Dextroamphetamine Abuse and Addiction
Dextroamphetamine is a prescription stimulant used to help manage ADHD but also has the potential to be addictive when abused as a “study drug” or for recreational purposes. People without ADHD sometimes take drugs like dextroamphetamine to stay alert and increase focus, but there are physical and mental health risks associated with using the drug outside of prescription guidelines, including dependence, withdrawal, and death from overdose. No matter how serious a person’s dextroamphetamine abuse might be, help is available.
What Is Dextroamphetamine?
Dextroamphetamine is one of a class of drugs called amphetamines, which act as central nervous system stimulants. It is primarily prescribed to manage symptoms of attention deficit hyperactivity disorder (ADHD) and is sometimes used as a treatment for narcolepsy, a condition in which a person may fall asleep without warning.1
For quite some time, several pharmaceutical formulations of dextroamphetamine were marketed under the brand name Dexedrine, which no doubt influenced the street nomenclature of illicitly obtained amphetamines, which many refer to as “dexies.”2,3 Other prescription stimulants used in the treatment of ADHD include methylphenidate (brand name Ritalin, Concerta) and a combination of amphetamine and dextroamphetamine (brand name Adderall).2
While these prescription drugs have legitimate medical indications for conditions such as ADHD and narcolepsy, they are sometimes abused by people who do not have a prescription or who take the drug in higher or more frequent doses than their doctor prescribes.2
How Does It Work?
Prescription amphetamines like dextroamphetamine increase the activity of dopamine and norepinephrine, which are neurotransmitters associated with pleasurable feelings and the brain’s reward system.3 In people with ADHD, the increased signaling provided by these neurotransmitters helps improve memory, attention, wakefulness, and the ability to concentrate.3 It can also help them feel calmer, less impulsive, and less restless.
While the effects of dextroamphetamine help those with ADHD feel normal, people without ADHD have been known to take the drug to experience a heightened sense of concentration, less need to sleep, and improved mental performance. This is why ADHD medications are often known as “study drugs” among students and young professionals.
The increase of dopamine in the brain caused by dextroamphetamine can also lead to a rush of euphoria. Recreational users may take high doses of the drug, crush up the pills into a powder to be snorted or mixed with water and injected, or mix dextroamphetamine with other drugs and/or alcohol in order to enhance this effect and experience a high.4
People with ADHD have more difficulty than the average person paying attention, focusing, and resisting impulsive behaviors. They may also be hyperactive and restless.
The primary symptoms of ADHD are:5
- Inattention—Difficulty paying attention to tasks or activities; difficulty following instructions; reluctance to take on tasks that require extended concentration; frequently losing or forgetting important items; not listening when spoken to directly.
- Hyperactivity or impulsivity—Excessive fidgeting, tapping, or squirming; inability to remain seated in situations where it is expected, such as a classroom; excessive talking and frequently interrupting others; unable to partake in quiet leisure activities.
Criteria for diagnosis varies depending on the child’s age and length of time they have experienced the symptoms. Behaviors typically associated with ADHD are usually apparent by the time a child is 7 years old but sometimes manifest in adolescence and early adulthood.5
The disorder is widespread, and according to the Centers for Disease Control and Prevention, as many as 11% of all children aged 4 to 17 have been diagnosed with ADHD.6 The number of children with ADHD varies by state; in Kentucky, more than 18% of children have been diagnosed.6
Even when taken as prescribed by a doctor for the treatment of ADHD, dextroamphetamine is associated with a number of side effects. The most commonly experienced side effects are:1
- Difficulty sleeping.
- Uncontrollable shaking, jitters.
- Appetite loss.
- Weight loss.
- Changes in sex drive.
Because ADHD medications like dextroamphetamine suppress appetite, they are sometimes abused for the purpose of weight loss, in addition to its stimulant and euphoric properties.4
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One of the most prominent reasons people take dextroamphetamine without a prescription is to enhance their performance at work or school. Some high school and college students believe stimulants like dextroamphetamine will help them achieve better grades by allowing them to stay up late and focus while studying for exams or working on assignments. For this reason, ADHD medications including dextroamphetamine, Adderall, and Ritalin, are sometimes referred to as “study drugs.”
While dextroamphetamine and other stimulants do promote wakefulness, studies indicate that students who take amphetamines to help with grades actually have lower GPAs than students who do not take these stimulant medications.4
A recent study showed that about 8% of adults between 18 and 49 years old admitted to taking stimulants without a prescription, and most of them stated that they did so to enhance school and/or work performance.7
Although study drugs are typically thought to be primarily used by high school and college students, there are increasing anecdotal accounts of adults misusing prescription stimulants in order to perform better in high-pressure jobs. A recent article in The New York Times described interviews with “dozens of people in a wide spectrum of professions” who said they misused amphetamine-based stimulants to attain a competitive edge in the workplace.8
In the article, health tech professionals and lawyers discuss how they had taken stimulants to stay alert while working excessively long hours. They attained the pills through friends, drug dealers, or by feigning ADHD symptoms to their physicians and receiving prescriptions of their own. These professionals recount how their stimulant abuse led to addiction in some cases and detrimental consequences to their overall physical and mental health in nearly all cases.8
Some high school and college students believe stimulants like dextroamphetamine will help them achieve better grades.
When abused in high doses and over long periods of time, dextroamphetamine and other prescription amphetamines can have a range of negative consequences, both physical and emotional. Dextroamphetamine abuse may lead to:5
- Heart attack.
People who snort crushed dextroamphetamine pills are susceptible to bleeding and irritation in the nasal passages and perforation of the nasal septum in some cases.5 In addition, using dextroamphetamine intravenously increases the risk of health dangers commonly associated with IV drug use, including:5
- Sexually transmitted diseases.
- Skin infections.
In rare cases, long-term amphetamine use can result in a chronic state of psychosis similar to schizophrenia.3 This can manifest as paranoia, delusions, and even hallucinations in some users.1,5
Can You Overdose?
It is possible to overdose on dextroamphetamine and other amphetamine-based prescription drugs. The toxicity associated with amphetamine overdoses is a result of the excessive release of certain neurotransmitters, including dopamine, serotonin, and norepinephrine—the same neurotransmitters that cause the user to get high from the drug.9
Though these chemical-signaling molecules are naturally occurring, an abnormal increase (such as is caused by large doses of amphetamines) can lead to overstimulation and injury to a number of the body’s physiological processes and systems (e.g., neurological, cardiovascular, gastrointestinal, etc.).
Dextroamphetamine overdose is potentially dangerous. If you suspect that you or a loved one is experiencing an overdose, call 911 immediately. Overdose symptoms include:1,9
- Extreme anxiety and agitation.
- Dilated pupils.
- Overresponsive reflexes.
- Diarrhea and/or stomach cramps
- Irregular heartbeat.
- Muscle weakness/aching.
- Dizziness and/or fainting.
Between 2005 and 2010, the number of emergency room visits related to stimulant ADHD medications, including dextroamphetamine, increased from 5,212 to 15,585.10 Recreational users will sometimes mix dextroamphetamine with other drugs or alcohol, a practice that can compound an individual’s risk of medical complication. Of emergency room visits involving ADHD medications, 45% involved other pharmaceutical drugs, 21% involved other illicit drugs, and 19% involved alcohol.10
Abuse and Dependence
Misusing prescription amphetamines is a slippery slope that can lead a person to develop a tolerance to the drug. Tolerance is characterized by the need to use the drug more frequently or in greater amounts in order to achieve the desired results. When tolerance becomes significant, the resulting increase in drug use needed to overcome it further drives the development of dependence—a phenomenon wherein the body becomes acclimated to the presence of the substance and experiences withdrawal symptoms without it.11
Misusing prescription amphetamines is a slippery slope that can lead a person to develop a tolerance to the drug.
Someone who uses dextroamphetamine to improve mental ability while studying may find themselves taking the drug more and more frequently to keep their perceived competitive advantage going. Eventually they may believe that they can’t study or complete an important assignment without using dextroamphetamine (psychological dependence), or they may feel excessively sluggish and tired when not using the drug (physical dependence).
A stimulant use disorder may have developed at the point that a person continues to use dextroamphetamine despite observable health problems, strained social relationships, loss of interest in hobbies that were previously important, and disruption in their work, school, or home life.5
Physical dependence is often accompanied by the onset of distinct withdrawal symptoms when the person stops using that drug. For stimulants like dextroamphetamine, the acute withdrawal syndrome is generally not medically life-threatening, but can be quite unpleasant. It may include debilitating symptoms such as:12
- Agitation and jitters.
- Fatigue or difficulty staying awake.
- Increased appetite.
- Drug cravings.
- Dulled senses, slow reactions.
One of the greatest risks encountered during dextroamphetamine withdrawal is the potential for the person to become violent and/or suicidal.12 The onset of abrupt mood changes, extreme agitation, and significant depression should be monitored closely so that the treatment team can take the proper steps to minimize the person’s risk of harming themselves or others.12 A professional detox and rehabilitation program can provide the necessary supervision and support during this difficult phase.
Professional detox and rehab may also be recommended for patients who:13
- Have a co-occurring addiction to another drug and/or alcohol.
- Have previously tried to quit using dextroamphetamine on their own without success.
- Have other medical or mental health issues that may complicate the rehab process.
Treatment is widely available for dextroamphetamine abuse, and there are many options to choose from depending on your individual circumstance. While a 30-day program may be an invaluable therapeutic intervention for helping people to overcome cravings and treat addiction, some benefit more from longer-term treatment (e.g., 60- to 90-day, or more, if needed). Perhaps you can commit to an inpatient facility and live at the rehab center full-time during your treatment, or you may prefer an outpatient treatment setting that enables you to continue going to work, attending school, or taking care of your family. In order to discover your treatment needs, the first step is to get an assessment by a qualified substance abuse professional who can evaluate your situation and determine the best course of treatment.
For most people, the first step in rehab is a period of detox, followed by a longer period of treatment. With stimulants like dextroamphetamine, detox usually lasts 24–72 hours to eliminate the drug from your body, manage any acute symptoms of withdrawal, and ensure that no medical complications arise. Detox can occur in an inpatient setting, with 24-hour supervision, or on an outpatient basis.
Detox, however, is not a substitute for ongoing substance abuse treatment. Detox only facilitates the clearing of dextroamphetamine from your body; if you do not address the reasons why you started abusing the drug in the first place, you are likely to relapse when the same issues arise again. Participating in a rehab program after going through detox can help you address the root of your addiction and develop a relapse-prevention plan. Treatment programs can range from a few days to a few months in length and can be in a variety of formats:
- Inpatient, where you live at the rehab facility under 24-hour supervision while participating in an intensive array of regularly scheduled counseling and therapy.
- Outpatient, where you continue living at home but attend treatment sessions at a facility or doctor’s office several days per week, from 2–4 hours per day.
- Partial hospitalization, where although you live at home, you participate in treatment session at the facility on 5–7 days per week, from 4–6 hours per day.
Regardless of the format you choose, you will have counselors and nurses available during program hours to help provide emotional and psychological support and to monitor your recovery progress. On-site medical professionals or access to medical and psychiatric services will help guarantee your safety should severe cravings or significant episodes of depression or other mood disturbances arise. Other program participants provide a supportive, understanding peer community. Participating in group therapy and support group meetings is a major component of most rehab programs.
Counselors provide a range of behavioral therapies to help you understand and overcome their substance use disorders. Through techniques like cognitive-behavioral therapy, the Matrix Model, and motivational interviewing, you will learn skills to cope with your feelings without using drugs and avoid or manage your triggers for drug use to help prevent relapse.
Get Help Today
If you think that you or your loved one has a problem with dextroamphetamine, don’t be afraid to seek help. There is no need try to go through this alone. Treatment costs and program options will naturally vary, but there are a number of recovery programs out there that will be right for your situation.
- U.S. National Library of Medicine (2017). Dextroamphetamine.
- U.S. Drug Enforcement Administration. (n.d.) Drug Fact Sheet: Amphetamines.
- University of Maryland Center for Substance Abuse Research. (n.d.) Amphetamines.
- National Institute on Drug Abuse. (2014). Stimulant ADHD Medications: Methylphenidate and Amphetamines.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Centers for Disease Control and Prevention. (2017). Attention Deficit/Hyperactivity Disorder (ADHD).
- Cassidy, T., Varughese, S., Russo, L., et. al. (2015). Nonmedical Use and Diversion of ADHD Stimulants Among U.S. Adults Ages 18-49: A National Internet Survey. Journal of Attention Disorders, 19(7), 630–640.
- Schwarz, A. (2015). Workers Seeking Productivity in a Pill Are Abusing A.D.H.D. Drugs. The New York Times.
- Spiller, H., Hays, H., Aleguas, A. (2013). Overdose of drugs for attention-deficit hyperactivity disorder: Clinical presentation, mechanisms of toxicity, and management. CNS Drugs, 27(7), 531–543.
- Center for Behavioral Health Statistics and Quality. (2013). The DAWN Report: Emergency Department Visits Involving Attention Deficit/Hyperactivity Disorder Stimulant Medications. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- U.S. Food & Drug Administration. (2017). Dexedrine.
- Substance Abuse and Mental Health Services Administration. (2001). Treatment for Stimulant Use Disorders.
- Substance Abuse and Mental Health Services Administration. (2006). Physical Detoxification Services for Withdrawal from Specific Substances.