Who’s At Risk for ADHD Medication Misuse? ADHD Presentations
ADHD is generally categorized into three main types, sometimes called presentations, which can be described by these characteristics:6
Inattentive Type
This type of ADHD signifies that the individual has challenges staying on task, keeping focused, and organized.
For a diagnosis of this presentation of ADHD, the individual must be experiencing five of these symptoms:
- Doesn’t pay close attention to details and/or makes careless mistakes during tasks.
- Has problems staying focused on what they are doing
- Does not seem to be listening when spoken to
- Does not follow through on instructions and does not finish work, chores, or other duties
- Has issues organizing tasks
- Avoids or does not like tasks that require ongoing mental effort
- Often loses things that are important, such as phones, keys, wallets, etc
- Gets distracted easily
- Forget daily tasks, appointments, errands, etc
- Daydreaming or mind wandering
Hyperactive/Impulsive Type
This type of ADHD is indicated when the individual has excessive energy, is fidgety, has trouble sitting still, is talkative and is impulsive when it comes to decision-making.
For a diagnosis of this presentation of ADHD, the individual must be experiencing five of these symptoms:
- Fidgets or taps their hands, feet or squirms
- Is not able to stay seated
- Runs around or climbs when they shouldn’t
- Is unable to do things quietly.
- Always seems to be “on the go”
- Talks too much
- Blurts out an answer before a question has been finished or finishing people’s sentences
- Finds it difficult to wait their turn
- Interrupts or intrudes on others and takes over what others are doing
Combined Type
This type of ADHD is indicated when the individual fits the criteria for both inattentive and hyperactive presentations of ADHD. It is considered the most common presentation.
Like many similar issues, ADHD is considered a spectrum. Individuals may experience a select few, some, or most symptoms to varying degrees, and the symptoms can change over time. This is especially true if the diagnosis is made in childhood and develops as the individual reaches adulthood.
Is ADHD Overdiagnosed?
Overdiagnosis happens when patients are diagnosed with ADHD but may not meet the criteria for the disorder or when the symptoms may be explained by other factors. ADHD shares similar symptoms with anxiety, learning disabilities, mood disorders, sensory processing disorders, sleep disorders, and even vision or hearing impairments.
With overdiagnosis, there comes overtreatment. This means unnecessary medication exposure and even the masking of the underlying issues mentioned before. Additionally, taking non-prescribed stimulants can cause cardiac irregularities, dependency, and paranoia.7
ADHD Medications
The prescription medications commonly used to treat ADHD can be classified as either stimulants or non-stimulants. The stimulant medications typically include methylphenidate-based or dexmethylphenidate-based options such as Ritalin, Concerta, or Focalin and amphetamine-based or dextroamphetamine-based options such as Adderall or Dexedrine.
Stimulant medications increase the levels of neurotransmitters in an individual’s brain to improve attention and impulse control. More specifically, methylphenidate-based medications work by blocking the reuptake of dopamine and norepinephrine, and amphetamine-based medications work by increasing the release of dopamine and norepinephrine from nerve terminals into the synapses.8
Non-stimulant medications include atomoxetine and guanfacine, which affect neurotransmitters but do not increase the levels of dopamine and norepinephrine like in stimulants. These are typically prescribed if the individual does not respond well to the stimulant medication or experiences intolerable side effects.
ADHD Medication Side Effects
Every drug comes with possible side effects, with ADHD medication being no different.
Some of the side effects can include:8
- Loss of Appetite/Weight Loss — A loss of appetite affects about 80% of stimulant medication users because it influences the areas of the brain responsible for appetite regulation. This may mean unintended weight loss.
- Difficulty Sleeping — Stimulant medications can interfere with sleep, often making it difficult to fall asleep or stay asleep.
- Gastrointestinal Issues — Some people taking stimulant medication can have nausea, stomach upsets, and other gastrointestinal issues.
- Tics or Twitching — Stimulant medications may exacerbate pre-existing tics or lead to the increased noticeability of involuntary movements such as eye blinking or throat clearing.
- Minor Growth Delays — Some children and adolescents have experienced growth reduction, usually occurring in the first one to three years of treatment. Most growth rates stabilize thereafter.
- Changes in Blood Pressure and Heart Rate — Stimulant medications can increase your heart rate. This increase is typically minor but can be concerning for individuals with pre-existing cardiovascular conditions.
ADHD Medication Misuse
Even before the coronavirus pandemic, prescription stimulant misuse has been on the rise over the past two decades.9 This misuse can be from individuals using the medication when they are not prescribed it or using their prescription incorrectly.
Misusing ADHD medication has health and psychological risks such as increased heart rate, elevated blood pressure, insomnia, anxiety, mood swings, and irritability. They can be habit-forming, and individuals may develop a dependence or addiction.
Besides these risks, taking too much of the medication or more than prescribed can lead to severe side effects, including:
- Psychosis
- Seizures
- Tremors
- Agitation
- Restlessness
- Heightened anxiety
- Nausea
- Vomiting
- Cardiovascular events
- And even death
There is also a growing concern about ADHD medication misuse among college students, who are often taking them to increase attention and focus and do better academically. Some estimate that up to 20% of college students abuse prescription stimulants for this purpose, along with for recreational use. Most of these young adults are getting the medications from their peers who have the prescription, which can lead to legal trouble.
10 College students who misuse prescription stimulants may experience dysfunction in self-monitoring and abnormalities in working memory. Combining these stimulants with other substances, such as alcohol, can increase the risks of overdose or toxicity.
ADHD Medication Addiction
Stimulants and other psychotropic drugs alter the way your brain receives messages via chemical signals. These changes take time and come from continual use, and it is possible that you can become dependent on a substance even if used as directed. Adderall, Ritalin, and Dexedrine are all classified by the Drug Enforcement Administration (DEA) as Schedule 2 due to their high potential for misuse, abuse, and psychological or physical dependency.
Since Adderall and other stimulant medications boost the chemicals norepinephrine and dopamine (otherwise known as the brain’s “reward center”), it can cause feelings of pleasure and happiness. Over time, chasing these feelings or the energizing effects of stimulants can lead to tolerance, a situation that occurs when the brain and body need more and more of the medication to achieve the same effects. Increased use over time can quickly lead to dependency when the brain and body have trouble functioning correctly without the medication.11
Warning Signs of ADHD Medication Abuse and Addiction
While misusing stimulants can quickly lead to becoming addicted to them, it is possible to grow dependent on stimulants while using them as directed.
Some signs of addiction are:
- Intense craving for the substance
- Inability to quit using a substance even though it is detrimental to relationships, employment, or finances
- Doing risky or dangerous things to get the substance
- Feeling agitated, anxious, or paranoid
- Appetite loss or weight loss
- Hiding the substance, being defensive about it, or avoiding discussions about the topic
- Irregular heartbeat
- Neglecting responsibilities such as work and school
- Social isolation
- Increasing dosage without doctor’s approval
- Prescriptions “running out early”
- Mania and psychosis
Since stimulant medications increase the levels of neurotransmitters in an individual’s brain, a dependency is created, and abruptly going off them causes withdrawal symptoms. Unfortunately, as a result, people who are addicted to ADHD medication frequently experience additional issues while attempting to cease using the medication.
Stopping ADHD medication comes with a plethora of side effects, such as:
- Mood changes like irritability, anxiety, or mood swings
- Fatigue
- Changes in sleep patterns
- Appetite changes
- Cognitive changes such as attention, memory, and executive functioning issues
Attempting to stop ADHD drug use has not been thoroughly studied, but one study suggests the withdrawal experience of ADHD drugs is similar to those of cocaine and other stimulant drugs.
Everyone’s withdrawal effects will vary, and not everyone will experience the same symptoms. If you need comfortable, inpatient care and natural holistic help for stimulant ADHD medication withdrawal, you can find more information on our services overview page.
Are There Other Ways to Treat ADHD Without Medication?
Since the most commonly prescribed medication treatment for ADHD is amphetamine-based stimulant drugs, many people seek non-pharmaceutical alternatives. Stimulants can be highly addictive, cause unwanted side effects and health outcomes, and are under-studied regarding what side effects they could cause long-term.
Non-medication treatment strategies commonly include behavioral therapy, counseling, and lifestyle changes. If you’re looking for more specific holistic ways to treat ADHD, you may want to explore behavior training, diets that eliminate common dietary hyperactivity triggers, omega-3 supplements, biofeedback, exercise, and more.
Finding Alternatives to ADHD Medication for You
If you have been diagnosed with ADHD, medication does not need to be your only option. There may be a combination of professional therapy, diet, lifestyle changes, and holistic options that work even better for you.
Medication is not the answer for everyone, and you do not need to be trapped in the cycle of symptoms and side effects. If you would like to talk with a professional team of licensed physicians, nutritional psychiatrists, and holistic professionals, contact us so that we can work together with you to find a safe alternative to relieve your ADHD symptoms.
Related Reading: Alternatives to ADHD Medication
