Adderall, a branded formulation of amphetamine and dextroamphetamine, is a stimulant that doctors prescribe for the management of:
- Attention deficit hyperactivity disorder (ADHD).
As a prescription stimulant, Adderall can be used to effectively manage these conditions by helping users remain alert and focused. Unfortunately, Adderall is also a popular drug of abuse. It is sold on the black market under many different names including "beans," 'black beauties," "dexies," "pep pills," "speed," and "uppers" 1.
This drug is abused recreationally because high doses can produce a euphoric high similar to illicit stimulants like cocaine and methamphetamine. People also abuse Adderall as a performance-enhancing drug. It is often called a “study drug” due to its misleading reputation for improving alertness and concentration even in those without ADHD.
The abuse of Adderall is rising fast according to the Drug Abuse Warning Network (DAWN), which tracks drug-related visits to emergency rooms across the country. In 2013, DAWN reported 17,000 Adderall-related visits to emergency departments in 2011, an increase of 650% over the number in 2004 2.
Misuse of Adderall is tied to numerous physical and mental risks; unfortunately, Adderall users who want to stop may find that they are not able to do so on their own. Adderall is known to produce tolerance and dependence in some individuals. Once a person has developed physiological dependence on this drug, they may experience a stimulant withdrawal syndrome as their body detoxes from the substance.
What is Amphetamine Withdrawal?
The term “drug withdrawal” refers to a group of negative symptoms that often occur when a dependent user stops taking a drug suddenly or attempts to significantly reduce their dose.
Like many other drugs of abuse, heavy amphetamine use may be associated with an unpleasant withdrawal syndrome—the severity of which will be relative to the average amount of drug being abused, amongst other variables.
Is Adderall Withdrawal Dangerous?
Withdrawal from certain drugs like alcohol or benzodiazepines can pose a dangerous, or even fatal, risk to abusers. However, withdrawal from stimulants like Adderall often results in relatively mild physical symptoms that are unpleasant but not usually life-threatening 3. These symptoms will vary in number and intensity for different people, but on the whole, they are typically less dangerous than the risks posed by continued abuse.
[Withdrawal] symptoms will vary in number and intensity for different people, but on the whole, they are typically less dangerous than the risks posed by continued abuse.
Although Adderall withdrawal does not usually pose a physical danger to abusers, this does not mean that withdrawal from this drug is easy or safe. The FDA-required labeling for this medicine warns of “extreme psychological dependence” 4, and prominent psychological dangers during withdrawal include including depression, anxiety, and drug cravings 5.
These psychological symptoms can make it very difficult for an abuser to resist the urge to resume taking the drug in order to relieve these unpleasant feelings. In extreme cases, the depression and anxiety induced by amphetamine withdrawal can lead to suicidal or violent actions 6, which can pose a danger to the individual or those around them.
In some cases, professional detox assistance and medical supervision may be required to mitigate the risk of potentially severe psychological withdrawal symptoms. For help finding a professional treatment program, call us today at 1-888-744-0069Who Answers?.
Signs and Symptoms of Amphetamine Withdrawal
Symptoms of withdrawal from Adderall or other stimulants can begin anytime from hours or days after the last use. These symptoms may differ depending on the individual and their personal history of using Adderall, but generally include 4,6,7.
- Extreme fatigue.
- Sleep disturbances.
- Insomnia, followed by hypersomnia.
- Intense and vivid drug-related dreams.
- Memory impairment.
- Drug cravings.
- Anhedonia (loss of interest in pleasurable activities).
These are symptoms of what is known as “acute withdrawal”, and will usually resolve themselves in 1-2 weeks 8. However, those recovering from stimulant abuse may also experience a post-acute withdrawal syndrome (also known as PAWS or protracted withdrawal) 8. In the case of PAWS, withdrawal symptoms can persist for months or years, long after the drug has left the body. The causes of PAWS are generally not well understood; however, symptoms of PAWS are thought to reflect long-lasting changes in the brain caused by drug abuse. There is no standard treatment for PAWS, but individuals in recovery should be aware that these symptoms are not permanent and will pass in time 8.
Can Medications Help?
Currently, there are no medicines approved for treating stimulant withdrawal, and because the physical withdrawal symptoms for stimulants are relatively mild, users will usually not usually require supportive medication during the withdrawal process 9. However, even though withdrawal symptoms are not life-threatening, they are unpleasant, and medical supervision can help to prevent those working through detox from either outright relapsing or self-medicating with other potentially harmful substances like alcohol, tranquilizers, or opioids 6.
As noted above, the psychological symptoms of Adderall withdrawal, like depression, can be quite serious and create the potential for self-harm, especially in patients with pre-existing depression. Vigilant monitoring and psychiatric medications may be required in these cases. Any agitation or insomnia to arise during acute withdrawal will likely first be addressed non-pharmacologically (e.g., stress management techniques, relaxation exercises). However, if persistent and/or severe, medications with minimal abuse potential such as trazodone may be administered on a trial basis 6.
While it is possible to withdraw from Adderall at home, some users prefer the supportive environment of a professional, medically monitored environment. Addiction professionals at a detox facility can help with the depression, anxiety, and insomnia that often accompany detox from this drug. Also, being in a supervised facility can help eliminate the danger of relapsing during this period of intense drug craving.
Following detox, people recovering from Adderall abuse or addiction may enter a drug treatment program in order to give them the best chance at a full recovery. Detox is not considered to be a standalone treatment for addiction, but rather the beginning step to stabilize the body and mind so recovery may begin in earnest.
Treatment for amphetamine addiction is based on behavioral therapies that are similar to those used for addictions to other stimulants. Three common behavioral interventions used for stimulants are 10:
- Contingency management interventions. These therapies use reward vouchers or cash prizes to reward positive behaviors like drug-free urine tests. The value of the rewards is low at first and increases with each consecutive positive step.
- The Matrix Model. This therapy includes elements from many different approaches, including group therapy, drug education, and self-help participation.
- 12-Step facilitation therapy. This model is designed to help the recovering individual to become actively involved in 12-step recovery groups in order to help support their continued abstinence following treatment.
Tips to Handle Adderall Cravings 8
- Distract yourself. Cravings often pass quickly if you do not act on them as soon as they occur. Make a list of distracting activities like going for a walk or engaging in relaxation exercises that you can turn to until the craving passes.
- Talk about it. Talking about your cravings to supportive friends, family members, or a therapist can help reduce the feelings of anxiety that often accompany drug cravings.
- Let cravings happen. Experience the craving without fighting or giving in to it. This technique should be practiced with a therapist before facing a craving on your own.
- Remember negative effects. Sometimes referred to as “playing the tape to the end,” people in recovery should focus on the negative consequences that inevitably accompany drug use instead of just the good feelings that come from getting high.
- Self-talk. Use positive self-talk to counter automatic, pro-drug thoughts that often come with cravings.
Why Is Quitting Adderall Important?
People often view Adderall and other prescription medicines as “safe” compared with illicit drugs because they are dispensed by professionals and there is less stigma associated with taking a pill than snorting or injecting drugs 11,12. However, like other stimulants, Adderall abuse can result in potentially damaging health effects including 7:
- Increased blood pressure.
- Increased body temperature.
- Increased heart rate.
- Decreased appetite.
Abusing Adderall at high doses—or for long periods of time—can produce even more dangerous effects like stroke, heart attack, or feelings of hostility and paranoia 7. The US Food and Drug Administration (FDA) also requires all packages of Adderall and generic versions of the drug to be labeled with a warning that misuse can cause serious cardiovascular problems and sudden death 4.
- Indiana Prevention Resource Center. (n.d.). Adderall.
- Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits
- 1 Heilig, M., Egli, M., Crabbe, J. C., & Becker, H. C. (2010). Acute withdrawal, protracted abstinence and negative affect in alcoholism: are they linked? Addict Biol, 15(2), 169-184. doi:10.1111/j.1369-1600.2009.00194.x
- 1 DailyMed. (2015). LABEL: DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE- dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablet
- Cao, D. N., Shi, J. J., Hao, W., Wu, N., & Li, J. (2016). Advances and challenges in pharmacotherapeutics for amphetamine-type stimulants addiction. Eur J Pharmacol, 780, 129-135. doi:10.1016/j.ejphar.2016.03.040
- Substance Abuse and Mental Health Services Administration. (1999). Quick Guide For Clinicians Based on TIP 33: Treatment for Stimulant Use Disorders.
- National Institute on Drug Abuse. (2014). DrugFacts—Stimulant ADHD Medications: Methylphenidate and Amphetamines.
- Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal. Substance Abuse Treatment Advisory, 9(1).
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
- National Institute on Drug Abuse. (n.d.) A Cognitive-Behavioral Approach: Treating Cocaine Addiction.
- Brennan, C. (2015, December 16). Popping pills: Examining the use of 'study drugs' during finals. USA TODAY College.
- The National Center on Addiction and Substance Abuse at Columbia University (CASA). (2005). Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S.