Table of Contents
I. Getting Help

I. The Basics

Adderall is commonly prescribed to treat Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) in adults and children, as well as narcolepsy (daytime sleepiness). Furthermore, Adderall is sometimes prescribed off-label for atypical anxiety and depression. In individuals with ADHD, Adderall often has the paradoxical effect of calming the mind.

In non-medical users, effects such as increased motivation, focus, productivity, wakefulness, and euphoria are frequently reported with Adderall. It is commonly abused as a “study drug” to increase performance in school and work, to stay awake, or to suppress appetite. However, Adderall does present risks.

According to an article by the Global Neuroscience Initiative Foundation overviewing the adverse effects of prescription stimulant misuse, long-term abuse of Adderall can result in addiction, weight loss, sleep disturbances, high blood pressure, irregular heartbeat, heart disease, seizures, and symptoms of psychosis, such as mania, hallucinations, and paranoia.

This guide explains the effects, trends, and dangers of Adderall use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Adderall addiction based on current research and publically available statistics. In some cases, usage statistics are derived from general prescription stimulant use, which includes Adderall, Ritalin, Concerta, and Dexedrine.

Primary Adderall Dangers

  • Addictiveness: A comprehensive 2007 study by Nutt et. al. evaluated the addictive potential of various substances based on factors such as physical dependence, psychological dependence, and pleasure. The scale scored amphetamines – including prescription stimulants – at a 1.67/3, making it the ninth most addictive substance of the 20 total drugs evaluated in the study. By comparison, benzodiazepines ranked 1.83/3, and alcohol ranked 1.93/3.
  • Risk of Overdose: Prescription stimulants can cause sudden death in some users even at therapeutic doses, especially in individuals with heart conditions. According to the CDC, 10,333 drug overdose deaths in 2017 involved rose 67%, leading to a 156% increase in emergency room visits involving prescription stimulants, from 862 visits in 2006 to 1,489 visits in 2011.
  • Unintended Side Effects: Adderall use can lead to anxiety, restlessness, aggressive behavior, irritability, mania, skin issues, digestive issues, malnutrition, and reduced appetite.
  • Legal Risks: Adderall is a Schedule II (2) controlled substance. Possession of Adderall without a valid prescription is a misdemeanor for a first offense, commonly punishable by up to a maximum of one year in prison and/or a $1000 fine.

Adderall Background Information

Derived FromOrganic synthesis varies but originally derived from ephedrine, an extract of the ephedra plant
Ways UsedIngested, snorted, sublingual, rectal, injected in aqueous solution
Scientific NameDextroamphetamine (75%),
Levoamphetamine (25%)
Slang/Street Names for AdderallAddys, speed, uppers, smart drug, smart pills, beans, double trouble, Christmas trees, hearts, crosses, LA turnaround, truck drivers, bennies, dexies
How Long in Bodily SystemHalf-life: 9-14 hours
Elimination in three to four days but up to a week in chronic users
Punitive Legal Measures: Using/PossessionSince Adderall is a Schedule II controlled substance, it is illegal to have possession without a prescription. Legal measures vary from state to state, but, generally, the first possession offense is a misdemeanor, with the potential for up to one year in prison and/or a fine of $1,000. Subsequent offenses may result in increased prison time and/or fines.
Punitive Legal Measures: Selling/DistributingAn individual convicted of selling or attempting to sell Adderall could face five to 20 years in prison, a fine of up to $1,000,000, or both. Exact penalties vary depending on the amount of the substance and the number of offenses. If the substance is sold near a school or other public facility, the penalty doubles.
DEA Drug RatingSchedule II

II. Signs of Abuse

Behavioral Symptoms of Adderall Usage and Abuse

How Adderall affects the brain

Adderall increases the levels of several neurotransmitters in the brain, including dopamine and epinephrine. Adderall has significant potential for abuse due to the substance’s strong reinforcing properties as a result of its action on the reward center of the brain. This results in its pleasurable effects, including increased energy, euphoria, and sociability.

One of the major brain regions affected by Adderall is still actively maturing in users under the age of 25. While the long term effects of Adderall on brain development is still an active area of investigation, a 2013 Public Library of Science study noted that children who have used prescription stimulants for at least a year demonstrated changes in their brain that require them to take more of the drug for the same effect. This potentially reduces treatment efficacy in those with ADHD and leads to an increased chance of dependency in both medical and nonmedical users.

Behavioral signs of Adderall usage and abuse

Signs of Adderall use may be subtle at first, but in dependent users who take frequent, high doses, significant changes in behavior can occur. Due to the combination of the high abuse potential and tolerance-building effects, a stimulant use disorder can ultimately develop. According to the 2016 National Survey on Drug Use and Health, an estimated 540,000 U.S. residents aged 12 or older – representing 0.2% of this demographic – had a stimulant use disorder in the past year, while only approximately 140,000 received treatment for this disorder.

According to the DSM V, one of the core symptoms of a stimulant use disorder is neglecting important responsibilities associated with the core spheres of life, including school, work, and family, in order to abuse the substance. One behavioral indicator of abuse is a decline in activities related to personal hygiene, such as bathing and grooming. This behavior may occur alongside a tendency to withdrawal from family members, friends, and co-workers.

Additionally, an Adderall abuser may have difficulties with finances in order to fund the addiction. This issue may reveal itself as exorbitant spending on credit cards or funneling money away from important financial responsibilities, such as paying tuition, to fund the addiction. Since Adderall is attainable as a prescription, some abusers will “doctor shop” to receive a higher dosage, sometimes faking ADHD symptoms in the process. In order to avoid detection, many abusers will fill prescriptions at several pharmacies. However, according to a 2016 study published in the Journal of Clinical Psychiatry, most misusers of Adderall attain the substance from family members or friends who have a valid prescription.

Adolescents and young adults are at a particularly high risk for prescription stimulant dependence given the relative ease of access to these substances and the competitive pressures to succeed in both high school and university settings. Since misuse is more likely among these age groups, leading to larger-than-prescribed and more frequent doses of the substance over time, they also have the most potential for harmful side effects.

Physical Symptoms of Adderall Abuse

How Adderall affects the body

Adderall is a central nervous system stimulant that increases levels of adrenaline in the body. The result is an activation of the sympathetic nervous system, which is associated with the “fight-or-flight” response. After consumption, users will experience an increase in heart rate and blood pressure, which can be dangerous in individuals with a pre-existing heart condition. Additionally, Adderall can cause an increase in perspiration, dilated pupils, constriction of blood vessels, dry mouth, and decreased hunger. When Adderall is used chronically, the inhibiting effects on appetite can result in malnutrition and significant weight loss.

Early physical effects of Adderall

Adderall can produce a multitude of short-term physical and psychological effects in the user, usually within 30-60 minutes of ingesting the substance. Many of these effects are unpleasant; some are even dangerous.

This table illustrates the possible short-term physical effects associated with Adderall.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.)Sweating
Excessive energy
Pupil dilation
Tremors/muscle twitches
Increased heart rate
Increased breathing rate
Increased blood pressure
Lingering (within an hour of taking the drug)Nausea
Seizures
Cardiac issues
Abdominal pain
Reduced need for food
Reduced need for sleep
Post-Use (several hours to days after use)Fatigue
Dependence (more likely in higher doses)

Severe and long-term physical effects of Adderall

Individuals with a chronic relationship with Adderall commonly take higher-than prescribed and more frequent doses, leading to the possibility of severe complications. In rare cases, sudden death due to a severe cardiovascular event, such as a stroke or heart attack, can occur. In chronic users, consistently elevated heart rate and blood pressure can be significant risk factors for heart disease and other cardiovascular problems.

The severe side effects of Adderall are compounded when the substance is combined with other “downer” drugs in a cocktail. Adderall and alcohol is a common drug cocktail used by students in order to increase energy and wakefulness while studying and partying. This cocktail can lead to an increased risk of heart problems, alcohol poisoning, and even a fatal amphetamine overdose.

Adderall and cocaine is another dangerous stimulant cocktail. Since both substances have a similar effect on the body, the combination leads to an amplification of the side effects of both. Combining Adderall and cocaine may lead to hyperactivity, dangerously high blood pressure, and cardiac issues, including an abnormally high heart rate. Due to the strong reinforcing effects of both substances, this is also a highly addictive cocktail with significant abuse potential.

This table illustrates the possible long-term physical effects associated with Adderall.
Long-Term Physical Symptoms
CasualDry mouth
Dry, itchy skin
Fatigue
Elevated heart rate
Loss of appetite
Malnourishment
Chronic
Including all of the above effects for casual use
Headache
Abdominal pain
Impotence
Circulation problems
Malnutrition
Weight loss
Heart palpitations
High blood pressure
Chest pain
Tremors
Kidney damage
WithdrawalFatigue/lethargy
Muscle pain
Headache
Nausea
Vomiting
Stomach/abdominal pain
Sleep disturbances
Seizures

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription stimulant addiction.

III. Adderall Usage

Global ADHD stimulant usage has increased over the past two decades

According to a 2018 international longitudinal study, an increased usage of ADHD stimulant medication has occurred over the past two decades in 13 countries around the world from Asia, Australia, Europe, and North America. This study included over 154 million individuals ages three and older and revealed that the overall prevalence of prescription stimulant medication usage across all 13 countries in individuals between the ages of three and 18 was estimated at 1.95%.

In adults aged 19 and older, the overall usage prevalence was lower, estimated at 0.39%. Researchers found considerable variation between countries, with rates as low as 0.003% in Japan to as high as 1.48% in the United States. In all countries except the United States, methylphenidate (Ritalin) was the most commonly prescribed ADHD stimulant.

Adderall and methylphenidate use without a valid prescription has increased globally as a means of cognitive enhancement to increase productivity while studying or at work. A 2018 study published in the International Journal of Drug Policy reported the results of two global surveys conducted in 2015 and 2017 that evaluated the use of prescription stimulant medications (methylphenidate and dextroamphetamine) in individuals aged 16 to 65 from 15 countries.

In the 2015 survey, 3.2% of individuals reported using prescription stimulants for non-medical use within the past year for cognitive enhancement, while 6.6% of individuals surveyed in 2017 reported the same behavior. Of the 15 countries, respondents in the United States reported the most non-medical use of prescription stimulants – but the lowest relative rate of increase – with 18.7% in 2015 and 21.6% in 2017 reporting non-medical usage of the substance within the past year.

Prescription Stimulant Use Throughout the World
HighestSecondThird
Regions with the Highest Number of Prescription Stimulant UsersNorth AmericaNorthern EuropeAsia and Australia
Countries with the Largest Increase in Non-Medical Prescription Stimulant RatesHungary
(0.1% in 2015, 1.6% in 2017)
France
(0.6% in 2015, 4.6% in 2017)
Belgium
(3.6% in 2015, 12.4% in 2017)

*This table includes data from users of both methylphenidate (Ritalin) and dextroamphetamine (Adderall).

Sources: Raman et al. 2018 and Maier et al. 2018

Adderall Usage Demographics in the U.S.

Prescription stimulant misuse is increasing in the U.S., especially among young adults

The United States has more prescription stimulant users than any other country in the world, paralleling the accelerating number of ADHD diagnoses in the country. According to a 2016 SAMHSA survey, 1.7 million Americans aged 12 or older – or about 0.6% of the total population – engaged in non-medical misuse of prescription stimulants in the past year.

By age group, about 92,000 adolescents aged 12-17 were current misusers of prescription stimulants, equating to 0.4% of adolescents. Approximately 767,000 young adults aged 18-25 – or 2.2% of that demographic – were current misusers of prescription stimulants. The illicit use of prescription stimulants was second only to marijuana in prevalence within this age group. Finally, an estimated 876,000 adults aged 26 or older were current misusers of prescription stimulants, representing 0.4% of this particular demographic.

Based on an analysis of 21 studies published in the Journal of the American Academy of Child and Adolescent Psychiatry and representing over 113,000 individuals, the non-prescribed use of stimulants ranges from 5% to 9% in grade school and high school-aged students and 5% to 35% in college-aged students. Roughly two-thirds of young adults in the United States are given Adderall from friends, roommates, and family members who have valid prescriptions.

Demographics of Prescription Usage
Past Year (2018)Lifetime
8th grade (14-15 yo)1.80%5.90%
10th grade (15-16 yo)4.10%8.60%
12th grade (17-18 yo)4.60%8.60%

IV. How to Find Help

Adderall abusers sometimes develop a tolerance for the substance, leading to a need for a higher dosage to achieve the same effects. Over time, both the reinforcing properties of the substance and the need to take more of it may result in addiction. Then, when an addict wishes to stop abusing the substance, withdrawal symptoms from sudden discontinuation of the substance can be debilitating.

Consequently, treating Adderall addiction is a multi-step process that aims to slowly taper the amount of the substance being ingested into the body, prevent the risk of relapse, and provide social support. To learn more about this process, read our Adderall rehabilitation guide, which provides a comprehensive resource for starting this process.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention
1. Don’t do it alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.

Get Help Now

To find help now for you or a loved one, find a rehabilitation facility near you using our directory below.

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