I went to university at a time that Adderall was commonplace, and am now old enough to see how it turned out for the individuals. At college, it was common for students to illicitly purchase Adderall to use as a stimulate to cram for a test/paper etc. It was likewise common for students to abuse these drugs by taking pills at a faster than prescribed pace to work for 48 hours straight amongst other habits.

In the workplace, I saw the same folks struggle to work consistently without abusive dosages of such drugs. A close friend eventually went into in-patient care for psychosis due to his interaction with Adderall.

Like any drug, the effect wears off - Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years. As I recall, the standard dosages of Adderall cease to be effective after 7-10 years due to changes in tolerance. Individuals trying to maintain the same therapeutic effect will either escalate their usage beyond "safe" levels or revert to their unmedicated habits.

> I understood Ritalin to have mild neurotoxic effects, but Adderall et al to be essentially harmless.

There is no conclusive research on humans, but you have these backwards. Ritalin (methylphenidate) is thought to have less risk for neurotoxicity than Adderall (amphetamine). Amphetamine enters the neuron and disrupts some internal functions as part of its mechanism of action, while Ritalin does not.

Both drugs will induce tolerance, though. The early motivation-enhancing effects don't last very long.

There are also some entertaining studies where researchers give one group of students placebo and another group of students Adderall, then have them self-rate their performance. The Adderall group rates themselves as having done much better, despite performing the same on the test. If you've ever seen the confidence boost that comes from people taking their first stimulant doses, this won't come as a big surprise. These early effects (euphoria, excess energy) dissipate with long-term treatment, but it fools a lot of early users and students who borrow a couple pills from a friend.

> Presumably, these drugs are (ridiculously tightly) controlled to prevent society-wide harm.

Maybe I'm misunderstanding what you mean - but I think almost any college student would disagree with this presumption.

> Do you have a source for the benefits giving way to problems long-term?

Although a very long read, I found this to be very insightful:

> It was still true that after 14 months of treatment, the children taking Ritalin behaved better than those in the other groups. But by 36 months, that advantage had faded completely, and children in every group, including the comparison group, displayed exactly the same level of symptoms.

https://archive.is/20250413091646/https://www.nytimes.com/20...

Source for amphetamines being a performance enhancing drug? Try some lol.

Really, they're habit forming and destructive so don't take them, but the reason they're so popular is they really do kick you up.

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