Addiction to ADHD Medication

ADHD Overview

Commonly diagnosed in childhood, Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that often begins during younger years and lasts into adulthood. The symptoms of ADHD include ongoing issues with self-regulating attention and hyperactivity-impulsivity, often causing problems at school, work, and interpersonal relationships.

ADHD can present in three types:

• Predominantly Inattentive Presentation
• Predominantly Hyperactive-Impulsive Presentation
• Combined Presentation

ADHD has often been considered a childhood illness that went away in adulthood. However,  research has shown this is not the case, leading to some getting diagnosed later in life. Symptoms may change as the patient ages, but ADHD is generally considered a life-long disorder.

ADHD Symptoms

Depending on what type of ADHD someone falls under, symptoms may vary.

The most common symptoms for each class are:

Predominantly Inattentive Presentation:

• Overlooking or missing details and making seemingly careless mistakes
• Difficulty sustaining attention during play or tasks, such as conversations, lectures, or lengthy reading
• Appearing not to listen when spoken to directly
• Difficulty following through on instructions or finishing tasks
• Starting tasks but losing focus and getting sidetracked easily
• Difficulty organizing tasks and activities, doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines
• Avoiding tasks that require sustained mental effort
• Losing things necessary for tasks or activities
• Easily distracted by unrelated thoughts or stimuli
• Forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

Predominantly Hyperactive-Impulsive Presentation:

• Fidgeting and squirming while seated
• Getting up during situations when staying seated is expected
• Feeling restless and choosing to run, dash around, or climbing at inappropriate times
• Unable to play or engage in hobbies quietly
• Constantly in motion or on the go or acting as if driven by a motor
• Excessive talking
• Answering questions before fully asked, finishing other people’s sentences, or speaking without waiting for a turn in a conversation
• Interrupting or intruding on others

In Combined Presentation, symptoms of inattentive and hyperactive-impulsive types are equally present. Combined Presentation is the most common type of ADHD.

Getting Assessed for ADHD

As with many other disorders like depression, anxiety, and other learning disabilities, there is no single test to diagnose ADHD. However, healthcare providers can use guidelines from the 5th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) to help determine someone’s diagnosis.

For this reason, it’s important to work with a licensed mental health professional who can evaluate you to assess if the patient meets these guidelines and has ADHD. Once you get your diagnosis, your doctor can go over a treatment plan which often includes a combination of prescription medication (if needed) and therapy.

Treatment of ADHD

Treatment of ADHD is often a mixture of medication and therapy. Medication options include stimulants, non-stimulants, and anti-depressants. Therapy is a great option to help patients restructure their lives to accommodate ADHD symptoms, as the medication will not solve all the problems ADHD can create.

Cognitive Behavioral Therapy (CBT) is the most common therapy to treat ADHD. CBT is ideal because it teaches the patient how to identify destructive thought patterns and avoid them in the future.

How Do Prescription Stimulants Treat ADHD?

Stimulants may seem counterintuitive for someone struggling to focus, but they are often the first-line treatment. People with ADHD have a deficiency of the neurotransmitter called norepinephrine, which is responsible for increased alertness and attention. Norepinephrine is also related to dopamine, the neurotransmitter that affects how we feel pleasure and reward.

Prescription stimulants work by “stimulating” the brain to produce more norepinephrine and dopamine. When there’s more norepinephrine and dopamine in an ADHD brain, symptoms reduce, and activity increases in parts of the brain responsible for focusing and completing tasks.

Types of ADHD Medication

The two most common types of medication used to treat ADHD are stimulants and non-stimulants, which include certain anti-depressants and high blood pressure medicines.

Stimulants are considered first-line treatment options that typically take effect in an hour or two, seldom lasting more than 12 hours. The stimulant family has three types—dextroamphetamine, methylphenidate, and dextroamphetamine/amphetamine.

Some prescription stimulants are short-acting, while others are long-acting or extended-release (XR). Common immediate-release prescription stimulants include drugs like Ritalin and Adderall, and common extended-release options include Adderall XR, Concerta, and Vyvanse.

The most common prescription stimulants prescribed for ADHD are:

• Adderall/Adderall XR (amphetamine)
• Concerta (methylphenidate)
• Dexedrine (amphetamine)
• Evekeo (amphetamine)
• Focalin/Focalin XR (dexmethylphenidate)
• Quillivant (methylphenidate)
• Ritalin/Ritalin LA (methylphenidate)
• Vyvanse (lisdexamfetamine dimesylate)

Non-stimulant prescriptions are used for patients who can’t tolerate stimulants or experience no benefits and typically take effect slower than stimulants but can last up to 24 hours. Because they don’t stimulate the brain, they don’t pose the same risk of abuse or addiction.

The most common non-stimulant medications prescribed for ADHD are:

• Strattera (atomoxetine hydrochloride)
• Kapvay (clonidine)
• Intuniv (guanfacine)
• Qelbree (viloxazine)
• Norpramin (desipramine)
• Pamelor (nortriptyline)
• Tofranil (imipramine)
• Wellbutrin (bupropion)
• Effexor (venlafaxine)

Are ADHD Medications Addictive?

Stimulants may produce euphoric feelings, suppress appetite, increase wakefulness, and improve focus and attention. When taken in doses higher than prescribed, stimulants can increase dopamine rapidly and amplified, producing euphoria and increasing the risk of addiction. These stimulants may also be abused for weight loss or performance enhancement by those with ADHD or those without it.

Is it safe for my child to take prescription stimulants for ADHD?

It’s very normal to feel nervous about having your child take stimulants. Many parents look at the generic names and see words like “methylphenidate” and “amphetamine,” fearing these drugs are the same as illegal drugs like meth and MDMA. Prescription stimulant medications are FDA-approved and are safe for children as young as six years old when taken as directed by a doctor.

If you are concerned about side effects or the risk of addiction for your child, it’s important to voice these with your doctor. There are many stimulant options on the market, so your prescribing physician can help you find the perfect solution for your child. Always ensure your child doesn’t have direct access to the bottle, and you monitor them each time they take the medication.

Signs of Addiction to ADHD Medications

Signs of addiction can vary depending on the person’s age, lifestyle, and co-occurring illnesses, so this is not an exhaustive list. Make sure you consider other influences if you suspect a loved one is abusing prescription stimulants.

Signs of addiction may include:

• Intense craving for the drug
• Withdrawal from relationships, school, or job
• Issues with money and/or constantly asking others for money
• Taking dangerous risks to get stimulants
• Agitation, anxiety, or paranoia
• Lack of appetite
• Sudden weight loss
• Less sleep
• Irregular heart rate
• Muscle pain and weakness
• Tremors and restlessness
• Intense anger and aggression
• Psychosis (believing, seeing, or hearing things that aren’t real)

Using ADHD Medications Responsibly

When a doctor prescribes prescription stimulants, it’s critical to take them as described on your prescription label and as instructed by your doctor. Do not take more than recommended, and do not crush, snort, or inject any form of your prescription.

Mixing stimulants with alcohol or other active substances should be avoided, as it could cause unwanted or dangerous side effects. If you’re the parent of a child taking prescription stimulants, ensure your child never has direct access to the medication and only receives it from an adult who monitors them.

Side Effects of Stimulant

Prescription stimulant drugs can significantly help people struggling with ADHD symptoms, but stimulants do come with some common side effects. Weighing the benefits versus the side effects is always a delicate balance, so talk to your doctor if particular side effects bother you.

Common side effects of prescription stimulant drugs include:

• Sleep problems
• Dizziness
• Nervousness
• Decreased appetite
• Weight loss
• Increased blood pressure
• Headaches and stomachaches
• Moodiness and irritability

Less common side effects of stimulants include:

• Tics (sudden, repetitive movements or sounds)
• Personality changes (such as appearing too intense or not being as enthusiastic as usual)

ADHD Medication Abuse and Addiction

Prescription stimulants are frequently abused by people looking to lose weight or as performance enhancers to help them study. When taken in high doses, stimulants can even cause feelings of euphoria because they increase the brain’s level of dopamine.

However, research shows prescription stimulants don’t enhance learning for people without ADHD, but this myth persists and contributes to continued abuse.

Even for individuals diagnosed with ADHD and prescribed stimulants, there is a risk of potential abuse and addiction. In fact, according to National Institute on Drug Abuse (NIDA), there’s a strong link between ADHD and substance use disorder (SUD), and more than 25% of substance-abusing adolescents meet the diagnostic criteria for ADHD.

With the connection between ADHD and addiction in mind, it’s important to keep an eye out for symptoms of addiction while taking prescription stimulants.

Signs of Prescription Stimulant Abuse

For people without ADHD, the benefits are ultimately few and far between. The most common side effects are decreased appetite, decreased sleep, and increased energy. When prolonged abuse amplifies these symptoms, the results can be very pronounced and noticeable to loved ones around the addict.

Signs of addiction may include:

• Intense craving for the drug
• Withdrawal from relationships, school, or job
• Issues with money and/or constantly asking others for money
• Taking dangerous risks to get stimulants
• Agitation, anxiety, or paranoia
• Lack of appetite
• Sudden weight loss
• Less sleep
• Irregular heartbeat
• Muscle pain and weakness
• Tremors and restlessness
• Intense anger and aggression
• Psychosis (believing, seeing, or hearing things that aren’t real)

Signs of Addiction to ADHD Medication

ADHD medication can be life-changing for those with ADHD, but when stimulants, in particular, are abused, they can negatively affect the body. When taken at the prescribed dose, stimulants help reduce the symptoms of ADHD and improve focus and executive functions (mental skills that include working memory, self-control, and flexible thinking). However, when abused, stimulants can wreak havoc on the addict.

Signs of addiction to ADHD medication may include:

• Lack of appetite and extreme weight loss
• Intense craving for stimulants
• Irregular heartbeat
• Unable to quit using despite damage to relationships, job, or money
• Taking dangerous risks by using stimulants
• Feeling agitated, anxious, or paranoid

Negative Consequences of ADHD Medication Abuse

Prolonged abuse of stimulants, even within a short time, can have serious side effects. Symptoms and severity will depend on the person, their dosage, and the type of ADHD medication they’re abusing.

Side effects of ADHD medication abuse may include:

• Psychosis, anger, or paranoia
• Heart problems
• Nerve problems
• Seizures
• Abnormally high or low blood pressure
• Circulation failure
• Nausea, vomiting, diarrhea, and abdominal cramps
• Increased risk of overdose

ADHD Medication Abuse Statistics

It’s important to be aware of how common addiction to ADHD medication is and the age ranges in which it’s most prevalent. Unfortunately, it is possible to overdose on prescription stimulants, so arming yourself with this information can be life-saving.

• According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2018, approximately 1 million people aged 12 or older misused prescription stimulants for the first time in the past year. An estimated 561,000 people aged 12 or older had a stimulant use disorder.
• In a 2015 study, SAMHSA found an estimated 6.0 percent of adults with SMI (590,000 adults) misused prescription stimulants in the past year, and 2.9 percent (279,000 adults) misused prescription sedatives.
• According to the CDC, overdose deaths from psychostimulants have been increasing since 2010. In 2019, more than 16,000 Americans died from an overdose involving psychostimulants, a 28% increase from the previous year. Nearly 23% of all drug overdose deaths in 2019 involved psychostimulants.

Treatment for Addiction to ADHD Medication

Several options are available if you or a loved one is ready to receive treatment for addiction to ADHD medication. The best treatment for stimulant addiction will depend on the patient and their unique situation, so working with a licensed medical provider can help determine the best path to sober living.

Some people with mild symptoms of addiction may benefit from therapy, while others with more severe symptoms may need inpatient or intensive outpatient treatment plans. Treatment can also vary depending on whether the patient has ADHD, so disclosing any diagnoses to medical providers is important when seeking treatment.

Medical Detox

Prescription stimulants like Ritalin and Adderall can have withdrawal symptoms, making it necessary to undergo medical detox to avoid potentially dangerous withdrawal effects. Medical detox will typically involve slow tapering off of the drug, often under the supervision of a medical professional, to ensure your body functions remain stable throughout the process.

Whether medical detox is an inpatient or outpatient process depends on the dosage taken and the addict’s body’s dependence on the drug. Inpatient detox would require the patient stays overnight, while outpatient would consist of detox treatment and guidance during the day but going home afterward.

Treatment Programs

The two most common prescription stimulant treatment programs people think of are inpatient and outpatient rehab, but several options are available. Choosing which is best for you or a loved one will depend on how bad someone’s addiction is and how at-risk they are of relapsing.

Inpatient programs will require the patient lives at the treatment center while undergoing medical detox, group therapy, and one-on-one therapy. Intensive outpatient programs offer similar features, but the patient goes home after several hours at the treatment center.

Therapy

Psychotherapy or “talk therapy” are common treatments for individuals struggling with ADHD medication addiction. These therapies can help you identify triggers and behaviors that led to the abuse and help you develop strategies to avoid that behavior in the future.

Common types of therapy used to treat stimulant abuse include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• Group Therapy
• Family Therapy

Support Groups

Treatment programs generally have an end date, but support groups can provide ongoing support to you and your loved ones. You can ask your local treatment center or doctor for information about local support groups and available resources.

Online support groups like Pills Anonymous, Nar-Anon, and Daily Strength’s Prescription and Synthetic Drug Abuse Support Group can be great resources for people recovering from prescription stimulant abuse.

For people with ADHD, support groups provided by CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), ADDA (Attention Deficit Disorder Association), and Learning Disabilities Association of America can be hugely beneficial.

Parents and Loved Ones of People Addicted to ADHD Meds

Watching a loved one struggle with ADHD medication addiction can be incredibly difficult. Addiction doesn’t just affect the addict—it affects all those around them, so it’s important to look after your mental health throughout the process.

Many parents of addicted children will blame themselves for the stimulant abuse, but guilt ultimately won’t help the situation. You can’t be there for your loved one or child if you are also struggling, so don’t hesitate to find resources for yourself during this time.

Getting Help If You’ve Become Addicted to ADHD Medication

When you or a loved one is struggling with addiction to ADHD medication, quickly finding treatment is imperative. With SAMHSA’s online treatment locator, you can help narrow down your choices. Visit https://findtreatment.gov/ or call (800) 662-4357 to learn what programs are in your area and ready to help.