Prescription Stimulant Addiction & Withdrawal

According to the National Institute on Drug Abuse (NIDA), prescription stimulants are a class of drugs that doctors typically prescribe to treat attention-deficit/hyperactivity disorder (ADHD). They may also be used for the treatment of narcolepsy, a condition that causes people to fall into a deep sleep involuntarily.

Prescription stimulants work because they make people more alert and attentive, and they increase energy levels. As their name might suggest, these drugs stimulate the brain. For a person who is living with ADHD, this is helpful, because these drugs stimulant areas of the brain associated with attention and concentration.

While prescription stimulants do have legitimate medical uses and can be beneficial for people who take them while under a doctor’s care, some people may develop a prescription stimulant addiction. To avoid an addiction, it is important to take stimulants only as a doctor prescribes them, and to avoid taking stimulant medications that belong to someone else.

What are the prescription stimulants?

Before learning about prescription stimulant addiction, it is helpful to know about the various types of prescription stimulants. Common prescription stimulants are as follows:

  • Dextroamphetamine: The brand name version of this drug is Dexedrine.
  • Dextroamphetamine/amphetamine combination product: This drug is most commonly known as Adderall.
  • Methylphenidate: Brand name versions of this drug include Ritalin and Concerta.

Per NIDA, people who abuse stimulants may refer to them by using street names, such as Speed, Uppers, and Vitamin R.

What are the prescription stimulants used for?

According to the Food and Drug Administration (FDA), Dexedrine is used to treat both narcolepsy and ADHD. On the other hand, Adderall, Ritalin, and Concerta are used for the treatment of ADHD.

Short-Term Effects of Stimulants

As NIDA has explained, prescription stimulants result in feelings of euphoria. This is because they promote the activity of a brain chemical called dopamine, which has a rewarding effect. Stimulants also elevate the activity of norepinephrine, which causes the following short-term effects:

  • Higher heart rate and blood pressure
  • Faster breathing
  • Reduced flow of blood
  • Elevated blood sugar
  • Opened nasal passages

The FDA has reported some common side effects of prescription stimulants like Adderall, which include headache, upset stomach, reduced appetite, sleeping problems, anxiety, and dizziness. If prescription stimulant doses are too high, a person may experience serious side effects, such as abnormally high body temperature, irregular heartbeat, heart failure, and seizures.

Prescription Stimulant Addiction

As previously mentioned, prescription stimulants can cause a person to feel euphoric. This means that some people may abuse stimulants in order to obtain a feeling of being “high.” Some people may abuse prescription stimulants by mouth in order to feel high, whereas others may crush pills and snort or inject them. Stimulants may also be attractive because of their ability to increase attention and alertness. This can lead to abuse among college students or busy professionals, who may use stimulants in order to stay up late studying or working on work-related projects.

Regardless of the methods or reasons for abuse, prescription stimulant abuse can take on a variety of forms. For instance, taking stimulants differently than a doctor prescribes them constitutes abuse. This means that someone who is prescribed stimulants but crushes them to snort them is abusing these drugs. On the other hand, buying prescription stimulants off the streets, taking stimulants that are prescribed to someone else, or seeing multiple doctors to obtain additional doses of prescription stimulants are additional forms of abuse.

Ongoing stimulant abuse can eventually lead to addiction. Addiction occurs when repeated stimulant abuse leads to changes in the brain that cause a person to compulsively seek drugs. When a person develops a stimulant addiction, a professional will diagnose a substance use disorder, which is the clinical term for an addiction.

Addiction Statistics

Stimulant addiction statistics provide information about the prevalence of stimulant abuse. According to 2018 research from the U.S. Department of Health and Human Services, 6.6 percent of adults in the United States had used prescription stimulants within the past year, with 4.5 percent of adults using these drugs as prescribed by a doctor. On the other hand, 2.1 percent of the adult population abused prescription stimulants, representing 5 million people. Addiction is less common, with just 0.2 percent of adults meeting criteria for a prescription stimulant use disorder.

According to the research, stimulant use was more common among people who struggled with depression, thoughts of suicide, or substance abuse problems. Over half of prescription stimulant users indicated that they use the drugs to improve mental functioning. While this may be a common reason for stimulant abuse, it is important to note that studies have found that stimulants do little to improve mental functioning among those who do not have ADHD. 

Signs of Addiction

The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) outlines the criteria for diagnosing a stimulant use disorder, which includes addiction to prescription stimulants. The diagnostic criteria, which can be stimulant addiction symptoms, include the following:

  • Taking larger doses of prescription stimulants than intended
  • Abusing prescription stimulants when it is physically dangerous, such as taking extremely large doses despite suffering from high blood pressure
  • Strong stimulant cravings
  • Building a tolerance for stimulants, meaning higher doses are needed to achieve the same effects
  • Suffering from unpleasant withdrawal symptoms when stimulant use is reduced or stopped
  • Spending a great deal of time seeking out or using prescription stimulants
  • Continuing to use stimulants even when it causes or worsens a health problem, such as a heart condition
  • Giving up other activities in favor of stimulant use
  • Continuing to use prescription stimulants despite relationship problems caused by drug use
  • Ongoing stimulant use that causes problems at home or work, such as inability to be productive at work
  • Being unable to reduce prescription stimulant use

The above symptoms are the signs of a stimulant addiction or stimulant use disorder, which can vary in severity. Someone who shows two or three of the above symptoms has a mild stimulant sue disorder, whereas an individual who has four or five symptoms has a moderate disorder. Displaying six or more of the above symptoms is considered to be a severe stimulant use disorder.

Prescription Stimulant Overdose

Another potential short-term effect of prescription stimulant use is overdose. In high enough doses, a person may experience overdose symptoms, including:

  • Restlessness
  • Tremor
  • Fast breathing
  • Confusion
  • Aggressive behavior
  • Panic
  • Hallucinations
  • Overactive reflexes
  • High fever

All of the above can lead to potentially fatal complications, such as circulation problems, heart attack, and seizure. It is therefore critical that a person who displays signs of prescription stimulant overdose receives prompt medical treatment.

Prescription Stimulant Withdrawal

While not everyone who abuses stimulants will experience withdrawal, it is possible to demonstrate signs of stimulant withdrawal when reducing or stopping the use of these drugs. This occurs because people can become dependent upon stimulants, meaning the body adjusts to the presence of the drugs and does not function the same without them. Common stimulant withdrawal side effects include fatigue, depression, and sleep problems, according to NIDA.

Signs of Stimulant Withdrawal

In a study of college students, published in a 2013 edition of Academic Medicine, students who abused prescription stimulants for cognitive benefits indicated that they became dependent on the stimulants for concentration. This means that poor attention or difficulty concentrating may be among the signs of stimulant withdrawal.

The World Health Organization (WHO) has reported some additional stimulant withdrawal symptoms:

  • Agitated behavior
  • Irritable mood
  • Increased appetite
  • More time spent sleeping
  • Sore muscles

WHO has also explained the stimulant withdrawal timeline, reporting that withdrawal symptoms typically begin within a day of the last stimulant dose and persist for 3 to 5 days.

Stimulant Withdrawal Treatment

Some people may wonder about a stimulant withdrawal scale, but WHO reports that such a scale is typically not used, as stimulant withdrawal treatment aims to address specific withdrawal symptoms. For example, a person who is in treatment for stimulant withdrawal may receive medication to address pain or mental health symptoms. Staff members providing treatment will monitor patients for complications and ensure that they receive proper nutrition, including vitamins B and C and plenty of water. A detox program can provide proper treatment for stimulant withdrawal.

Detox Program

While a detox program can assist with the initial withdrawal symptoms that occur after a person stops taking prescription stimulants, ongoing addiction treatment is necessary for a person to permanently stop using these drugs. A detox program is just the first step in the treatment process. As WHO has explained, after initial withdrawal symptoms pass, people who are addicted to stimulants will experience what is called protracted, or prolonged, withdrawal symptoms. These are side effects that last for a month or two after a person stops using stimulants.

Protracted withdrawal symptoms include:

  • Anxiety
  • Mood swings
  • Abnormal sleep patterns
  • Strong cravings
  • Lack of energy

The above symptoms can make it difficult to remain sober from prescription stimulants, so ongoing treatment should include psychological services that help people to avoid relapse. A relapse prevention program may include group treatment, where people can learn skills for remaining sober. In stimulant addiction treatment, people will also work with an addiction professional to develop a relapse prevention plan, which helps them identify relapse triggers and determine what they will do to avoid these triggers.

People who have developed an addiction to prescription stimulants may also benefit from individual therapy to help them address the underlying issues that led to drug abuse. For example, they may have underlying depression, trauma, or social problems that led them to seek the comfort of drugs. In therapy, people can identify these underlying issues and develop healthier ways of coping.

Prescription Stimulant FAQs

In addition to the above information, the following frequently asked questions (FAQs) can provide a quick overview of prescription stimulant addiction:

What is Adderall?

Adderall is a prescription stimulant that doctors prescribe to treat ADHD, but some people may abuse this medication to get high or because they feel that it helps them to perform better at work or school.

How is Adderall taken?

When prescribed by a doctor, people take Adderall by mouth as a pill; however, some people may abuse Adderall by crushing it up and snorting or injecting it.

What is Concerta?

Concerta is the brand name for the drug methylphenidate. Like Adderall, Concerta is a prescription medication used for the treatment of ADHD. Ritalin is another brand name version of methylphenidate.

Is Concerta a stimulant?

Like Adderall, Concerta is a stimulant drug. Ritalin is also a prescription stimulant.

What is Dexedrine?

Dexedrine is the brand name for the stimulant drug dextroamphetamine. Like Adderall, Ritalin, and Concerta, doctors prescribe Dexedrine to treat ADHD. Dexedrine is also used to treat narcolepsy.

Are prescription stimulants safe?

When a person takes prescription stimulants as prescribed by a doctor to treat a legitimate condition like ADHD or narcolepsy, these medications are safe. On the other hand, abusing prescription stimulants can be dangerous and lead to serious consequences such as overdose, addiction, and health problems.

What are Adderall side effects?

Prescription stimulants like Adderall can result in some unpleasant side effects, such as headache, upset stomach, reduced appetite, sleeping problems, anxiety, and dizziness. In a study of college students who abused prescription stimulants such as Adderall, about two-thirds reported reduced appetite, and just over half indicated that they had trouble sleeping. Other fairly common side effects included racing heart, anxiety, tremor, and headache.

What is prescription stimulant withdrawal like?

When people stop using prescription stimulants, they may experience some uncomfortable withdrawal symptoms, such as fatigue, depression, agitation, irritability, sore muscles, increased appetite, and concentration problems.

How long does stimulant withdrawal last?

Initial stimulant withdrawal symptoms tend to pass within three to five days, but people may experience some ongoing symptoms, such as low energy, mood swings, and drug cravings for up to two months after giving up stimulants. This is why ongoing addiction treatment is important.

Prescription stimulant medications can be addictive, but it is possible to stop using these drugs with the help of treatment. Treatment for prescription stimulant addiction typically begins with a detox program to help people cope with initial withdrawal symptoms, and ongoing psychological care can help people to manage relapse triggers and address underlying issues that led to stimulant abuse and addiction.

While prescription stimulants can be helpful for those who have a legitimate need for this type of medication, it is never safe to abuse stimulants, as misuse can lead to overdose, serious side effects, or drug addiction. To avoid these potential consequences of stimulant use, it is important to take prescription stimulants exactly as a doctor prescribes them.

It is never safe to take a larger dose than a doctor prescribes, to share prescription stimulants with friends or family, or to take prescription stimulants that belong to someone else. Furthermore, buying these drugs off the streets or crushing them up to snort them or inject them is especially risky. It is always important to discuss stimulant use with a doctor and to take these drugs only while under a doctor’s care. Those who have been abusing stimulants and find that they are unable to stop should reach out for professional treatment.

Sources & Resources:

  1. https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/017078s042lbl.pdf
  3. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
  4. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021121s038lbl.pdf
  5. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/010187s080,018029s049,021284s027lbl.pdf
  6. https://www.drugabuse.gov/news-events/news-releases/2018/04/five-million-american-adults-misusing-prescription-stimulants
  7. https://accessmedicine.mhmedical.com/content.aspx?bookid=2509&sectionid=200980686
  8. https://journals.lww.com/academicmedicine/Fulltext/2013/07000/The_Use_and_Misuse_of_Prescription_Stimulants_as.26.aspx
  9. https://www.ncbi.nlm.nih.gov/books/NBK310652/