Many young people are misusing Adderall—what can clinicians do about it?

By Kristen Fuller, MD | Medically reviewed by Kevin Kennedy, MD
Published October 6, 2022

Key Takeaways

  • Adderall is a prescription medication used to treat ADHD but is commonly misused by adolescents.

  • This “study” drug has potentially dangerous side effects, and it is essential to counsel your patients on the potential of misuse before prescribing this medication for ADHD or narcolepsy.

  • As a physician, it is crucial to be aware of the signs and symptoms of ADHD misuse and to ask appropriate screening questions when seeing adolescent patients in your office.

Misuse of dextroamphetamine-amphetamine (Adderall) is highest among teens and young adults, according to research which indicates these users are typically getting it without prescriptions. Many are using it as a “study drug” to avoid sleeping.[]

Knowing the signs of Adderall misuse—and strategies to address this problem—are valuable tools to enable clinicians to help affected patients.

Adderall facts

Adderall is a prescription medication that’s classified as a central nervous system stimulant, since it works on the brain’s neurotransmitters (such as dopamine) that affect hyperactivity and impulse control. The FDA approved Adderall in 2001, and it’s currently used to treat ADHD and narcolepsy.

Other prescription stimulants in the same class include methylphenidate (Ritalin), lisdexamfetamine (Vyvanse), methylphenidate extended-release (Concerta), and dextroamphetamine (Dexedrine).

The DEA classifies Adderall as a Schedule II drug, the same as cocaine, indicating its potential for abuse is high. Such stimulant drugs are the most widely used class of illicit drugs worldwide behind cannabis.[]

A study in the Journal of American Pharmacy found that Adderall is frequently being purchased through online pharmacies without prescriptions.[] These “rough” pharmacies are prevalent in Google search engines, enabling individuals to buy from unsafe sources and potentially misuse this medication.

Misuse rising among young people

Anecdotal evidence once suggested that Adderall abuse was most prevalent among pre-teens and adolescents. However, research from Johns Hopkins Bloomberg School of Public Health found that Adderall misuse is highest in 18–25 year-olds who obtain Adderall without a prescription, primarily from friends or family members.[]

Young adults are misusing this prescription medication to cram for tests, pull all-nighters, and work night shifts, calling Adderall a “smart drug”, “study drug” or “academic steroid.”

“Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying,” said study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School. “We need to educate this group that there could be serious adverse effects from taking these drugs, and we don’t know much at all about their long-term health effects.”

Such potential risks include high blood pressure, stroke, sleep disturbances, depression, bipolar disorder, and hostile and aggressive disorder.

Is your patient misusing Adderall?

Physicians seeing young patients should watch for signs and symptoms of Adderall misuse and to ask the appropriate screening questions. Ask about their school performance, study habits, and sleep schedule.

Find out if your patients work night shifts and how they manage their sleep routines.

If your patient does have a prescription for Adderall, be cautious if they are trying to refill their prescription too frequently. Counsel these patients on the potential for misuse and the effects it can have. Talk to their parents about any warning signs.

Signs and symptoms of Adderall abuse include:[]

  • Hyperactive, talkative

  • Strong desire to work or study for long hours

  • Tendency to overthink things

  • Feelings of nervousness, anxiety, impatience, and worry

  • Problems falling or staying asleep

  • Frequent headaches

  • Malnutrition or extreme weight loss

  • Excessive twitching

"Drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years."

Ramin Mojtabai, MD, MPH, PhD

Dr. Mojtabai suggested that prescriptions should be entered into a database physicians could check before writing prescriptions to ensure patients aren’t getting multiple medications from various physicians, as several states have done.

“It would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug,” Dr. Mojtabai added. “Many of these college students think stimulants like Adderall are harmless study aids. But there can be serious health risks, and they need to be more aware.”

What this means for you

Adderall is a “study drug” that is on the rise for misuse among adolescents. Physicians should be aware of the signs and symptoms associated with Adderall misuse to educate your patients about its dangerous associated side effects. Ask appropriate screening questions for Adderall misuse when seeing adolescent patients.

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