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Friday, October 20, 2017

Adderall

Overview

Amphetamine, often known by its brand name “Adderall”, is a highly addictive prescription stimulant that has medical use in treating hyperactivity disorders such as ADD and ADHD as well as narcolepsy, and is one of the most commonly abused stimulants available. Adderall abuse is common in the U.S and abroad, with an estimated 6.4% of college students using Adderall recreationally.1 Adderall is so addictive due to its close interaction with dopamine production in the brain. Adderall remains one of the most popular recreational drugs found today due to its ability to increase focus and energy when abused, and commonly develops into an addiction due to how easy it is to build a tolerance to it. While overdoses are relatively uncommon on Adderall, death can occur from a variety of issues such as respiratory failure and cardiac problems well below the quantity required to overdose. Adderall exhibits short-term effects similar to other prescription stimulants including alertness, euphoria, decreased appetite, and mood shifts. Long term abuse of Adderall can lead to a variety of physiological and mental ailments including depression, skin deterioration, cardiovascular problems, and respiratory damage. There are currently many effective pharmaceutical drugs that can be used in treatment of Adderall addiction, and rehabilitation facilities offer extensive resources for recovering from Adderall addiction in a safe, stable, and comfortable manner.

What is Adderall?

Adderall is among some of the most popular stimulant drugs available today, and has both legal medical usage in treating ADD and ADHD, as well as illegal use as an upper. Adderall holds a reputation for its long lasting feelings of energy and euphoria, its potent addictiveness, and its commonality. Stimulants are a class of drugs that include dangerous street drugs like cocaine, common prescription drugs such as Ritalin, and even your ordinary cup of coffee. More specifically, Adderall is a combination drug made up of amphetamine salts. Amphetamine is a specific central nervous system stimulant that is chemically related to drugs such as methamphetamine, and is notable for its potent stimulating effects as well as its strong addictiveness. Amphetamine has been in regular use since the turn of the 20th century, and had popular usage during WWII. Members of the U.S. Army often took “pep pills”, which consisted of uncut amphetamines, and it has been reported that the Germans and even Adolf Hitler himself regularly abused amphetamines for the increased alertness and stimulation it provided. Usage of Adderall has been steadily and quickly increasing as the drug becomes more popular, particularly in college-aged groups due to Adderall’s use as a study aid. Statistics show that 6.4% of all college students have used Adderall recreationally; and even more troubling, Adderall usage has shown significant increase in the likelihood of using other drugs such as cocaine, and participating in dangerous habits like binge drinking. While it is somewhat difficult to overdose on Adderall, death can still occur on Adderall significantly below the amount required to overdose due to amphetamine’s strong effect on the heart. Cardiac arrest, heart attack, and other heart-related conditions can occur on any amount of Adderall, with the risk increasing with the dose and in those with pre-existing heart conditions.

How Does Adderall Addiction Work?

Adderall’s deadly addictiveness can be attributed primarily to its effectiveness as a central nervous system stimulant, which stimulates dopamine production in the brain. This forces the dopamine out of the cell, trapping it in the synapse and leading to severe overstimulation of dopamine receptors in the brain. Dopamine is a neurotransmitter that is colloquially known as the ‘happiness drug’ due to its purpose in producing feelings of well-being and pleasure when released into the brain. When the body is hurt, the brain produces natural opiates that allow dopamine to be released in the areas of the brain commonly responsible for feelings of pain and stress, which works to reduce overall feelings of pain. However, once dopamine has done its job, it must be taken back out of the synapse to avoid overstimulating the cell. Adderall disables this preventative measure in the brain by taking the place of dopamine. Because the brain isn’t capable of handling such frequent binding of dopamine, dopamine receptors become damaged and make it more difficult to feel pleasure, leading users to use more and more Adderall to chase the fleeting euphoria it once offered them. Adderall is particular addictive because, once ingested, it concentrates in the area of the brain known as the reward pathway. These numerous issues compound to create a very strong addiction potential for Adderall, which becomes more and more difficult to feed the more it is abused. This deadly self-feeding cycle of addiction is at the root of Adderall’s effectiveness at becoming addictive.

Short and Long Term Effects

Adderall is usually taken in the form of compressed tablets, but is also regularly used recreationally by crushing it into a powder and snorting it. Onset of effects varies with the method used to take it, but Adderall generally takes effect between 30-60 minutes after ingestion.

Users report short-term mental effects such as feelings of:

 

    • Increased energy

 

    • Increased alertness

 

    • Euphoria

 

    • Sexual stimulation

 

    • Excessive talking

 

    • Increased motivation

 

    • Aggressiveness

 

    • Paranoia

 

    • Rapid mood shifts

 

And physical effects such as:

 

    • Dizziness

 

    • Numbness

 

    • Excessive sweating

 

    • Severe dryness of the mouth

 

    • Insomnia

 

    • Restlessness

 

Repeated long-term use of Adderall leads to physical side effects such as:

 

    • Decay in skin health – Regular usage of Adderall has been linked to a variety of skin conditions including those associated with both excessively oily and excessively dry skin. Adderall has been linked with a significant increase in acne, as well as dry, irritated, and itchy skin with chronic use.

 

    • Anorexia – Because of Adderall’s effect of appetite suppression, Adderall has been linked to unhealthy weight loss. This can result in anorexia, as well as a host of illnesses and conditions brought about from malnutrition including muscle atrophy and immune disorders.

 

    • Respiratory damage – Chronic Adderall usage has been shown to begin and cause a number of respiratory issues. This can include respiratory depression, irregular breathing, and chronic shortness of breath.

 

    • Insomnia – Due to Adderall’s stimulating effect, a general decay in personal health, as well as frequent interruptions in ordinary circadian activity, Adderall users often experience worsening sleeping problems that can develop into insomnia.

 

Long-term use of Adderall also carries several mental side effects including:

 

    • Severe addiction – Because of Adderall’s addictiveness, both mental and physical addiction are developed very quickly, leading to a complete dependency on the drug.

 

    • Depression – Due to overstimulation of dopamine receptors, Adderall frequently leads to depression due to the brain’s inability to properly manage its circadian rhythm and dopamine production.

 

    • Anxiety – Anxiety is a frequent symptom of drug abuse in general, and is common in Adderall abuse due to internal factors from the psychological and physical effect of the drug itself, as well as external factors such as pressure family, friends, and work that may all be affected by addiction. This can compound and develop into chronic paranoia.

 

Other risks posed by Adderall abuse include:

 

    • Risk of overdose – Adderall overdose is a sometimes understated but dangerously frequent occurrence. Because Adderall tolerance is so volatile, and deadly effects can take place well under the accepted limit that can be taken, Adderall has caused a significant number of deaths from taking doses too high or too often. Death by heart failure is common, and survival rates of overdoses are low.

 

Adderall withdrawal is notoriously difficult to go through, and includes symptoms such as:

 

    • Psychosis

 

    • Fatigue

 

    • Respiratory failure

 

    • Fever

 

    • Anxiety

 

    • Depression

 

    • Heart palpitations

 

    • Tremors, muscle aches and cramps

 

    • Insomnia

 

 

Methods of Treatment

Pharmacological:

There are a large number of drugs that can be used for Adderall addiction and the drug or drugs used depend upon the circumstances of the addiction and the condition of the patient. Some drugs such as baclofen, a GABA antagonist, work by reducing Adderall’s effect on the dopamine reward pathway in the brain. By lessening this effect, baclofen is able to dissociate the drug from its associated feeling of pleasure. Other drugs such hydroxyzine work by reducing the negative effects of withdrawal, allowing the patient to go through detox and likely rehabilitation while minimizing the difficulty of no longer using the drug. This helps not only to reduce the pain of withdrawal, but makes it easier to maintain sobriety afterward as well. Drugs such desipramine, a tricyclic antidepressant, can increase the quantity of norepinephrine in the brain, allowing it to replenish naturally and maintain abstinence. This drug may be particularly useful for drugs like Adderall because despiramine has been used in the treatment of ADHD, and may be able to treat or reduce the effects of hyperactivity disorders that may have led to the use of Adderall in the first place.

Therapeutic:

Other forms of treatment for Adderall addiction come in the form of psychological and behavioral therapies. These treatments focus on the behaviors and habits that led to addiction in the first place in an attempt to remove the root of addiction. Amongst these forms of treatment, Cognitive Behavioral Therapy (CBT) is one of the most common, and is growing in support from the scientific and clinical communities all the time. Cognitive Behavioral Therapy sees substance abuse such as Adderall addiction as a symptom of a greater psychological issue, and not a cause in and of itself. By utilizing reflective and analytic techniques, an addict is better able to understand what led them to addiction in the first place, change bad habits, and avoid behaviors that may trigger cravings. The twelve-step program, which is utilized by Alcoholic Anonymous, is a long-established method of treating drug and alcohol addiction. The twelve-step program works as a gradual method of guiding principles and pragmatic steps that can be taken to go from the depths of addiction and unhealthy habits to sobriety. These twelve steps are aimed at effectively recovering from compulsive and addictive behaviors, and addressing mental and behavioral problems that led to addiction in the first place. These twelve steps include both internal and external actions aimed at making amends for past mistakes, accepting responsibility for the actions that led to addiction, and moving forward to establish healthy habits and a positive mindset.

Rehabilitation

There are two main types of rehabilitation: inpatient and outpatient. Inpatient rehabilitation refers to programs that require patients to check themselves into a facility where they will undergo all rehabilitation treatment. Although inpatient rehabilitation requires a greater level of commitment, the facilities, environment, and support offered by these facilities are conducive to a stable and effective recovery. Inpatient facilities generally offer services such as psychiatrists, counselors, group therapy, and all of the living facilities necessary for a comfortable stay. The extensive support offered by these facilities, combined with an environment that is focused on self-improvement and wellness is a great combination for providing the motivation to push through the difficulties of withdrawal and to establish good healthy habits to prevent relapsing once you leave. This form of rehabilitation is effective for those who would benefit from a stricter more scheduled recovery in which the outside distractions and temptations of life won’t get in the way of focusing on recovery.

Outpatient rehabilitation is based on the principle of spending only part of your time in recovery programs while offering you the freedom to continue daily living on your own. Generally these programs will require ten to twelve hours of commitment per week spent in a treatment facility participating in similar activities to those done in an inpatient facility such as group therapy, counseling, and even detox. While this does offer easier access to drugs, some may find being able to maintain their normal daily schedule more beneficial. This form of rehabilitation is effective for those who require more freedom and contact with friends and family.

Both forms of rehabilitation are effective solutions at combatting Adderall addiction, and there is a variety of different types of both inpatient and outpatient rehabilitation to suit the personal needs of each individual.

References

 

 

    1. National Survey on Drug Use and Health (NSDUH). “What Is the Scope of Adderall Abuse in the

 

United States?” NIDA, National Institute on Drug Abuse, Sept. 2013, www.drugabuse.gov/publications/research-reports/Adderall/what-scope-Adderall-abuse-inunited-states.

 

    1. Eric Patterson, MSCP, NCC, LPC. “Adderall History and Statistics.” DrugAbuse.com, DrugAbuse, 29 Jan. 2016, drugabuse.com/library/Adderall-history-and-statistics/.