By Daniel Triassi, Katelyn Ball, Brittany McKinney and Jessa Squellati
Special to the Mustang Daily
EDITOR’S NOTE: Due to the illegality of using and selling prescription ADD/ADHD medications for use other than their intended use, many of our sources have requested anonymity. They will be referred to by their first name or a pseudonym.
Last quarter, 11,407 students frequented the 24-hour study room at Kennedy Library after hours. Courtney was one of them. Like many students, she often finds herself pressed for time and she has pulled countless all-nighters in her academic career.
Staying up all night to study is never easy, but Courtney enlists some chemical help: a 30-milligram tablet of Adderall. This prescription medication, which she acquires illegally from a friend, is a tiny orange pill that she washes down with a caffeinated beverage to stave off sleep and help her focus.
“I would use it like candy if it was always available to me,” said Courtney, who requested that her last name not be used. When on Adderall, she typically doesn’t sleep for at least a day, but she does not believe the drug is dangerous. She usually scores As on her exams.
On college campuses nationwide, the ingredients for academic success now include a dose of analeptics, the class of prescription amphetamines that is used to treat attention deficit hyperactivity disorder. By some accounts, the use of Adderall and other ADD/ADHD medications as study aids are becoming almost as socially accepted as energy drinks and coffee.
In an online poll conducted by the Mustang Daily, 34.5 percent of students admitted to having used Adderall, Ritalin or Concerta without a prescription. Ninety percent of them said they used it as a study aid; other uses included weight loss and as a recreational drug.
A recent survey by the National Survey on Drug Use and Health found that full-time college students aged 18 to 22 are twice as likely as their counterparts who were not in school to have used Adderall non-medically in the past year. Studies at other college campuses have found rates of illegal stimulant use that range from 4 to 35 percent.
Helpful or harmful?
Like Courtney, many students see their use of these drugs as technically illegal but otherwise benign, but drug enforcement officials and some medical experts disagree.
Adderall is an amphetamine and therefore classified as a Schedule II controlled substance — the same class as cocaine — by the United States Drug Enforcement Administration due to its high potential for abuse with consequences including severe psychological or physical dependence.
Possession of these drugs without a valid prescription is a misdemeanor, according to California Health and Safety Code, Section 11550. Violation of the law means a jail sentence between 90 days and one year and possibly probation for up to five years.
There have been at least four cases involving the illegal use or possession of Adderall by Cal Poly or Cuesta College students since January 2009, according to Officer Cory Pierce of the San Luis Obispo Police Department.
“All the students involved with the recent Adderall cases have given two specific explanations for using or possessing the drug,” Pierce said. “The first explanation is that they need Adderall because they have ADHD or ADD and need it to self-medicate, and the second is that they need it to help them study.”
Though doctors frequently prescribe these drugs for ADD/ADHD treatment, that doesn’t mean they are safe for off-label use. The difference between legal and illegal use is the presence of medical supervision, said Laura Freberg, a Cal Poly psychology professor.
“My students are commonly under the misconception that somehow if you don’t have ADHD, the stimulant meds behave differently,” she said. “They don’t.”
Doctors modify prescription doses according to a patient’s age and body weight and do not prescribe these drugs to those who have any sort of pre-existing condition that would put the user in increased danger.
For instance, there are several types of antidepressants that can be hazardous when combined with Adderall; therefore, it is never prescribed to patients who use those antidepressants. According to PDRHealth, a physicians reference Web site, if Adderall is taken within 14 days of taking one of these antidepressants, a life-threatening spike in blood pressure could result.
Equally serious is the effect of Adderall on those with a pre-existing heart condition. In 2005, Canada suspended the marketing of Adderall after a dozen children using Adderall died. It was discovered that the deaths were the results of underlying heart abnormalities in each child.
“Misuse of amphetamine may cause sudden death and serious cardiovascular adverse events,” reads the warning that was immediately placed on the Adderall label by the FDA in response to the Canadian deaths.
The U.S. Drug Enforcement Administration compares the effects of amphetamines like Adderall to the effects of cocaine. However, an article on the U.S. DEA’s Web site describes these effects as having a slower onset and a longer duration. Drugs with a slower onset are typically considered to be less addictive, however the longer duration means that amphetamines typically remain in the central nervous system longer, which produces prolonged stimulant effects.
Chronic abuse of amphetamines can produce a psychosis that resembles schizophrenia, according to the U.S. DEA. “It is characterized by paranoia, picking at the skin, preoccupation with one’s own thoughts, and auditory and visual hallucinations.”
The Partnership for a Drug-Free America gives a description of both the short-term and long-term effects of Adderall use. Short-term effects can feel like an increase in alertness, attention and energy partnered with a sense of euphoria. Yet short-term effects when the drug is abused also include the potential for heart attacks or lethal seizures.
If Adderall is used compulsively it can be addictive. Repeated uses can lead to feelings of paranoia as well as hostility. Taking high doses of it may also cause a dangerously high body temperature and irregular heartbeat.
Illegal and potentially harmful as they may be, Adderall, Ritalin and Concerta are not difficult to acquire.
According to a study done on the use of “cognition-enhancing drugs” in the April 2008 edition of the science journal Nature, approximately one-third of survey respondents claimed that they purchase the drugs on the Internet.
In the Mustang Daily survey, 58 percent said that they got the pills from friends who shared their prescriptions, 53.5 percent purchased it from someone, and of those who chose “other” as a response, most said they had obtained their own prescription from a doctor. (These percentages add to more than 100 because participants were allowed to choose all answers that applied to them.)
A student who asked to be identified by his first initial only, A, is one of the many who receive pills from a friend. “It’s not my prescription,” he explained. “My friend has one and gives me the rest of the pills that he doesn’t end up taking.”
Students who have legal prescriptions to Adderall become quite popular among friends who also take the drug for studying purposes, but who do not have their own prescription.
“I don’t sell Adderall, but will trade it from time to time,” said Jim, an agricultural systems management senior. “I find it amazing how during finals week my cell phone rings off the hook.”
The Adderall experience
Adderall affects each individual differently, but students typically describe a period of jittery hyperawareness, followed by a crash.
“At the peak … it makes me feel completely concentrated and also very irritable,” said Jim, who gives Adderall partial credit for his academic success. “Sometimes I even find myself looking for fights,” he said. Other side effects: “I get a love toward techno music, weight lifting and sex.”
Like other amphetamines, the experience can be uncomfortable when the pill wears off.
“There is an extreme ‘comedown’ and sometimes I find myself leaning toward a state of depression,” Jim said, adding that he combats the feeling by self-medicating with another drug, marijuana. “If I smoke weed I can relax and have a smooth comedown without the headache.”
Despite the psychological rollercoaster and potential health effects, Jim said he sees Adderall use as critical to his success in school.
“I would not be as far as I am academically if Adderall was not there for me,” he said.
— Fallon Scholl, Jessica Wynne, Zach Lantz and Kate McIntyre contributed to this report.
FOR THE SECOND PART IN THIS SERIES, “An academic edge with potential for addiction,” CLICK HERE