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For most people, medications offer a safe and effective way to relieve Attention Deficit Hyperactivity Disorder (ADHD) symptoms. While they are not a permanent cure for ADHD, medicines may help improve the ability to control impulses, concentrate, follow through with tasks, and plan ahead. A majority of the medications commonly prescribed for ADHD are controlled substances regulated by the law. This means that the drugs used for ADHD treatment have a potential for abuse and could become addictive over time.
Medications for ADHD
There is a wide range of medication, dosage, and schedule alternatives for ADHD medicines. The two most common groups of ADHD medications are:
Stimulant medications
Stimulants are the most commonly prescribed medications for managing ADHD symptoms such as impulsive behavior, hyperactivity, and short attention span. These drugs improve symptoms in 70% to 80% of children and about 70% of adults shortly after starting treatment. Stimulants have a very high potential for abuse when taken by persons without an ADHD diagnosis. Caffeine, methamphetamine, nicotine, and cocaine also fall in the drug category of stimulants. The most frequently prescribed ADHD stimulants are:
Get in touch with a doctor immediately if you notice any of the following symptoms while taking stimulant medication for ADHD:
- Shortness of breath
- Fainting
- Chest pain
- Paranoia
- Hallucinations (seeing or hearing things that aren't real)
Non-stimulant medications
Non-stimulant treatments for ADHD fall into one of three broad categories:
- ADHD-specific medications: These are drugs specifically created for ADHD treatment. The three main non-stimulant medications approved by the FDA are Atomoxetine (Strattera), Guanfacine (Intuniv, Tenex), and Clonidine (Kapvay).
- Blood pressure medications: As some of these have the same active ingredients as ADHD-specific non-stimulants, they can help some people manage ADHD symptoms.
- Antidepressants: Although these are commonly prescribed for depression and other mood disorders, they may also help control ADHD symptoms. Antidepressants work by affecting neurotransmitters in the brain. This can help lower distractibility and improve attention in people with ADHD.
The primary advantage of non-stimulants over stimulants is that they don't pose the same risk of abuse or addiction. They also tend to have longer-lasting and smoother effects as compared to stimulant medications that can wear off abruptly.
What is a controlled substance?
Any drug or chemical substance that is regulated by federal or state laws is a controlled substance. Chemical compounds that can be used to make such a substance are also controlled. Controlled substances are regulated by strict laws regarding who can make a drug, sell it, have it in their possession, and use it.
The Controlled Substances Act (CSA) has been in effect since 1970. It has detailed legislation on the making and distribution of controlled substances. Within the act, drugs and medications are divided into five categories or “schedules” based on their medical use, safety, and potential for abuse.
All stimulant medications for ADHD are classified as 'Schedule II' controlled substances. The Drug Enforcement Administration defines a Schedule II drug as a substance that has “a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
Why are ADHD medications considered controlled substances?
Stimulants prescribed for ADHD increase the activity of neurotransmitters or brain chemicals that reinforce rewarding behaviors. As a result, they make a person feel more awake, energetic, alert, and confident. But this also makes it easy to become dependent on ADHD medications and to develop a substance use disorder (SUD).
When people without ADHD take these stimulants, they may experience a temporary boost that makes them more alert and focused. Because of this, many people take these drugs illegally to try to do better at school or work. The abuse of ADHD medications is increasingly common among adolescents and young adults. If the stimulant medication is crushed and snorted or injected, it can cause a "high" similar to cocaine. This further promotes psychological and physical dependence on stimulant drugs.
People who have become dependent on ADHD medications will experience withdrawal if they stop taking the drugs. The typical withdrawal symptoms of SUD include anxiety, fatigue, depression, nausea, and sleep disruption, including insomnia. Behavioral therapies like cognitive-behavioral therapy and contingency management are currently the leading treatments for prescription stimulant addiction.
The FDA has recently approved some non-stimulant medications for the treatment of ADHD. Since they do not have a potential for abuse, they are not classified as controlled substances. These are newer medications that do not have as much evidence supporting their use as non-stimulants. For this reason, most non-stimulants are currently considered second-line (second-choice) treatments. Atomoxetine (Strattera) is the only non-stimulant in the first-line category, but it has been found to be only about two-thirds as likely to be effective as stimulant medications.
Is it illegal to carry ADHD medications?
No, it is generally not illegal to carry ADHD medications as long as you are able to produce a proper prescription for them. A parent or caretaker of the person who was prescribed the medication is also allowed to carry it with them. Some states require that the medication be carried in the original prescription bottle, with a valid label that identifies the person for whom it is intended. A proof of prescription is usually sufficient in most states.
