Stimulant Use in ADHD vs. Non-ADHD: A Clinical Psychology Analysis

This essay provides a comparative analysis of stimulant use, specifically Adderall and Lisdexamfetamine (LDX), in individuals diagnosed with ADHD versus those without the condition. It explores the benefits of prescribed stimulants in managing ADHD symptoms, such as improved concentration and academic performance, while also addressing potential risks like cardiovascular complications, especially in older adults. The essay further examines the non-prescription use of stimulants, highlighting the higher prevalence among both ADHD and non-ADHD individuals and the associated risks, including neuronal complications and hospital admissions. It emphasizes the importance of controlled medical supervision and appropriate dosage regulation when using stimulants for ADHD treatment, while also acknowledging the potential for substance abuse and mental health issues with unregulated stimulant use. The essay concludes that while stimulants can be effective in managing ADHD, careful monitoring and responsible usage are crucial to minimize potential harm.

Running head: CLINICAL PSYCHOLOGY
Clinical Psychology
Name of the Student
Name of the University
Author Note

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Stimulant Use (E.G., Adderall; Lis/Dexamfetamine) As Prescribed By A Doctor Among
People With Adhd Vs. Stimulant Use Without A Prescription By People Without Adhd
(E.G., As A Study Aid Or Drug Of Abuse)
Introduction
Stimulants are pharmacological drugs that help to uplift the activity of the central
nervous system. The main category of stimulants includes caffeine, nicotine, illegal drugs,
over-the-counter decongestants and other prescription medication. The common use of
prescription stimulants is treatment of attention deficit hyperactivity disorders (ADHD)
(Canadian Centre on Substance Abuse, 2019). Prescription stimulants are mainly taken in the
form of pill for medical uses. However, some people tamper with this stimulant pills in order
to obtain euphoric effects. This kind of tampering leads to generation of several
complications like infection at the site of infection, blockage of the small blood vessels and
rapid onset of the blood pressure and heart rate (Canadian Centre on Substance Abuse, 2019).
The following essay aims to analyze pros and cons behind the use of the doctors prescribed
stimulants (adderall; Lis/Dexamfetmine) among the people with ADHD and stimulants used
without doctor’s prescription by people who have no known cases of ADHD or people who
use stimulants in the form of drug abuse. The essay thus helps to highlight the harmful or the
toxic effect of stimulants among diseased person or individuals who use it as substance abuse
along with beneficial effects of stimulants in treating ADHD.
Discussion
Positive Effects of Adderall
In the domain of stimulants use for treating ADHD, methylphenidate is current
regarded as most widely used medication. Numerous studies have used methylphenidate as

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an active comparator medication in order to evaluate the efficacy of newly discovered
stimulant, Adderall. The studies highlighted that Adderall is superior to placebo and thus
suggest that it is as effective as standard-release form of methylphenidate. It also has a longer
course of action. In order to test the efficacy of the physicians’ prescribed Adderall among
the children with ADHD, Narine, Sarwar and Rais (2013) conducted a meta-analysis. The
meta-analysis of available research highlighted that Adderall has a small but statistically
significant advantage over standard-release form of mthylphenidate. Thus the authors
concluded that Adderal can be effectively used for the treatment of ADHD among the
children. However, in order to gain a promising outcome and reduction in the side-effects,
fixed-dose and best-dose designs must be done under the consideration of the healthcare
physicians. The systematic review conducted by Chan, Fogler and Hammerness (2016),
highlighted that the use of the Adderall is useful in reducing the severity of ADHD among the
children. Adderall,, the slow release medication helps to bring change in the neurological
function and thereby reflecting a negative score on ADH Rating scale. The meta-analysis
conducted by Coughlin et al. (2015) stated that psychostimulants used for the treatment of
ADHD is effective in improving the health-related quality of life of the children by
generating significant reduction in the anxiety development.
Positive effects of Lis/Dexamfetamine
Kollins et al. (2014) conducted a pilot study in order to test the efficacy of the
Lis/Dexamfetamine (LDX) towards the treatment of the ADHD among the adults. The
analysis of the results highlighted that LDX helps in the promotion of the significant
reduction in the self-reported and clinicians-rated ADHD symptoms. Moreover, LDX was
also well tolerated among the chain smokers of ADHD who is attempting to quit smoking.
LDX also demonstrated in reducing the tendency of smoking habits among the adults with
ADHD. Getahun et al. (2013) are of the opinion the decreasing in the tendency of smoking is

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effective in reducing the severity of the ADHD among the adults in reducing the negative
impact on the nerve impulses upon smoking of tobacco.
However, Chan, Fogler and Hammerness (2016) stated in effective outcome is
achieved when stimulants or pharmacological treatments and given along with non-
pharmacological treatments for the treatment of the ADHD. Common non-pharmacological
treatments used include behavioural contingency management, motivational enhancement
and other social skill training techniques.
Cons of using stimulants under the doctor’s prescriptions
There is always a concern regarding the use of stimulant medications for ADHD
during childhood has adverse effect in promoting vulnerability of development of ASU
(adolescent substance use). The controlled longitudinal studies conducted by Groenman et al.
(2013) and naturalistic clinic-based studies conducted by Steinhausen and Bisgaard (2014)
highlighted that ADHD medication helps to prevent ASU. However, meta-analysis of
longitudinal studies highlighted that the use of medication neither increases nor decreases the
risk of developing ASU (Humphreys, Eng & Lee, 2013). The majority of the experts
underscore the lack of consistent evidence behind the effect of long-term medication and its
role in improving the ADHD related problems that mainly direct towards the predisposition
of the AUS like social maladjustment and school under-performance (Molina & Pelham,
2014). While the others alert that the longitudinal studies still not comprehensively accounted
for important modulating factors of the disease development. These factors include age of the
first consumption of the medication, the level of compliance of medication and severity of
duration of ADHD along with the presence of psychiatric co-morbidities. Thus Hogue, Evans
& Levin (2017) concluded from their review that medications like stimulants for the
treatment of ADHD is safe and do not leads to an increase in the likelihood of developing

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substance misuse. However, whether the use of the stimulants during early childhood for
ADHD is helpful in preventing ASD is still not clear.
Cardiomyopathy is associated with stimulant abuse however, cardiomyopathy rates
under the therapeutic administration of stimulants for ADHD is being studied poorly.
Mosholder et al. (2018) conducted a descriptive study in order to study the occurrence of
heart failure and cardiomyopathy after the initiation of the medication for the treatment of the
Attention-Deficit/Hyperactivity disorder. The analysis of the results highlighted that heart
failure or the rate of cardiomyopathy is not associated with use of stimulants for the treatment
of ADHD for tenure of 3 years in comparison to the short-term use of the stimulants. Among
the older adults, the higher rates of cardiomyopathy are observed immediately after the
initiation of the medication (Mosholder et al., 2018).
Non-prescribed use of stimulants in individuals with or without ADHD
Egan et al. (2013) stated that undergraduate students who has untreated or
undertreated ADHD symptoms at times develop academic motives for the misue of the
stimulants. Benson et al. (2018) conducted a study in order to evaluate the relationship
between the ADHD symptoms for controlling the comorbid oppositional defiant disorder
(ODD), to misuse and to explore how these symptoms are associated with the motives to
indulging in misuse. Analysis of the 900 students from public university highlighted that rate
of prevalence of misuse of the stimulant is around 20%. The participants who satisfied the
criteria of ADHs are 2.90 times are more likely to indulge under the misuse the stimulants
than those who are not suffering from ADHD. Among the percentage of the mis-users who
satisfied the criteria of ADHD are more likely to indulge in the mis-use of the stimulants due
to academic motives. The results further highlighted that the misuse of the stimulants is
mainly driven by the lack of adequate or absence of care for the executive functioning of the

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impairments related to ADHD. Thus Benson et al. (2018) recommended a greater focus can
be given to the assessment and treatment of students with symptoms of ADHD.
The similar study conducted by Egan et al. (2013) among the 4090 students in the
North Carolina universities in fall 2009. The survey based study aimed to determine the
prevalence of the simultaneous use of alcohol and non-medical prescription stimulant
(NMPS) use and to determine the consequences of simultaneous NMPS use and alcohol
abuse among the undergraduate students. The analysis of the survey results highlighted that
the simultaneous use of NMPS along with alcohol is mainly high among the NMPS users.
Moreover, the NMPS usage among the undergraduate college students increases a sense of
the negative emotions within them. This spurge of the negative emotions provokes them to
indulge under further intoxication leading to the development of the alcohol abuse. Increased
consumption of the alcohol along with the use of NMPS might lead to the development of
visual hallucinations, headache, insomnia and other nervous problem. In relation to this,
Sweeney et al. (2013) conducted a cross-sectional population based survey among the U.S
civilians aged 12 years and above in order to analyze illicit drug use initiation patterns, illicit
use of the prescription drugs and lifetime use of the NMPS. The analysis of the results
suggested that non-medical use of the prescription ADHD stimulants is not the sole initiating
factor leading towards the development of the illicit drug abuse. However, the analysis of the
results of this population based study showed that non-medical use of the prescription ADHD
stimulants is mainly adopted by the individuals who are already engaged in the alcohol abuse
or drug misuse (Sweeney et al. 2013). The tendency of the use of the stimulants for the non
ADHD is high when they suffer from the academic stress of their mental depression. Prolong
use of the stimulants under unregulated dosage lead to the development of the mental health
complications along with the malfunction in the central nervous system. In case of the
individuals who are suffering from ADHD, the non-prescribed use of the stimulants might to

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lead to harmful outcome immediately however, during the course of time, unregulated
consumption of the dosage of ADHD leads to the development of further mental health
disequilibrium (Deluca et al., 2012).
Narine, Sarwar & Rais (2013) stated that over-dosage of “study drugs” Adderall are
no less susceptible to the dangers. During 2014 nearly 11.7 million Americans were reported
of consuming Adderall for non-medical use during some time in life. There were than 4.8
million adults (18 to 25 years) who were reported to use Adderall under non-prescription
mode. This number might grow in future depending upon the increase in the study stress. The
overuse or unregulated use of Adderall is a serious concern as it might lead to dangerous
healthcare concerns. The overuse or non-prescription use of amphetamine drugs like Adderall
or methamphetamine leads to unwanted hospital visits. The main side-effects or the
symptoms of the Adderall and LDX abuse include rapid heart rate, uncontrollable shaking,
hallucinations, disorientation, depression, blurry vision, panic attack, anxiety and aggression.
In some cases it might also lead to stomach upset, diarrhoea, fatigue, fainting seizures and
muscle weakness. However, symptoms might vary from person to person depending upon the
rate of overdose, the tenure for which the drug is used along with age, gender and body mass
(Mooney et al., 2015).
Conclusion
Thus from the above discussion, it can be concluded that, Adderall and LDX are
effective reducing severity of the ADHD by increasing the level of concentration of the
students and thereby helping to improve the level of the academic performance among them.
However, long-term use of this medication or uncontrolled usage of the medication might
lead to the development of cardio complications. Such conditions are mainly prevalent
among the older adults. The essay also highlighted that non-prescription usage of the

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stimulants are higher both among the individuals with or without ADHD. The initial
outcomes of the non prescription usage of the stimulants among ADHD patients are not
severe. However, prolong usage of the medication leads to the development of the several
neuronal complications. Among the non ADHD individuals, the usage of the stimulants in the
absence of the doctors’ advice leads to unwanted hospital admission. The essay also
highlighted that the usage of the stimulants for the treatment of the ADHD must be done
under the controlled supervision f the doctor along with dosage regulation based on age,
gender and weight. The physicians also proposed the importance of the usage of the both
pharmacological and non-pharmacological interventions in order to gain effective outcome
while reducing the severity of the developing the side-effects from the pharmacological
interventions.

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