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Adderall can be administered in an immediate-release version (Adderall IR) or an extended-release version (Adderall XR). The extended-release version is particularly useful for children in school because a teacher does not have to administer the medication in the middle of the day. The effects from the immediate-release version will last 4-6 hours, whereas the effectiveness of the extended-release version is estimated to last around 12 hours.
Because Adderall contains highly potent stimulants that can be effective for their medicinal purposes at prescribed doses but can be dangerous when abused at large doses, the Drug Enforcement Administration (DEA) categorizes Adderall as a Schedule II controlled substance. Medicines in this category are in the highest schedule that can still be prescribed by a physician. Drugs classified in the higher classification, Schedule I, are only available with special permissions from the government and typically just used in research. Thus, while Adderall does have useful medicinal functions, it also has an extremely high potential for abuse and for the development of physical dependence.Alcohol is a central nervous system depressant that is known to be a significant drug of abuse. Drinking alcohol has a totally different effect than using a stimulant. Stimulant medications generally increase the availability of excitatory neurotransmitters in areas of the brain that, when activated, improve focus, physical activity, alertness, etc. Adderall generally increases the availability of norepinephrine and dopamine. Alcohol acts to inhibit the function of the excitatory neurotransmitter N-methyl-D-aspartate (NMDA) while at the same time enhancing functioning of the inhibitory neurotransmitters gamma-aminobutyric acid (GABA) and glycline. Alcohol in its various forms is the most frequently abused substance in the United States, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Dangers of Mixing Drugs
Basic written instructions for nearly every prescription medication warn against taking the medication in conjunction with alcohol. In addition, most physicians strongly advise against using any prescription medication in conjunction with alcohol.The Food and Drug Administration (FDA) has issued numerous warnings regarding the dangers of mixing drugs, and textbooks like Concepts of Chemical Dependency and Chemical Dependency Treatment: Innovative Group Approaches discuss some of the reasons that it is not advisable to mix any prescription medication with alcohol.
- Mixing alcohol with most types of medications reduces the effectiveness of the medication. Mixing alcohol with stimulants leads to the perception that the effects of both the alcohol and stimulants are not as salient as they would be if one used either the stimulant or alcohol alone.
- Despite the perception that the stimulant or alcohol is not working as effectively as one believes, the actual content of the drug has not been altered. This makes it far easier to overdose on either stimulants or alcohol when both drugs are used in combination.
- When one mixes drugs with different effects, there are a number of potential unpredictable effects that can occur that often would not occur if one consumed either alcohol or Adderall alone. These can include potentially dangerous side effects, such as seizures.
- The potential for idiosyncratic effects (effects of the drugs based on individual differences in physiology and psychological makeup) is markedly enhanced.
- Continued use of large amounts of Adderall and alcohol in combination can lead to an extremely complicated situation where an individual has developed polysubstance abuse or co-occurring substance use disorders.
Why Individuals Mix Adderall with AlcoholAbuse of Adderall can occur across all age groups, but the group that most often abuses this drug are males between the ages of 15 and 30. Research has indicated that Adderall abuse is extremely more common on college campuses than among individuals who are not in college. Research also indicates that the majority of individuals who have a prescription for Adderall and use it for medicinal reasons (e.g., to treat ADHD) are not the major abusers of the drug. Instead, individuals who abuse the drug often procure it:
- From a friend or relative who has a prescription for it
- As a result of stealing it from someone who has a prescription for the drug
- As a result of buying it illegally (without a prescription)
- Under the mistaken impression that the misuse/abuse of a prescription drug does not represent a potentially dangerous situation
Even though most individuals with a prescription for the drug do not abuse it, the increase in prescriptions of stimulants for ADHD leads to an increased availability of these drugs for potential abusers.
Research also indicates that a significant number of individuals who abuse prescription stimulant medications will abuse them in conjunction with alcohol at least occasionally. The reasons for abusing the substances together are varied.
- Based on research findings, it appears that the reason individuals abuse both drugs together is to blunt the undesirable side effects of the stimulant drug (e.g., Adderall) by drinking alcohol.
- Adderall abuse in college students is associated with the onset of college examinations. Individuals abuse Adderall is an attempt to improve their concentration or to study for lengthy periods of time. Because using large amounts of Adderall can lead to hyperactivity, jitteriness, etc., individuals may drink alcohol to counteract these effects.
- In studies, a number of individuals reported drinking alcohol with Adderall in an attempt to allow them to “party” longer. The stimulant will counteract some of the depressant effects of alcohol.
- Some people are under the mistaken impression that because Adderall is a prescription medication, using it in conjunction with alcohol is not as potentially dangerous as using an illicit drug with alcohol.
Specific Dangers of Mixing Adderall and AlcoholNumerous research studies have suggested that there are some specific dangers associated with abusing alcohol and Adderall together.
- Although it appears that individuals primarily drink alcohol when abusing Adderall in an effort to lessen the effects of the stimulant, it is far more likely that individuals will overdose on the alcohol or suffer from alcohol poisoning due to the effects of the stimulant negating the intoxicating effects of alcohol. Of course, alcohol poisoning or an overdose of alcohol is a potentially fatal situation.
- Issues with judgment and rational thinking are exacerbated when an individual is under the influence of both drugs.
- Research indicates that the potential for negative side effects from either drug is enhanced when the drugs are combined. This can include issues with nausea and vomiting that can lead to dehydration, cardiovascular problems, issues with aggressiveness, and failure to inhibit behavior that can lead to taking serious risks.
- Despite the perception that reflexes and motor coordination are not as affected by alcohol when one mixes Adderall and alcohol together, individuals remain significantly impaired in regard to their reaction time, motor coordination, and visual perception. This can lead to a number of potentially dangerous situations.
- Mixing Adderall and alcohol leads to a significant stress on the cardiovascular system and can lead to short-term issues with hypertension as well as long-term issues with cardiovascular disease and even an increased potential for stroke.
- The potential to develop serious neurological effects, particularly seizures, is significantly increased when one mixes the two drugs.
- Long-term abuse of Adderall and alcohol can lead to serious cognitive issues that reflect damage to the central nervous system. These issues most often manifest as issues with attention/concentration, learning and memory, and complex problem-solving. In addition, a number of emotional effects that may represent damage to the central nervous system may also occur, including longstanding issues with depression, apathy, loss of motivation, and even potential psychosis.
- Many individuals are under the mistaken impression that serious ramifications from mixing Adderall and alcohol only occur if one engages in this practice repeatedly for a significant length of time. Research has indicated that this may not necessarily be true. For example, a study published in 2009 in the Journal of the American Board of Family Medicine presented a case study of a young individual with no prior history of cardiovascular disease or substance abuse who suffered a heart attack as a result of mixing alcohol and Adderall. Based on the information provided in the case study, the individual did not use excessive amounts of either drug. Other research looking at the self-reports of individuals who abuse these two drugs in conjunction notes that these individuals have more negative complaints regarding their drug use, such as issues with motivation, quality of life, depression, and health, than individuals who simply drink alcohol alone or abuse stimulants alone.
- Even though one of the primary reasons that individuals give for abusing Adderall is to enhance their ability to study, learn, and improve their grades, research indicates that individuals who abuse Adderall, or who abuse Adderall and alcohol together, typically have lower grades and significantly lower levels of academic and professional achievement than individuals who do not abuse these drugs. Thus, even though the primary reason that many individuals report for abusing stimulant medications like Adderall is to enhance their cognitive abilities, this alleged effect appears to be a myth.
Based on available research and other information from professional organizations, such as the FDA, it can only be concluded that it is not safe to combine alcohol and Adderall in any amount or for any purpose. When individuals engage in this practice, they are leaving themselves open to a number of potentially dangerous effects.