Dear Dr. Jeff: Sometimes, before a night of drinking, we take some Adderall. It's a prescription medicine that many students take normally every day?so that can't be dangerous, right? C.L.

Dear C.L.: Actually ...

Adderall (amphetamine salts, a stimulant) before alcohol (a depressant) will possibly allow you to party on longer into the night (and presumably drink more) before you fall asleep or pass out from the drinking. I'm not sure, though, that you can do that safely or legally.

Among the short-term adverse physical side effects of Adderall are nausea and vomiting, palpitations, tremors and muscle twitching, dizziness, and headaches. Adverse short-term psychological side effects include paranoia, psychosis, anxiety, and severe depression. If you're taking someone else's Adderall, the dose may not be right for you. Those for whom Adderall is properly prescribed are monitored very carefully for the first few weeks.

If you're snorting Adderall, you will be at higher risk for untoward side effects. The potency and the speed of the onset of Adderall are both greatly increased when it's snorted rather than ingested and digested. The risk of dangerous respiratory problems, cardiac arrhythmias, and paranoid or psychotic reactions are all significantly greater.

Adderall, like the other stimulants used to treat ADD, does not have these "speed"-like effects on people with ADD. But like the other "controlled substances" on the Schedule II Drug list, Adderall does have a high propensity for misuse, abuse, and dependence. That's precisely why its prescription is controlled.

Taking someone else's prescription medication is never advisable. Taking someone else's Schedule II prescription medication is unsafe and illegal. Taking it for recreational purposes is doubly unsafe and very illegal. If caught, you can be arrested and charged with possession of illegal drugs. What might begin as a security or police officer stopping you for "just" drinking could end with your arrest on possession charges if you're asked to empty your pockets, or if you're detained and searched, and you have someone else's Adderall.

Using one medication or substance to offset the side effects of another is not a good idea. It's something health care providers avoid unless there are compelling medical reasons (like nausea from chemotherapy).

If you're looking for a way to party longer, C.L., mixing Adderall with alcohol is not the way to go. It's better to pace yourself, or drink slower, or alternate water or juice between drinks, or eat some food before and while drinking. Or better still, drink at a safe rate?one drink per hour?and up to a safe point, no more than four or five per night.

And finally, consider this: using Adderall to fight off the depressant effects of alcohol does not eliminate those effects, only masks them.

Your blood alcohol will still rise at the same rate and to the same levels whether you're "pre-medicated" or not, and very importantly, any and all toxic effects of the alcohol will still occur at the same rate. You just may not notice them as quickly or clearly. That, C.L., may be especially dangerous. Falling asleep or passing out from drinking may be your body's only way to stop you from drinking more and getting yourself into really deep trouble.

Be well!

Jeff Benson, MD

Dudley Coe Health Center