Prescription (Rx) Drug Abuse
ADDERALL, RITALIN and Other ADHD Drug Abuse. Adderall and Ritalin are two popular drugs which are used primarily to treat the symptoms of attention-deficit hyperactivity disorder (“ADHD”). Other ADHD drugs include Dexedrine, Focalin, Vyvanse and Concerta. Adderall, normally referred to as “Addies”, is the most commonly abused of these drugs and is a combination of amphetamine (known as “speed” or “uppers”) and dextroamphetamine. Ritalin is also abused and is a methylphenidate, which has similar effects to amphetamines.
Stimulant Classification. These drugs are classified as central nervous system stimulants, which means they speed up and heighten certain bodily processes. Those who have been diagnosed properly as having ADHD and take these drugs feel a calming, centering effect.
Abuse is Common. Yet, increasing numbers of teens and young adults who don’t have ADHD inaccurately believe that taking these drugs will help improve their ability to maintain focus and productivity while studying, taking tests, working or participating in sports. Some take these drugs recreationally. For those users, taking these drugs feels just like taking speed - legal speed.
Adderall and Ritalin abuse is becoming ubiquitous in high schools and college environments. For a Redwood High School Bark article on the use of Adderall by students, go to www.redwoodbark.org/2012/11/students-turn-to-drugs-to-enhance-test-performance.Side Effects. Common symptoms of Adderall abuse include dry mouth, headache, hoarseness, nausea, digestive issues, reduced appetite, anxiety, restlessness, insomnia, irritability, excessive fatigue, pounding or fast heartbeat and shortness of breath. Ritalin abuse runs the risk of similar negative side effects.
Dangerous Consequences. With long-term or high dose abuse, the symptoms can compound and lead to even more dangerous effects. These include weakness or numbness in the arms or legs, dizziness, slowed or difficult speech, chest pain, hives or rashes, changes in vision, aggressive behavior, paranoia, mania and seizures. Since these are stimulants, serious cardiovascular complications include increased heart rate, increased body temperature to dangerous levels, heart attacks, cardiac arrest or strokes.
Symptoms of Overdose. These include panic attack, hyperventilation, cardiac rhythm abnormalities, hallucinations, uncontrollable tremors, profound confusion or delirium, vertigo, loss of consciousness and coma.
Post-effect Crash. Like Cocaine or any other stimulant, the “up feeling” from Adderall and Ritalin is followed by a crash, a feeling of fatigue, depression and decreased alertness. This can lead to additional abuse to obtain the high.
Tolerance, Dependency and Addiction. Unprescribed abuse of Adderall can be very addictive. Long-term abuse can lead to increased tolerance. Often, as use increases, it becomes impossible to ever recreate the initial high. This can lead to dependency, which in turn can lead to addiction. Over time, the resulting increase in dopamine activity can because subtle brain changes that reinforce drug behavior to the point of being quite difficult to reverse on one’s own.
An interview that highlights why teens are more susceptible to addiction is at http://www.npr.org/sections/health-shots/2015/01/28/381622350/why-teens-are-impulsive-addiction-prone-and-should-protect-their-brains
Short versus Long-term Use. On a short-term basis, non-ADHD users may stay up all night, read more and finish more problems, or work harder, but on a long-term basis, sleep/wake cycles are interrupted and the drugs do not improve one’s ability to learn or work. Non-ADHD users are learning or working in an “altered state” which is called “state dependent learning”. Someone who studies or works in an altered state may not remember the information when he or she returns to a non-altered state.As Dr. Jan Maisel, a Greenbrae pediatrician has stated, “if someone stays up all night, whether assisted by a medicine or not, and does all this work and then goes off to take a test on this work or make a presentation, if they haven’t slept sufficient hours, they are much less able to put the work that they did into their long-term memory”. Studies show that students who abuse Adderall and Ritalin are more likely to have lower grades than students who do not abuse the substance.
Easy Access. A 2016 survey among 18-28 year olds found that roughly 63% obtained these drugs from friends, 18% from classmates and 20% from family.
Using for Recreational Purposes or Combining with Alcohol. Popping ADHD drugs with alcohol keeps users awake for more partying as these drugs counter the depressive effects of alcohol. The euphoria and happiness from these drugs, as well as reportedly better and more frequent sex, can lead to recreational abuse at parties and nightclubs.
Gateway drug. Unprescribed Adderall, Ritalin and other ADHD drugs are becoming known as gateway drugs to Cocaine, Ecstasy, Heroin and Methamphetamine (“meth”), especially when those drugs are cheaper. Meth and Adderall are almost chemical siblings - the methyl group simply allows the Meth to race through the body and hit harder. After that, meth breaks down and metabolizes into amphetamine. Meth and amphetamine cause the same side effects, same potential for overdose and same risk of physical dependence and addiction.
Research done at UC Berkeley identified a relationship between ADHD and use of stimulants in childhood and dependence on other stimulants in adulthood. According to another study, adolescent rats given repeated doses of Ritalin were more likely to self-administer Cocaine.
Slang Terms. These include Kiddy Cocaine, Truckdrivers, Uppers, Speed, Double Trouble, Christmas trees, Skippy, Jif, Bennies, Beans, Black Beauties, Roses, Hearts, Crosses, LA Turnaround, Addies (for Adderall) and Rittys, Rits (for Ritalin).
Prevention. A critical part of prevention is to inform your child that there is no association documented between ADHD drug abuse and increased study abilities or intelligence. The more you speak with your child about the dangers of drug use, the less likely your child will abuse drugs. If your child is prescribed ADHD drugs, monitor their use to ensure that the drugs are not being diverted to others.