We live in a time when we know the dangers of a highly addictive prescription drug entering into the mainstream. We\u2019ve seen it before with amphetamines in the 1960s. And we see it now with opioid painkillers. With all this wisdom and knowledge, can we prevent it from happening again with Adderall? The real issue is trying to get people to care about the dangers inherent in Adderall use. When performance-enhancing drugs are available, they will attract a sub-population of people who don\u2019t care about the risks. For example, people will abuse steroids regardless of side effects because they get what they want, whether that\u2019s to be more muscular or to boost their athletic performance. There are increasing numbers of people who turn to Adderall, even if they do not have ADHD, in order to enhance attention, motivation and concentration. This drive to enhance performance is similar to the way people try to enhance performance through steroids or erythrocytes or erythropoietin. The problem is that there\u2019s frequently a boomerang effect: The more people see others \u201csucceeding\u201d with Adderall, the more they will want access to the drug, and this creates a larger pool of individuals who will become addicted and move on to higher doses and street drugs. There\u2019s also a question about the ethics of using Adderall for non-medical reasons to get a competitive edge. Is Adderall for the Privileged? A recent documentary by Maria Shriver, Take Your Pills, suggested that privileged kids have access to medically prescribed amphetamines and poor kids have access to methamphetamine. They are chemically similar, but they are two different things. For people who are getting meth on the street, it's not to get better grades in school or perform better at work. Meth simply is not used for trying to achieve more in life. It\u2019s possible that young people of privilege may be more vulnerable to Adderall addiction if they have greater access to the medicine legally, or money to pay for it illegally. They may also have parents who advocate that they be allowed to medicate for tests or study. This means there is one group getting supervision that would maximize the likelihood that they would get the performance benefits of the drug and the other group does not have that opportunity. So that group has an edge on performance enhancement from the drugs. But the real question is: Will having the opportunity to get the drug under controlled circumstances create an epidemic just the way it did with opioid pain pills? It's possible that we're going to see a second wave because pharmaceutical companies, physicians, patients and their parents are treating amphetamines like Adderall as if they have no abuse potential, even though we know they do. The Problem With Performance-Enhancing Drugs One thing that differentiates amphetamines from a lot of other drugs is that there\u2019s clear experimental evidence in animal models and pretty compelling human evidence of long-term, potentially irreversible neuronal changes from chronic, high doses of amphetamines. The question is what do chronic, low-dose amphetamines do if you don\u2019t have ADHD? Research has shown that long-term use in people with ADHD may not be that problematic, but people who do not have that condition may not have the same safety profile. There is a strong genetic component to addiction. So if you\u2019re predisposed and you happen to get a prescription amphetamine like Adderall, you may have a problem. Another issue is that some drug-drug interactions with Adderall could be fatal. Most of the opiate overdose deaths today are caused by a combination of benzodiazepines and opiates. This cannot be ruled out as a problem for Adderall addicts who may take other drugs to be able to sleep or to counteract withdrawal symptoms. It\u2019s possible that Adderall is in breakout mode. Some experts think it isn\u2019t likely because methamphetamine is cheap and readily available. But it is important to factor in this reality: There is already a population of people who have become addicted to Adderall because of medical exposure to these drugs and if we look at the history of prescription drug epidemics, those numbers will grow.