Why Adderall and Alcohol are a Bad Combination

The Hidden Dangers of Mixing Stimulants and Alcohol

What is Adderall Prescribed for?

Adderall is a prescription medication primarily used to treat ADHD and narcolepsy. It belongs to a class of drugs called central nervous system (CNS) stimulants, which increase brain activity and speed up certain bodily functions, such as heart rate. For individuals diagnosed with ADHD, Adderall can enhance focus and improve cognitive functioning, helping to manage symptoms like inattention, hyperactivity, and impulsivity. While FDA-approved for these conditions, its effects can be harmful if misused or taken without a prescription.

Is Adderall Addictive?

While Adderall is an effective treatment for conditions like ADHD and narcolepsy, its potential for addiction cannot be overlooked. Misuse—such as taking the medication without a prescription or in higher doses than prescribed—can lead to dependency, as it interacts with the brain’s reward system. Recognizing the signs of addiction is crucial for addressing the issue early. These signs often include:

• Increased Tolerance: Needing higher doses of Adderall to achieve the same effects.
• Obsessive Focus on the Drug: Thinking about when and how to obtain or use Adderall, even at the expense of responsibilities or relationships.
• Using Without a Prescription: Taking Adderall recreationally or without medical supervision.
• Physical Symptoms: Restlessness, insomnia, rapid weight loss, headaches, or irregular heartbeat.
• Behavioral Changes: Becoming secretive, isolating from loved ones, or engaging in risky behaviors.
• Emotional Symptoms: Increased irritability, anxiety, or mood swings when not using the drug.
• Neglect of Responsibilities: Struggling to meet work, school, or personal obligations due to Adderall use.
• Withdrawal Symptoms: Fatigue, depression, or intense cravings when stopping use.

Adderall Abuse

A person may misuse Adderall in any of the following ways:

·      Taking Adderall in different amounts or different frequencies than prescribed by their doctor

·      Taking someone else’s prescription Adderall

·      Taking Adderall for effects other than its intended use, including euphoria.

People misuse Adderall for a variety of reasons. Some seek euphoria from the use, while others may hope for increased energy, improved mental performance, or enhanced athletic performance.

One common group that misuses Adderall is college students. Many believe it can improve academic performance or help them stay awake to study longer. Up to 28.6% of students believe that nonmedical use of Adderall can help them achieve higher grades. However, research shows that students who misuse stimulants often perform worse academically compared to their peers who avoid substance misuse.

According to the 2023 National Survey on Drug Use and Health, 3.9 million people aged 12 and older misused prescription stimulants, such as Adderall, in the past year.  

Adderall is classified as a Schedule II drug under the Controlled Substances Act of the Drug Enforcement Administration, indicating a high potential for misuse and severe physical or psychological dependence.

Effects of Alcohol on ADHD

In an attempt to manage ADHD symptoms, some people may turn to alcohol as another way of medicating uncontrolled symptoms. While alcohol can temporarily increase dopamine levels in the brain—providing short-lived relief—it ultimately reduces dopamine over time. This can worsen ADHD symptoms in the long run and contribute to a cycle of dependency.
This combination can mask the effects of alcohol, leading to overconsumption and a higher likelihood of alcohol poisoning. Additionally, frequent mixing of alcohol and ADHD medications increases the risk of developing alcohol abuse or dependence.

What Happens When You Mix Adderall with Alcohol

Mixing Adderall and alcohol is a form of polysubstance use, which involves taking multiple substances over a short period. This process can be intentional or unintentional, but the risk remains. Interactions between different substances, including prescription drugs, can be unpredictable and more intense than when each is used independently. This unpredictability can lead to potential dangers, including severe health risks.
Adderall is a stimulant, generally speeding up brain and body activity, while alcohol is a depressant that slows down the nervous system. When taken together, the body metabolizes them more slowly, amplifying their effects even at lower doses.
For example, Adderall can delay the sedative effects of alcohol, making a person feel more alert while drinking. This may lead to overconsumption of alcohol, increasing the risk of alcohol poisoning. Additionally, the masking effect—where one substance hides or alters the impact of the other—makes it harder to gauge how much has been consumed. This further raises the likelihood of overdose and other adverse health outcomes.

Dangers of Mixing Adderall and Alcohol

There are many short- and long-term effects of mixing Adderall and alcohol. Some risks of combining alcohol and prescription stimulants include:
·      Heart problems (including elevated heart rate and blood pressure)
·      Dizziness
·      Impaired judgment
·      Liver damage
·      Increased risk of addiction
·      Substance use disorder
·      Overdose
Over time, combining Adderall with alcohol can increase the risk of developing alcohol use disorder or other substance misuse problems. Additionally, the risk of overdose is significantly heightened due to the masking effects of one substance on the other.
If adverse effects or signs of overdose occur, seek medical attention immediately. In life-threatening situations, call 911—acting quickly can save a life.

Sources

Centers for Disease Control. (2024, April). Polysubstance use facts.

Arria, A.M., Geisner, I.M., Cimini, M.D., Kilmer, J.R., Aldeira, K. M., et al. (2017). Perceived academic benefit is associated with nonmedical prescription stimulant use among college students. Addictive Behaviors. 76, 27-33.

Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration..

National Institute on Drug Abuse. (2023, June). What classes of prescription drugs are commonly misused?

 Egan, K.L., Reboussin, B.A., Blocker, J.N., Wolfson, M., Sutfin, E.L. (2013, July 1). Simultaneous use of non-medical ADHD prescription stimulants and alcohol among undergraduate students. Drug and Alcohol Dependence. 131(0), 71-77.

National Institute on Mental Health. (2023). Attention-deficit/hyperactivity disorder.

U.S. Department of Veterans Affairs. (no date). Substance use.