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In the U.S., the abuse of prescription stimulants – recreationally known as “uppers” – has become a major public health issue in recent years, if not an epidemic in its own right.
In April 2018, the U.S. Department of Health and Human Services reported that around 16 million Americans had, at that time, been prescribed stimulants for one medical reason or another.
However, around a third of these – approximately 5 million adults – actively misused their stimulant medication.
For nearly half a million of these people, it had even led to full-blown addiction – medically termed as prescription stimulant use disorder.
We take a closer look at these prescription medications, and ask:
- Why are prescription stimulants misused and abused to the point of addiction?
- How are they being abused?
- Why are college students eagerly buying counterfeit versions online?
- Can you overdose on these stimulants?
- What is the right professional treatment to successfully treat prescription stimulant addiction?
Continue reading to learn more about prescription stimulant abuse and how easily it can turn into an uncontrollable addiction.
What are Prescription Stimulants?
Prescription stimulants are legal and approved medicines that increase levels of alertness, attention, and energy.
However, they are classified as Schedule II drugs under the Controlled Substances Act because they have a high potential for abuse and addiction.
They also affect the user physically by elevating blood pressure, heart rate, and respiration.
These medications are generally used for the treatment of:
- Attention-deficit hyperactivity disorder (ADHD)
- Narcolepsy (uncontrollable episodes of deep sleep) and, only occasionally,
- Treatment-resistant depression
The most commonly known prescription stimulants being used in the U.S. include:
- dextroamphetamine (Dexedrine®)
- dextroamphetamine / amphetamine [combination product] (Adderall®)
- methylphenidate (Ritalin®, Concerta®)
The term “stimulant” describes any drug that improves your normal performance levels, enabling you to perform beyond your expected limits. They do this by increasing your alertness, your attention level, your mood, and your energy.
It is for these very reasons that prescription stimulants – “uppers” – are prime targets for both misuse and abuse.
Most Commonly Used Prescription Stimulants in the U.S.
U.S. Brand Name:
amphetamine / dextroamphetamine
- Adderall XR (extended release)
- Adzenys ER
- Adzenys XR-ODT
(orally disintegrating tablet)
- Dyanavel XR
- Adhansia XR
- Aptensio XR
- Cotempla XR-ODT
- Jornay PM
- Metadate ER
- QuilliChew ER
- Quillivant XR
- Focalin XR
dexmethylphenidate / serdexmethylphenidate
Abbreviations: CD: Controlled dose; ER: Extended release; LA: Long-acting; ODT: Orally disintegrating tablet; PM: prescription medicine; SR: Sustained release; XR: Extended release
How & Why are Prescription Stimulants Misused / Abused?
The majority of prescription stimulants come as either a tablet, a capsule, or in liquid form, all of which are intended to be taken orally.
However, when misusing a prescription stimulant, and apart from simply swallowing the medication, alternative means include:
- Crushing the tablets or opening the capsules, and snorting or smoking the powder, or
- Dissolving the powder in water, and then injecting the liquid into a vein
For a rapid high, drug users will either inject or snort prescription stimulants, whereas smoking or swallowing the medication will provide longer lasting but less intensive effects.
Enhancing Cognitive Abilities
Prescription stimulants are often abused because they increase wakefulness, motivation, and several aspects of cognition, learning, and memory.
People take these drugs solely to enhance mental performance.
The very first amphetamine to be legally available in the U.S. was Benzedrine, used in a range of treatments, such as nasal congestion and depression.
In 1937, at the Emma Pendleton Bradley Home for disturbed and difficult children, Dr. Charles Bradley performed the first of two experiments to test the effects of Benzedrine on children.
The result? The children calmed down, were less rowdy, and were keen to study.
The idea of amphetamines being used as an ADHD treatment had arrived. However, Benzedrine was eventually banned when its addictive properties were fully discovered.
Militaries, for example, have historically used stimulants to increase the soldiers’ performance during combat, and the U.S. Armed Forces even allow their use in limited operational settings.
However, prescription stimulant abuse is now most commonly associated with high school and college students studying for exams.
Abusing prescription stimulants is now reported:
- Among professionals to increase productivity
- Among older people to offset their declining cognition, and
- Among both high school and college students to improve their academic performance
However, misusing and abusing prescription stimulants for reasons other than treating ADHD or narcolepsy can lead to harmful and serious health effects, including:
- Substance use disorder (SUD), and commonly known as addiction
- Cardiovascular (heart) problems, and even
Prescription Stimulants: Slang / Street Names
Other ADHD Medications
- Vitamin R
- Vitamin A
- Coke Jr.
- Silver Bullet
- West Coast
- Black Beauties
- Poor Man’s Cocaine
- Poor Man’s Heroin (Ritalin and Talwin*)
- Pep Pills
- Crackers (Ritalin and Talwin*)
- Diet Coke
- One and Ones (Ritalin and Talwin*)
- Ritz and Ts (Ritalin and Talwin*)
- Speedball (Ritalin and Cocaine)
- Study Buddies
- Kiddie Cocaine
- Speedball (Ritalin and Heroin)
- Smart Pills
- Ts and Rits (Ritalin and Talwin*)
IMPORTANT: *Talwin is a prescription opioid medication containing pentazocine, an opioid analgesic.
It is important to remember that the term “stimulant” as a drug classification includes both legal and illegal drugs; notable examples of these include:
- Nicotine (eg. cigarettes)
- Cocaine / Crack cocaine
- Caffeine (eg. coffee, tea, and energy drinks)
- Methamphetamine / “Meth”
- Prescription stimulants (eg. Adderall,
Ritalin, Dexedrine and Concerta)
- MDMA / Ecstasy
““Do you want an Adderall?” she asked. “I can’t stand them. They make me want to stay up all night doing cartwheels in the hall.” Could there be a more enticing description? My hand shot out to receive it. In college, Adderall gave me a sense of focus that felt sublime. Then I OD’ed.” – Casey Schwartz, U.S. author and former Adderall addict: excerpt taken from “Attention: A Love Story”
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Prescription Stimulants: Side Effects
The following side effects are reported by those who misuse and abuse prescription stimulants, such as Adderall, Ritalin and Dexedrine:
Prescription Stimulants: Side Effects
- Rush of euphoria (the “high”)
- Decreased appetite
- Difficulty sleeping
- Increased concentration
- Increased pulse and blood pressure
- Increased breathing
- Increased blood sugar
- Constipation / diarrhea
*High Doses of Prescription Stimulants: Side Effects
- Dangerously high body temperature
- Heart failure
- Irregular heartbeat
How Do Prescription Stimulants Affect the Brain?
Prescription stimulants used for the treatment of ADHD, like Adderall and Ritalin, are known as “psychomotor stimulants.”
These medications stimulate the central nervous system (CNS) by boosting the release of certain chemicals, and their beneficial effects are provided by the increased levels of dopamine, serotonin, and norepinephrine in the brain:
- Dopamine is related to concentration, attention, feelings of reward and pleasure, and their reinforcement. It is the sudden release of large quantities of dopamine that provide the euphoric high that drug users seek.
- Serotonin stabilizes mood, feelings of well-being, and happiness.
- Norepinephrine plays an important role in alertness, affecting blood vessels, blood pressure and heart rate, blood sugar, and breathing.
Some stimulant drugs also increase the level of glutamate, a neurotransmitter associated with behavioral control and inhibition. People experiencing ADHD often have low levels of glutamate.
The continued abuse of prescription stimulants conditions the brain to lower its natural levels of dopamine. This results in the brain no longer producing the normal amounts of the neurotransmitter.
Can You Overdose on Prescription Stimulants?
Yes, you can experience an overdose when abusing prescription stimulants. A drug overdose occurs when the user takes enough of the drug to produce a life-threatening reaction.
When people overdose on a prescription stimulant and depending on the amount taken, they can experience the following signs and symptoms:
Prescription Stimulant Overdose: Signs & Symptoms
- Overactive reflexes
- Rapid breathing
- Abnormally increased fever
- Muscle pains and weakness
- Nausea / Vomiting
- Abdominal cramps
- Abnormally high or low blood pressure
- Possible circulation failure
- Irregular heartbeat
- Possible heart failure
- Seizures / Convulsions
- Potentially fatal poisoning
Prescription Stimulant Overdose: What Should I Do?
Because of the severe and possibly life-threatening physical consequences of a prescription stimulant overdose, call 911 immediately for emergency medical attention.
First responders and ED doctors attempt to treat these types of overdose with the intent of restoring blood flow to the heart, and stopping the seizure – with medications, if required.
Prescription Stimulant Addiction in the U.S.: Facts & Stats
The U.S. federal health authorities reported in April, 2018 that around 5 million adults have misused and abused prescription stimulants and 0.4 million were suffering from prescription stimulant disorders.
More than half (56.3%) stated that the reason for their misuse was cognitive enhancement.
Around 4% reported they misused and abused prescription stimulants to lose weight – mostly reported by women.
Research has shown that adults suffering from depression and suicide ideation were more at risk of abusing prescription stimulants and developing an addiction – a prescription stimulant use disorder.
ADHD: Already a Trigger for Substance Use Disorders in Young Adults
Regardless of those who abuse ADHD medication for “cognitive enhancement,” those actually diagnosed with the condition – true ADHD sufferers – have been found to be particularly vulnerable to substance use and addiction.
According to a new University of Toronto study, half of young adults (aged 20-39) with attention deficit hyperactivity disorder (ADHD) have had a substance use disorder (SUD), resulting from previous attempts to “self-medicate” their condition.
Additionally, young adults with ADHD and a history of depression or anxiety were especially vulnerable.
In contrast, only 23.6% of young adults without ADHD have had a SUD in their lifetime.
The study’s researchers found alcohol use disorders were the most common SUD among young adults with ADHD (36%), followed by cannabis use disorders (23%).
For children and teenagers, the abuse of prescription stimulants is still a public issue and a major concern for parents, even though year-on-year numbers fluctuate.
As you can see from results of the National Institute on Drug Abuse’s (NIDA) annual “Monitoring The Future – 2020” study, the misuse of prescription stimulants like Adderall and Ritalin remains a public health issue not just for college students, but for high schoolers, too.
Sadly, Adderall misuse among 8th Graders (13- and 14-year-olds) continues to worsen
Year-on-year, and Ritalin misuse is gradually worsening for 10th and 12th graders:
Adderall / Ritalin Misuse Among
For older college and university students, this kind of “study aid” abuse has become simply a normal and “accepted” part of campus life.
Teenagers & Young Adults: Buying Study Drugs Online
Obviously, the question needs to be asked:
Just where exactly are these kids and youngsters getting their supply of stimulants from?
The answer is a simple and fairly obvious one, too: Either online, from friends, or from other students who have some to sell.
Case Study: Buying Adderall Online
Purchasing Adderall online, for example, is sadly way too easy, considering its supposed status as Schedule II “controlled” substance and a prescription-only medicine.
According to a research study into Adderall availability online, the online pharmacy marketplace is contaminated with illegitimate and unscrupulous retailers that will happily sell prescription medications without requiring a valid prescription.
Their findings showed:
- Adderall is readily accessible with no prescription through common search engines.
- 62 online pharmacies were analyzed, and nearly all – 61 – permitted access to Adderall without a prescription.
- For all formulations, doses, and quantities, Adderall was on average more expensive from illegitimate online pharmacies than prices advertised on GoodRx.
- By looking at the IP addresses of these illegitimate retailers, it’s clearly a global enterprise: U.S., Russia, Bulgaria, Holland, Panama, Ukraine, Canada, Hong Kong, Romania, and Singapore.
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Prescription Stimulant Abuse: Short & Long-Term Effects
In the short-term, misusing and abusing prescription stimulants will result in exhaustion, apathy and depression – the inevitable “down” after using “uppers.”
However, it is the constant state of exhaustion that mostly drives users to feel they need more of the drug, and more regularly.
Prescription Stimulant Abuse: Short-Term Effects
- Loss of appetite
- Increased heart rate
- Disturbed sleep/ insomnia
- Increased blood pressure
- Pupil dilation
- Increased body temperature
- Nausea / Vomiting
- Muscle pains and weakness
- Fatigue / Exhaustion
- Bizarre and / or erratic behavior
- Aggression and violence
- Panic attacks
- Seizures / Convulsions (high doses)
In a reasonably short space of time, the stimulant abuse is no longer a recreational attempt to get “high” – it is an attempt to simply feel normal, and to have more energy like before.
Additionally, the repeated abuse of certain stimulants can also result in hostility, psychosis and paranoia.
In the long-term, misuse and abuse will undoubtedly have developed into a severe and active addiction. Physically, the effect on the body can be highly damaging, and if the prescription stimulant is injected, there is the ever-present risk of HIV / AIDS and hepatitis C.
Prescription Stimulant Abuse: Long-Term Effects
- Destruction of nasal tissues
- Respiratory (breathing) problems
- Permanent damage to vital blood
vessels, ie. in the heart and brain
- Infectious diseases / abscesses
- High blood pressure
- Increased risk of heart attack / stroke
- Malnutrition and weight loss
- Liver, kidney and lung damage
- Decreased sexual function
- Severe, chronic headaches
- Disorientation / Confusion / Apathy
- Persistent anxiety
- Substance Use Disorder (addiction)
- Psychosis / Paranoia
- Brain damage
Prescription Stimulant Addiction: Treatment & Recovery
As with other stimulants in its classification, prescription stimulants, such as Adderall and Ritalin, can lead to substance use disorder (SUD). As with any substance addiction, the temporary or complete stop of misuse and abuse will lead to the user experiencing a range of withdrawal symptoms.
Prescription Stimulants: Withdrawal Symptoms
Withdrawal symptoms associated with discontinuing stimulant use can include:
- Hostile behavior
- Disturbed sleep patterns
- Anxiety, and
Treating prescription stimulant use disorder (eg. an addiction to Adderall) requires both professional detoxification and a professional addiction treatment program.
Trying to quit using these drugs on your own when you are addicted is very difficult. You can experience both physical and mental symptoms which are highly uncomfortable, and can make many people simply start using again.
In addition, many people – especially teenagers – may be hesitant to admit it, there are reasons why they chose to misuse and abuse these stimulants.
Perhaps originally begun out of cognitive enhancement or simply because their friends and peers are pressuring them to try it, they soon realize they enjoy the effects of misusing and abusing prescription stimulants, the drugs make them feel better about themselves, and they want to experience those feelings again.
Prescription Stimulants: Medical Detox
It is advisable to have a professionally supervised detox within a clinical setting, such as an accredited drug rehab facility. This type of detox can also provide prescription medicines to make these symptoms less severe.
A professional detox will not only remove any traces of prescription stimulants from your system, it will also remove any dangerous toxins from your body created by the misuse.
Prescription Stimulants: Drug Rehab Treatment
Professional prescription stimulant addiction treatment can be provided by an intensive outpatient program (IOP) at a professionally recognized and accredited drug and alcohol rehab facility. The program will address and treat the addiction, along with any other contributing issues, such as co-occurring disorder or other behavioral condition.
What is Co-Occurring Disorder?
When someone has a substance use disorder (SUD or substance addiction) and a mental health disorder or issue at the same time, this is known as co-occurring disorder or dual diagnosis.
The NIDA reports as many as 50% of all people who go to drug rehab will need treatment for co-occurring disorder. Dual diagnosis treatment is recommended to ensure that both are treated simultaneously, and any underlying reason for the person’s DXM misuse is properly addressed.
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SpringBoard Recovery Can Treat Prescription Stimulant Addiction
At SpringBoard Recovery, we understand how serious prescription stimulant addiction can be, and we know the best ways to treat it. We also offer personalized treatment plans and services targeted to our patient’s specific needs.
Our intensive outpatient treatment program for prescription stimulant addiction includes the following evidence-based therapies, counseling, and therapeutic activities, plus many other therapeutic modalities and services:
- One-on-one Counseling
- Group Counseling
- Cognitive Behavioral Therapy (CBT)
- Accelerated Resolution Therapy (ART)
- Therapeutic Activities
- Nutritional Counseling
- Case Management
All of our intensive outpatient treatment programs provide the following benefits:
- Address underlying psychological conditions and past traumas
- Learn how to identify and avoid high-risk situations, triggers, and relapses
- Develop a new lifestyle that doesn’t depend on substance use
- Receive treatment at our facility and continue living at home
- Maintain school and family commitments while receiving treatment
Do you have questions about prescription stimulant addiction? Would you like to know more about our outpatient addiction treatment program? Please contact us today.
Prescription Stimulants: FAQs
- What are prescription stimulants used for?Prescription stimulants are medicines used to treat ADHD and narcolepsy, because they increase levels of alertness, attention, and energy. However, they are classified as Schedule II drugs under the Controlled Substances Act because they have a high potential for abuse and addiction.
- How do people abuse these medicines?Most prescription stimulants come in tablet, capsule, or liquid form, which a person takes by mouth. When misusing or abusing a prescription stimulant, a person can either swallow, snort, smoke, or inject the drug.
- How do people get high from prescription stimulants?Prescription stimulants increase the activity of the brain chemicals dopamine – the brain’s “happy” chemical – and norepinephrine.
- Can abusing these drugs result in physical or mental harm or damage?Prescription stimulants increase alertness, attention, and energy. Their misuse, including overdose, can also lead to psychosis, anger, paranoia, heart, nerve, and stomach problems. These issues could lead to a heart attack or seizures.
- Can you get addicted to prescription stimulants?Yes, prescription stimulant misuse can lead to a substance use disorder / SUD (commonly known as addiction).
- What withdrawal symptoms are experienced when someone stops abusing the medication?Withdrawal symptoms include fatigue, depression, and sleep problems. Concerns about use should be discussed with a health care provider.
- How is prescription stimulant addiction treated effectively?Behavioral therapies can be effective in helping people recover from prescription stimulant addiction, including cognitive-behavioral therapy, one-to-one counseling, and contingency management.
- National Institute on Drug Abuse (NIDA). Five Million American Adults Misusing Prescription Stimulants. April 2018. Available at DrugAbuse.gov.
- National Institute on Drug Abuse (NIDA). Prescription Stimulants Drug Facts. June 2018. Available at DrugAbuse.gov.
- U.S. Drug Enforcement Administration (DEA). Drug Scheduling. 2021. Available at DEA.gov.
- U.S. National Library of Medicine: Medicine Plus. Pentazocine. February 2021. Available at MedicinePlus.gov.
- Google Books. “Attention: A Love Story” by Casey Schwartz. 2020. Available at Books.Google.com.
- Science News for Students. What is Dopamine? January 2017. Available at ScienceNewsforStudents.org.
- Hormone Health Network. What is Serotonin? December 2018. Available at Hormone.org.
- Hormone Health Network. What is Norepinephrine? September 2019. Available at Hormone.org.
- U.S. National Library of Medicine: “Glutamate as a Neurotransmitter in the Healthy Brain.” March, 2014. Available at NLM.NIH.gov.
- Oxford Academic: Alcohol & Alcoholism Journal. “Attention-Deficit/Hyperactivity Disorder and Alcohol and Other Substance Use Disorders in Young Adulthood: Findings from a Canadian Nationally Representative Survey” (University of Toronto, Canada). August 2021. Available at Academic.OUP.com.
- National Institute on Drug Abuse (NIDA). “Monitoring The Future – 2020”. December 2020. Available at DrugAbuse.gov.
- American Pharmacists Association (APA): Journal of American Pharmacists Association (APA). “Characteristics of Online Pharmacies Selling Adderall.” September 2020. Available at JAPHA.org.
- National Institute on Drug Abuse (NIDA). Comorbidity: Substance Use & Other Mental Disorders. June, 2021. August, 2018. Available at DrugAbuse.gov.
- National Institute of Drug Abuse (NIDA): Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) – “Evidence-Based Approaches to Drug Addiction Treatment.” January, 2018. Available at DrugAbuse.gov.