs, and we don’t know much at all about their long-term health effects.”

Such potential risks include high blood pressure, stroke, sleep disturbances, depression, bipolar disorder, and hostile and aggressive disorder.

 

Is your patient misusing Adderall?

Physicians seeing young patients should watch for signs and symptoms of Adderall misuse and to ask the appropriate screening questions. Ask about their school performance, study habits, and sleep schedule.

If your patient does have a prescription for Adderall, be cautious if they are trying to refill their prescription too frequently. Counsel these patients on the potential for misuse and the effects it can have. Talk to their parents about any warning signs.

Signs and symptoms of Adderall abuse include:

Adderall addiction: signs and symptoms of Adderall misuse. American Addiction Centers. Updated September 9, 2022.

 

• Hyperactive, talkative

• Strong desire to work or study for long hours

• Tendency to overthink things

• Feelings of nervousness, anxiety, impatience, and worry

• Problems falling or staying asleep

• Frequent headaches

• Malnutrition or extreme weight loss

• Excessive twitching

Drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years.

Dr. Mojtabai suggested that prescriptions should be entered into a database physicians could check before writing prescriptions to ensure patients aren’t getting multiple medications from various physicians, as several states have done.

“It would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug,” Dr. Mojtabai added. “Many of these college students think stimulants like Adderall are harmless study aids. But there can be serious health risks, and they need to be more aware.”