As a stimulant drug, Adderall speeds up heart rate, blood pressure, body temperature, and other functions of the central nervous system. It is a prescription amphetamine-based medication primarily used to treat attention deficit hyperactivity disorder (ADHD) or narcolepsy. It works by increasing energy, focus, and attention, and decreasing the need for sleep and suppressing appetite.
Adderall can be addictive as it impacts brain chemistry and increases levels of dopamine in the brain. Dopamine is one of the brain’s chemical messengers that works by elevating pleasure and happiness. Elevated levels of dopamine can be reached when Adderall is abused, creating a “high.” Adderall may be abused for this reason, as a kind of “study drug” to get ahead in school or at work, or even as a “diet drug.” According to the National Survey on Drug Use and Health (NSDUH), 1 million Americans (over the age of 11) were currently abusing a stimulant drug that was not methamphetamine at the time of the 2014 survey.
Dependence and Withdrawal Symptoms
Regardless of the reason Adderall is abused, it can lead to dependence when taken regularly, the National Institute on Drug Abuse (NIDA) publishes. A drug dependence occurs when the brain expects the drug to be there, so it alters its circuitry and chemistry accordingly. In the case of Adderall, this means that dopamine production and flow may be impacted. When this happens, dopamine levels drop when Adderall wears off or stops being active in the bloodstream.
Adderall comes in two main types: Adderall and Adderall XR (which is an extended-release format). The regular formulation of Adderall likely stops being active in a person’s bloodstream after about six hours, while the extended-release type may wear off in 10-12 hours, Stanford School of Medicine reports.
As soon as the amphetamines in Adderall stop being active in a person dependent on it, drug withdrawal can start. Adderall withdrawal may include various symptoms, such as:
- Vivid dreams
- Irregular heart rate and blood pressure
- Increased appetite
- Suicidal thoughts
- Inability to feel any pleasure
- Mood swings
- Mental “fogginess”
- Trouble concentrating
- Anger or hostility
- Lack of motivation
- Crying for no reason
- Psychosis (auditory or visual hallucinations)
Duration of Withdrawal and Mitigating Factors
Generally speaking, Adderall withdrawal is likely the most intense in the first few days following cessation of use, and the symptoms largely taper off in 7-10 days. Some of the psychological symptoms and cravings may persist for longer.
There are several factors that can influence the duration and severity of Adderall withdrawal, including:
- Length of time using or abusing Adderall: The longer a person takes the drug, the more likely it is that a strong dependence will form that may take longer to disrupt.
- Amount of Adderall abused regularly: Higher doses of Adderall can increase dependency and increase the odds of creating an addiction to the drug.
- Manner in which Adderall was abused: Snorting, smoking, or injecting Adderall may lead to higher levels of the drug being released in the bloodstream at one time and raise the risk for developing a dependence, and potentially an addiction to it, more rapidly. For instance, the Medication Guide published by the U.S. Food and Drug Association (FDA) states that Adderall XR releases medication into the body slowly throughout the day and therefore is intended to be taken once daily. Altering the medication changes how it is absorbed into the body and can therefore heighten dependence as well.
- Polydrug abuse: A study of college students who used Adderall for nonmedical purposes in the year prior to a national survey that was published by the Substance Abuse and Mental Health Services Administration (SAMSA) found that almost 90 percent also binge drank alcohol in the previous month. Adderall users were also eight times more likely than their peers to have used cocaine or prescription tranquilizers, five times more likely to also have used prescription painkillers, and three times as likely to have abused marijuana. Polydrug abuse can complicate and potentially intensify Adderall withdrawal.
- Presence of any co-occurring disorders: SAMHSA publishes that close to 8 million Americans (aged 18 and older) battle both mental illness and substance abuse disorders at the same time. A dual diagnosis can mean specialized treatment is in order, and withdrawal duration and severity may be affected.
- Age at which Adderall abuse began: Stimulant drugs are most commonly abused by individuals between the ages of 18 and 25, according to the 2014 NSDUH. CNN reports fulltime college students are twice as likely to abuse Adderall as their peers who aren’t in college fulltime. Using mind-altering substances before the brain is completely developed (at some point in a person’s mid-20s) may escalate the risk for dependence and addiction, as it can damage regions of the brain involved with motivation and willpower.
Adderall withdrawal can be significant and emotionally intense, making medical detox an optimal choice. Detox, in general, typically lasts between five and seven days on average, give or take a couple days depending on necessity. Medical detox is the most comprehensive form of detox, and it provides the highest level of safety and security.
Medical detox is offered in a secure and specialized facility staffed by highly trained medical, mental health, and substance abuse treatment providers. Adderall dosages may be slowly weaned, or tapered down, in a controlled manner during detox to minimize cravings and withdrawal symptoms.
While there are no specific medications for the treatment of stimulant withdrawal, pharmacological tools may be helpful for specific withdrawal symptoms, particularly in the case of co-occurring medical or mental health disorders. Physically, stimulant withdrawal is not generally considered to be life-threatening; however, individuals may become violent or suicidal during withdrawal and may therefore benefit from close monitoring and supervision to ensure both their own safety and the safety of those around them.
The primary goal of detox is to help an individual to become physically stable and to remove all toxins from the body. Typically, a drug screening will be performed prior to admission to better understand what drugs may be in the body and how to safely and effectively remove them.
Drug cravings, depression, anxiety, and dysphoria may be withdrawal symptoms that linger beyond detox, and they may be treated with medications like antidepressants or anti-anxiety medications and with therapeutic modalities.
It may take time for the brain to heal and for the previous levels of dopamine to regulate. Supportive care, behavioral therapies, and holistic methods may help. Sleep and good nutrition are important to the healing process, and an exercise regime and healthy diet plan can be beneficial and helpful in managing Adderall withdrawal symptoms. Adderall interferes with both sleeping and eating habits, and improvement in both of these areas can enhance recovery. Exercise and other holistic methods or creative outlets may also help to increase dopamine levels in the brain naturally and facilitate a return to a healthy, balanced life.