Prescriptions for stimulant unchanged, but researchers find more nonmedical use and emergency room visits among adults
By Hub staff report
/ Published Feb 16, 2016
Abuse and emergency room visits associated with Adderall have risen dramatically in young adults, even though prescriptions for the stimulant have not, according to new research from the Johns Hopkins Bloomberg School of Public Health.
The study, published today in The Journal of Clinical Psychiatry, found that 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.
Adderall, the brand name for dextroamphetamine-amphetamine, is typically prescribed for conditions like attention deficit/hyperactivity disorder and narcolepsy. Among the known side effects are sleep disruption and increased risk for mental health problems, including depression, bipolar disorder, and aggressive or hostile behavior. There are also cardiovascular risks like high blood pressure and stroke, which have warranted a black-box warning on the drug from the Food and Drug Administration. There’s little research available on the drug’s long-term effects.
The popular conception has been that Adderall abuse is most severe among older children and adolescents. But the Hopkins researchers found that 60 percent of non-medical Adderall use for ages 12 and up was happening among 18- to 25-year-olds.
In the study’s focus period from 2006 to 2011, researchers saw that non-prescribed use of Adderall by young adults went up by 67 percent and associated emergency room visits rose by 156 percent. Over the same period, regular treatment visits involving Adderall remained unchanged for this age group. The problem appears to be less severe with younger adolescents. For this age group, the study saw that treatment visits for Adderall declined during the six-year period, non-medical use remained stable, and emergency room visits declined by 54 percent.
In addition, researchers found that trends for two other prescription stimulants, including Ritalin, were unchanged over this period.
To see more problems from Adderall without a rise in prescriptions “suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion—people taking medication that is legitimately prescribed to someone else,” says study author Lian-Yu Chen, a former PhD student at the Bloomberg School. “Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.”
The researchers found that the major source for non-medical use of Adderall was family or friends; two-thirds of those family or friends obtained it by prescription.
Study co-author Ramin Mojtabai, a professor of mental health at the Bloomberg School, says there needs to be more education for young adults on the risks of Adderall.
“Many of these college students think stimulants like Adderall are harmless study aids,” he says. “But there can be serious health risks and they need to be more aware.”
Mojtabai suggests that drugs like Adderall should be treated with the same scrutiny as prescription painkillers. He says Adderall prescriptions should be entered into a database to prevent “doctor shopping,” where patients get multiple prescriptions from different physicians, sometimes with the intent of selling or distributing pills.
Prescriptions for the stimulant unchanged, but study finds more nonmedical use and emergency room visits among adults
While the number of prescriptions for the stimulant Adderall has remained unchanged among young adults, misuse and emergency room visits related to the drug have risen dramatically in this group, new Johns Hopkins Bloomberg School of Public Health research suggests.
Anecdotal evidence had suggested the most severe problem of Adderall misuse was among older children and adolescents, but the new research – published Feb. 16 in The Journal of Clinical Psychiatry – finds otherwise. The study examined trends from 2006 through 2011 and found that it is mainly 18-to-25-year-olds who are inappropriately taking Adderall without a prescription, primarily getting the medication from family and friends and without a physician recommendation or prescription.
“The growing problem is among young adults,” says study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School. “In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram. Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying. We need to educate this group that there could be serious adverse effects from taking these drugs and we don’t know much at all about their long-term health effects.”
Says first author Lian-Yu Chen, MD, who received her PhD in 2014 from the Bloomberg School: “The number of prescriptions for Adderall has fallen and yet we are seeing more medical problems from its use. This suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion, people taking medication that is legitimately prescribed to someone else. Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.”
Adderall, the brand name for dextroamphetamine-amphetamine, does improve focus, Mojtabai says, but it can also cause sleep disruption and serious cardiovascular side effects, such as high blood pressure and stroke. It also increases the risk for mental health problems, including depression, bipolar disorder and unusual behaviors including aggressive or hostile behavior. There is little research on long-term effects. In 2006, the Food and Drug Administration (FDA) put a black box warning on dextroamphetamine-amphetamine due to cardiovascular risks. It is prescribed for conditions such as attention deficit/hyperactivity disorder and narcolepsy.
For their study, the researchers examined three separate sets of data: the National Survey on Drug Use and Health, a population survey of substance use; the Drug Abuse Warning Network, a survey of emergency department visits; and the National Disease and Therapeutic Index, a survey of office-based practices including prescribing.
They found that in adults, over the six-year study period, treatment visits involving Adderall were unchanged, while non-medical use of Adderall (that is, taking the drug without it being prescribed) rose 67 percent and emergency room visits went up 156 percent. Over the same period, in adolescents, treatment visits involving Adderall went down, nonmedical use was stable and emergency room visits declined by 54 percent. The trends for methylphenidate, sold under the brand name Ritalin among others, and another prescription stimulant prescribed for attention-deficit/hyperactivity disorder, were unchanged over the period.
Meanwhile, the major source for nonmedical use of Adderall was family or friends; two-thirds of those family or friends obtained it by prescription.
The researchers found that of all Adderall nonmedical use, from age 12 and up, 60 percent of it was among 18-to-25-year-olds.
Mojtabai says that from a public health perspective, drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years. He says prescriptions should be entered into a database that a physician could check before writing a prescription to make sure the patient isn’t receiving multiple medications from multiple physicians, a warning sign of diversion or abuse.
He also says it would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug. “Many of these college students think stimulants like Adderall are harmless study aids,” he says. “But there can be serious health risks and they need to be more aware.”
“Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants” was written by Lian-Yu Chen, MD, PhD; Rosa M. Crum, MD, MPH; Eric C. Strain, MD; G. Caleb Alexander, MD, MS; Christopher Kaufmann, MHS; and Ramin Mojtabai, MD, MPH, PhD.
This study was supported by the National Institutes of Health’s National Institute on Drug Abuse (K24 DA023186), the Agency for Healthcare Research and Quality (RO1 HS01899600 and a National Research Service Award (F31AG044052).
Alexander is Chair of the FDA’s Peripheral and Central Nervous System Advisory Committee, serves as a paid consultant to IMS Health, and serves on an IMS Health scientific advisory board. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Mojtabai has received consulting fees and research grants from Bristol-Myers Squibb and Lundbeck.
Why is adolescence a critical time for preventing drug addiction?
As noted previously, early use of drugs increases a person’s chances of becoming addicted. Remember, drugs change the brain—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.
Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. 35 When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.
A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens’ tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen’s ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure. 36
Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control. 12
Can research-based programs prevent drug addiction in youth?
Yes. The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities. Studies have shown that research-based programs, such as described in NIDA’s Principles of Substance Abuse Prevention for Early Childhood: A Research-Based Guide and Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders, can significantly reduce early use of tobacco, alcohol, and other drugs. 37 Also, while many social and cultural factors affect drug use trends, when young people perceive drug use as harmful, they often reduce their level of use. 38
How do research-based prevention programs work?
These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:
- Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.
- Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.
- Indicated programs are designed for youth who have already started using drugs.
Young Brains Under Study
Using cutting-edge imaging technology, scientists from the NIDA’s Adolescent Brain Cognitive Development (ABCD) Study will look at how childhood experiences, including use of any drugs, interact with each other and with a child’s changing biology to affect brain development and social, behavioral, academic, health, and other outcomes. As the only study of its kind, the ABCD study will yield critical insights into the foundational aspects of adolescence that shape a person’s future.
Economics of Prevention
Evidence-based interventions for substance use can save society money in medical costs and help individuals remain productive members of society. Such programs can return anywhere from very little to $65 per every dollar invested in prevention. 39
It would be so amazing if our kids could grow to be adults with a clear mind that was free of drugs.
They would be so much more prepared to take on the world and create a life for themselves.
Drug use is preventable.
We know many factors can add to a person’s risk for substance use.
After providing the basic needs for your child, there are ways in which you can help protect your child from early drug use.
There is no perfect parenting recipe for raising drug-free kids. It just doesn’t exist, as every situation is different.
My hope is that sharing tips from those who have been down this path with their kids is a good starting point.
It is easier to build strong children than to repair broken men.
Here are some ideas to help you as a parent protect your child from using drugs.
- Communicate. Talk often to your children about the risks of drug use.
- Listen. Be a good listener when your children talk about the pressure they feel, and be supportive of their efforts to resist it.
- Set a good example. Don’t abuse alcohol or drugs. Children of parents who abuse drugs are a greater risk of drug addiction.
- Work on the relationship with your children. A strong, stable bond between you and your teen will reduce your teen’s risk of using or abusing drugs.
- Sit down for a regular family dinner. There is power in this kind of habit that anchors a family and protects children from all types of harm.
- Be clear on your expectations. Communicate clearly what you expect and stick with your consequences.
- Treat your children with respect. No matter what your children do or don’t do, treat them with respect.
- Teach your children. Children who learn about the risks of drugs and alcohol from their parents are less likely to use than those who do not.
- Know your child’s risk level. Genetics can be a risk factor in becoming addicted to drugs or alcohol. Know your child’s genetic risk and explain to them the importance of being extra vigilant.
- Understand the 5 risk factors. Help your teen understand the risk factors for developing a substance use problem. Five risk factors are early use, genetics, mental health issues, childhood trauma, or ACEs (adverse childhood experiences), as well as the environment.
- Have a conversation with your children. Having a conversation rather than a confrontation helps to keep a strong relationship with your child.
Please share your thoughts about parents who are raising teens in the comments. Maybe some of these ideas will help a parent prevent a young person from early drug use.
Thank you for all you are doing to help your child live a healthy life.
While school programs such as DARE teach most children the harmful effects of marijuana, ecstasy, heroin, or methamphetamine, the biggest substance abuse problem facing young adults might be the one that’s right under your nose, but rarely talked about.
Young adults (18 to 25-year-olds) are the biggest abusers of prescription drugs in the United States but it’s a problem that’s rarely discussed and even lesser known than problems with drugs such as heroin and methamphetamine. Opioid pain relievers (Oxycontin, Vicodin, etc.), ADHD drugs (Adderall, Ritalin), and anti-anxiety medication (Xanax, Valium) are the most commonly abused drugs in this demographic, yet most parents aren’t even aware that their own prescriptions are responsible for approximately 3,000 overdose deaths each year. The number of overdose deaths from prescription drugs (typically opioids) exceeds the number of deaths caused by the more widely known problems associated with heroin, cocaine and methamphetamine – combined.
For each of those 3,000 deaths there were 66 emergency room visits, and 17 admissions into short or long-term drug treatment programs. What’s worse is the fact that this problem is still flying under the radar even after we’ve seen a 250-percent increase in the number of overdose deaths between 1999 and 2010.
How Do Young Adults Access Prescription Drugs?
Much like heroin, cocaine or many other popular street drugs, pharmaceuticals are often bought and sold by individuals. While availability through dealers is certainly a reality, most of these drugs come right from an adult’s medicine cabinet. Nearly 50-percent of the United States population takes at least one prescription medication, which gives young adults their pick of medications taken by parents, aunts, uncles, grandparents or relatives of their friends.
In addition, “pharming” (pronounced “farming”) is a newer trend that essentially acts as a prescription drug swap meet by holding parties for young adults to exchange, purchase, or sell pharmaceuticals in addition to providing a place to get high with their friends. While pharming is the most commonly known name, you might also hear these parties referred to as “Skittles parties” or just “skittling.”
What Can Parents Do to Prevent Young Adults from Accessing Prescription Drugs?
There isn’t often a great deal that a parent can do to keep kids from accessing pharmaceuticals through friends, or acquaintances, but they can take steps to secure their own prescriptions. Locking them up, monitoring quantities used/left, and disposing of unused or expired medications can help to cut off the supply of pharmaceuticals available to young adults.
In addition to monitoring your own prescriptions, communication is an important aspect to prevention as some young adults have a false sense of safety when taking prescription medications. Pharmaceuticals are often perceived as safer and more reliable ways to get high when compared with the relative unknowns faced by users that abuse street drugs. For example, little is known about heroin or methamphetamine types due to the unknown origin of the drug before it made its way to the dealer, and as such it may contain a host of filler ingredients that decrease overall quality or cause harmful side effects. A sense of security that is often lacking with street drugs isn’t as apparent in doctor prescribed pharmaceuticals and may lead users to consume higher quantities of the drug or taking unknown pills in an attempt to get high.
There’s certainly no way to remove access to the supply of prescription drugs, but education does go a long way in helping young adults to understand that these drugs carry their own set of risks, whether it be from accidental overdose, or long-term dependence.
Do your part by ensuring that your prescription drugs don’t fall into the hands of your young adult and keep actively educating them about the dangers of this and other substances and the long-term negative implications they can have on their lives.
If you or a loved one struggles with substance abuse, please contact us today to find out how we can help.
These days there is a focus on preventing youth substance abuse. It is important to understand what supports are out there for students and young adults, particularly if you are in a role to help guide students to them. According to the National Institute on Drug Abuse , prevention is a key principle in protecting today’s youth from the dangers of drug abuse.
Although schools have always been involved in prevention of substance abuse, recently there are more proactive programs available. This includes:
- telling the truth about drugs,
- treating the causes of drug abuse such as social issues and social isolation,
- decreasing the gap between students in different classes,
- using programs to educate students and teachers on risk factors rather than on the drugs themselves, and
- teaching students who to go to for treatment and who can help.
This is a different approach from what schools traditionally use. The new approach uses less scare tactics and more prevention methods.
Teachers are undergoing extensive training in order to better identify and prevent substance abuse.
Teachers are now undergoing training in recognizing the signs and risk factors rather than training to recognize the drugs themselves. Districts and states are working with teachers in an effort to head off drug addiction before it becomes a problem. By educating teachers in how to identify and reach at risk youth, they hope to prevent young adults from becoming addicted.
Community outreach programs are becoming more popular especially in at risk communities. Again, the focus is on identifying youth that are at risk rather than those that have substance abuse problems already. It is meant to catch those who are headed into substance abuse before they become abusers.
There are now programs for teaching positive parenting in place. These programs teach:
- communication skills between parents and their children,
- establishing an open door policy,
- encouraging positive behaviors,
- setting reasonable limits, and
- allowing teens to talk and express who they are in respectful ways.
These programs are designed for all parents not just those who consider their children at risk. There is no specific type of young person who is particularly at risk for becoming addicted to drugs and alcohol. Recognizing this is becoming more important than simply focusing on those who were traditionally at risk for drug and alcohol problems.
The National Institute on Drug Abuse is sponsoring one of the largest online prevention and awareness online programs. Their latest attempt to help ease the problem of youth drug abuse is their National Drug Awareness Chat Day. This is to unite the United Institute of Health, the National Institute on Drug Abuse, and the Food and Drug Administration, along with teens, parents, and teachers. The purpose is to shatter myths and raise awareness about the growing issues with drug abuse.
Although prevention is key to solving today’s drug and alcohol problems, it does not always work. It is important to know where and how to seek treatment when it is necessary. For more information on implementing a prevention program or to seek treatment options call us at 1-800-895-1695.
Prescription stimulants increase—or “stimulate”—activities and processes in the body. When prescribed by a doctor for a specific health condition, like ADHD, they can be relatively safe and effective. However, it is considered misuse when they are taken not as prescribed, to get “high,” or when you take some prescribed for someone else. This can lead to dependence and addiction.
Dependence means you will get uncomfortable withdrawal symptoms when you try to quit. Addiction means you continue to seek out and take these drugs despite negative consequences.
There are three commonly misused types of stimulants: dextroamphetamines (e.g., Dexedrine®), dextromethylphenidate (e.g., Ritaln®), and stimulants that are a combination dextroamphetamines and amphetamines (e.g., Adderall®). Medical uses for these stimulant drugs are listed below:
- dextromethylphenidate/amphetamine combination
- Narcolepsy (sleep disorder)
Read more about prescription drugs and what happens to the brain and body when someone misuses them.
How Stimulants Are Misused
Prescription stimulants are normally taken in pill form, but some people who misuse them to get “high” crush the tablets and snort or inject them. This can be dangerous because ingredients in the tablets can block small blood vessels, damaging the heart and other organs.
Some teens are prescribed stimulants to manage their ADHD. But if they share their medication with friends, it is considered misuse. People misuse stimulants by taking them in a way that is not intended, such as:
- Taking someone else’s prescription stimulant medication, even if it is for a medical reason, like ADHD.
- Taking stimulant medication thinking it will improve your grades even though you do not have ADHD.
- Taking more than the prescribed dose.
- Taking a prescription stimulant medication in a way other than prescribed—for instance, crushing pills, adding them to water, and injecting the liquid.
- Taking the prescription stimulant to get “high.”
- Mixing the prescription stimulant with alcohol and certain other drugs. A pharmacist can tell you which drugs are not safe to mix with stimulants.
Stimulants have been misused as an “academic performance enhancer,” (for example, to stay awake all night to cram for an exam). That’s why people sometimes refer to them as “study drugs.” However, there is no evidence that stimulants increase your grades if you do not have ADHD; although there might be several other reasons those students struggle in school. For example, a decline in grades can be related to students skipping classes. Skipping classes can be linked to the use of a variety of drugs or mental health issues.
What happens to your brain when you misuse prescription stimulants?
The brain is made up of nerve cells that send messages to each other by releasing chemicals called neurotransmitters. Common stimulants, such as amphetamines and methylphenidate, have chemical structures that are similar to certain key brain neurotransmitters including dopamine and norepinephrine. Stimulants boost the effects of these chemicals in the brain and body.
When doctors prescribe stimulants for a medical condition, they start with low doses and increase them slowly until they find the dose that works best. However, when taken in amounts or ways other than prescribed, like snorting or injecting, stimulants can increase the dopamine in the brain very quickly. This changes the normal communication between brain cells, producing a ‘high’ while also increasing the risk for dangerous side effects. Over time, this can lead to addiction, which is when you continue to use the drug despite negative consequences.
What can happen to your body when you misuse prescription stimulants?
Stimulant use can have side effects, even when prescribed by a doctor. Misusing them can be especially dangerous. Taking high doses of a stimulant can cause:
- increased blood pressure
- irregular heartbeat
- dangerously high body temperatures
- decreased sleep
- lack of interest in eating, which can lead to poor nutrition
- risk for seizures and stroke at high doses
- if drugs are injected, there is an increased risk of HIV, hepatitis, and other infectious diseases from shared needles
Over time, prescription stimulant medications can cause:
- heart problems
- psychosis (having false thoughts or seeing or hearing things that aren’t there)
- intense anger
- paranoia (feeling like someone is going to harm you even though they aren’t)
Can you overdose or die if you misuse prescription stimulants?
Yes, it is possible to die from stimulant misuse. Taking high doses of a stimulant can raise a person’s body temperature and blood pressure to dangerous levels and make the heart beat irregularly. This can lead to seizures, heart failure, and death. Stimulants should not be mixed with medicines used to treat depression or over-the-counter medicines that contain decongestants. This is why it is important to discuss with your doctor all the drugs you take.
Deaths from an overdose of prescription drugs have been on the rise since the early 1990s. Learn more about drug overdoses in youth.
Are prescription stimulants addictive?
Yes, misusing stimulants can lead to addiction. Addiction is when you continue to seek out and take the drug even though you know it is damaging your health and life, even ruining your relationships and causing you problems in school or at work.
When a person who regularly misuses stimulants stops taking them, they may experience withdrawal symptoms. Stimulant withdrawal can cause:
- an inability to feel pleasure
- thoughts of suicide
- anxiety and irritability
- feeling very tired, lack of energy, and changes in sleep patterns
- intense drug cravings
People who have these symptoms should seek medical help. People should ask their doctor for advice on how to safely stop using stimulants.
Approximately 2.5 million Americans are prescribed prescription stimulants such as Adderall or Ritalin to treat Attention Deficit Hyperactivity Disorder (ADHD).  ADHD is a brain disorder that makes it difficult to concentrate and increases impulsive behavior.  Prescription stimulants help to reduce these symptoms. However, many people use these drugs for non-medical purposes and without a prescription, especially college students who buy them from a friend with a prescription. [ 1]
The use of drugs like Adderall and other so-called “study drugs” has skyrocketed over the past two decades. One reason is that the Food and Drug Administration (FDA) approved a version of the drug, Adderall XR, which lasts much longer than other prescription stimulants. Another reason is that more young Americans are diagnosed with ADHD and this results in more prescriptions. In fact, over the past decade, the manufacturing of prescription stimulants has increased by a whopping 9 million percent! 
How many of these pills are used to treat ADHD? A study of more than 10,000 college students from across the country found that more than half of students with an Adderall or other ADHD drug prescription were asked to sell the medication to peers and friends.  Almost every student who abuses these drugs in college gets the drug from a friend or classmate with ADHD.  One study of students at Bates College, a small Maine liberal arts college, found that one in every three students had abused Adderall at some point.  In contrast, a national study of 10,000 students found that approximately 7% had abused “study drugs,” although the percentage varied at different colleges. 4 Whether the typical abuse rate is 7% or 33%, or something in between, the extent of the problem is alarming.
People who abuse Adderall and similar drugs tend to have several characteristics in common. For example, a disproportionate number are white, in college, and belong to a fraternity or sorority. Because these drugs are commonly used to help students focus on reading or studying, abusers tend to have grade point averages of a B or lower. [ 4]
Causes and Common Justifications
Not surprisingly, around three quarters of prescription stimulant-abusers use the drug for academic purposes—to help them stay awake, focus, and study before a big exam.  However, ADHD medications do not make students ‘smarter.’ It may help them focus and stay awake, but abusers should not expect the drugs to help with more complex learning such as writing better papers or studying for college-level exams. 
Prescription stimulant abuse may also occur for social reasons because students want to stay up later than they would otherwise. Some students claim that taking Adderall makes them more talkative and better company. Additionally, about a third of students have taken to get high or experiment. Most of those that take the drug for this reason are men. These experimenters usually only use the drug to get high a few times, whereas regular users tend to use stimulants for academic purposes. Approximately one in five women who take the drug do so to lose weight.  Because Adderall and other stimulants reduce appetite, some abusers see it as a means to simultaneously study and stay in shape. However, taking these drugs to reduce appetite is unhealthy for a number of reasons, especially because the body does not get the nutrients that it needs.
Many students with an Adderall or other ADHD prescription believe that distributing the drug is legal and a good way to make money. However, these drugs are Schedule II drugs, meaning the Drug Enforcement Agency has labelled it highly addictive. The minimum sentence for distributing a Schedule II drug like Adderall is five years in prison. [ 4] Very few students are aware of this and it is not commonly enforced.
Why “Study Drug” Abuse Is a Problem
Students often do not feel guilty after abusing Adderall and similar drugs because they believe they are self-medicating for an attention deficit disorder or do not consider the drugs to be as dangerous or illegal as other Schedule II drugs, such as cocaine or opioids. Educators, however, may need to decide if the abuse of “study drugs” is comparable to an athlete using steroids, and if more attention should be paid to the prevention and punishment of illegal prescription stimulant use. Even though these drugs do not make students smarter, does using them the night before the test to stay up cramming give a student an unfair advantage the next day? Even if the advantage is not greater than caffeine, should it be treated differently if the drug was illegally obtained?
Every drug comes with risks, and Adderall and other ADHD drugs have more risks than many other commonly used medications. When physicians prescribe a patient that has ADHD a drug like Adderall, they should carefully weigh the risks against the benefits it provides. Students who abuse these stimulants often do not consider the risks of the drug either because they are not aware of them or they assume that, as an FDA-approved drug, there are no risks. The most common side effect of Adderall and other stimulants is insomnia, which appeals to students who use it stay awake. In short-term studies of Adderall’s safety, conducted by the manufacturer, they found that the drug caused gastrointestinal problems, blurred vision, increased body temperature, increased blood pressure, increased heart rate, reduced circulation, and irritability. While these effects are minor for most young people, if a student has a heart condition, Adderall could be deadly. In rare cases, Adderall can cause hallucinations, cardiac arrests, and even death for people with a heart condition. The likelihood of these risks occurring increases if Adderall is used without a prescription and at higher than recommended dosages, as often is the case among abusers.  Similarly, a study of Ritalin found that the drug significantly increases risk for heart arrhythmia, and, for users with pre-existing heart conditions, may lead to serious conditions like heart failure. 
The attitudes of parents, students, college administrators, and law enforcement towards Adderall and Ritalin abuse have been ambivalent; since they are used for studying, they are often assumed to be just a little different than caffeine. However, if students have serious attention issues, they should see a doctor for a medical diagnosis instead of asking a friend to illegally use Adderall or other prescription stimulants. At the very least, students need to be aware of the serious risks that can occur; although the most serious are rare, that doesn’t matter if it happens to you or someone you care about. Parents, health care professionals, counselors, and college administrators should be sure to include Adderall and other “study drugs” in any conversation about the dangers of substance abuse.
All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.