As an emergency medicine physician who sees the side effects of addiction daily, I believe the question of whether stimulants are safe for treating adults with ADHD is a crucial one. The answer to this question is complex and depends on multiple factors.

Whether you are already taking a stimulant to treat ADHD or considering starting a stimulant, it is imperative to discuss all the risks of stimulant use with your mental health provider and primary care professional. I also recommend that you consult any health care specialists that you may be seeing for other conditions, such as a cardiologist. During these discussions, you must be frank about your symptoms and how disruptive they are to your life. It is possible that you may not have ADHD or that your symptoms are not clinically significant enough to warrant treatment with stimulants.

It is essential to know that stimulants work to treat ADHD by affecting naturally occurring brain chemicals, most notably the neurotransmitters dopamine and norepinephrine. Dopamine activates the brain’s reward center, allowing for more extended periods of concentration, while norepinephrine is associated with the “fight-or-flight” response and increases wakefulness. This is the same powerful mechanism that illicit drugs, including cocaine and methamphetamine, use to affect the brain.

The most common stimulant prescribed for Adult ADHD is called Adderall. It is made from mixed amphetamine salts, which are a combination of two forms of amphetamine and two forms of dextroamphetamine. When taken as directed, Adderall is generally considered safe; however, when misused, taken in high doses, or used for a prolonged period, Adderall can have many adverse side effects.

Common side effects of stimulants include increased blood pressure and heart rate, and insomnia. There is growing evidence that long-term use of stimulants can increase the risk of cardiovascular disease, which could lead to a heart attack, stroke, or peripheral vascular disease, which is a slow and progressive disorder of the blood vessels.

On the mental health side, stimulants can cause anxiety, emotional lability, which is a tendency to shift rapidly and dramatically between different emotional states, mania, and even psychosis. Just like opiates, stimulants can be habit-forming, may lead to tolerance and dependence, and can be very addictive. These drugs are becoming increasingly popular drugs of abuse. If you have a history of addiction to other substances, you may be particularly susceptible to Prescription Stimulant Use Disorder (PSUD). With all these potential serious side effects, your doctors must know about all your health conditions and medications if they are considering prescribing a stimulant to treat ADHD.

Finally, while the idea of taking someone else’s prescription of a stimulant or purchasing these stimulants online for self-treatment of ADHD, weight loss, or other uses may be tempting, it is crucial to understand the real and serious risks involved. Online or street purchases may be ineffective ‘sugar pills,’ but even more dangerous, they may be pills that contain fentanyl or other potentially deadly medications.

Bottom line, no medication of the kind described in this article should be taken without a candid conversation with your health care provider and under their direct supervision: your life and your health matter.