Adderall is the brand name for a prescription stimulant medication that combines dextroamphetamine and amphetamine. This stimulant medicine is most widely used to treat attention deficit hyperactivity disorder (ADHD) in both children and adults, but it may be prescribed for off-label use in rare instances. Sometimes, it is prescribed to promote weight loss when other approaches do not work, and it is sometimes used to treat daytime drowsiness in people with narcolepsy.
The U.S. Food and Drug Administration (FDA) approved Adderall for prescription use in the United States in 1960; however, the drug hit its most famous and widely prescribed point in the 1990s when more children began to receive prescriptions for stimulant drugs, particularly Ritalin and Adderall. Between 2002 and 2010, prescriptions for Adderall for children rose 45 percent in the U.S., making it the second most prescribed substance; the total number of prescriptions for this medication rose to more than 18 million.
Since the drug is so widely prescribed, it is widely available to steal or be diverted in other ways. Children who see their peers with ADHD become more focused and perform better in school often assume that Adderall can do the same for them. Adolescents and young adults with ADHD often give or sell their medication to friends, or children steal it from their peers. This is a form of drug abuse, and it can lead to addiction.
If you have a prescription for Adderall, you may develop a tolerance for the medication, which means that it will stop working as well over time. Tolerance is not the same as addiction, but people who abuse Adderall without a prescription may also develop drug tolerance as they struggle with addiction to the drug.
What is Tolerance?
Tolerance is a term that’s used to describe the diminishing effects of a drug or medication. It’s common among substances of abuse, but it can also occur with normal prescription drug use. But why does this happen? Tolerance occurs after a period of consistent drug use. Some substances can cause tolerance more quickly than others, and some are resistant to tolerance.
As with other drugs, Adderall tolerance occurs as your body adapts to the presence of the drug over time. Your brain chemistry and the chemical messaging pathways are altered by the consistent presence of a foreign chemical. One of the most common is called receptor down-regulation. Many drugs work by manipulating the chemical messaging symptoms between nerve cells. Messages are sent when one nerve cell releases a chemical, which binds to receptors on another nerve cell. When it comes to Adderall, the drug stimulates the release of chemicals like dopamine and prevents them from being removed from your system. This causes more dopamine to bind to the receptors on your nerve cells, causing increased effects.
However, when a large amount of a chemical inundates a nerve cell for long enough, the cell will down-regulate receptors, which means there will be fewer receptors for chemicals like dopamine to bind to. In some cases, this can be counteracted by increasing the dosage. But some drugs may see diminishing effects even after increasing the dose. For instance, methamphetamine can damage dopamine receptors, making it so that it’s more and more difficult to achieve a rewarding feeling, even as you increase the dose.
Tolerance can also occur because of upregulation. If a drug is preventing certain chemicals from binding to their receptors, upregulation will cause an increase in the number of receptors on a nerve cell. This allows more of the inhibited chemicals to find and bind to their receptors. Opioid pain relievers are an example of upregulation causing tolerance. Opioids block pain receptors. Upregulation will cause an increase in the number of pain receptors, leading to the diminishing effects of the drug.
Does Tolerance to a Prescription Drug Indicate Addiction?
Tolerance occurs with regular use of nearly any substance that changes brain chemistry, whether it is a prescription medication or a substance of abuse. Adderall is no exception to this rule, and people who abuse Adderall can develop tolerance as do people who take the drug as prescribed.
As a stimulant drug, Adderall releases dopamine in the brain, improving how neurotransmitters work with one another and stimulating the reward system. ADHD is a condition in which there is not enough dopamine in the brain to manage certain behaviors, such as focusing or learning, so increasing available dopamine in the brain improves symptoms.
However, releasing more dopamine in the brains of people who do not have ADHD or a dopamine-involved condition can trigger the reward system in a way that causes a high, with increased physical and mental energy. This can lead to compulsive behaviors, taking larger and larger doses for recreational reasons, or taking it to feel “normal” after developing a dependence on the drug to manage brain chemistry. These are signs of addiction, and they typically do not occur in people who have a physical need for a therapeutic dose of Adderall.
Adderall prescriptions are usually not based on personal attributes such as age, body weight and composition, gender, or hormonal inputs. This means that the way you metabolize your prescription can change over time and require adjustment.
Do You Need a Break from Adderall?
If you have taken Adderall as prescribed for months or years, you may notice the medication does not work as well as it did when you started. This indicates that you have developed a tolerance for the prescription dose, and you should speak with your doctor about your next steps. Your doctor can help you with several options, including taking a break from Adderall.
Whether your child needs a short break from Adderall, or you as an adult need a break from this medication, there are benefits and detriments to consider. Your doctor will speak with you in more detail, but there are many benefits of stopping Adderall use for a week or a month.
Side Effects Will Decrease
You may find that you sleep better, your appetite returns, and you experience fewer headaches when you take a break from this prescription stimulant. This may improve your quality of life in the short term.
You Can Determine if Behavioral Treatments Work Alone
Many people find that the combination of medication and behavioral therapy is the best method for managing the symptoms of ADHD. However, especially as an adult, you may find that behavioral therapy alone works well and that you can quit taking any medication until your symptoms change.
You Can See if Your ADHD Symptoms Change
An important way to manage any underlying condition is to see what the actual symptoms are. You may have experienced breakthrough symptoms while taking Adderall that you did not understand. Taking a break, supervised by your doctor and therapist, to determine what your current symptoms are can help you plan the next steps of your ADHD treatment.
Some important downsides to consider are:
Your Symptoms May be Uncomfortable or Hard to Control
Experiencing a return of poor concentration, physical restlessness, and other ADHD symptoms can lower your quality of life, especially beyond a week or more. While it is important to monitor ADHD symptoms without medication once in a while, you may find that returning to a prescription stimulant works best to improve your life.
You Will Need to Pay Extra Attention
Without medication, focusing on your behavior can be even more difficult, but it is crucial during this time. This lowers your chances of performing impulsively or engaging in risky behaviors. You may need to ask for help with this or to attend more frequent counseling sessions.
It Takes Time for the Medication to Work Again
Even when you return to a prescription stimulant like Adderall, it takes time for the drug to build up in the body and reach equilibrium. You may experience new or uncomfortable side effects during this time while also struggling with behavioral symptoms.
Taking an Adderall break is worthwhile if you develop a tolerance for the drug or have breakthrough behavioral symptoms, but you should never stop taking your medication without a doctor’s supervision.
What is the Adderall Tolerance Reset Timeline?
Taking an Adderall tolerance break to reset its effects on your body can be a complicated process. Each person is different, and the time it takes to reset your tolerance may be unique. Another important thing to consider is withdrawal. Tolerance is often a sign of chemical dependence, which is when your body comes to rely on a drug. When you stop using it, you’ll experience a sudden chemical imbalance in your nervous system that can cause uncomfortable physical and psychological symptoms. Adderall, and other stimulant medications, aren’t known to cause life-threatening withdrawal symptoms. Still, they can cause discomfort, fatigue, anhedonia, depression, and anxiety. In some cases, the psychological symptoms can be severe, causing suicidal thoughts or actions.
You may have heard that you should take a 3 day Adderall break to reset. But you shouldn’t alter your dose or quit cold turkey without speaking to your doctor first. It’s often safer to taper off slowly if you want to take a break from Adderall or other prescription drugs. Your doctor can help you create a safe and effective tapering schedule.
Adderall Abuse Requires Treatment
Many adolescents are exposed to ADHD medications when they watch their peers perform better at school after receiving Adderall or another drug. Many young people who do not need Adderall to overcome ADHD symptoms begin to take the medication as a “study drug” because they mistakenly believe it will enhance their performance. In many cases, this abusive behavior does not simply go away on its own. It requires treatment at an evidence-based addiction program.
Detox and rehabilitation end the body’s dependence on Adderall to feel normal or good. They often include behavioral therapy to manage cravings and avoid relapse back into substance abuse. For those without a prescription, taking Adderall is a form of drug abuse. You may need help not just to take a break, but to stop using the drug altogether.