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Illegal study drug boosts concentration

Students buy Adderall from students with prescriptions despite physical, legal and ethical consequences

by Sarah Mirk

All names denoted with * have been changed

At sunrise Erika* was riveted to a computer screen in Cleveland lab, her pulse racing and her body exhausted as the amphetamine she'd popped seven hours before began to wear off. Rushing to finish the 10-page philosophy midterm she had begun at midnight, Erika stopped and took a break to send her professors polite e-mails preemptively apologizing for missing class. Then she took another Adderall.

At Grinnell and colleges across the country, many high achieving students have increasingly taken on a new label: drug user. The prescription Attention Deficit Disorder (ADD) drug Adderall, an analeptic stimulant similar to Ritalin, is primarily used illegally by students to help them finish homework. Since students use the drug to study hard, not party hard, users have avoided the scrutiny and stigmas often associated with illegal drug use.

Adderall, like any amphetamine, speeds up the user's heart rate, which can cause unpleasant side effects such as sweating, dry mouth, headaches and insomnia, according to the manufacturer's website. "What drugs like Ritalin and Adderall do is they activate the alerting systems of the brain responsible for wakefulness," said Raphael Cabeza, Biology, who does research on sleep. For users, this can produce hours of intense focus and energy, which appeals to students looking to study fast and hard.

Quantifying Adderall use on campus is difficult because the exterior signs of use-fatigue, jitteriness, sleep deprivation-could, during some weeks, describe almost the entire student body. There have been no security reports involving illegal Adderall use. Also, there is no definitive way to track who is using the drug because the annual anonymous Health Center survey does not ask about Adderall. Also, there is not a list of all students with prescriptions on campus. Though the school psychiatrist keeps track of the students whom she treats, many students obtain their prescriptions at home.

According to the FDA, prescriptions for Adderall have risen 16.9 percent from 2002 to 2004, from 6.8 million to 8.3 million users nationwide. The number of people with access to the drug may be much higher. A 2000 University of Wisconsin-Madison, survey revealed that one in five students who had a valid prescription for a stimulant misused his medication.

"The current research shows that use may be increasing," Dr. Eric Heiligenstein, the clinical director of psychiatry of the University of Wisconsin Health Services who was behind the survey, wrote in an e-mail to The S&B. In response, Madison has been enforcing stricter rules for students seeking prescriptions. "We are unsure if measures have affected use patterns as students obtain prescriptions from a variety of sources," said Heiligenstein. "Until broad-based measures are instituted one can only do so much."

The manufacturer, Shire Pharmaceuticals, realizes that Adderall has the potential for abuse. They dispense the drug in once-a-day pill doses of five to 30 milligrams. "Shire is aware that there is an abuse potential and we stand in taking the appropriate dosage with a valid prescription. Unfortunately we're only in the part of manufacturing and we try to regulate with the FDA and the DEA about abuse potential and making sure that it is appropriately used," a spokesperson for Shire told The S&B.

The DEA and FDA are concerned about the risks of taking the drug without a prescription and thus without professional supervision of its physical and psychological side effects, including dependency. "Addiction is not a simple process," said Cabeza. "It's not like, the drug does this, that means it's addictive." Instead, he said, chemicals in prescription drugs can affect two people in completely different ways and personality also plays a large role in whether the user will become dependent. "Prescription drugs are prescription for a reason," said Beth Chung '94, who works as a psychiatrist in the Health Center, "they can be very dangerous if taken incorrectly ? people go to school for years to learn how to prescribe these drugs ? it is never okay to take them without a prescription."

According to the FDA website, no fatalities have occurred from abuse or misuse of Adderall by itself. Some American students have died in recent years from taking amphetamines with other drugs, even ones for which they had valid prescriptions. Chung worries about Grinnell students taking Adderall with other drugs, especially alcohol. "The effects of alcohol are delayed [when taking Adderall] and students will not be able to tell how much they are drinking or how drunk they are getting." Currently, the administration has no plan for monitoring illegal Adderall use on campus. Students with Adderall problems who want to seek solutions are directed to make use of the Health Center's anonymous walk-in visits.

"It's not that hard to find it here at all," said Travis*, a senior who has used Adderall roughly every three weeks for the last two academic years. "It used to be a lot harder to get. You used to have to buy it weeks in advance and it would be more expensive. Now you can buy it the same day." He attributes the change to an increased number of students with prescriptions on campus, who give or sell the drug to their friends. "Usually it's not hard to get a prescription, especially in Grinnell where people are so into mental health ? most of the people who go to this school are pretty smart and know how to fake their way through things."

Before coming to college, Erika described herself as "straight edge:" no drugs, no alcohol. Facing the night in Cleveland computer lab with her unwritten midterm, Erika half-jokingly mentioned to a visiting friend that a little Adderall would solve her predicament and, to her surprise, the friend offered to sell her an entire bottle for $4 a pill. She bought the pills, made her tardy trek to the computer lab, took what she was told was roughly 45 milligrams of the drug and finished her paper on time. "I generally avoid taking drugs unless I feel I have a good reason to," Erika said, "and the work has to be done ? I have to keep this scholarship."

The relatively casual attitude many Adderall users have toward the drug reveals a deeper skepticism about the legal use of the drug for a disorder which is infamously misdiagnosed. While Erika considers speed drugs like cocaine and meth, which have similar yet much more severe effects than Adderall, "a foreign thing," prescription drugs are familiar and relatively benign. "We all grew up with kids in our grade-school classes taking Ritalin and Adderall," she said, "I'm not even convinced that ADD exists."

More ethical gray area for students stems from how Adderall itself is bought and used on campus. Since it is primarily consumed as a study drug, even students who are personally anti-drug are often divided about others' use of Adderall. "It's socially acceptable to abuse caffeine, said Jon Henry '07, a south campus SA. "So for many students, it is hard to say it's absolutely wrong to abuse a substance to improve your academics."

Dealers at Grinnell are typically prescribed users who sell their unused pills to close friends for little or no profit. "I would never think of it like I need to go to a drug dealer [to buy Adderall]," said a north campus first-year. Erika found nothing unusual about taking her pills in public. "I was in Cleveland computer lab, taking pills and people are all giving me advice."

Daniel* is a second-year Grinnellian and an Adderall dealer. He does not have ADD. "In high school I got my prescription because I had a shrink and I asked for it," he wrote in an email to the S&B. He takes the drug occasionally, either to study or "recreationally," but usually he sells his 20 milligram pills to between 15 and 20 people a month and estimates he makes $100 per month from the sales. He claims that he does not feel like a drug dealer. "It doesn't feel like drug-dealing because for every pill I sell, that's one less I take, which makes getting rid of them a beneficial activity for my personal health."

While many Grinnell users do not fear the drug itself, fears of dependency loom large. Jim*, another first-year with a self-recognized addictive personality, said he opts for personal regulation of his Adderall usage. "I take it hesitantly and cautiously ? I'm taking it in such moderation ? half of what is prescribed," he said. Even with such precautions, the student acknowledged that he found himself taking Adderall "in situations that, before I had started, I wouldn't have needed it." He assumes he will rely on Adderall for the rest of his college career. "It has been useful and I don't see myself stopping."

Adderall has become a necessary evil for Travis, the senior who has been using the drug since sophomore year. "If I had to sit down and plan out my work, I would have dropped out of this school three years ago." Travis usually puts off his biggest papers until a few nights before they are due and takes Adderall for two nights in a row and completes the paper without sleeping. His body reacts strongly to the drug, causing profuse sweating, bad headaches and dry mouth. Still, he prefers these physical consequences to what he believes would be the alternative -- losing the social time spent with the close friends he will miss after he graduates. "When it's a choice between -- staying up till two in the morning every night finishing homework or staying up all night once every few weeks, it's obvious what people are going to choose."

Sidebar: Adderall quick facts from Shire

Side effects

• loss of appetite
• difficulty falling asleep
• stomachache
• dry mouth
• headache
• weight loss

"Abuse of amphetamines may lead to dependence. Misuse of amphetamine may cause sudden death and serious cardiovascular adverse events. These events have also been reported rarely with amphetamine use."

In Feburary, 2005, Health Canadian suspended the sale of Adderall to children after reports of sudden unexplained death (SUD) in children taking Adderall and Adderall XR. Of the 12 deaths, five children were found to have structural heart defects and none were using the drug without a prescription. The drug has since returned to the market, but the FDA is continuing close monitoring of Adderall.

-www.adderallrx.com

Penalties

• Classified by the DEA as a Substance II, the same legal category as cocaine and heroin. ?For first time possession of between five and 49 grams, the minimum federal sentence is five years.
• If death or serious injury occur, the minimum sentence is 20 years.
• Individual first time offenders can be fined up to two million dollars.
• If a first-time offender possesses more than 49 grams, the minimum sentence is ten years and the maximum is life imprisonment.

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