Midterms are fast-approaching here at Berkeley, and with the changing leaves and cool winter air comes the thick scent of crippling anxiety and stress for the students. While some of those students will prepare for their upcoming midterms by studying rigorously, others may take a less…savory route by abusing a well-known drug designed to treat patients of attention deficit/hyperactivity disorder: The infamous Adderall.
As a central nervous system stimulant, Adderall’s mechanism of action is very similar to that of cocaine, and creates a very high potential for addiction. The figure below shows the biological effects of Adderall on neurons. Amphetamines like cocaine and Adderall inhibit dopamine, serotonin, and norepinephrine uptake by inhibiting their transporters [1]. With inhibited transporters, a build-up of dopamine takes place and causes hyper-stimulation of the receptors. This neurotransmitter build-up enhances awareness and mental function, but also gives users a sense of euphoria (a “high”) as dopamine continues to accumulate at neuron synapses…and therein lies the problem. Over time, the elevated dopamine levels will desensitize the dopamine receptors, and users will have to take more and more of the drug to reach the same level of “high” they achieved previously. It’s a classic reinforcement of behavior, where the users are conditioned to continue taking the drug to be rewarded with a high. College students who are abusing Adderall often aren’t aware of how high of a risk there is to becoming addicted, and use the drug habitually to study, unknowingly increasing their addiction risk.
Those who take Adderall will often experience fight-or-flight responses characteristic of a central nervous system stimulant, such as increased heart and respiratory rates, repetitive muscle contractions (twitching), and even overdose [1]. Tachycardia, hypertension, pulmonary edemas, and cerebral hemorrhaging are all possible overdose effects of stimulatory amphetamines like Adderall and cocaine [1], but even worse is the possibility that students in college are taking Adderall while also consuming alcohol. In general, alcohol should not be consumed while you’re on medication, especially with a strong drug like Adderall. Students buying Adderall illegally, however, don’t exactly get the medical warning labels with their under-the-table purchase. Instead, they think that they’re young and invincible, and drink while on Adderall, risking alcohol poisoning and/or heart issues.
If it’s so addictive and potentially dangerous, why is it still around? The short answer is because there are patients who actually need it. When properly prescribed by a doctor, Adderall’s effects can reduce symptoms of ADHD patients. Adderall’s mechanism of increasing neurotransmitter levels, as mentioned earlier, actually has on-target effects intended for treating ADHD, because the hyper-stimulation of the dopamine neurotransmitter receptors at the neuron synapses increases patients’ attention. In other words, although this mechanism sounds “bad” because it could lead to addiction in abusers, this mode of action is exactly what needs to happen in ADHD patients in order for their symptoms to improve. The build-up of dopamine is an intentional effect of Adderall, and can really improve mental cognition, increase focus, and help patients with legitimate ADHD when prescribed by a doctor.
*Homeland Security, seriously, I’m 100% joking. Good luck on midterms, everyone!
References:
- Robert L. Findling, Elizabeth J. Short, Michael J. Manos, Short-Term Cardiovascular Effects of Methylphenidate and Adderall, In Journal of the American Academy of Child & Adolescent Psychiatry, Volume 40, Issue 5, 2001, Pages 525-529.
- Cohen, Ronald. “Yerkes–Dodson Law.” Springer, Springer New York, 1 Jan. 1970, link.springer.com/referenceworkentry/10.1007%2F978-0-387-79948-3_1340.
- Johnston LD, O’Malley PM, Miech RA, Bachman JG, Schulenberg JE. Monitoring the Future National Results on Drug Use: 1975-2013: Volume 2, College students and adults ages 19-55. Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2014.
Somehow, I’ve never heard of the Yerkes-Dodson…intriguing idea.
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I think it’s a cool phenomenon too! It came up a lot when I was studying for the MCAT 🙂
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I really liked your article Mars! 🙂
The thumbnail of the chemical structures between Aderall and Meth really attracted me from the get-go. It’s really interesting how Meth is more potent just because of the extra methyl group increasing its solubility across the blood-brain barrier. The Yerkes-Dodson was also a cool thought! I would love more of these drug articles.
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