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If you or a loved one has an Adderall prescription or is using it recreationally, you probably have questions. In 2021, some 41.4 million Adderall prescriptions were dispensed in the United States. Adderall is used for prescription uses to treat ADHD, narcolepsy, and sometimes depression. It’s also used as a study and recreational drug, abused for its ability to help people stay alert, to focus, to concentrate, and to feel happy. That makes it extraordinarily popular for students struggling with heavy exam loads as well as for ravers and party-goers wanting to stay up and enjoy more of their night.
As a result, somewhere between 6 and 30% of all college-aged students have used Adderall recreationally.
But, whether you’re taking Adderall on a prescription or not, you should have questions, like knowing how it works, is it addictive, and can it cause long-term harm. The short answer is that as long as you stick to prescription doses, it’s mostly very safe.
Adderall is a prescription drug comprised of amphetamine salts, primarily 3 parts dextroamphetamine and 1 part levoamphetamine. The mix is used in a number of prescription drugs including Myadis, Adderall, and Adderall RX. There are also generic versions of the same drug. It’s also markedly similar to most other amphetamine-based drugs, including street drugs like methamphetamine (methamphetamine is a 1:1 mix of levoamphetamine and dextroamphetamine).
Here, reducing the mix of dextroamphetamine reduces the euphoric effects of the drug. For example, even similar drugs like Dexedrine and Evekeo which are entirely dextroamphetamine have extremely different effect profiles and are used for different purposes.
Still, Adderall results in an increase in focus, reduction in impulsivity, and an increase in energy levels. It does this by increasing dopamine and norepinephrine levels, which then goes on to impact attention span, energy, alertness, and mood.
If you’re using Adderall according to a prescription, there should be some long-term side-effects. However, these are listed on the label. For example, whether you’re getting a 2.5 or a 60mg dose, you should experience loss of appetite, weight loss, dry mouth, stomach upset, nausea, headache, dizziness, fever, nervousness, and sleeplessness. Many people who take Adderall experience these symptoms as a normal part of their daily life – although if they are significant, you can typically try switching to a different drug for the same treatment.
People who use Adderall outside of a prescription are more likely to face heavier side effects because they are more likely to use more than the maximum prescribed dose of 60mg per day. Any dose over 40mg per day qualifies as a “heavy” dose and is potentially addictive. This means that if you have a prescription for Adderall set at 60mg per day, you are at risk of developing tolerance and addiction.
Most people who use Adderall over a longer period show no changes to the brain. However, if you are a heavy user, you might start experiencing significant changes. For example, prolonged heavy Adderall use can result in burning the nerve endings that absorb dopamine – because there’s too much dopamine in your system as a norm. Many people also start to experience emotional blunting, where the brain stops producing enough dopamine and norepinephrine on its own, because it’s accustomed to the drug doing it. This means that if you don’t take Adderall, you feel depressed, have no ability to concentrate, hostile, and may have trouble experiencing emotions or motivation at all.
That can also lead to trouble sleeping, because the chemical signals that send you to sleep go wrong. Therefore, insomnia is a very common side effect.
Adderall can also result in physical health problems. For example, as a stimulant, it’s not safe to consume in high doses over a longer period. It may put strain on your heart increasing risks of heart disease, stroke, and heart attack. That’s especially true for individuals with a history of heart problems. However, the longer you use a heavy dose, the higher those risks get.
Very high doses over a longer period can also result in neurotoxic, where amphetamine salts build up in the central nervous system resulting in extreme neurotoxic effects. That can result in schizophrenia-like symptoms where the person suffering has no idea what’s real and what’s not, which can cause permanent psychiatric problems.
Anyone using Adderall over the long-term is at risk of addiction. Here, the heavier the dose, the greater the risk. In most cases, addiction starts as tolerance where you have to up the dose to get the same effects. Then you start having withdrawal symptoms if you stop using. Then, behavioral disorders like seeking behavior, compulsory use, and increased reckless decision-making around the drug start to set in and typically become worse over time. Behavioral disorders are treatable, but primarily require a significant amount of therapy to overcome.
For many people, Adderall side effects start out mild and increase over time. In fact, individuals who don’t have issues with early use may find that prolonged heavy use results in more and more side-effects. Some of those side-effects like insomnia, damage to the gastrointestinal tract, tremors, headaches, and respiratory issues can be near-permanent –as many can take years to heal and may not ever heal. The more damage you do, the less likely it is that issues will go away – which means that if you’re experiencing negative side-effects of Adderall use, it’s important to stop, talk to a doctor, and get help.
For many people, longer-term use results in using higher doses as tolerance develops. That can mean increased risk of overdose as well as other negative side-effects. However, Adderall is relatively safe in terms of overdose risk. For example, an estimated 4,000 people died of an Adderall overdose in 2021, compared to an estimated 108,000 people who died of drug-related causes in the same year.
At the same time, recreational Adderall use can be as much as 100x that of a prescription dose. That can result in significantly increased risks over using a prescription. Non-prescription usage also results in increased risks of co-occurring drug use – even accidental. For example, it’s very common for faux prescription pills to contain cheap doses of fentanyl rather than Adderall. If users take those thinking they are Adderall, they’re at increased risk of (opioid) overdose. And, if you mix it with drugs like your own Adderall prescription, it can cause significantly increased risks. With half of all drug-related hospital visits involving more than one drug, mixing drugs significantly increases risks.
Today, millions of Americans use Adderall as a necessary part of their daily life. Adderall can improve quality of life by giving you the tools to focus, to hold a normal job, and to do the things you want to do. It’s safe to use over the long-term providing you stick to prescription doses, you talk to your doctor if you start to have problems, and you talk to your doctor if you start to experience tolerance.
Adderall is never safe to take outside of a prescription. That’s because Adderall effects people in different ways and you may need medical monitoring to ensure that the drug doesn’t effect you in unexpected ways. In addition, if you’re taking the drug in higher doses than a prescription, you’re putting yourself at risk. And, if you’re taking the drug from a source other than a pharmacy, even if it looks the same, you’re putting yourself at risk of taking fentanyl or another dangerously strong opioid.
If you or a loved one is seeking help for alcohol or other substance abuse, contact us at Stairway Resource Center today. At Stairway Resource Center we provide a 60 to 90-day outpatient program that takes place in an engaging and supportive community setting. We offer dual diagnosis treatment and daily group and individual therapy for our clients, in addition to fun community-based events and activities.