Jessica Herz, LMHC

adderall written in book

Modern life bears little resemblance to the lives past generations have lived. Technology has changed, expectations have changed and how we spend our time has changed. In today’s world there is pressure to be the best of the best; not just sometimes, but all the time. We live in a world of constant comparisons, judgements, and competitions with others because of social media and advances in technology. The changing culture of our workplaces and schools have also created a consistent world of unrealistic expectations. We have so much going on all at once, 24 hours a day. How do we keep up? How do we keep from getting distracted? How do we stay focused? How do we keep up with the demands of today? As our society continues to push
us to our mental limits, many people, in particular, young adults, are turning to a particular type of drug to help them “meet” these unrealistic expectations. And these drugs I am referring to are not illegal. These drugs are prescription amphetamines. One in particular that many people have heard of or know about is Adderall.

What is Adderall? Adderall (amphetamine-dextroamphetamine) is intended to increase focus and attention spans in those suffering from attention deficit hyperactivity disorder, or ADHD. It is also prescribed to treat narcolepsy at times. When prescribed for these purposes, it can be very helpful for those suffering from these issues. However, when this medication gets into the hands of someone who plans to intentionally misuse it or is not diagnosed with ADHD or Narcolepsy, the effects for that individual can be very different. Instead of the drug helping with these issues, people are using it to “feel better” or get high.

Close to 50 million prescription stimulant drugs like Adderall were dispensed in 2011 to treat symptoms of ADHD. This represents an almost 40 percent rise in these prescriptions since 2007, the Drug Enforcement Agency (DEA) states. The problem with this is that more and more of these prescriptions are being prescribed by doctors and then falling into the hands of people who are not prescribed these drugs. If used correctly, Adderall will not produce a “high” in those diagnosed with ADHD. But if misused or misprescribed, the effects of Adderall can become very addicting and can cause serious harm both psychologically and physically.

A 2016 study in the Journal of Clinical Psychiatry found that Adderall use among young adults who didn’t have ADHD jumped 67 percent in recent years and that emergency room visits related to these medications rose 156 percent. Adderall misuse is highest among 18- to 25-year-olds, who are primarily getting the medication from friends or family members and without a doctor’s recommendation or prescription.

Why is this happening?
Adderall works by increasing dopamine and norepinephrine levels in the central nervous system. Norepinephrine affects how the brain responds to things that happen in life, particularly the speed at which it reacts to outside stimuli. Dopamine, the body’s “feel good” chemical, creates a rewarding effect for the individual when increased. Although dopamine occurs naturally in the body, drugs like Adderall produce unnaturally high levels of dopamine. This is an important fact to understand because increasing dopamine to unnatural levels using a drug can create a dependence or addiction to that drug. Many of the people who are abusing this medication are looking for a high, a spurt of energy, productivity, or focus. This may sound like a temporary solution or “quick fix” when you’re feeling tired and feel like you need an extra boost. But the effects of this drug use, long-term, are very risky and can lead to serious harmful effects to the body. Adderall and other ADHD stimulant medications are addictive and using them recreationally or wrongfully may increase the chances of developing a psychological and physical dependence on them.

The psychological and emotional withdrawal from Adderall can create major changes for those abusing it. Why? Because the natural production of dopamine is reduced due to overstimulation at unnaturally high levels when abusing Adderall. This causes low moods and trouble feeling pleasure/interest in normal life activities. Adderall also suppresses appetite, making it appealing as a weight loss drug. The problem with this is that all the same physical, psychological, and emotional withdrawal symptoms can be created. Other times, Adderall may be abused in conjunction with other drugs or alcohol to get high. Mixing Adderall with other substances can be very dangerous and may more easily result in a life-threatening overdose or negative interaction between the substances.

Adderall Dependence
Individuals who are dependent on Adderall may begin to have trouble sleeping and concentrating, lack motivation, feel depressed, irritable, lethargic, or fatigued when the drug has left the body or they do not have more of the substance. This can create withdrawals. Just like other drugs and alcohol, withdrawal or “hangovers” can occur from abusing Adderall. The U.S. Department of Health and Human Services states that other very serious symptoms can also occur during Adderall withdrawals including risk of increased aggression and suicidal thoughts, raised body temperature, heart rate and blood pressure. Repeated abuse of Adderall can cause even more serious medical issues including stroke, seizure or heart attack. The heart muscle may be weakened with prolonged stimulant abuse, leading to more complications. Because of these serious risks, the Drug Safety and Risk Management Advisory Committee of the FDA recommended a ‘black box’ warning describing the cardiovascular risks of stimulants used to treat ADHD. Anxiety and panic attacks may also be triggered by long-term use of amphetamine stimulants or during Adderall withdrawal. The U.S. Food and Drug Administration even prints warnings on Adderall labels about potential negative psychiatric side effects.

So, what do we do?
It is common that people abusing Adderall are not educated on the possible negative effects of using this substance. We must educate those we love and educate ourselves on the topic. If you know of a family member or friend abusing Adderall, it is best to help them understand the adverse effects this drug has on the body, both short-term and long-term. Speaking to a medical professional, a therapist, or seeking further specialized help may be needed. In this nonstop world we live in, it can be difficult to keep up, to be the best of the best, and to meet these unrealistic expectations we set for ourselves. Most people do not have adequate self-care habits in place. Many individuals don’t get enough sleep, don’t have good eating habits, and overwork at their jobs and other roles in life. This can lead to poorer performance, unachieved goals, mental health problems like anxiety and depression, poor cognitive performance and the list goes on. But the solution of taking a pill is not always the best answer.

It is important to consider that maybe what we really need to be doing, is addressing our stress. A change in our mindset and habits may be what is needed to feel more fulfilled and productive. Maybe getting more sleep, eating better, exercising, practicing mindfulness or meditation, or therapy could help? We must take better care of our mental and physical health. If you’re feeling tired, unproductive or less focused, maybe we should take a step back and look at how you are balancing your physical, emotional, mental, spiritual and intellectual health. Now don’t get me wrong, many people take prescribed Adderall daily and it is needed for their daily functioning due to a diagnosis like ADHD or Narcolepsy. Excluding this, we need to address the underlying causes and thoughts that motivate our choices, actions and behaviors before finding a “quick fix” to make us feel differently. We must address what is in our control and change these habits that damage our lives.

It is not an easy task to change habits and lifestyles in comparison to just taking a pill like Adderall to achieve the feeling you want. But, are the possible adverse effects worth the risk? Maybe we just need to take a second, listen to what our bodies need, and ask for help from professionals, loved ones, and friends. Charles Lyell said it best, “Mind over matter”.

Jessica Herz is a Licensed Mental Health Professional. She specializes in crisis intervention, dual-diagnosis, and addiction disorders. She has years of experience working with individuals struggling with addiction, chronic mental illness, mood and personality disorders, and trauma-related issues. Working with individuals of all ages, she emphasizes a strength-based perspective and utilizes cognitive and behavioral interventions to assist clients in creating their best lives- lives worth living for. She earned her Master’s degree in Mental Health Counseling from Florida Atlantic University and her Bachelor’s degree in Psychology from the University of North Carolina Wilmington.