Drug Misuse and Abuse Northeastern University

Adderall: Drug Misuse and Abuse
Northeastern University
Adderall is a highly addictive drug that is often abused. While the drug is commonly used
in the treatment of attention deficit hyperactive disorder (ADHD), there is no reliable method of
diagnosing the disease. This makes it easy for those seeking the drug to acquire legitimate
prescriptions. Not only does this lead to controversy over the use of study drugs by high school
and college students, but the frequent distribution of the drug allows pharmaceutical companies
to capitalize off of illicit drug use. This paper aims to propose methods for decreasing the rates
of Adderall abuse by tightening regulations on the drug as well as developing a more effective
method of diagnosing ADHD. The paper also aims to find a solution for the financial impact of
Adderall abuse on consumers.
Adderall and ADHD
Adderall is a neurological stimulant that is prescribed to treat narcolepsy and, more
commonly, attention deficit hyperactive disorder (ADHD).1In recent years, the prescription rate
of Adderall has increased dramatically in the US. The jump in Adderall prescriptions has both
social and financial effects. This drug was intended for use in treating a childhood disease, but
as those children grow up they continue taking Adderall, often using it as a study aid. The
prevalence of Adderall among school and college-aged young adults leads to the illicit
circulation of the drug and its abuse as a study aid. Drug trade in itself creates economic issues,
and in addition to this, large pharmaceutical companies capitalize off of the abuse of the drugs
that they put into circulation.
ADHD, the primary medical use of Adderall, is a behavioral disorder generally seen in
children. ADHD can present with a wide range of symptoms; however at its core, it causes lack
of focus and impulse control.2
It is a prevalent belief that technology is responsible for the
increase in ADHD cases seen in recent years. While there is no evidence that exposure to
technology causes ADHD, it can be seen to exacerbate an already existing condition.2 However,
not all technology is bad. While some television shows offer nothing more than a mindless
distraction, other programs can promote learning, positive social behavior, and even help
increase focus.3 The more research that is done regarding ADHD, the clearer it becomes that
there is no one cause, but rather an interaction of many smaller factors that lead to the disorder.
Because there is no known cause of ADHD, it is difficult to find an accurate method of
diagnosing the disorder. There is currently no scientific test used to identify patients with ADHD;
the diagnosis is reached by assessing behavior and matching the patient with a list of
symptoms. As a result, it is relatively easy to be misdiagnosed with ADHD, whether by accident
or by design. In young adults, the diagnosis is almost entirely in the hands of the patient. A
student seeking an Adderall prescription could easily describe in themselves behaviors typical
of those with ADHD. This holds true for those diagnosed as children who wish to continue taking
the drug, regardless of whether they still need it. The official diagnosis of ADHD, and the access
to stimulants, can often stand as a safety net: a medical excuse for lack of focus or the inability
to complete work on time and meet deadlines.
Adderall Misuse
Every medication has side-effects, and medications are only prescribed when the
benefits outweigh the risks posed by these side-effects. With most other drugs it is easy to
determine whether the pros and cons of use are in balance. However, with Adderall it is not so
easy. Common side effects of Adderall, when being used as prescribed, include headache,
insomnia, and loss of appetite. When Adderall is not used correctly, an overdose can cause
more serious side effects. These include increased heart rate, tremors, and even seizures.4
Adderall is highly effective in those that have ADHD; however, those that misuse the drug
experience only limited benefits while still experiencing all of the side-effects and are at a
greater risk for the more severe effects that come with an overdose. These patients claim to
need the drug, claim to see results, and physicians currently have no way of distinguishing if
these claims are true or not. In order to resolve this issue, the process of diagnosis with ADHD
must be re-assessed and made more rigorous.
Economics and Drug Policy
In addition to the medical issues of misuse, there are also economic issues. Big Pharma
companies are capitalizing off of the misuse of the drugs that they produce. According to a
report released by EvaluatePharma, 2013 showed a rise in drug approvals from the prior four
years, many of which were simply increased dosage versions of existing drugs.5 Stimulant sales
for the treatment of ADHD between 2002 and 2012 rose from $2 billion to $9 billion, while
ADHD diagnosis rose from 600,000 cases in 1990 to 3.5 billion cases today.2

Adderall was introduced in 1994 by Shire Pharmaceuticals, along with other stimulants
including Concerta, Vyvanse, and Ritalin. These drugs are all highly effective, but also highly
damaging, coming with a laundry list of side effects. In addition to the physical effects, these
drugs cost patients thousands of dollars, while they make millions for the companies backing
them.6 According the the Center of Disease Control (CDC), ADHD costs patients over $1,500
annually in medical care and costs society between $12,000 and $18,000 annually per
individual with the disease.2

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In order to combat the soaring costs of Adderall to the public, tighter regulations need to
be placed upon its distribution. Adderall prescriptions must be treated with the same caution as
other addictive medications, such as opioids. In 1988 the Anti-drug Abuse Act was put into
place, which established The White House Office of National Drug Control Policy (ONDCP).7
This program works to combat illegal use of prescription drugs as well as other illicit drugs. Of
prescription drugs, this program has in the past focussed mostly on opioids, pain relieving
drugs. The ONDCP allocates a portion of its budget towards educating the public on the
dangers of prescription drug abuse.7 Despite the presence of the ONDCP, very little has
changed regarding drug policies in the past few decades. The resources allocated to the
ONDCP circulate through an endless cycle of apprehending drug dealers, and new dealers
taking their place.8 The decriminalization and legalization of drugs such as Marijuana, which has
already begun, will free up resources to focus on more dangerous drugs and the abuse of
prescription drugs. If these resources were focused on the dangers of Adderall abuse in addition
to opioids, in combination with the diligence of physicians in weeding out drug seekers, Adderall
misuse could be decreased dramatically.
Moving Forward: Diagnosis and Treatment
With tighter regulations on who can be given an Adderall prescription, a more accurate
method of diagnosis of ADHD must also be developed. While it is important to prevent those
who would misuse the drug from receiving it, this cannot be done at the expense of those who
actually need access to Adderall in order to function effectively. Accurate diagnosis is the key to
achieving this balance. A reliable method of diagnosis continues to evade researchers and
physicians. They have yet to identify a biological marker that can be used to identify those with
the disorder. However, current research is developing new methods to recognise the disorder. A
study conducted by He et al. makes a step in the right direction. Using 3D high-resolution
structural magnetic resonance imaging (hr-sMRI) technology, the study was able to identify
several regions of the brain in which individuals with ADHD had reduced gray matter.9While an
MRI alone cannot serve as a method of diagnosis, it could in the future be used to confirm
diagnosis of ADHD.
A second new method of identifying ADHD has also been proposed in a study run by M
Ahmadlou. This method use an electroencephalograms (EEGs) to distinguish patients with
ADHD from healthy controls.10 An EEG detects electrical activity in the brain through electrodes
placed on the scalp. By comparing EEG patterns between patients and controls, Ahmadlou was
able to identify deficits in neural activity in the patients, diagnosing ADHD with 95.6%
accuracy.10 These added steps could streamline the diagnosis process, helping to prevent the
unnecessary introduction of stimulants to children who do not need them, as well as weed out
young adults who are seeking Adderall as a study drug.
Even after assuring that only those that need medication are receiving Adderall,
alternate methods of ADHD treatment are still needed. The best way to preemptively combat
ADHD and Adderall misuse is to limit behaviors in early childhood that lead to ADHD symptoms.
This would include watching too much tv, playing video games, and playing with smartphones
and tablets. As technology continues to move forward, it is highly unlikely that the prevalence of
these forms of entertainment among children will decrease. Therefore, it is up to the parents to
set restrictions on the use of technology. Another option is to use technology as a tool in
increasing focus. Smart Brain Technologies has developed a neurofeedback system using
technology developed by NASA, implemented in both video game form as well as in a DVD
player. The player is fitted with a headset monitoring brain activity. The video game is a car
racing game; the more the player focuses on the game, the faster the car goes and the more
steering control the player has. In the DVD player, the child’s focus controls the size of the
screen as well as the volume.11An increase in the prevalence of games and technologies like
this would make combating and preventing ADHD without medication much more effective.
ADHD is a disease which is on the rise in the United States, and as such, the research
associated with it must advance. While Adderall and other stimulants provide effective treatment
of the symptoms of ADHD, these drugs do nothing to correct the underlying behavioral issues
that the disease creates. Moving forward, methods of behavioral therapy should be used in
place of, or in conjunction with, drugs in the treatment of ADHD. Tighter regulations need to be
placed on Adderall, and new methods of diagnosis of ADHD must be established and validated.
Tighter control on the distribution of Adderall will help defray the cost of healthcare for patients
and their familoies, preventing large pharmaceutical companies from capitalizing off of their
Reflective Note
Throughout this paper, the authors seek to address the issues of the misuse and abuse of
Adderall, a stimulant used to treat ADHD. The paper also aims to express awareness of the
capital gain made by pharmaceutical companies during the sale this and similar drugs. Failure
in the system is identified, and methods are suggested to better control the effective diagnosis
of ADHD. Research is primarily taken from peer reviewed material and statistical sources whilst
each author collaborated using their own individual discipline, as well as reaching beyond their
fields of interest into topics concerning economics and drug control policies. The main goal of
the proposed changes to the treatment of ADHD is to better control the distribution of Adderall:
to prevent children from being given unnecessary drugs and to prevent students from abusing
Adderall as a study-drug.
1. Findling RL, Dogin JW. Psychopharmacology of ADHD: children and adolescents. J Clin
Psychiatry. 1998. Accessed 13 June, 2015.
2. CDC Staff. Attention Deficit/Hyperactive Disorder.
http://www.cdc.gov/ncbddd/adhd/index.html. Accessed 10 June, 2015.
3. Acevedo-Polakovich ID, Lorch EP, Milich R. TV or Not TV: Questions and Answers
Regarding Television and ADHD. The ADHD Report. 2005. Accessed 14 June, 2015.
4. Fitzgerald KT, Bronstein AC. Adderall (Amphetamine- Dextroamphetamine) Toxicity. Top
Companion Anim Med. 2013. Accessed 14 June, 2015.
5. IMS Institute for Healthcare Informatics. The Use of Medicines in the United States:
Review of 2011.
thcare%20Informatics/IHII_Medicines_in_U.S_Report_2011.pdf. Accessed 10 June,
6. Wakeam E. Price Check! An Analysis of Direct-to-Consumer Pharmaceutical Marketing.
Academic Medicine. 2009. Accessed 15 June, 2015.
7. Manchikanti L. National Drug Control Policy and Prescription Drug Abuse: Facts and
Fallacies. Pain Physician. 2007. Accessed 10 June, 2015.
8. Reuter P. Why Has US Drug Policy Changed So Little over 30 Years? Crime and
Justice. 2013. Accessed 14 June, 2015.
9. He N, et al. Neuroanatomical deficits correlate with executive dysfunction in boys with
attention deficit hyperactivity disorder. Neurosci Lett. 2015. Accessed 9 June, 2015.
10. Ahmadlou M, Adeli H. Wavelet-Synchronization Methodology: A New Approach for
EEG-Based Diagnosis of ADHD. Clin EEG Neurosci. 2010. Accessed 15 June, 2015.
11. Smart Brain Technologies. Smartbraintech.com
http://www.smartbraintech.com/home.asp. Accessed 9 June, 2015.

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