How Cocaine Compares to Adderall: Which Stimulant Is More Dangerous?

When it comes to stimulant drug use, methamphetamine receives a lot of attention. The illicit stimulant drug is responsible for the meth epidemic during the late 20th and 21st centuries. While meth’s dangers should never be downplayed, it is dangerous to minimize the health risks associated with other stimulant drugs, such as cocaine and Adderall. Here’s what you should know about these stimulants and how they compare to each other.

‘Plant-Based’ or Synthetic?

It’s easy to get confused with drug categories, especially with the various stimulant drugs available. To better understand these varieties of stimulant drugs, we can break them down into two specific categories: plant-based stimulants and synthetic stimulants. These categories help us put cocaine and Adderall into perspective as well; one is plant-based, and the other is a synthetic drug. To be clear, we should not confuse the term “plant-based” to mean safe or pure as it is used in the health food industry. Instead, we are only talking about what the base ingredient is for these stimulant drugs, whether it comes from a plant or not.

Cocaine is a plant-based stimulant in the sense that cocaine is made from coca leaves. Coca leaves are used medicinally in its native continent, South America. However, that practice is far different from the use of the synthesized form of coca leaves, cocaine. That practice involves a series of chemical transformations in which the plant-based ingredient turns into the white powdery chemical compound we are familiar with today.

Adderall is also a stimulant, but unlike cocaine, it is not a plant-based drug. The drug is a human-made combination of amphetamine and dextroamphetamine. Adderall is medically legal as a drug used to treat attention-deficit hyperactivity disorder (ADHD) and sleep disorders such as narcolepsy. Beyond its medical use, Adderall is a popularly abused drug, nicknamed a study drug for its use on college campuses and people who use the drug to stay up for long periods of time, especially young working professionals.

Which Is More Dangerous?

Unlike alcohol and other central nervous system depressants, cocaine and Adderall stimulate the central nervous system, which increases activity and communication between the brain and the body. This is why both stimulant drugs are generally used in active settings compared to other drugs, although stimulating the central nervous system can also increase attention spans, which is why they can be used for people with ADHD. Based on the DEA’s drug schedule, both drugs are Schedule II substances, meaning they have a high potential for abuse and can lead to severe psychological or physical dependence. 

While cocaine is technically approved for medical use in very rare cases, it is almost exclusively a street drug. On the other hand, Adderall has a range of medically approved uses. Because of this, people might assume that Adderall is safer. However, Adderall carries a black box warning from the U.S. Food and Drug Administration (FDA), which is their highest warning level for abusive and life-threatening medications. The reason for this warning is because of cardiovascular risks, such as heart attacks, strokes, hypertension, and arrhythmias.

Potency and Drug Cutting

In terms of potency, the comparison is a bit difficult. Cocaine is responsible for 1 in 5 overdose deaths worldwide, according to the U.S. Centers for Disease Control and Prevention (CDC). Even before the pandemic, overdose deaths related to Adderall and other stimulant drugs saw an increase of almost 30% from 2018 to 2019.

Most potency comparisons we can find will use methamphetamine as the standard since it is by far the most potent and abusive stimulant. But chemically speaking, Adderall (amphetamine) is almost identical to meth and is, therefore, more potent when compared to cocaine. Cocaine has a much shorter half-life and lower potency than Adderall, but the comparison gets challenging beyond that.

The reason is that cocaine is a street drug, while Adderall is a regulated drug for medical use. This means there is no guarantee of how potent a cocaine supply will be from day to day. At the same time, illicit forms of Adderall on the street cannot be guaranteed as a pure substance either. Illicit Adderall is cut with other drugs regularly, especially when bought in powdered form. In fact, even people who specifically prefer cocaine or Adderall to meth may discover that the active ingredient in their drug is meth, after all. Since meth is easier and cheaper to produce, people regularly sell it under the guise of other stimulant drugs.

The Verdict

With these things in mind, it’s easy to see how cocaine and Adderall make them more dangerous when compared to each other. Both drugs have a high risk of overdose and can overlap with meth use because of drug-cutting practices. While Adderall may be safer as a regulated drug for medical use, it still carries the FDA warnings that put it on a level playing field with cocaine. Because of this, the safest pathway is to avoid all stimulant drug use. If you use a prescription stimulant drug such as Adderall, learn about the associated risks. Most importantly, if you or someone you know is addicted to these dangerous drugs, seek help from medical professionals right away.

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