Prescribed Amphetamines
December 13, 2004 10:32 PM   Subscribe

How come prescribed amphetamines do not cause health problems like amphetamine psychosis or those horrid pictures of the woman who looks like a skeleton after so many years of abuse? I know people who take 80mg of Adderall a day (prescribed) and I've heard of up to 120mg a day users. Are these doses too low to cause ill effect? If they stopped using would they be subject to the same withdrawals as street users? I realize street users must take more, and a different kind, but the basics are still there, unless they are taking a lot more. It seems like 10+ years of daily Adderall take would produce similar effects.

Let's play 'how many typos can geoff make in a question'.
posted by geoff. to Health & Fitness (20 answers total)
Holy crap! I take 20mg a day and the first few days I couldn't stop cleaning.
posted by Keyser Soze at 10:40 PM on December 13, 2004

I am taking concerta, 54mg. I have noticed my body adjust, so the effects aren't as pronounced. I love this stuff--it's like getting a brain implant.

I once took double my recommended dosage of dexedrine when the pharmacist gave me double-strength pills, just half as many. I had a nice warm glow and sense of well-being. Plus, people seemed sorta slow.
posted by mecran01 at 10:52 PM on December 13, 2004

LOL, Keyser. My first experience with someone on meth was watching one of my floormates cleaning the fuck out of his dorm room at 3 in the morning, including vacuuming around a severely passed out roommate. Oh, Chico State students, is there a substance you won't abuse?

ObOnTopic: uh, fuck if i know.
posted by keswick at 10:58 PM on December 13, 2004

I suspect that people taking ADD meds suffer less dramatic physical consequences than your average deranged tweaker because they generally don't go on multiple-day binges without eating or sleeping. Amphetamine psychosis doesn't normally kick in until you've been awake for days...

Habituation and withdrawals are fairly common with these medications, though. I believe they're usually mild 'cause the doses usually are too, but I'd be really surprised if someone taking 80mg of adderall a day for years could stop suddenly without suffering nasty withdrawals. (That's a hefty dose even for a recreational user, unless they have an amphetamine tolerance, which often goes in hand with addiction.)
posted by introcosm at 11:20 PM on December 13, 2004

You could only call Adderall the equivalent of the methamphetamine that messed that lady up if it was killing monster trucks with its bare hands while destroying giant samurai gorillas with radioactive-flaming-ice balls that it shot out of its fingers. The extra methyl group in speed is what gives it its superpowers, like the difference between Superman (who is super-strong and can fly) and the Hulk (who is just awesome). While Superman is waiting outside ostensibly to make sure the brain has done something sufficiently naughty (but is really using the time to mack on Lois Lane and apply more hair gel), the Hulk is all "GRAAAARGH" and ripping everything apart and damn, you can have Wolverine come in there and try to rip out his heart but that's not stopping him, oh no, the Hulk does not stop until he wants to stop thank you very much. Since Adderall's made up of amphetamine salts the body's like "Hey, check out that kitten in the tree!" and thus it's absorbed at a slower rate.

Not that there aren't similar effects, 'cause Superman will eventually get in--if you crush those meds and snort them you'll get a serious rush. That's the same reason reason doctors usually have ADHD/ADD patients work up to a dose rather than giving them 40mg a day--you give the body time to get used to it, since most people feel jittery and crappy enough for the first week on just 5 or 10mg.

As with speed, your body starts getting used to doses so you need higher and higher amounts to get the same effect. The rate of increase varies from person to person--as with SSRIs, people might end up switching from med to med trying to find the most effective blend that they can take at the lowest possible dose.

I think there are some addictive properties (or at least dependency issues); maybe it's just me. Days I don't take my meds I feel lethargic and unmotivated, but if I stay off them for a week or so things start feeling quite a bit better.

From what I've heard, there are brain scan studies that show ADHD/ADD brains process amphetamines differently than those of people without the condition. What speeds others up slows ADHD brains down, or organizes them, or something like that. This would explain why someone with ADHD could work up to 120mg of Adderall (Jesus, that's a crazy amount), but "normal" people would be up for a week knitting. Or something.

Anyway, medication is supposed to be a temporary thing--something you use to help you develop good habits so you can deal with the ADHD when not on it. Nearly everyone I know who started taking meds for ADHD has eventually worked themselves off in well under a decade and those that don't only use it on days they feel they need it.
posted by schroedinger at 11:50 PM on December 13, 2004 [2 favorites]

Um. I think I second what schroedinger said.

Yes, you're taking 80mg of Adderol or 54mg of Concerta, but those are time release. The high tech capsules deliver the medication over a period of six to eight hours. A recreational drug user will consume that much without the regulated delivery.

If you think about it, a shot of tequila might give you a little buzz, but you probably wouldn't feel a thing if you took a teaspoon of tequila every two hours instead.

And, as (I think) schroedinger says, they're not quite the same drug. The medicinal formulations try to minimize the "speedy" effects and increase the beneficial effects, while recreational users probably enjoy the jitters and the paranoia.
posted by chrchr at 12:20 AM on December 14, 2004

A friend who took a course in the psychobiology of pain says that the difference is because the drug is being used as a medication and to compensate for a problem. Even people who use morphine, for example, can quit after over a decade without serious withdrawal symptoms.
posted by lorimt at 12:34 AM on December 14, 2004

Oops! I just realized that I had adderall doses mixed up with dexedrine doses (which are much lower), so 80mg time release isn't a hefty recreational dose after all, although it's still double the FDA's recommended limit.
posted by introcosm at 2:05 AM on December 14, 2004

It is quite possible to take too much prescribed adderall. I've done it. And if you're on 80mg, you are on a LOT of adderall. Those pictures aren't from 'Requiem For A Dream,' are they? Because that (fictional) woman was on prescribed speed.
posted by bingo at 2:06 AM on December 14, 2004

"amphetamine psychosis" can happen to anyone even on a small dosage. Why don't we see it more often? Think the difference is street use vs prescribed by a doctor. There are a bunch of physical side effects for amphetamine use (hair loss, a type of dematitis) even when prescribed but mostly they are central nervous symptom related (depression, anxiety, irritability, etc)

There is a difference between street use of the drug; desire to get high and taking the drug to lessen the effects of ADD/ADHD, sort of like comparing apples to oranges in my mind.

I can't help but wonder geoff., are you refering to the series of mugshots of a women over a period of years - if so she was addicted to crack which is different.

schroedinger studies were done but I can't recall if the NIMH (or others) actually did studies (link to an overview of various studies) comparing the ADD/ADHD brain on amphetamines vs a control group. I know some of the studies involved PET scans and they consider those highly invasive and aren't done often. The general theory is that an ADD/ADHD runs slower than a normal brain due to some physical differences in the brain.
posted by squeak at 3:05 AM on December 14, 2004

Why don't we see it more often? Think the difference is street use vs prescribed by a doctor.

Scratch that. Sloppy reasoning.
posted by squeak at 3:14 AM on December 14, 2004

Oh it was crack she was addicted to. Okay I thought it was speed.
posted by geoff. at 3:59 AM on December 14, 2004

the difference is because the drug is being used as a medication and to compensate for a problem. Even people who use morphine, for example, can quit after over a decade without serious withdrawal symptoms

That's nonsense, isn't it? The drug doesn't know why you're using it. With the same dose of the same drug over the same period of time, you're going to have the same withdrawal symptoms whether it was being used for recreation or for pain relief. The difference in your morphine example is that the doctor prescribing it is presumably controlling the dosage, keeping it as low as possible and then tapering off slowly to avoid the worst effects; the street addict presumably is not.
posted by ook at 7:30 AM on December 14, 2004

giant samurai gorillas with radioactive-flaming-ice balls that it shot out of its fingers

Why I keep coming back for more (ask.mefi, that is)

/took the green pill
posted by mecran01 at 8:39 AM on December 14, 2004

Dependence and addiction are different things. The physical withdrawal symptoms of dependence may be similar but the psychological symptoms of addiction are only going to be an issue in the street user.

I smoked for 10 years - I knew it was causing me harm - yet I continued. I quit - and while physical withdrawl only took a week or so - 3 years later - I still have to fight the urge to smoke. My understanding is that these urges rarely develop in people who are using "addictive" substances for legitmate reasons.
posted by Wolfie at 9:49 AM on December 14, 2004

Uh, meth is every bit of a bastard fuck-ed up drug to waste your life on as crack is - you should see the line-up pictures of locals running erzatz methlabs here in Tennessee - the meth-lab capital. They look like the crack-lady's family. Run, don't walk away.

And Shroedinger -I almost spit coffee all over my keyboard. What mecran01 said.....
posted by Pressed Rat at 10:21 AM on December 14, 2004

l: the difference is because the drug is being used as a medication and to compensate for a problem.

o: That's nonsense, isn't it? The drug doesn't know why you're using it.

I heard the same thing from a med student friend, but specifically about morphine (and hence rather offtopic for this thread): first it kills pain, and only then do extra amounts get you high. This matches my own experience in being shot up with morphine (I had a kidney stone; not recommended) -- they gave me enough to erase the awful awful awful pain, and I got no attendant euphoria.

(In fact they asked at some point if I needed more, and like an idiot I said no. Man, I must have been on drugs!)
posted by Aknaton at 10:54 AM on December 14, 2004

That's nonsense, isn't it? The drug doesn't know why you're using it.

I think the factors mentioned elsewhere in the thread are far more significant, but I also think there's something in this too. Remember Timothy Leary's "set and setting" speech? Part of the patient's experience is shaped by his or her expectations.

I remember in jr. high, a kid gave an ibuprofen to another kid, and then told him it was a sleeping pill. The kid who took the faux sleeping pill -- weak minded in the extreme -- dutifully went to sleep.
posted by chrchr at 11:59 AM on December 14, 2004

Like Bombay Sapphire vs. Heaven Hill gin, maybe? The good stuff is easier on the body. Or, to channel the Grumpy-Smurf irate-shopper voice, "Why does this really awesome thing cost way more money than this other, not-as-good, thing?"
posted by oldtimey at 12:13 PM on December 14, 2004

They do; no; yes.

No free lunch, man.
posted by ikkyu2 at 5:18 PM on December 14, 2004

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