The drug Adderall (amphetamine and dextroamphetamine) is composed of two stimulant medications that are typically employed to treat attention deficit hyperactivity disorder (ADHD) and the sleep disorder narcolepsy.
Adderall is available in two forms: Adderall IR, an immediate-release option, or Adderall XR, an extended-release version. The extended-release version permits those with ADHD to take only one dose per day, making it a more suitable choice for children since they don't require multiple doses throughout the day. The medicinal effects of immediate-release versions typically last for 4-6 hours while the extended-release version is advertised as having a duration of more than 12 hours.
Stimulant medication designed to help treat ADHD are very popular substances of use among college students who utilize them to "cram" during exam time to keep them awake and alert. However, misuse of these drugs often is coupled with other drugs, for example, alcohol, other stimulants, and opiate substances. According to the United States Drug Enforcement Administration (DEA) categorizes Adderall as a Schedule II controlled substance, that is, it is a substance that could lead to the development of physical dependence, and could be an extremely addictive drug when not utilized according to the prescribed use as well as under supervision by a physician.
Suboxone (buprenorphine and Naloxone) is a prescription drug that is specifically designed for people with addiction disorders to opiate in safely getting off opioid drugs of use. Buprenorphine is an opioid agonist partial to the degree that connects to the same neurons in the brain that other opioids do, however, it doesn't produce the full opioid effect. It helps individuals discontinue their chosen drug, but without experiencing any withdrawal symptoms.
The DEA classifies buprenorphine as a Schedule III controlled substance, suggesting that it is a moderate risk for abuse and the creation of physical dependence. The naloxone component in Suboxone is intended to serve as an effective way to prevent the abuse of the drug. Naloxone is a complete opioid antagonist, and is frequently used to help individuals recover following an overdose of opioids. When activated, the drug immediately blocks the opioid receptors within the brain, eliminating any opioids already there, and it does not permit any other drug that is opiate to attach to these receptors. Furthermore to that, activation of this drug triggers a rapid withdrawal reaction from people who are taking it. The naloxone contained in Suboxone is not activated unless the substance is used in a way that is not compatible with its intended use that is, for instance, grinding it and trying to inject or snort it.
Using Suboxone and Adderall in Combination
If someone is trying to use Suboxone and Adderall with each other would be able to do so only with the guidance by a physician. This combination of medications is not usually recommended. People who are recovering from an addiction to opiates and who are taking Suboxone are often not prescribed stimulant medication like Adderall to treat ADHD until they are weaned off Suboxone.
It's not apparent that these drugs are often employed together as a drug of abuse; however, some scattered accounts of people who use these two substances in combination do happen. As per the publication Basic & Clinical Pharmacology and the information about the prescriptions associated with these medications, as per the Substance Abuse and Mental Health Services Administration (SAMHSA), there are a variety of issues that can arise when an individual is taking a stimulant medication with Suboxone.
One of the main concerns is the potential to overdose on one or more of the medications as a result of taking two different drugs with distinct mechanisms of action. Buprenorphine while it is a partial opioid agonist, is still a central nervous system depressant effects, and as a stimulant, Adderall results in increased activities of the central nervous system. When taken in combination both drugs will cancel out some effects of one another, and users may not be convinced that they're getting the desired psychoactive effects from each drug. This can lead to the possibility of overdose because the person may take more to feel the effects. The situation would be most difficult for someone who is trying to abuse or misuse both drugs, however, not for someone who has been prescribed both drugs and taking them in the recommended dosages. Since buprenorphine can reduce the effects of stimulants in Adderall so it can be assumed that one is more likely to get overdosed on Adderall than on buprenorphine; but, it is possible to certainly be reversed. Dosing too much on Adderall would result in a range of health issues, among them:
The possibility of paranoia and hallucinations
More aggression and restlessness
The heart rate is increased and so is blood pressure
Potential for stroke or heart attack
The potential for seizures
Suboxone in excess could cause issues such as
Complications resulting from respiratory suppression
Heart rate is decreased and blood pressure
Possibility of unconsciousness or Coma
A powerful stimulant medication using buprenorphine might result in diminution in the level of buprenorphine that is present in an individual's system, or it could block its effects. For those who are taking Suboxone for opioid replacement drug, this may quickly result in the patient experiencing withdrawal symptoms from opiates.
The potential for unpredictable reactions as a result of combining these substances is also an increased risk. This can be particularly problematic for individuals who develop severe reactions that aren't typical, as it could be difficult for medical professionals to identify the cause of the reaction the individual unless they find information on their use of the drug directly from the person who is using it or someone else.
The effects of both medications can change significantly. The result could be atypical reactions that may not resemble the side effects normally experienced with the drugs in isolation.
Common side effects associated with buprenorphine comprise:
Muscle aches and cramps
Insomnia
Constipation, nausea, or vomiting
The feeling of agitation, jitteriness or nervousness
Fever
Common side effects associated with Adderall include:
Increased or irregular heartbeat
Hyperactivity
It is a common occurrence for people to experience mood swings.
Tremors in the extremities
Psychotic behavior
Tics or muscles twitches
Increased blood pressure
Seizures, in rare cases
There is evidence to suggest that using stimulant medication while an individual is taking Suboxone for recovery from an opiate dependence disorder is linked to an increase in the desire for opiate substances. This may result in an individual delaying the purpose of taking Suboxone in the first place. Patients in recovery, particularly in the initial stages of recovery, usually require considerable assistance with cravings for their substance of choice. Any circumstance that can trigger the development of cravings should be avoided.
It is important to remember that a person who is diagnosed with ADHD could be more prone to engage in drug-seeking behaviors when their symptoms aren't treated. Thus, an individual who has ADHD and is receiving treatment for withdrawal from opiates could be prescribed Adderall in addition to Suboxone. In these cases, doctors will likely be monitoring these patients with great care.
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