Adderall Treats ADHD But Can Lead to Addiction. One Clinic Tries to Help OC Kick 'College Crack'
Who’s Your Addy?
Adderall has been hailed as a ‘miracle drug’ for ADHD sufferers. But they’re not the ones using it
Morgan Richardson’s pickup zips along a dark, lonelystretch of highway. His mind is not on the thick, acrid smoke from San Diego’s apocalyptic wildfires that have accompanied him on this late-night ride, but the past.
Twenty-two years earlier, the then-fidgety, withdrawn and disruptive sixth grader was diagnosed with what was then a barely heard-of medical condition: attention-deficit hyperactivity disorder, or ADHD. The family physician eventually prescribed the boy Adderall, a powerful psychostimulant that seemed to make everything better.
With his speedometer hitting 85 mph as he races along Highway 8 in remote northeastern San Diego County, everything is not better. Richardson is out of his mind, high on methamphetamine. He chose this road because it is far from everyone he loves. As tears stream down his face, he folds up his left leg, wedging it under his steering wheel. His hands now free, he grabs a sawed-off shotgun from the bench seat. Twinkling lights from an Indian casino seem to dance on his pickup’s shiny hood as he pushes the muzzle against his temple. He takes one last glance at his reflection in the rearview mirror. He shuts his eyes. He pulls the trigger.
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“The round did not go off,” Richardson explains now, five years later. He took that as a sign.
“I had a spiritual awakening. A lot of addicts will tell you this has happened at certain points in their lives. I had that moment. I thought about how the place I had decided to take my life, I didn’t have my life taken. I realized I had to so something.”
A ruggedly handsome 37-year-old, Richardson calmly relates his harrowing tale from a counseling office at SouthCoast Recovery. The San Juan Capistrano drug-treatment facility has helped meth addicts for years, but SouthCoast recently launched what is believed to be the county’s first program solely dedicated to kicking the first amphetamine that Richardson ever tried: Adderall.
“We just see it a lot,” says SouthCoast Recovery’s Tom Petersen. “It’s so entrenched.”
Adderall thus joins Oxycontin, Vicodin and many more prescription drugs that SouthCoast counselors deal with—in addition to traditional street drugs such as cocaine, heroin and meth. Down economy? The recovery business is booming.
“I don’t know if it’s an epidemic or if we are just paying more attention to it,” SouthCoast Executive Director Dennis Larkin says. “The kids have switched to things that are in mom’s medicine cabinet. They found out pharmaceutical medications work better than street-grade drugs. They have cocktail parties with medications everyone brings from their homes. They discovered Adderall is a cool one, it works. So then they don’t add it to the cocktail; they keep it for themselves. A lot of parents don’t know the Adderall is missing.”
* * *
Before Richardson was diagnosed withADHD and schools knew how to assist the learning disabled, young Morgan was consigned to classes for the physically handicapped, isolating and embarrassing him. He grew to hate school and started ditching class and gravitating toward misfits. And he could never seem to grasp why doing things like picking up a BB gun and shooting out all windows in his neighborhood was a big deal.
Knowing he had a medical condition made it easier to cope, and the drugs made it easier to learn.
Today, ADHD is the most commonly diagnosed affliction in American children. The National Institute of Mental Health says about 2 million schoolchildren, or 3 percent to 7 percent of them, have ADHD. More kids than ever before are legally ingesting methylphenidate (Ritalin and Concerta) and dextroamphetamine (Dexedrine and Adderall).
Those who suffer from ADHD are more likely than others to have their attention sidetracked by the sights, sounds and smells around them. While a classmate can block everything else out to concentrate solely on the lesson the teacher is writing on the chalkboard, the ADHD sufferer’s brain is bombarded by the sound of footsteps in the hall, the sight of a bird perched on the windowsill, even the smell of the sandwich in Joey Flanagan’s backpack.
Small doses of Adderall slow down the racing minds of ADHD sufferers so they can focus. (See “This Is Your Brain on Adderall.”) Studies show that after an initial dose, students can better solve math problems and keep up with classroom studies.
“Ritalin and Adderall are my first memories of prescription drugs,” Richardson says. “They really took hold. The first prescription worked very well. It straightened me out. I was teachable, more manageable.”
But such drugs are not without their risks. The Journal of the American Board of Family Medicine has reported the induction of schizophrenic-like states in children on prescribed doses of Adderall.
Dextroamphetamines increase blood pressure and heart rate, constrict blood vessels and increase blood glucose. High doses may result in dangerously high body temperature and irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures.
Long-term effects can include stunted growth, psychotic episodes, heart complications, fatigue, depression, sleeplessness and addiction. Critics charge it will eventually deplete your creativity; published research shows Adderall increases horniness and impotence at the same time.
The U.S. Food and Drug Administration attaches this “black box warning”—the government’s strongest measure short of banning a drug—to Adderall and extended-release Adderall XR: “Amphetamines have a high potential for abuse. Administration of amphetamines for prolonged periods of time may lead to drug dependence and must be avoided. . . . Misuse of amphetamine may cause sudden death and serious cardiovascular adverse events.”
The FDA only issued that warning after the drug’s maker, Shire Pharmaceuticals Group PLC, issued a statement in early 2005 acknowledging that 20 sudden deaths and a dozen strokes had been suffered by patients taking Adderall XR. Children were the victims of 14 of the deaths and two of the strokes; the adverse reactions were not associated with overdoses, misuse or abuse. The Canadian government immediately yanked the drug off shelves, but the FDA investigated and concluded that most of the deceased had pre-existing heart conditions. The Canadians then lifted their Adderall XR ban.
The American medical community is split over whether ADHD is under- or overdiagnosed and, therefore, whether its treatments are under- or overprescribed. A Walnut Creek physician says the case was made at a medical conference he attended a few years ago that the condition is both under- and overdiagnosed, the implication being that too few ADHD drugs are getting to poor kids and too many are going to the wealthy.
Many mental-health professionals say the wrong doctors are writing the prescriptions in the first place. A diagnosis should come not from the family physician, they believe, but psychologists or psychiatrists who have properly evaluated whether the child has an attention disorder, a learning disability, a mental-health issue or something else. Or nothing at all.
Jack M. Gorman, professor of psychiatry at Columbia University and director of the New York State Psychiatric Institute, writes in 2007’s The Essential Guide to Psychiatric Drugs that prescribing Adderall XR as a front-line drug to treat ADHD in children and young adults, “is, in my opinion, a very serious mistake.” He calls Adderall “a very powerful drug that undoubtedly works for ADHD, but there are alternatives with less abuse potential that should be tried first.”
* * *
There is little stigma attached to taking Addys in a country that consumes 80 percent of the world’s stimulants. Adderall is indeed popping up everywhere, even pop culture.
When Tom Cruise went apeshit on NBC’s Today show in June 2005, Adderall was among the medications he complained children were being prescribed without parents fully being told of their harmful effects. “Do you know what Adderall is?” he barked all wild-eyed to a defensive Matt Lauer.
Adderall was onboard when Al Gore III, the then-24-year-old son of the vice president-turned-Nobel laureate, was pulled over for driving 100 mph on Interstate 5 in Laguna Niguel on July 4, 2007.
After an April 10 New York Daily News gossip column ended with this blind item—“Which show keeps its dim-witted if ultra-popular ‘reality’ stars peppy with Adderall supplied by a producer in handfuls between scenes?”—bloggers outed the show as MTV’s The Hills, which follows the exploits of Lauren Conrad after she left Laguna Beach: The Real Orange County.
IMS Health, which conducts health-care-market research, found that of the 11 million prescriptions written for amphetamine products in the U.S. in 2004, 7 million were for Adderall. Sales of the medication soared 3,100 percent in America between 2002 and 2005.
Adderall and two other ADHD medications owned by Shire Pharmaceuticals combined for more than $336 million in sales for the quarter that ended June 30. Shire’s other ADHD medications are Daytrana and Vyvanse, which the Basingstoke, England-based company is pushing hard because its Adderall patent expires in 2009, at which point a generic version will come out and cause sales of the original to plummet. But Adderall, Vyvanse and Daytrana are “on their way to blockbuster status this year,” according to popular market researcher the Motley Fool.
Too many prescription meds are reaching abusers, however. Sales of drugs without prescriptions from Internet pharmacies, which are generally headquartered outside the U.S., have reached alarming proportions, according to separate reports various public and private drug watchdogs have released in the past year. The Drug Enforcement Administration (DEA) has also tracked a huge jump in medications bound for pharmacies being stolen off delivery trucks.
Of course, it’s much easier to simply get them from family and friends, which is how 59 percent of Americans who report abusing prescription drugs say they acquired them, according to the 2006 National Survey on Drug Use and Health, the largest substance-abuse survey in the country.
Many young abusers who wind up at SouthCoast Recovery get Adderall through “doctor shopping,” according to Larkin.
“Kids are sophisticated; they’ll go to their family doctor and cite the symptoms of ADHD,” he says. “The doctor will suggest they try Adderall. If you try that with a few doctors, you’ve got a pretty good thing going.”
The nonprofit advocacy group Partnership for a Drug-Free America reports one in 10 teens, or 2.3 million young adults, has used Adderall without a doctor’s prescription. Abuse and addiction often follow them to college campuses, where Adderall is nicknamed “college crack,” “the miracle drug” and “steroids for the brain.”
It’s small wonder why. Students report they can study twice as fast and remember twice as much after cramming on Addy. Use of the drug can mean the difference between an A and a B on a final. And the more elite the university, the more likely you are to find Adderall “drug dens.” The medical journal Addiction reports one in four college students have misused ADHD medications, with abuse rates highest at prestigious Northeastern universities and institutions with the most competitive admissions standards.
MSNBC recently reported that parents are now going to their primary-care physicians to demand Adderall for their children in middle school, not for ADHD, but because they want to improve their grades. With the announcement of a new PSAT test for eighth graders, expect lines out the door at your neighborhood Rite-Aid.
But people are mistaken if they believe Adderall is simply a tool for improving grades. Teen girls desperate for that Gossip Girl look pop Adderalls like Chiclets. The drug’s formula was originally used in Obetrol, which Rexar developed for weight loss. It is also used to treat narcolepsy.
A local college junior who requested anonymity says he and his roomies regularly use Adderall as a study aid, suffer through a major crash when they come down from the drug, and then crush and snort a few more Addys to fuel a night of partying.
In these cash-strapped days, Adderall is cheap, just two or three bucks per pill vs. the $10 apiece Ritalin fetches—and it’s easy to score. Nineteen percent of teenagers find it easier to purchase prescription drugs than beer, cigarettes or marijuana, according to a survey published Aug. 14 by the National Center on Addiction and Substance Abuse at Columbia University. That’s up from 13 percent last year.
There are no hard numbers for Adderall abuse in Orange County. The Adderall brand name and its chemical compound amphetamine and dextroamphetamine do not appear on the DEA’s Office of Diversion Control’s most recent “Drugs and Chemicals of Concern” list. But the ADHD medication is “definitely on our radar,” a DEA official who requested anonymity tells the Weekly. The DEA classifies Adderall a Schedule II drug, which means it has a “high potential for abuse.”
Richardson knows all about that potential. Like many others who initially took small doses of Adderall for ADHD, he remembers experiencing a slight feeling of euphoria that made studying more pleasant. Small doses eventually stopped creating that feeling, so his doctor increased the dosage. When that dosage stopped working, Richardson took more pills than prescribed. He believes the doctor upping the uppers planted the notion in his young mind that it was okay to “self-medicate” to achieve the feeling he desired, his parents welcomed and his teachers demanded.
By seventh grade, he wasn’t getting the euphoric kick from Adderall, so he tried marijuana—but it made him sick. So did PCP. He didn’t like getting drunk. Finally, he found meth, which did the trick. “It made me feel like I had on Adderall,” he says.
But Richardson found himself needing to smoke, shoot or swallow more and more meth to re-create the feeling. He now blames Adderall for turning him into an addict.
* * *
SouthCoast Recovery started in founderLarkin’s garage in 1994, but it has grown so quickly it is overtaking a sprawling, Spanish-style office complex tucked near the back of a nondescript shopping center.
Tom Petersen, who as court liaison helps usher SouthCoast clients through the legal system, led a visitor through an impromptu tour of the treatment center recently. He showed off classrooms, counseling offices, conference rooms, two rooms with acupuncture/massage tables, and crying rooms inside a former bank vault. Every inch of the place is spotless.
SouthCoast also operates eight homes sprinkled throughout Dana Point and San Juan Capistrano, with 66 beds for overnight accommodations. One residence is a state-licensed detoxification facility, just like the treatment center itself. Ironically, four homes were previously occupied by drug dealers.
“We’re no problem to neighbors,” Petersen says. “Police were coming to these houses every four or five days when they were drug-dealer houses. We haven’t heard from anyone who says, ‘You can’t have a rehab there; I want the drug dealers back.’”
The tour winds up in Larkin’s spacious office, which has been decorated for maximum relaxation. So has Larkin, with his casual attire, beads around his neck and slippers parked next to his desk.
As Larkin speaks about his rehab’s radically different approach to treating ADHD, his bare feet are warmed by the staff’s “unconditional-love specialist,” a golden retriever named Kona.
Clients battling ADHD symptoms are not treated with stimulants at SouthCoast, but instead get Chinese herbs, massages, meditation and acupuncture, the belief being that calmness will generate greater concentration.
“If a person is not cognitively able to sit still, why try to make them?” Larkin asks rhetorically. “When you teach meditation, they are able and willing and want to sit still to get peace.”
Grant Collins enters the office midway through Larkin’s explanation and jokes, “Yeah, speed will increase your focus. You’ll be so focused you’ll go look for a contact lens for six hours.”
Collins is not the staff comedian, but an acupuncturist and herbalist. He acknowledges that stimulants do help those suffering from ADHD concentrate, but he believes it is healthier to their bodies to follow the SouthCoast program, which also eliminates food additives and allergens from the addict’s diet. The staff chef prepares meals based on a 5,000-year-old Indian tradition.
Larkin concedes some potential clients fear his program is too religious, spiritual or “New Agey,” but the medically managed detox is state-licensed. And at a July 31 ceremony where he honored Larkin for being among the state’s best treatment leaders, California Association for Alcohol/Drug Educators president Father Frank Kearney said he’s found infractions, from the very minor to the very major, at every facility he’s investigated in the state except one.
“I couldn’t get them on anything,” he said of SouthCoast. “All of their counselors are not only up-to-date and certified, but they also all have the highest levels of accreditation available in the state of California.”
* * *
Petersen leads his visitor to a smallreception office and introduces Richardson, who says that, as a child, he never participated in a psychological evaluation before being prescribed Adderall. This is especially troubling in light of studies that show most adult addicts started using drugs in their teen or tween years. Unwittingly, it seems, the accepted treatment for misbehaving children turned some into misbehaving adult addicts.
“Someone with an addictive personality can be shot down the path to addiction,” says Petersen, himself a former cocaine addict. “When I was in law school, I thought speed was great. But it led me to the next thing to make me feel better: cocaine. Prescription drugs appear so innocuous, so prevalent. But they are a gateway to other drugs.”
Richardson says that by his early high-school years, he was turning to crime to satisfy his unquenchable need for meth. “I had to go to hustling, stealing, lots of different stuff, small stuff at first like surfboards, skateboards and bikes,” he says. “I’d swap those out to dealers in high school for speed. Gradually, as my addiction progressed, I started stealing electronics and burglarizing houses.
“I totally rationalized this. I was feeding a hunger. I was answering a fierce voice. Getting meth, you are very motivated. The motive for me was to feel normal. Nothing could put itself in my way to getting to that.”
When the meth stopped working, Richardson went for that drive with a shotgun riding shotgun.
After the weapon jammed, he picked up the phone and called his “only sober friend.”
The friend met Richardson alongside a pitch-black road and took him home. The next morning, she sat Richardson in front of his home computer with orders to find a treatment center.
Richardson ultimately chose SouthCoast because it was the only local facility he found that banned drug use during detoxification. Many treatment centers, under the strict guidance of physicians, give decreasing doses of an abused drug, or something similar, to ease painful withdrawal symptoms. “It’s harder than jail,” Petersen says of SouthCoast’s drug-free detox.
“I wanted to be made clear in every aspect of my life,” Richardson says. “This was the only treatment center that offered that, plus life skills, personal care, a new way of living.”
Ultimately, he broke his meth addiction.
“The relationship I had with speed was so strong,” he says. “It took a lot of people and a lot of care to stop from finding other habits.”
He no longer wants drugs for anything that ails him, real or imagined. “Medications mask other problems,” Richardson says. “That’s why I picked a program with a holistic center.”
* * *
When an addict phones SouthCoastRecovery for help, he or she is immediately connected with an intake counselor. And if that addict sounds very desperate—as in preparing-to-take-their-own-life-on-a-remote-stretch-of-highway desperate—the intake counselor who usually takes the call is Richardson.
“He’s now our first line of defense,” Petersen says. “He speaks with almost everyone who comes through this facility.”
There is nothing clients can tell Richardson that hasn’t come out of his own mouth, he says. But besides having personal experience to draw upon, he now has a degree in drug-and-alcohol counseling.
To say his life has turned since that frightful night on Highway 8 would be an understatement.
“When I got here, I had no trust, no faith in anyone other than myself,” Richardson says. “I formed a bond with a counselor and learned to trust people. You can get a client sober, but you need to teach them how to live their life again.”
His father is Mormon, but Richardson grew up in his mother’s Catholic Church. Re-establishing his Christian faith became paramount after he got sober. His new life is illustrated with full-color tattoos on his lower right leg. On his shin is a picture of him collapsed in the arms of Jesus Christ. Richardson holds a hammer in one hand and a spike in the other. One side of the same leg has a portrait of Our Lady of Guadalupe, the unofficial patron saint of addicts. Praying hands are depicted on the back of that leg.
“It reminds me of what I am doing here,” he says. “Recovery presented to me a life that is very worth living. It way outweighed a life worth dying.”
Richardson credits SouthCoast with helping him learn to live again, but now he worries other addicts are not getting the message.
“America looks at addiction half-measured,” he says. “No one looks at cancer half-measured. Getting someone [who’s] impaired under control is only half the treatment.
“I see a United States that is in crisis because of these pharmaceutical drugs. I picked a place where they looked at things from the inside out. Once you take away the pills, the problem still exists.”
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