Increasing number using ADHD drug to stay alert
By her sophomore year of college, Kaley, a Washington State University student, routinely popped the prescription drug Adderall to help her study.
The 20-year-old has never had a prescription for the stimulant, but she found it easy to obtain from friends. She first swallowed pills, then began “railing,” or snorting, it at parties. Kaley, one of several students who agreed to speak on the condition their last names not be printed, used Adderall to stay up for days at a time studying for exams or finishing her homework. At parties, she could drink more alcohol without feeling intoxicated.
Last year, while cramming for a midterm, she stayed up all night, fueled by the drug.
“I ended up being in a complete daze for my midterm, and turned it in half-blank, crying,” Kaley said. “Then I slept for two days.”
National studies show that as many as 1 in 4 students in a college setting may have abused Adderall, and two surveys are under way at WSU to examine student use. College students are twice as likely to use the drug nonmedically as their peers who aren’t in college, according to a report this year from the U.S. Department of Health and Human Services.
For students seeking a quick, cheap fix – pills cost about $3 to $5, though the price spikes during final exams – the stimulant allows them to be more productive and focused during late-night cram sessions.
The way students are taking the drug poses additional concerns. Studies show that up to 40 percent of students are snorting the drug, increasing the rate of absorption and the risk, said Patricia Maarhuis, prevention coordinator for WSU’s Alcohol, Drug Counseling, Assessment and Prevention Services.
Adderall has also emerged on the party scene, where the stimulant lets students stay awake, even after a night of heavy drinking.
“In a full blackout normally they would be down, out for the count, passed out – but they’re up, they’re walking, they’re talking, they’re even a little jittery,” Maarhuis said. “But they have absolutely no recall the next day. They might even drive or walk around, but they are indeed in a full blackout. They just haven’t lost consciousness.”
The drug’s legitimate pharmaceutical uses include treatment of attention-deficit hyperactivity disorder and narcolepsy. But experts say Adderall is surprisingly simple to obtain, and its side effects are not well-known by casual users, including potentially severe health risks such as cardiac problems, psychosis and weight loss.
“It’s a careful balance,” said Kevin Conway, deputy director at the National Institute on Drug Abuse in Bethesda, Md. “We want to make sure people who need it get it. We are concerned because there is a high rate of misuse of a serious drug.”
Handing it out ‘like gum’
When Matthew, a 22-year-old WSU student, wanted a prescription for Adderall, he turned to a sympathetic doctor.
“I know I don’t have (ADHD), but Adderall helps me a lot with school, so I got the prescription so I wouldn’t have the hassle of finding it,” Matthew said. “I was written a prescription for 60 pills, which is a lot, so I would save a stash for myself and then give some to my friends.”
Access is fairly easy. Many students know friends or family members with a prescription, according to several students interviewed. Others say it’s simple enough to look up ADHD symptoms, then describe them to a physician.
“(Students) will hand it out like gum,” Maarhuis said.
Adderall’s popularity is spread through social media tools such as Facebook and Twitter.
More than a dozen students at WSU have joined Facebook groups praising Adderall. On Twitter, posts on Adderall roll in by the minute, typically praising but occasionally cursing the drug.
“Gonna party up all night with alcohol and Adderall!!” a sample Tweet from Tacoma reads.
But students are doing more online than just talking about it. A Google search for “buy Adderall” results in more than 900,000 hits. Internet sales of medical drugs by illegitimate and often off-shore “pharmacies” may reach $75 billion a year by 2010, according to a 2008 study from the University of Maryland.
Maarhuis predicts more and more students will buy Adderall online, posing another concern.
“The real stuff is bad enough,” she said. “God knows what you’re getting from these sites, and what it’s being cut with.”
Traditionally, alcohol has been the No. 1 substance abused on college campuses. Marijuana has ranked second, and substances like cocaine come in at a distant third. In the past 10 years, the use of Adderall and other cognitive stimulants has shot up, outpacing cocaine and almost reaching marijuana levels, Maarhuis said.
Adderall poses a significant risk for psychological addiction, which leads to people using the drug compulsively, regardless of negative effects, said Rebecca Craft, a WSU biopsychology professor. Alice Young, a psychology professor at Texas Tech University who specializes in psychopharmacology, said the drug may temporarily help a student study and remember, but recall may suffer if the student stops taking it.
“My main concern is not the single use,” Young said. “It’s the beginning to think you have to use to get the edge.”
Officer Matthew Kuhrt, a drug recognition expert for the WSU Police Department, confirmed that “prescription medicine is becoming more and more of a problem.” The WSU Police Department has had three cases involving Adderall this year. In 2008, the school revoked the recognition of the Alpha Kappa Lambda fraternity after drug detectives found evidence of cocaine, marijuana and “significant quantities of Ritalin and Adderall.”
Washington State Attorney General Rob McKenna is working on several programs to combat Adderall abuse in the state. He wants to reach students before they make bad drug decisions, not after, he said.
“The solution lies in education and outreach, not law enforcement,” McKenna said.
Long-term effects not known
Even critics of Adderall acknowledge that the drug benefits some people.
Brian, 24, a 2009 WSU graduate, is one. He began taking Adderall after being diagnosed with attention-deficit disorder at age 7, but stopped when he was in high school because he thought it was unnecessary.
“I started taking it again in college,” Brian said. “I’m sure I wouldn’t have graduated on time without it.”
On the other side, WSU student Nicholas Cone stopped using his legal prescription of Adderall because he said he did not like the crash he experienced after taking it.
“The focus I had for about four hours wasn’t worth feeling sick when it was over,” said Cone, a senior economics major.
The biggest concern may be the lack of knowledge about Adderall’s effects on the body, experts say. Adderall has been on the market less than 10 years, and long-term studies have not been completed, nor have studies on Adderall’s interactions with other drugs, Maarhuis said.
Others see cognitive stimulants as a step toward the future. With care, they could be used to help professionals maintain focus, according to a December 2008 article in the science journal Nature.
Drugs like Adderall eventually may be recommended for jobs that require alertness and focus, such as pilots or emergency room doctors, according to interviews with experts.
While the best option may be well-rested surgeons, in today’s society the choice may be between an Adderall-taking doctor and a sleep-deprived one, Craft said.
Craft said she believes the use of Adderrall to be rising among professors and researchers, although she hasn’t seen it at WSU. As people age, they cannot perform on the same schedule they could when they were younger, but some people cannot handle this, so they take a drug, she said.
Professionals like Maarhuis, Young and Craft worry about a culture of expectations beyond human limits and risky medication for everyone who cannot perform as expected.
“It’s a real reflection of this cascading shift toward higher and higher production,” Craft said. “I’d rather be a little less productive.”
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