What Is Adderall Addiction?

Adderall addiction is a condition in which a user is unable to control their use of the drug in spite of adverse consequences. The addiction leads to health issues and/or problems at work, home, or school. If left untreated, an Adderall addiction may result in overdose, which can cause a heart attack, stroke, liver failure, psychosis, and/or death.

Adderall addiction is classified as a stimulant use disorder in the "Diagnostic and Statistical Manual of Mental Disorders, Edition 5" (DSM-5) issued by the American Psychiatric Association (APA). The addiction is diagnosed based on specific diagnostic criteria, and it is usually treated with detox and behavioral therapies.

Signs and Symptoms

Adderall is a combination of amphetamine and dextroamphetamine, which are substances that increase the availability of stimulating neurotransmitters in the brain.

It is prescribed for control of symptoms of attention deficit hyperactivity disorder (ADHD) because people who have this disorder are believed to have a defect in the processing of these neurotransmitters.

Adderall is a Schedule II controlled substance, which means that it has a high potential for abuse, and therefore is strictly regulated. At therapeutic doses, this medication may induce:

• Euphoria
• Increased wakefulness
• Cognitive control
• Faster reaction time
• Fatigue resistance
• Increased muscle strength

These effects, which are also sometimes associated with increased libido and high energy levels, can lead some users to take more and more of the drug to amplify the effect. Other easons for abusing Adderall include:

• For a recreational high
• To enhance athletic performance
• As an appetite suppressant

As addiction develops, some users snort or smoke the crushed pills for a faster effect. Often, people who begin to use higher than needed doses of Adderall are unaware of the negative impact of drug use on their lives. The drug’s euphoric effects cause people to overestimate their own performance and to neglect the negative response of others.

The signs and symptoms of Adderall abuse might include:

• Confusion
• Violent behavior
• Lack of appetite
• A decline in physical appearance and self-care
• Decreased performance at work or school
• Lying about the need for the drugs
• Hiding the drug use
• Using the drugs when alone
• Missing work, school, sports, or social activities due to the drug use
• Feeling unable to control drug use or reduce the drugs
• Being unable to function without the drugs
• Continuing to use the drugs, despite the harm they are causing
• Hostility when questioned about drug use

Complications

The most dangerous complication of Adderall abuse is overdose, which results in amphetamine toxicity. The clinical effects of amphetamine overdose occur abruptly and can worsen rapidly.

The signs and symptoms of toxicity include:

• Dry mouth
• Dilated pupils
• Chest pains
• Hyperthermia (high body temperature)
• Rapid breathing
• Tachycardia (rapid heart rate)
• Arrhythmia (irregular or rapid heart rate)
• Palpitations (a sense of a pounding heart)
• Sudden onset of hypertension (high blood pressure)
• Coronary vasospasm (sudden narrowing of the blood vessels in the heart- can cause a heart attack)
• Hallucinations
• Paranoia
• Psychosis

It can be hard to predict if overdose will occur. Sometimes factors such as using other drugs or medications, weight loss, or illness can lead to toxicity even when a person uses the same dose they have used before. And a small increase in amphetamine dose can lead to an unexpected overdose.

Causes and Risk Factors

Stimulant addiction is thought to develop in relationship to a complex combination of genetic, neurological, biochemical, and psychological factors.

Risk factors associated with stimulant abuse disorders include:

• Family History: A family history of substance use disorders may increase the risk for Adderall abuse.
• Psychiatric disorders: People with depression, bipolar disorder, and other psychiatric conditions are more likely to abuse stimulants.
• Addictive tendencies: People who are prone to addiction have an increased predisposition to Adderall addiction.
• Sex: Men are more likely to use illicit drugs in general. With that said, women and men are equally at risk of substance use disorders.

Pathophysiology

Amphetamines, including Adderall, increase transmission of the neurotransmitters dopamine, serotonin, and norepinephrine. Some people have a predisposition to Adderall addiction and other addictions. This can be due to factors such as brain structure or neurochemistry that alter a person's experience of the drug, making the cravings stronger.

Diagnosis

According to the DSM-5, stimulant use disorder is a subcategory of substance use disorder. Blood and urine tests can confirm the presence of Adderall, but these tests cannot diagnose Adderall addiction or any other substance use disorder. The diagnosis is based on whether a person meets the diagnostic criteria outlined in the DSM-5.

For a person to be diagnosed with stimulant use disorder, they must meet at least two of 11 criteria within the previous 12 months:

• Taking more of the stimulant drug than prescribed (more frequent or higher dose)
• Unsuccessful in trying to cut down or control use of stimulants, despite wanting to do so
• Spending excessive amounts of time on activities associated with stimulant use
• Feeling urges and cravings for stimulants
• Falling short on obligations of home, school, or work
• Continuing to take stimulants, even though use has lead to relationship or social problems
• Giving up or reducing recreational, social, or work-related activities because of stimulant use
• Using stimulants in a physically risky way
• Continuing to use stimulants despite awareness of a worsening physical or psychological problem
• Tolerance to stimulants
• Withdrawal from stimulants if you don't take them

The severity of the disorder can be classified as “mild” if two to three criteria are met, “moderate” if four to five are met, and “severe” if six or more are met. These classifications are used to help direct the most appropriate course of treatment.

Treatment

There are no medications used to treat Adderall addiction. The treatment is focused primarily on detoxification (often referred to as detox) and behavioral therapies. 

Treatment may be delivered on an outpatient basis and may require a period of inpatient care in a treatment center (particularly since withdrawal symptoms can lead to depression and, in severe cases, a risk of suicide). 

Detoxification

During a detox program, you would have medical supervision as you discontinue or gradually reduce use of the drug.

Symptoms of withdrawal, such as depression, irritability, or anxiety, would be monitored and managed with counseling or medical treatment as needed. Physical issues like fatigue or changes in blood pressure, pulse, or respiration would be managed safely.

Behavioral Therapy

You would also need psychotherapeutic intervention, which is a process that requires your participation. There are several different types of psychological treatments for addiction and you might benefit from a combination. Generally, one or more would be suitable for you, while others might not.

Techniques include:

• Cognitive behavioral therapy (CBT): Therapy focused on examining how your thinking and behaviors contribute to your addiction.
• Motivational interviewing (MI): A process of guided discussion to help with sorting out conflicted feelings or ideas about changing your addictive behavior.
• Contingency management (CM): A strategy of using motivational incentives to modify behavior
• Dialectal behavioral therapy (DBT): This approach is directed at regulation of emotions.
• Rational emotive behavioral therapy (REBT): This therapy is focused on rational thinking and changing thought processes that are based in irrational beliefs

A “Matrix Model” involves a combination of therapies specifically adapted to address stimulant abuse.

A traditional 12-step program can provide ongoing support and better ensure sustained abstinence. For further options, clinical trials may expand treatment options for stimulant addiction.

How to Find Help

If you or a loved one is struggling with substance abuse or addiction, you can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357. SAMHSA also provides an online treatment center location.

If you or a loved one are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.