The Adderall Crash: What Can I Do to Ease Adderall Withdrawal?
Adderall is a combination of amphetamine and dextroamphetamine that is used to treat attention deficit hyperactivity disorder (ADHD) symptoms and narcolepsy.
Adderall comes in two different forms: Adderall IR (immediate release) and Adderall XR (extended release). There is also Mydayis (another extended release option), as well as generic options for both immediate release and extended release.
Adderall is classified as a central nervous system stimulant, and any amphetamine and dextroamphetamine combination products are deemed Schedule II drugs by the Drug Enforcement Administration. Schedule II drugs are considered to have medical uses but also to have a high potential for abuse and dependence. Adderall can only be legally obtained with a prescription.
Although there are warranted medical uses for stimulant medications, they are also misused by many. Based on the 2017 National Survey on Drug Use and Health, it is estimated that about 18.6 million Americans ages 12 and up used prescription stimulants in the past year, including both those who were prescribed the medication and those who obtain stimulants through other means. Of those 18.6 million users, about 5.8 million misused prescription stimulants in the past year. Misuse includes using prescribed stimulants in larger amounts, more frequently, or longer than instructed; using prescribed stimulants in other ways not directed by the prescriber; or using stimulants that were not prescribed to that person. Misuse of Adderall and other prescription stimulants is especially common among young adults – it is estimated that over 2.5 million Americans aged 18 to 25 misused prescription stimulants in the past year, or about 7.4 percent of that population. This is over 40% of all prescription stimulant misusers ages 12 and up.
People misuse prescription stimulants in various ways. Some people swallow them normally, some people dissolve the powder from opening capsules or crushing tablets and then inject it into their veins, and some people smoke or snort the powder. One reason a person may misuse stimulants is because they think it will help their cognitive abilities. Students may misuse them to help them study, work on projects, take tests, or otherwise try to improve their grades. Some older adults may try to enhance their memory by misusing stimulants. Other reasons may include trying to increase one’s energy, trying to stay awake, or seeking a “rush.”
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), based on data from 2006 and 2007:
- Students in college full time and between the ages 18 to 22 were more than twice as likely to have misused Adderall in the past year as 18- to 22-year-olds who were not students in college full time.
- Students in college full time who misused Adderall in the past year were 5 times as likely to have misused prescription pain medications in the past year, 8 times as likely to have misused prescription tranquilizers in the past year, nearly 3 times as likely to have used marijuana in the past year, and 8 times as likely to have used cocaine in the past year, compared to those who had not.
- Almost 9 out of 10 students in college full time who misused Adderall in the past year had binged on alcohol in the past month. Over half had used alcohol heavily.
Possible common side effects of Adderall include:
- Decreased appetite
- Weight loss
- Trouble sleeping
- Dry mouth
- Stomach pain
- Mood swings
Possible severe side effects of Adderall include:
- Heart attack
- High blood pressure
- Sudden death
Misusing Adderall is especially dangerous for several reasons. When a person obtains an Adderall prescription, the prescriber carefully monitors the person for any adverse effects; if the person obtains Adderall without a prescription, no one is monitoring their health. Additionally, a person who is misusing Adderall may be taking much higher doses than are prescribed, increasing the risk of dangerous adverse effects. High doses of prescription stimulants can cause heartbeat irregularities, heart failure, dangerous body temperatures, seizures, and even overdose. Misusing prescription stimulants can lead to anger, psychosis, and paranoia. Furthermore, a person may think they’ve obtained Adderall from an illicit source, but it may be a different drug or mixed with a different drug, and therefore can have unpredictable, dangerous effects.
Possible symptoms of overdosing on a prescription stimulant include:
- Quick breathing
- Overactive reflexes
- Muscle weakness
- Muscle pain
- Irregular heartbeat
- Heart attack
- Blood pressure changes
- Inadequate blood circulation
- Abdominal cramps
If you think you or someone else may have overdosed on Adderall or another stimulant, call 911 immediately.
Negotiating the ‘Crash’ from Adderall Abuse
Misuse of stimulants can result in a person developing a substance use disorder. Using stimulants for a long time, even when using them appropriately, can lead to a development of tolerance (the need to use more of the drug to get the same effect one got initially). A person may also develop dependence, where their body depends on the drug to function normally. If a person suddenly stops using prescription stimulants, they may go through withdrawal. This may include symptoms such as:
- Trouble sleeping
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There are some medications that may be beneficial when someone is detoxing from Adderall; however, these should only be taken under the direction of a medical provider. This can be done either in an inpatient or outpatient setting. Individuals should discuss their options with a licensed treatment professional.
Treatment can assist with the development of coping strategies and relapse prevention plans.
There are no medications currently approved by the FDA for treating stimulant dependence, but there are some medications that may help treat withdrawal symptoms. These medications may be beneficial if someone is having problematic withdrawal symptoms from stopping Adderall use.
- Modafinil is a mild stimulant that can reduce the fatigue that may be experienced during withdrawal.
- Propranolol is a beta blocker that can reduce the anxiety that a person may feel during withdrawal.
- Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) that can help with the unpleasant mood symptoms that may be experienced during withdrawal.
For most individuals with a stimulant use disorder, stopping drug use and going through detoxification (if needed) is not enough for a lasting recovery. Anyone with a substance use disorder should seek treatment that fosters long-term recovery. Therapies that can help treat addiction to prescription stimulants include:
- Cognitive behavioral therapy (CBT): CBT can help a person change unhealthy thoughts and behaviors, and consequently change their feelings. CBT can help individuals addicted to prescription stimulants to better manage stress and triggers and to alter their expectations of drug use and their behaviors.
- Contingency management/motivational incentives: Contingency management involves giving individuals rewards or vouchers for desired behaviors, such as staying abstinent from drugs.
It is important to remember that the “crash” a person may experience after discontinuing Adderall is only a temporary situation. However, even once any withdrawal symptoms resolve, a person may still experience cravings, especially when encountering triggers. This is why it is crucial to engage in a treatment program that helps patients develop coping strategies and relapse prevention plans, preparing them for long-term recovery.