What to Understand About Adderall Abuse

Millions of people use the stimulant Adderall to successfully treat the symptoms of attention-deficit/hyperactivity disorder and narcolepsy, but the medication is commonly misused and can result in significant short-term and long-term consequences. The most significant long-term risks of taking Adderall involve cardiac problems, such as arrhythmias or the development of ischemic heart disease. Other symptoms, such as psychosis, addiction, Parkinson’s disease, and diminished ability to experience pleasure, are also more likely to occur with long-term heavy usage or misusage.

Adderall is the trade name for a mixture of the mirror image stimulants dextroamphetamine and levoamphetamine. It is a preferred treatment for attention-deficit/hyperactivity disorder (ADHD) and for narcolepsy.

Like most stimulants, Adderall works by increasing the access of the central nervous system (CNS) to the chemical messengers dopamine and norepinephrine, among others. This action puts the body into “fight or flight” mode, conferring the benefits of increased energy, focus, and alertness.

Rates and Methods of Adderall Abuse


The National Institute on Drug Abuse estimates that about 1 million Americans have misused or abused Adderall and that 2 percent of Americans have used a stimulant in the past year.

Adderall is abused by taking it in larger doses or more frequently than prescribed, by taking it in a medically unintended way (e.g., snorting or injecting it), or by taking it without a prescription. When this happens, the same chemical processes that are responsible for its helpful effects can lead to significant health problems, especially if such abuse continues over time.

Medical Consequences of Adderall Abuse


  • Cardiac-related problems: Normally, the CNS can quickly and precisely adjust the heart’s pumping activity to account for increasing or decreasing demands on the body. However, when the CNS is flooded with dopamine and norepinephrine from stimulant use, this control becomes much more erratic. That often results in arrhythmias, the medical term for heart rhythm disturbances. It also results in blood vessel spasm and dilation of the heart’s filling and pumping chambers, interrupting blood flow. When this happens, the heart may have its own blood supply reduced, leading to its inability to respond to increased body demands. This is known as ischemia, and it can result in damage to any organ or system that receives insufficient blood supply. For example, reduced supply to the brain can result in stroke, and reduced supply to the kidneys can result in renal failure.

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Psychiatric Effects of Adderall Abuse


  • Amphetamine-induced psychosis: An excess of dopamine in the midbrain can lead to a person having difficulty distinguishing what is real and what isn’t. This type of psychosis becomes more likely with long-term, high dose usage. Symptoms include auditory and visual hallucinations, paranoia, delusions, ideas of reference (e.g., a person believing that messages are being sent to them through a television or radio broadcast), and agitation.
  • Diminished pleasure (also known as anhedonia): In the short term, high doses of Adderall can increase pleasurable sensations as dopamine levels increase in the nucleus accumbens, the brain’s center for processing reward. However, with continued high-dose usage, two things happen: first, the brain’s available dopamine supply gets depleted, and it takes longer to restore the supply. Second, the brain eventually adapts to this high level of dopamine and assumes that this level is its new normal. That means activities that would normally induce pleasurable sensations—like eating good food, having sex, or performing well on an exam—create relatively less dopamine and the brain is less responsive to it, making these activities feel less pleasurable than they used to be.
  • Depression: The reduction or inability to experience pleasure can result in depression, which can sometimes be severe and include suicidal thoughts and attempts. Depression of this magnitude requires immediate treatment.
  • Addiction: The tolerance that the brain shows to the effects of continued high-dose Adderall usage is an essential component to triggering addiction. Addiction involves the loss of control over one’s drug use, intense cravings for the drug, and continued use of the drug despite negative consequences. Mental health professionals refer to Adderall addiction as a severe form of stimulant use disorder. The criteria for this type of disorder can be found here.

Treatment for Adderall Abuse


Many of these conditions can be reversed by stopping Adderall usage, though some of them result in permanent damage or even death. Care at a residential treatment facility can provide you with the guidance and medical attention to properly address your underlying issues and provide you with the treatment you need in a safe environment to fully recovery and best address your diagnoses in a healthy way. It is very important, however, to note that regular prescribed usage of Adderall for the treatment of ADHD or narcolepsy is usually safe and does not usually result in significant medical or psychiatric consequences; in fact, research shows that the risk of consequences like developing a substance use disorder from untreated ADHD is higher than the risks of regular prescribed Adderall usage.

If you believe that you or a loved one are abusing—or are addicted to—Adderall, please contact one of our caring advisors today for more information about how we can help.