Unauthorized use of Adderall concerns health and sports officials

Banned substance acts as 'tremendous jolt of caffeine,' but only approved to treat select illnesses

September 12, 2014|By Andrea K. Walker | The Baltimore Sun

The banned amphetamine that will keep Chris Davis off the baseball diamond for 25 games has become a go-to for stressed college students and worn athletes looking for a quick boost of energy.

Adderall acts like a "tremendous jolt of caffeine" that some have used to fight through fatigue before a big test or make it through a tough game, said Eric Strain, director at the Johns Hopkins Center for Substance Abuse Treatment and Research.

But the drug is not supposed to be used for that and is only approved to treat a few illnesses, including attention-deficit disorder and the sleeping ailment narcolepsy.

The drug's unauthorized use by athletes and others have raised concerns in the last few years among the medical community about the potential health dangers and in the professional sports world about players' attempt to gain an athletic advantage

Major League Baseball banned the use of amphetamines such as Adderall starting with the 2006 season but allowed for special therapeutic use exemptions. After concerns about abuse, baseball tightened the rules so it could ask players to prove their need for the drug.

Davis said he previously had such a exemption, but sources said his most recent request, likely in 2012, was rejected, and he has not applied since.

A record 119 baseball players, or 1 in 10, received exemptions, according to Major League Baseball's annual drug policy report for the 2013 season. Fewer than 1 in 20 adults have attention disorders, and the rate of narcolepsy is estimated at 50 per 100,000 people, according to medical journals.

Davis joins a growing list of athletes in baseball and other sports who have gotten in trouble for Adderall use, including seven disciplined in the 2013 season. Denver Broncos receiver Wes Welker was suspended by the NFL this month for four games after sources said he tested positive for Adderall. Baseball player Miguel Tejada was suspended for the third time in his career this summer for using Adderall — for 105 games.

Adderall is different from other banned drugs, such as steroids, Strain and other doctors said. Steroids are taken for long periods of time before athletes see changes in the body, while the effects of Adderall set in much more quickly.

"Amphetamines aren't going to build muscle mass or anything like that," Strain said. "You aren't going to use it repeatedly over time. They are drugs you will use because you want an effect that is going to happen today because you're sleep-deprived or something like that."

Athletes who take Adderall without a doctor's supervision put themselves at risk for heart attack and stroke, particularly if abusers take more than the recommended dose. There is also the risk of addiction. The long-term consequences on mental health are not known.

"When people go outside of the normal channels, they don't know what they're getting," said Dr. Kathryn Boling, a family medicine doctor at Mercy Medical Center. "They don't know the pharmaceutical grade. They're making their own dosing decision. There's no way to monitor for real risks."

Adderall generally stimulates neurotransmitters such as norepinephrine and dopamine. In the central nervous system, these medications tend to enhance the effects of these neurotransmitters — either by facilitating their release, or prolonging their effects, Strain said.

In those with ADHD, it calms down hyperactivity. For others without ADHD, the drug stimulates attentiveness and wakefulness.

The abuse of Adderall has raised concern among public health officials as it has become more popular.

"One of the consequences in the increased use of Adderall is the increase in the diversion of these drugs from the legal to the illegal market," said Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at John Hopkins Bloomberg School of Public Health. "You see a real increase in the availability of these drugs on the black market."

Baltimore Sun reporter Dan Connolly and Tribune Newspapers contributed to this article.

andrea.walker@baltsun.com

twitter.com/ankwalker

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