Adderall
Adderall is a prescription medication that combines two stimulants, amphetamine and dextroamphetamine, primarily used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. ADHD is characterized by impulsiveness, hyperactivity, and difficulties in concentration, affecting approximately 11% of children in the United States. While Adderall is effective for many, its increased prescription rates have sparked debate, with some critics suggesting that it contributes to the medicalization of normal childhood behavior. The drug works by enhancing the activity of neurotransmitters like norepinephrine and dopamine, which are often deficient in individuals with ADHD.
However, Adderall is also misused for recreational purposes, including weight loss and to enhance focus and academic performance. Misuse rates among college students can be as high as 35.5%, with many obtaining the drug from friends who are prescribed it. Adderall is classified as a Schedule II drug due to its potential for abuse, and it is banned in professional sports unless legally prescribed. While it can be effective and safe when used appropriately, Adderall may cause side effects such as insomnia, anxiety, and changes in heart rate. Understanding the complexities surrounding Adderall can help inform discussions about its appropriate use and the implications of its misuse.
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Adderall
Adderall is the brand name of a drug that combines two stimulants, amphetamine and dextroamphetamine, and is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall is also misused as a recreational drug to induce weight loss and to improve concentration and academic performance. As the diagnosis of ADHD among school-age children has increased over the years in the United States, so have the number of prescriptions written for Adderall and other stimulants. However, both the increased rate of ADHD diagnosis and increased use of medications to treat it have come under criticism, with some charging that psychiatrists are medicalizing normal childhood behavior.
Overview
Adderall is most often prescribed for attention deficit hyperactivity disorder (ADHD), a condition characterized by impulsiveness, difficulties with concentration, and hyperactivity. According to the Centers for Disease Control and Prevention (CDC), in 2022 an estimated 11.4 percent of children in the United States between the ages of three and seventeen had been diagnosed with ADHD. ADHD was diagnosed in 15 percent of boys and 8 percent of girls, though some clinicians have argued that this disparity does not reflect a greater prevalence of the disorder in boys, but a tendency to underdiagnose girls, as their symptoms often manifest differently. Prevalence of ADHD diagnoses also varied by race and ethnicity, as well as by state.
By 2022, approximately 53.6 percent of children ages three to seventeen years old with an ADHD diagnosis were taking medication for the disorder. The use of Adderall and other prescription stimulants to treat ADHD is controversial because some believe it serves to medicate children who cause problems in the classroom or at home, rather than dealing with the causes of their problems. Treating ADHD with a combination of medication and behavioral therapy is considered best practice among pediatricians.
Adderall's mechanism of action is related to its increasing the activity of the neurotransmitters norepinephrine and dopamine. These are thought to be deficient in people with ADHD, leading to low activity in certain parts of the brain key to planning, decision-making, and impulse inhibition, particularly the prefrontal cortex. An increase in these neurochemicals can also provide cognitive benefits to people with healthy brain function, leading to the potential for the misuse of Adderall.
Adderall is classified in the United States as a Schedule II drug, meaning that it provides positive medicinal effects but also has considerable potential for abuse. Shaheen Lakhan and Annette Kirchgessner in a 2012 study published in Brain and Behavior summarized a number of studies that found rates of the misuse of prescription stimulants among US college students as high as 35.5 percent, with many reporting that they obtained the misused drugs through diversion, i.e., from a friend for whom the drugs were prescribed. Some studies have found rates of diversion as high as 29 percent among those prescribed prescription stimulants, and one study found that over half (54 percent) of college students with a prescription for an ADHD medication had been asked to divert their medicine to someone else.
People use unprescribed stimulants for several reasons: to induce euphoria (“getting high”), to lose weight, and to improve concentration and academic performance. Adderall has come under increased scrutiny as many high school and university students admit using it to study or to complete academic projects. Among professional sports leagues such as the National Football League, Major League Baseball, the National Basketball Association, and the National Collegiate Athletics Association, Adderall is considered a performance-enhancing drug and is banned unless prescribed by a physician.
Adderall has been shown in multiple studies to be safe and effective when used as prescribed, but can have side effects that, while not dangerous, are unpleasant. Possible side effects include hypertension or hypotension, tachycardia (increase in heart rate), loss of appetite, insomnia, and anxiety. A 2011 study by the Cochrane Collaboration found that among adults with ADHD, Adderall had a higher discontinuation rate than nonstimulant medications due to these side effects. Authors of a 2021 systematic literature review published in Frontiers in Psychiatry concluded that more research was needed to determine how long treatment with stimulant medications should last and which patients could benefit from discontinuing such treatment.
Bibliography
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