It’s well known that many college students use prescriptions stimulants, designed to treat people with attention-deficit hyperactivity disorder (ADHD), as study aids/enhancers, but that begs a question: does using a medication like Adderall increase the chance a person will use cannabis or illicit drugs?
A recent study called “Association Between ADHD Medication, Cannabis, and Nicotine Use, Mental Distress, and Other Psychoactive Substances” explores this question.
In this article, we’ll briefly review the results of the study, which includes data related to the association between Adderall use, cannabis use, and nicotine use with the use of other drugs and various forms of psychological distress.
We’ll start with the data the researchers published on Adderall use.
Adderall: Connection to Psychological Distress, Cannabis Use, and Use of Other Drugs
Here’s the specific question posed by the research team with regards to Adderall:
Was stimulant use – i.e. use of ADHD medication – associated with use of other drugs or psychological distress?
We’ll start by reporting the number of people at risk, to put this question into perspective. We’ll include data on other age groups as well, in order to understand the relative rates of prescription stimulant use and misuse. These figures will help us understand why researchers focused on college-age people.
The 2023 National Survey on Drug Use and Health (2023 NSDUH) reports the following prevalence of prescription stimulant – i.e., Adderall – use and misuse:
Prescription Stimulant Use by Age Group
- 12-17: 7.0%
- 1.8 million
- 18+: 7.0%
- 18.0 million
- 18-25 (peak college age): 10.8%
- 3.8 million
- 26+: 6.4%
- 14.3 million
That’s instructive: one out of every ten people around college age use prescription stimulants, a percentage significantly greater than adjacent age groups.
Now let’s look at prescription stimulant misuse.
Prescription Stimulant Misuse by Age Group
- 12-17: 0.9%
- 230,000
- 18+: 1.4%
- 3.6 million
- 18-25 (peak college age): 3.1%
- 1.1 million
- 26+: 1.2%
- 2.6 million
Again, college age people misuse prescription stimulants at rates significantly greater than adjacent age groups.
Now let’s revisit that research question:
Was stimulant use – i.e. use of the ADHD medication Adderall – associated with use of cannabis, other drugs, or psychological distress?
Here’s what the researchers learned:
- Use of ADHD medication, by prescription or otherwise, increased symptoms of anxiety and depression.
- Unprescribed use of ADHD medication was associated with to higher past-year alcohol and cannabis use
Next, we’ll look at the data the researchers published on cannabis use.
Cannabis: Connection to Use of Other Drugs and/or Psychological Distress
Here’s the specific question posed by the research team with regards to cannabis:
Was cannabis use associated with use of other drugs or psychological distress?
To put this question into perspective, we’ll do the same thing we did with prescription stimulant use/misuse. We’ll report the number of people at risk, and include data on other age groups as well, in order to understand the relative rates of cannabis. This data set will focus on past-month cannabis use, since the researchers observed differences between frequent – i.e. past month – cannabis use and infrequent cannabis use.
This data is also available in the 2023 NSDUH.
Past-Month Cannabis Use by Age Group
- 12-17: 7.2%
- 1.8 million
- 18+: 16.3%
- 42.1 million
- 18-25 (peak college age): 25.2%
- 8.5 million
- 26+: 15.0%
- 33.5 million
Like the data on prescription stimulant use and misuse, this data is helpful. People around college age engage in frequent cannabis use at significantly greater rates than people in the adjacent age groups. With regards to the research question, here’s what the research team learned:
- Infrequent cannabis usage showed was not associated with psychological distress
- Frequent cannabis usage was associated with psychological distress
Our final set of data for this article is on nicotine use, which we’ll examine now.
Nicotine: Connection to Use of Other Drugs and/or Psychological Distress
For nicotine, the research team formulated this research question:
Was nicotine use associated with use of other drugs or psychological distress?
We’ll follow the pattern we established above. First, we’ll share data on the prevalence of nicotine use for college-age people and the adjacent age groups, then share the results from the study. Like the datasets above, we retrieved this data from the 2023 NSDUH.
Past-Month Tobacco/Nicotine Use by Age Group
- 12-17: 7.4%
- 1. 9 million
- 18+: 24.3%
- 62.4 million
- 18-25 (peak college age): 30.0%
- 10.2 million
- 26+: 23.4%
- 61.5 million
There’s an element of Groundhog Day to this prevalence data. Like the two sets of prevalence of data above, people around college age show significantly greater rates of use than the adjacent age groups. In answer to the research question, here’s what the team learned:
- Infrequent nicotine use showed was not associated with psychological distress
- Frequent nicotine use was associated with psychological distress
- Frequent nicotine use was associated with the use of cocaine, cannabis, LSD, pain relievers, sedatives, psilocybin mushrooms, MDMA, and inhalants.
We’ll discuss all these results below.
Study Drugs (Adderall), Psychological Distress, Cannabis, and Illicit Drugs
In previous generations, parents sending kids off to college worried primarily about excessive alcohol use. Fears revolved around living a party lifestyle rather than focusing on grades. In some cases, parents worried alcohol use might lead to marijuana (cannabis) use, or escalation to drugs typically considered more dangerous than cannabis, such as psychedelics, cocaine, and other drugs such as sedatives.
Now, a new problem exists: instead of using a drug to party, students use a drug – in this case, the ADHD medication Adderall – to get better grades and be better students.
In an effort to get ahead, and for some, in an effort to please their parents, the data in the study show that students who use Adderall, with or without a prescription, increase risk of developing symptoms of depression and anxiety. In addition, data shows use of Adderall with or without a prescription increases rates of alcohol and cannabis use. But that’s not all. Here’s a summary of the results, in the words of the research team:
“These findings suggest that cannabis, nicotine, and ADHD drug use may be related to increased mental distress and also increased substance [mis]use.”
Many people – teenagers, young adults, and parents alike – consider cannabis, nicotine, and ADHD medication to be relatively benign, when thinking about them in relation to mental health and addiction. Everyone knows about the serious health risks associated with nicotine use, and most people understand that while cannabis use is almost normalized, it’s not without risk. However, most people don’t connect ADHD medication with symptoms of depression and anxiety, or associate use of ADHD medication with increased alcohol or cannabis use.
Yet that’s exactly what this study shows. Therefore, based on this research, we can warn parents, college students, and college-age young adults that using Adderall, with or without a prescription, is associated with decreased quality of mental health, and increased use of substances which, themselves, can lead to disordered use, and have a negative impact on overall health and wellbeing.
