Neuroscientist: Meth Is Virtually Identical to Adderall—This Is How I Found Out

Carl Hart
Feb 04 2016

Neuroscientist: Meth Is Virtually Identical to Adderall—This Is How I Found Out

The long subway ride from DC’s airport to Silver Spring was unusually pleasant. It had been about an hour since I had taken a low dose of methamphetamine. It was my 40th birthday—October 30, 2006—and I was headed to a National Institute on Drug Abuse (NIDA)-sponsored meeting.

A friend, who had a prescription for the drug, had given me a couple of pills as a gift, knowing that I was an expert on amphetamines but had never actually taken any myself. I sat on the train feeling alert, mentally stimulated, and euphorically serene.

And when the effects had worn off after a few hours, I thought, “that was nice,” worked out, and enjoyed a productive two-day meeting. Well, maybe not enjoyed—it was a NIDA meeting after all. But I didn’t crave the drug or feel the need to take any more. I certainly didn’t engage in any unusual behaviors—hardly the stereotypical picture of a “meth head.”

So why is it, then, that the general public has such a radically different view of this drug?

Perhaps it has something to do with public “educational” campaigns aimed at discouraging methamphetamine use. These campaigns usually show, in graphically horrifying detail, some poor young person who uses the drug for the first time and then ends up engaging in uncharacteristic acts such as prostitution, stealing from parents, or assaulting strangers for money to buy the drug. At the end of advertisement, emblazoned on the screen, is: “Meth—not even once.” We’ve also seen those infamous “meth mouth” images (extreme tooth decay), wrongly presented as a direct consequence of methamphetamine use.

These types of media campaigns neither prevent nor decrease the use of the drug; nor do they provide any real facts about the effects of meth. They succeed only in perpetuating false assumptions.

Swayed by this messaging, the public remains almost entirely ignorant of the fact that methamphetamine produces nearly identical effects to those produced by the popular ADHD medication d-amphetamine (dextroamphetamine). You probably know it as Adderall®: a combination of amphetamine and d-amphetamine mixed salts.

Yeah, I know. This statement requires some defense.

This is not to suggest that people who are currently prescribed Adderall should discontinue its use for fear of inevitable ruinous addiction, but instead that we should view methamphetamine rather more like we view d-amphetamine. Remember that methamphetamine and d-amphetamine are both FDA-approved medications to treat ADHD. In addition, methamphetamine is approved to treat obesity and d-amphetamine to treat narcolepsy.

In the interest of full disclosure, I too once believed that methamphetamine was far more dangerous than d-amphetamine, despite the fact that the chemical structure of the two drugs is nearly identical (see figure). In the late 1990s, when I was a PhD student, I was told—and I fully believed—that the addition of the methyl group to methamphetamine made it more lipid-soluble (translation: able to enter the brain more rapidly) and therefore more addictive than d-amphetamine.

It wasn’t until several years after graduate school that this belief was shattered by evidence not only from my own research, but also by results from research conducted by other scientists.

In our study, we brought 13 men who regularly used methamphetamine into the lab. We  gave each of them a hit of methamphetamine, of d-amphetamine, or of placebo on separate days under double-blind conditions. We repeated this many times with each person over several days and multiple doses of each drug.

Like d-amphetamine, methamphetamine increased our subjects’ energy and enhanced their ability to focus and concentrate; it also reduced subjective feelings of tiredness and the cognitive disruptions typically brought about by fatigue and/or sleep deprivation. Both drugs increased blood pressure and the rate at which the heart beat. No doubt these are the effects that justify the continued use of d-amphetamine by several nations’ militaries, including our own.

And when offered an opportunity to choose either the drugs or varying amounts of money, our subjects chose to take d-amphetamine on a similar number of occasions as they chose to take methamphetamine. These regular methamphetamine users could not distinguish between the two. (It is possible that the methyl group enhances methamphetamine’s lipid-solubility, but this effect appears to be imperceptible to human consumers.)

It is also true that the effects of smoking methamphetamine are more intense than those of swallowing a pill containing d-amphetamine. But that increased intensity is due to the route of administration, not the drug itself. Smoking d-amphetamine produces nearly identical intense effects as smoking methamphetamine. The same would be true if the drugs were snorted intranasally.

As I left DC and travelled home to New York, I reflected on how I had previously participated in misleading the public by hyping the dangers of methamphetamine. For example, in one of my earlier studies, aimed at documenting the powerfully addictive nature of the drug, I found that when given a choice between taking a small hit of meth (10 mg) or one dollar in cash, methamphetamine users chose the drug about half the time.

For me, in 2001, this suggested that the drug was addictive. But what it really showed was my own ignorance and bias. Because, as I found out in a later study, if I had increased the cash amount to as little as five dollars, the users would have taken the money almost all of the time—even though they knew they would have to wait several weeks until the end of the study before getting the cash.

All of this should serve as a lesson on how media distortions can influence even scientific knowledge about the consequences of drug use.

It took me nearly 20 years and dozens of scientific publications in the area of drug use to recognize my own biases around methamphetamine. I can only hope that you don’t require as much time and scientific activity in order to understand that the Adderall that you or your loved one takes each day is essentially the same drug as meth.

And I hope that this knowledge engenders less judgment of people who use meth, and greater empathy.


Carl L. Hart is a professor (in psychiatry) at Columbia University. He is also the author of the book High Price: A neuroscientist’s journey of self-discovery that challenges everything you know about drugs and society. You can follow him on Twitter: @drcarlhart

  • NIDA is still pushing propaganda that use of drug can quickly turn kids into criminals. I thought your book debunked that trope very effectively. Anyway, I heard that real meth has a more euphoric edge. But hey what do I know, I’m not a real scientist.

  • the wiles

    Good piece. I’d also read that dextroamphetamine+mixed amphetamine salts (adderall or generic equivalent) cause more, or more intense, side effects than dextromethamphetamine. This led some to perceive it as less addictive, hence the preference for Adderall over Desoxyn for AD(H)D. Kind of silly that we avoid the more efficacious drug… For the life of me I can’t figure out why they put those levorotary isomers in there…

  • HiJanx

    If this is a comparison between Desoxyn & Adderall then , eh duh! But you can in no way compare a prescription drug that is made in a lab to a street drug that is made in a motel room. The ingredients are entirely difficult. Meth mouth & the rapid deterioration of the bodies of chronic users of street meth is due to the fact that they are repetitively ingesting toxic, industrial solvents. People who abuse Adderall won’t look that healthy either, but the likelihood of an Adderall addict getting full blown meth mouth is slim to none. However, long term use of amphetamines & other psychotropic medications can cause terrible chronic dry mouth which , in turn, can cause tooth decay that ordinarily wouldn’t happen.

    The high is different between street meth & prescription meth. I know people who have tried to snort/smoke Desoxyn, Dexedrine, Adderall & Ritalin etc & apparently, it was a waste of time in comparison to street meth. The same was true for IV introduction.

    Perhaps I’m misinterpreting this article, but if you give a user of street meth the choice between a hit of street meth or a pill Adderall, they’ll take the street meth each time. Prescription methamphetamines only work for so long in the system whereas street meth can keep you high for a week after 1 or 2 hits.

    • Meth Mouth is not the result of “ingesting toxic solvents” or dry mouth. It is the direct result of poor oral hygiene. This is often due to the life that the user of street drugs lives. Many people experience “cotton mouth” due to medication, but few develop significant dental problems.

      As for “street meth can keep you high for a week after 1 or 2 hits” that is an impossibility due to the half life – and I have done plenty of street meth. Meth that could keep you “high” for a week or two would have a fantastically long half life and would be a scientific breakthrough.

      • HiJanx

        Meth mouth is far different than poor oral hygiene. Just to be clear, it’s caused by a combination of side effects that include chronic clenching/grinding of the teeth, infrequent oral hygiene, consumption of sugary drinks, & due to the caustic nature of the chemicals used to make street meth, it is exceptionally acidic, therefore making it very capable of causing extensive tooth decay & fracture.

        As for taking a hit or 2 & staying awake for a week, I was making a stupid general statement. My mistake! I have met IV meth users who have taken 1-2 hits & have stayed awake for 5 days straight. It depends on your environment as you stated in your other comment above. Snorting & smoking meth can cause a high that can last for up to 6-12 hours while IV use can keep a user high for up to 24hrs. It depends on the quality & the quantity consumed & the physiological make-up of the user.

        • Now, there you go. I much appreciate that you clarified what you suspect are the primary causes of “meth mouth.” I immediately caught your reference to “solvents” in street meth. But your reference to “caustic…chemicals” along with other factors was spot on. The point of using chemicals likely causing some of that damage is as a means to alter the PH, required to pass the meth from a water solution to a solvent (aqueous) solution and back again. My solution would be to decriminalize meth so that a cleaner source could be found.

  • It is really interesting. I use stimulant drugs daily. Pharmaceutical stimulants. And for about a decade I used street methamphetamine. Who I am today and who I was back then are very different people in terms of functionality and productivity*. Why? Well, it has nothing to do with pharmacology or addiction, as many would have us believe. Dr Hart has just shown this. The difference can be boiled down (primarily) to two things: Dose and social construct.

    Firstly, when using street drugs, and when using drugs on the street there are major inconsistencies in dose. I had no idea what dose I was taking on the street, and often my use was based not on effect, but on availability of supply. There are also major differences in setting – there is very good reason to be paranoid when using street meth on the street, bought from street-corner dealers and under the scrutiny of law enforcement. There are very valid reasons why people take more than is needed in the street setting, in the same way that in economies where there is little stability and hope for a future, there is little saving – why keep something for tomorrow?

    Secondly, using street drugs on the street also comes with a set of social constructs that creates a set of expectations around behaviour and reliability and level of participation in a “legitimate” society. These are often reinforced by a set of behaviours that are a result of fluctuating dose. There is also the way the individual creates a “meaning” around the drug – the “meaning’ and experience of scoring a drug from a dealer is very different from getting a script (this is a whole separate book!).

    Pharmaceutical drugs are, on the other hand, the domain of privilege. Stable dose, stable supply and few of the negative social constructs.

    So while pharmacology is identical, the effect is very different. And if you think I am talking rubbish, consider the very strong evidence for the use of diacetylmorphine for people who find heroin use problematic. Known dose, different setting, different construct, and a position of privilege make diacetylmorphine a very different drug to heroin, although they are identical.

    *My own example is a sample of one, and highly biased. I use this for illustrative purposes only.

  • painkills2

    As an allergy sufferer, I can’t tell you how frustrating the restrictions for these drugs are. In November 2015, Walmart refused to sell me a box of Claritin-D because I had reached an alleged yearly limit. I wrote to the DEA, who said there was no annual limit. But to this day, I am unable to buy the cheaper box of allergy medicine at Walmart. I still don’t know why. Well, I know why, it’s because of the drug war — and all I want to do is stop sneezing.

    I wanted to thank you so much, Dr. Hart, for your work on this medical condition. As a 30-year intractable pain patient, I have tried to convince other pain patients that those who suffer from addiction are not the cause of the DEA’s current war on opioids. Pain patients see the drugs they choose for pain management vilified in the media, all because of those who abuse and become addicted to their medications. Anti-drug advocates have proclaimed that opioids are just like heroin. If you take just one pain pill, you’ll become a homeless drug addict. Sound familiar? Yes, opioids are white people’s heroin, but tens of millions of pain patients use them to their benefit. Legal opioids are now being seen as illegal heroin, just like legal stimulants are treated like illegal meth.

    Pain patients are angry and have every right to be. Many of them are accused of being what this society sees as shameful drug addicts. I have taken the time to learn all I can about addiction, but most pain patients just don’t care about a medical condition that others suffer from. They’re being forced into lowering their current dosage of medications, or into cold-turkey detoxes (been there, done that, wouldn’t recommend it). All this to say that I wish an expert like you would address the opioid war and the plight of tens of millions of pain patients. They are scared and losing hope that anyone cares. I’m not worried about the opioid “epidemic” — I’m more concerned about the suicide epidemic.

    Thanks for reading.

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  • Karen Ferguson

    Wow. I read articles all the time and never have I ‘met’ someone so ‘after-the-truth.’ Thank you. Not only did you write it so I could understand it, but I *cringed* thinking “I passed on that info, too.” It’s what we were ‘told’ at the time. I remember I invited a police officer to class to talk on meth. I couldn’t get my arms around it. Drugs, Inc. said it was epidemic.
    Whew…good thing I told him: no embellishment..these students have been hearing about drugs for 10 years. Yet, the “meth and rotten teeth” came out. I know better now. Thank you. You Rock the house down, Dr. Hart!!! Is your sabbatical up yet? 😉

  • December27

    A book by Andrew Weil, *From Chocolate to Morphine: Everything You Need
    to Know About Mind-Altering Drugs*, makes a similar case for a wide
    range of mind-altering substances. As I recall (it’s been maybe 20 years
    since I read it; there is a more recent 2004 update), his argument is
    similar about the false impression created by anti-drug hype, and that
    just like with alcohol, the vast majority of people who experiment with
    drugs–even heroin, cocaine, and other illegal ones–can use them
    recreationally or socially without becoming addicted or dependent.

    I
    think all of these substances should be legal, regulated, and
    quality-controlled just as marijuana is in some places. Adults should be
    able to experiment with our own bodies as we choose as long as we
    don’t harm others. Removing the criminal element, then, will make it
    much easier (and less expensive) to help those few who do have problems.

  • Jeff Zacharias

    As someone who has worked in the addiction field for 12 years – and been in recovery from meth as my drug of choice for 13 years – I think this article compares apples to oranges. It doesn’t take into account a wide variety of individuals who use any of these stimulants through the lens of power/control/oppression/cultural issues/gender issues/etc. For me it seems like the author is trying to be a contrarian and make a case for something that is destroying the lives of the demographic I mainly work with which is gay/bi/queer men around meth usage.

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  • RebelWriter1960

    So, methamphetamine HCL is “virtually” identical to…methamphetamine HCL. Who knew?

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  • rwscid

    Thanks for an informative article. Once again, to my absolute shock, it appears the mass market journalists have been content with writing what sells advertisements, i.e., what titillates the reader, rather than pursuing a comprehensive understanding of an issue, i.e., what bores the reader.

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  • The article says “see figure,” but there is no figure included in the article. Was this an oversight?

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  • Michael McCasland

    I think Dr. Hart is a breakthrough voice on this subject and have a lot of respect for him, but the study he presented, which varied meth, aderol, and a placebo to existing addicts does not address the question he presented: does the addition of a methyl group to methamphetamine make it more addictive than aderol? His research was conducted on people who are already addicted to meth so it is no surprise they liked meth and aderol, a derivative of meth.

    A better study would be to simply normalize (if possible) a comparison of people who use meth and those who use aderol and see if there is a statistically significant difference in addiction rates.

  • Megan Davis

    You need to be clear that you are comparing Adderall to pharmaceutical meth and NOT street meth. Very reckless on your part. Last I checked, Adderall isn’t made of paint thinners and battery acid. Also, you cited a study that had all of 13 subjects. I don’t even need my chemistry degree to see how asinine that is. Come on now!
    Adderall has helped countless people for so many reasons. I would be dead if it weren’t for Adderall, and that’s not an exaggeration. Yes I am fully aware of the abuse, however that doesn’t change the fact that it has been a godsend for so many people that truly do suffer from ADD and ADHD
    Adderall already has a huge stigma and you’re just adding fuel to the fire. Shame on you.

    • Zach

      For real you don’t need a chemistry degree to know that they are completely the same I mean a birch and oak tree are further apart genetically so seriously tell me they are not the same thing