Teen drug abuse – most notably of alcohol and opioids – has declined considerably over the past decade. But this is not true for amphetamines, now the second most commonly abused drug among high school seniors after marijuana.

As many as one in 10 teens may be abusing amphetamines like Adderall, the stimulant commonly prescribed to treat Attention Deficit/Hyperactivity Disorder (ADHD), according to a New York University study published last fall in the Journal of Drug and Alcohol Dependence. NYU researchers found that a major national survey reporting amphetamine abuse by nearly 8 percent of high school seniors may have been significantly underestimating the problem. A third of the teens they interviewed weren’t admitting to amphetamine abuse because they didn’t realize that Adderall is an amphetamine.

The problem is that Adderall and other prescription stimulants like it are so readily available and so widely prescribed, young people tend to think of them as harmless. Nearly every child has a classmate or sibling who has been prescribed an amphetamine for ADHD – an estimated 5 to 10 percent of young people. They see friends using the drug – with the blessings of doctors, teachers and parents – to do better in school or on the athletic field, and see no danger in using the drug to achieve the same apparent benefit. They consider it a “study drug,” a drug meant to enhance their performance.

As a pediatrician, this scares me because these drugs are not always harmless. Serious potential side effects include sleep disorders, seizures, depression, weight loss, psychosis, heart attacks and stroke. Amphetamines (like their illicit cousin methamphetamine) carry a high risk of addiction, both physical and psychological, and we know there is a correlation between amphetamine abuse and abuse of other drugs. There is a reason these drugs are classified as a controlled substance and require a written or specially coded digital prescription.

My young patients tell me Adderall is incredibly easy to obtain – from the medicine cabinets of family and friends, from their peers at school and from online strangers. If they can’t get it for free, they can often buy it for just a few dollars per pill.

Many teens see nothing wrong with using these drugs to stay up and study or to better focus on a test. Some are even using them to improve their athletic performance, which is especially dangerous because of the cardiovascular impact: narrowed blood vessels, increased blood pressure, dangerously high body temperature and irregular or rapid heart rate. And, of course, participating in sports already places a considerable burden on the cardiovascular system.

Some kids who abuse amphetamines just like the high. Many young people grind up pills and snort them like cocaine.

As with any drug, the more you use an amphetamine, the more you may need to take to achieve the same results. Young people who have been heavily abusing amphetamines often have a miserable time stopping: They may crash, binge eat, sweat, tremble, cry and rage. And if young people – who are under a lot of pressure to perform – believe they can’t function in their lives without misusing a drug, that is a psychological dependence that should cause grave concern.

What to Look For

How do you know if your child is abusing Adderall or another stimulant? Though signs of amphetamine abuse are similar to indicators of other issues, including mood disorders like depression, these are a few things you might notice:

• Insomnia and other sleep irregularities

• Anger and other aggressive outbursts

• Paranoia and/or anxiety attacks

• Loss of appetite

• Sudden weight loss

• Shortness of breath

If someone in your household is using Adderall or another stimulant for ADHD, there are some practical things you can do to prevent abuse:

• Count pills. Though you want to encourage your teen’s independence, there is so much pressure to share this drug that it is worth monitoring to be sure your child is using it as prescribed.

• Lock your medicine chest. Even if you trust your own child, you don’t want to make your drugs available to his or her visiting friends.

• Set a good example. Don’t use drugs yourself without a prescription or to get high.

• Dispose of unused medication . Many communities have medication take-back programs, or your pharmacy may be able to dispose of them for you. Don’t flush them down the toilet, because they will contaminate the water supply.

The best way to protect your child is to be aware and communicate. Find out what your teen knows, both about drugs they are taking with a prescription and the dangers of taking drugs like Adderall without a prescription. Do research together. Learn and discuss the risks of abusing stimulants and the research that shows they do not improve performance in the long run. The NYU study is just one indication that many young people abuse drugs like Adderall based on what their peers are doing, without any idea of what they’re taking.

If you suspect amphetamine abuse or addiction, you and your child may need to see a behavioral psychologist or another specialist recommended by your pediatrician. The best long-term therapy will help your child develop coping skills to get through life without drugs.

For more information about Adderall abuse among teens, visit the websites of the National Institute on Drug Abuse and the Teen Treatment Center