Contributed by StartYourRecovery.org
Reviewed by Kim Dennis, MD, CEDS
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StartYourRecovery.org (SYR) provides helpful information for people who are dealing with substance use issues — and their family members, friends, and co-workers, too.  SYR knows that there is no one-size-fits-all solution to the challenges faced by those who misuse alcohol, prescription or illegal drugs, or other substances, and they aim to break through the clutter to help people at any stage of recovery.

You may have a friend or family member with ADHD or narcolepsy whose condition is much better thanks to prescription stimulants like Adderall or Ritalin. However, misuse of these medications can lead to dependence and other harmful effects, and people with eating disorders may face even greater risks from so-called “study drugs.”1

If you or a loved one is experiencing an eating disorder and misusing prescription stimulants, know that help is available and treatment works.

What are Prescription Stimulants?

Prescription stimulants are used to manage various conditions, including attention-deficit/hyperactivity disorder (ADHD). When used as prescribed, these stimulants can increase a person’s alertness and energy and sharpen their attention.2,3

Common prescription stimulants include:4,5

  • Adderall.
  • Concerta.
  • Dexedrine.
  • Provigil.
  • Ritalin.
  • Vyvanse.

People misuse these medications by taking them without a prescription, at a higher dose than prescribed, or for reasons other than for what they were prescribed. Stimulant misuse can increase the amount of dopamine in the body, producing euphoric effects. However, it can also increase blood pressure, heart rate, and blood sugar and cause hyperventilation. At high doses, it can cause dangerously elevated body temperature, decreased sleep and appetite, irregular heartbeat, heart failure, and seizures.3,6

For people with a diagnosis of bipolar disorder, stimulants can destabilize mood. Repeated stimulant misuse can cause psychosis, anger, or paranoia. When a dose wears off, you may experience painful withdrawal symptoms and strong cravings. Stopping use can cause temporary uneasiness, depression, suicidal thoughts, mood changes, hunger, strange or bad dreams, tiredness, and disrupted motor skills.7 Most withdrawal symptoms go away in about a week.7

If you have become dependent on prescription stimulants, know that recovery is possible.

Link Between Eating Disorders and Prescription Stimulant Misuse?

Some people experiencing disordered eating may be drawn to Adderall, Ritalin, and other prescription stimulants, which can decrease appetite.8,9 Taking these drugs repeatedly can lead to stimulant dependence or development of a stimulant use disorder.10

Both eating disorders and stimulant use disorder can be serious and even lethal.11,12,13 Substance misuse may lead to an eating disorder, and an eating disorder may also lead to substance misuse. They often occur together and overlap.

Eating disorders and stimulant use disorders share common risk factors, such as:12,14,15,16

  • Anxiety.
  • Depression.
  • Family history of these or other mental illnesses.
  • Low self-esteem or a susceptibility to social pressures.

Help Prevent an Overdose

Have you ever bought or acquired pills somewhere other than a pharmacy? Fake pills may be laced with potentially deadly substances like methamphetamine and fentanyl, which can lead to overdose.17,18,19

Naloxone, known by brand names like Narcan and RiVive, is an over-the-counter medicine that can stop an overdose and save a life.

If you suspect someone is experiencing an overdose:

  • Call 911.
  • Administer naloxone if it’s available.
  • Keep the person awake and on their side until first responders arrive.
  • Administer CPR if the person does not have a pulse.

Find Treatment and Start Your Recovery

Recovery from eating disorders and substance misuse and dependence is a personal journey, and there’s no single solution that works for everyone.19 

Start by finding a trained health care professional to assess your physical and mental health needs. They then can work with you to create a recovery plan.20 Find treatment and support for eating disorders and substance misuse. 

Learn More

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Sources

[1]Baker, J. H., Mitchell, K. S., Neale, M. C., & Kendler, K. S. (2010). Eating disorder symptomatology and substance use disorders: prevalence and shared risk in a population based twin sample. The International journal of eating disorders, 43(7), 648–658. https://doi.org/10.1002/eat.20856

[2] Gregorowski, C., Seedat, S., & Jordaan, G. P. (2013). A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC psychiatry, 13, 289. https://doi.org/10.1186/1471-244X-13-289

[3] National Institute on Drug Abuse. (2023). Prescription stimulants DrugFacts. National Institutes of Health. https://nida.nih.gov/publications/drugfacts/prescription-stimulants

[4] The American Society of Health-System Pharmacists. (2019). Dextroamphetamine: Medlineplus Drug Information. MedlinePlus. https://medlineplus.gov/druginfo/meds/a605027.html and Dextroamphetamine-amphetamine, StatPearls, National Library of Medicine, May 2022

[5] Sharbaf Shoar N, Marwaha R, Molla M. (2023). Dextroamphetamine-Amphetamine. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507808/

[6] Gibbs, E. L., Kass, A. E., Eichen, D. M., Fitzsimmons-Craft, E. E., Trockel, M., & Wilfley, D. E. (2016). Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders. Journal of American college health : J of ACH, 64(4), 300–308. https://doi.org/10.1080/07448481.2016.1138477

[7] Shoptaw, S. J., Kao, U., Heinzerling, K., & Ling, W. (2009). Treatment for amphetamine withdrawal. The Cochrane database of systematic reviews, 2009(2), CD003021. https://doi.org/10.1002/14651858.CD003021.pub2

[8] Jeffers, A., Benotsch, E. G., & Koester, S. (2013). Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors. Appetite, 65, 8–13. https://doi.org/10.1016/j.appet.2013.01.008

[9] Nutley, S. K., Mathews, C. A., & Striley, C. W. (2020). Disordered eating is associated with non-medical use of prescription stimulants among college students. Drug and alcohol dependence, 209, 107907. https://doi.org/10.1016/j.drugalcdep.2020.107907

[10] U.S. Food and Drug Administration. (2020). Public Meeting on Patient-Focused Drug Development for Stimulant Use Disorder. FDA. https://www.fda.gov/media/143403/download 

[11]American Psychiatric Association. (2023). What are eating disorders? Available at: https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

[12] Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9), e10309. https://doi.org/10.7759/cureus.10309

[13] Substance Abuse and Mental Health Services Administration. (2023). Mental health and substance use disorders. SAMHSA. Available at: https://www.samhsa.gov/find-help/disorders

[14] National Center on Addiction and Substance Abuse at Columbia University. (2003). Food for thought: Substance abuse and eating disorders. Commonwealth Fund & National Institute on Drug Abuse. Available at: https://www.ojp.gov/ncjrs/virtual-library/abstracts/food-thought-substance-abuse-and-eating-disorders

[15] Ressler, A. (2008). Insatiable Hungers: Eating Disorders and Substance Abuse. Social Work Today, (8) 4, 30. Available at: https://www.socialworktoday.com/archive/070708p30.shtml

[16] Munn-Chernoff, M. A., Grant, J. D., Agrawal, A., Sartor, C. E., Werner, K. B., Bucholz, K. K., Madden, P. A., Heath, A. C., & Duncan, A. E. (2015). Genetic overlap between alcohol use disorder and bulimic behaviors in European American and African American women. Drug and alcohol dependence, 153, 335–340. https://doi.org/10.1016/j.drugalcdep.2015.05.043

[17]  Department of Justice, & Drug Enforcement Administration. (2021). Counterfeit Pills Fact Sheet. Drug Enforcement Administration. Available at: https://www.dea.gov/sites/default/files/2021-12/DEA-OPCK_FactSheet_December%202021.pdf

[18] U.S. Attorney’s Office. (2022, June 28). West Michigan man sentenced to 23 years in prison for illegally possessing firearms and intending to sell fake adderall pills. Western District of Michigan, United States Department of Justice. https://www.justice.gov/Usao-wdmi/pr/2022_0628_Wilson

[19] Bahji, A., Mazhar, M. N., Hudson, C. C., Nadkarni, P., MacNeil, B. A., & Hawken, E. (2019). Prevalence of substance use disorder comorbidity among individuals with eating disorders: A systematic review and meta-analysis. Psychiatry research, 273, 58–66. https://doi.org/10.1016/j.psychres.2019.01.007

[20] Substance Abuse and Mental Health Services Administration. (2011). Clients With Substance Use and Eating Disorders. SAMHSA Advisory, (10) 1. Available at: https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4617.pdf