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Adderall: A "Gateway" to Hell?

Thomas Breyfogle, Neighbor

Posted Mon, Dec 23, 2013 at 1:21 pm CT|Updated Mon, Dec 23, 2013 at 2:25 pm CT

There is evidence that Adderall and other ADHD drugs can lead to addiction and abuse, making them so-called “gateway” drugs.

Let’s look at some ADHD statistics.

First off, is ADHD on the rise?

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Well, Safer and colleagues estimated the prevalence of ADHD in American schoolchildren as 1% in the 1970s, 3% to 5% in the 1980s, and 4% to 5% in the mid to late 1990s. The New York Times currently states that 11% of school aged-children have received medical diagnosis of ADHD in the U.S. The same article claims that nearly one in five high school age boys (as opposed to all children) has been diagnosed with ADHD. So, according to these statistics, the number of people diagnosed with ADHD is 10 or 11 times what it was in the 70s.

That number is set to go up. The American Psychiatric Association is planning to change the definition of ADHD to allow more people to be diagnosed with ADHD. Science Daily states updated guidelines from the American Academy of Pediatrics (AAP) offer new information on diagnosing and treating Attention-Deficit/Hyperactivity Disorder (ADHD) in younger children and in adolescents.

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They state that evidence makes it possible to diagnose and manage ADHD in children from ages 4 to 18 (the previous AAP guidelines, from 2000 and 2001, covered children ages 6 to 12). The new guidelines describe the special considerations involved in diagnosing and treating preschool children and adolescents. They also include interventions to help children with hyperactive/impulsive behaviors that do not meet the full diagnostic criteria for ADHD.

Clearly, more children are being diagnosed with ADHD. Are more drugs being prescribed for it?

According to FDA research, ADHD prescriptions have risen 46% from 2002 to 2010 for children up to age 17. IMS Health states that 48.4 million prescriptions for ADHD stimulants were written in 2011. From 1990 to 1995, there was a 500% percent increase in the number of children labeled and medicated with Ritalin for ADD (or ADHD). That was during the “early years” of ADHD diagnosis and treatment. The term ADHD was first used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1987 (though there were earlier terms for similar things, such as "hyperkinetic reaction of childhood"). The DSM is the manual used by doctors and psychiatrists to help them define ADHD.

The DSM, by the way, does not have a biological cause for ADHD or define laboratory tests for it. ADHD just describes a group of observed symptoms: the child often fidgets, makes careless mistakes in schoolwork, often loses his pencils, has difficulty waiting his turn, blurts out answers in class, and so forth. That is according to Psychology Today.

According to the DEA, the production of Ritalin, which is pharmacologically similar to amphetamines, grew from 5,000 kilograms in 1993 to 20,967 kilograms in 2002 – probably the largest ever prescribing explosion for a controlled substance, according to Alternet.

Abuse of ADHD drugs is increasing.

ADHD drug emergencies quadrupled from 2005 to 2011 for people aged 18 to 34, according to SAMSHA. It went from 5,605 in 2005 to 22,949 in 2011. According to that same report, over 50 percent of those who had an ADHD drug emergency got the drug from a friend or relative at no charge, while 17 percent bought them from someone they knew.

According to Pediatrics and the American Association of Poison Control Center’s National Poison Data System, calls to the center related to teenage abuse of ADHD medication rose 76% from 1998 to 2005. This was for people aged 13 to 19. This was a faster rise than calls for victims of substance abuse generally and teen substance abuse.

Over those 8 years, estimated prescriptions for teenagers and pre-teenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. However, the percentage of poison center calls related to amphetamine ADHD drugs, such as Adderall, rose from 22% to 70%, which outpaced sales of these drugs.

According to a study in the Journal of Child Psychology and Psychiatry, childhood, adolescent, and adult ADHD predicted higher drug-related activities, as did childhood conduct problems.

According to the NIH: “addiction to stimulants is also a very real consideration for anyone taking them without medical supervision.”

This leads us to our next topic: Many people who abuse the ADHD drugs haven’t even been diagnosed with ADHD. Many college students and young professionals abuse the drug to help them study or work harder.

According to the NIH: Stimulants have been abused for both “performance enhancement” and recreational purposes (i.e., to get high). For the former, they suppress appetite (to facilitate weight loss), increase wakefulness, and increase focus and attention. The euphoric effects of stimulants usually occur when they are crushed and then snorted or injected. Some abusers dissolve the tablets in water and inject the mixture.

However, when taken in doses and routes other than those prescribed, stimulants can increase brain dopamine in a rapid and highly amplified manner—as do most other drugs of abuse—disrupting normal communication between brain cells, producing euphoria, and increasing the risk of addiction.

A study from the University of Kentucky stated that 34 percent of their students admitted using ADHD stimulants illegally. Students can fake symptoms to get a prescription, which was shown by another study from the University of Kentucky.

According to U.S. News and World Report, “…(I)n a 2012 University of Michigan study sponsored by the U.S. National Institute on Drug Abuse, 10 percent of high school sophomores and 12 percent of seniors admitted to using a ‘study drug’ that was not prescribed by a doctor.”

A New York Times article entitled “Drowned in a Stream of Prescriptions” was about a young college grad on a long, slow journey into psychosis and death due to his addiction to the ADHD medication Adderall – an amphetamine. The young man didn’t actually have ADHD, but got involved using meth during college to help him study. After college, he just never stopped, and continued taking the meds while studying to go to medical school. He never made it to medical school, but instead hung himself in a closet in his apartment. It is worth a read.

Does the use of ADHD drugs lead to the abuse of other, illegal drugs?

Research done at the University of California Berkeley identified a relationship between ADHD with the use of stimulants in childhood and dependence on tobacco and other stimulants as adults. The study found that half of those treated with ADHD stimulants went on to smoke cigarettes. Also According to the study, 36 percent of adult cigarette smokers who were treated with Ritalin as children became dependent on cocaine.

Adolescent rats given repeated doses of Ritalin are more likely to self-administer cocaine as adults, according to a study at the Finch University of Health Sciences/Chicago Medical School.

According to Statistics Brain, 79.9 percent of people who use Adderall have used Marijuana in the past year.

An article in OC Weekly interviews Morgan Richardson, a self-proclaimed drug addict. The article states that by seventh grade, he wasn’t getting a euphoric kick from Adderall, so he tried marijuana—but it made him sick. So did PCP. He didn’t like getting drunk. Finally, he found meth, which did the trick. “It made me feel like I had on Adderall,” he says.

Elizabeth Hartney, PhD on About.com states: Ritalin can be a “gateway” drug for some people, who go on to take other drugs. Taking Ritalin can also create early experiences of drug dealing for some students. And if the drug is taken in higher doses, or through routes that intensify the effects—such as snorting the drug through the nose or injecting it—the risk of addiction increases.

http://www.psychologytoday.com/blog/suffer-the-children/201209/why-french-kids-don-t-have-adhd-part-2

http://www.vibe.com/article/adderall-americas-new-gateway-drug

http://www.statisticbrain.com/adderall-statistics/

http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html

http://www.usatoday.com/story/news/nation/2013/11/25/twitter-adderall-college/3700111/

http://www.irle.berkeley.edu/culture/papers/vallee09.pdf

http://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder_controversies

http://psychrights.org/research/Digest/ADHD/ADHD.htm

http://topdocumentaryfilms.com/the-drugging-of-our-children/

http://www.samhsa.gov/data/spotlight/spot103-CNS-stimulants-adults.pd

http://www.cchrint.org/issues/psycho-pharmaceutical-front-groups/chadd/

http://abcnews.go.com/Health/number-prescriptions-adhd-drugs-increasing-study/story?id=16590807#.T-DluytYvig