Adderall an illegal study aid, causes potential addiction

It’s finals season, and the first floor of Hillman Library buzzes with distracted college students. But among the socialites, a junior stares unblinkingly at his computer monitor, hammering at the keys.

His foot taps uncontrollably. His courageous pencil clings to life under the constant gnawing of a clenched jaw. He’s not hungry. He has cottonmouth. And a headache might be creeping up.

But this junior, who asked not to be named, isn’t thinking about what his body is doing. He’s not thinking about the fury of dopamine and norepinephrine neurotransmitters pumping into his brain’s nerve endings — only the words cascading down the once-blank screen, seemingly typing themselves.

About one hour ago, he took a 30-milligram Adderall pill. Later he’ll take another one to ensure a doze-free all-nighter. He bought both illegally from his friend — five bucks each.

The most commonly prescribed attention deficit hyperactivity disorder medication, Adderall is a psychostimulant that contains amphetamine. Recently though, college students across the country have been abusing the drug, and some Pitt students seem to have a craving for the ubiquitous “study buddy.”

The New York Times ran a 5,000-word exposé in February on just how pervasive and potentially damaging ADHD medication abuse can be. It tells the story of Richard Fee, a promising college student athlete who hanged himself two weeks after his prescription ran out. At its highest, his prescription was for 80 milligrams of Adderall per day.

Tevya Zukor, director of the Counseling Service Center at Pitt, said Fee’s case is no isolated incident.

“I’ve seen it multiple times. Those who abuse Adderall in high doses can become psychotic,” Zukor explained. “I’ve had to hospitalize students.”

When prescribed correctly and monitored by a physician, Adderall and its sister drugs, such as Vyvanse and Ritalin, are meant to alleviate the academically crippling symptoms of ADHD.

Impulsivity, inattention and hyperactivity hallmark the condition, said Brooke Molina, a professor of psychiatry at Pitt.

“Someone with ADHD has problems sustaining attention and completing tasks that are not fun or novel or rewarding.”

“For children [that impulsivity] might mean running into the street without thinking, and adults might spend money without considering or speak without thinking,” she added. Tendencies toward hyperactivity are more common in children.

Procrastination, forgetfulness, disorganization and constant irrelevant distractions burden college students suffering from the condition.

“When people come to college, they leave the very structured setting at home,” said Srihari Bangalore, an assistant professor of psychiatry at Pitt. “And here they struggle with new social and academic stressors.”

Anthony Xenakis, a senior majoring in industrial engineering, had to start taking 40 milligrams in college because “reading and comprehending just took hours.” He said it would take three or four journeys through a single paragraph before he absorbed any of the information.

Since being prescribed the drug, Xenakis said he can make it through a two-hour lecture without even checking his phone. And studying for tests proves easier than it ever was in high school.

It’s Adderall’s tunneling focus that makes it an attractive cramming tool for those without a prescription. The toe-tapping junior studying for midterms said it “just makes sense to do it for studying.”

“Honestly, I should probably be prescribed,” he added. “Because it actually makes me want to do the work — to learn the material.” But instead of going through the “hassle” of the increasingly thorough assessments, he’d rather just spend a few bucks every week at the pharmacy with a prescription.

Molina said there’s an unfortunate variance among institutions in how they go about their assessment of a patient to determine if he or she should receive a prescription. Much of this discrepancy derives from the fact that there is no test to determine whether or not a patient has ADHD.

“Some will give a very brief evaluation and others will do a very thorough assessment,” she explained.

“It’s a problem that we have busy practitioners that don’t have enough time to be thorough, and that makes it easy to obtain a prescription,” Molina said.

Xenakis said that since his initial screening four years ago, which took about 30 minutes, he hasn’t been reevaluated. Every six months he sees his psychiatrist, who “pretty much just asks me how I’m doing, then re-ups my script.”

At Western Psychiatric Institute and Clinic, where Bangalore directs the ADHD clinic, students in search of help go through comprehensive screening.

Even before patients get to see a professional, they need to complete a packet of rating scales, and a parent or partner completes one about the patient.

“We ask general life questions, so we see how you’re functioning and how you’re relating with peers,” Bangalore noted of the preliminary assessments.

After scanning for red flags, such as signs of depression, the clinic decides if the applicant should see a clinician.

“It’s very easy to fake symptoms,” Bangalore said of the candidates he tries to weed out. “So I often suggest starting therapy before medication. Those that are seriously seeking help will stick with it. Someone just looking for meds will quit right there.”

Bangalore said the key is collaborative information, seeing if the symptoms began early — well before age 7.

Despite the numerous precautions that professionals take, people still beat the system: Students without ADHD still obtain prescriptions, and the rest can purchase the pills secondhand. Students still abuse the drug.

Bangalore, Zukor and Molina all agreed that Fee’s violent psychosis is indeed a rare consequence of ADHD medication abuse. Instances of exchanges among friends — students looking to start and finish a paper or cram before a big test — make up the majority of students’ abuse of the “smart drug” on college campuses.

“It reminds me of a lot of performance-enhancing drugs in sports,” said Zukor of Adderall’s prevalence in the hands of those who are not prescribed the medication. “Just like a competitive athlete will choose that edge even when they know it’s not in their best long-term interest, a lot of students crave that edge they can get, despite the legal and health consequences,” he said.

The possible legal ramifications are clear-cut. Adderall is a Schedule II stimulant, and selling or possessing the drug without a prescription is a felony. A Schedule II drug is defined by a high potential for abuse in its users that might lead to severe psychological or physical dependence. Other Schedule II drugs include cocaine, morphine and opium.

But Adderall’s fluid, casual movement around campuses simply doesn’t receive that sort of attention.

Molina said that the trade of Adderall and similar stimulants is “under-policed because law enforcement and campus security hasn’t caught up to the wave, and when it happens, it’s going to catch a lot of people by surprise.”

But for the studying junior at Hillman, that message doesn’t resonate. “I don’t think of it as a drug deal, but a friend helping out a friend,” he said of one of the numerous times he’s illegally obtained ADHD medication, which he calls “the wonder drug.”

“I think it’s so ingrained in college culture, and everyone knows it’s just something some people need.”

Zukor worries that this attitude can have serious mental-health implications for students.

“Adderall and other stimulant medication can have drastic interactions with other meds, like antidepressants, reducing their effectiveness,” he said of unmonitored pill-popping without concern . “On the immediate side, there’s increased nervousness, headaches, anxiety, dizziness and, as many psychotropic [mood-altering] meds do, it can decrease sex drive.”

He added that small, recreational use can have lingering effects, including sleep problems, unease and the jitters, not unlike the feeling of caffeine overload. There have even been cases of severe cardiac responses.

Most who have used the drugs notice these side effects, which often become more intense during withdrawal, but the market for the medications persists.

“There’s money to be made for the kids that have it,” Zukor said. “And they don’t seem to fear getting caught.”

Lisa Nichols, a graduating senior who asked to have her name changed, said she made close to $400 her sophomore year during finals week.

“I couldn’t believe how high the demand was, and I was just selling them to my close friends.”

She noticed that during finals and midterms, her phone vibrates nonstop with texts: “Can I get a 20 [milligram]?”

Leo Pencolt, a junior who also asked to have his name changed, sells to an even smaller group, including the Hillman toe-tapper.

“I know it’s a felony, but I’m really just doing it for my friends,” he explained. “It’s not like I’m doing it wholesale, like some people I know of.”

“People need it,” he said.

It’s that “need” that concerns the medical community. It flirts with dependence and addiction.

“Students are putting more pressure on themselves to be academically successful,” Zukor said of the culture surrounding “study aids.”

Bangalore said that students can’t look at stimulants such as ADHD medication as “a quick fix to help their academic success, which does not come by doing well on one exam.”

“They will feel increasingly that they don’t have to work hard to be successful, to do well,” Bangalore said.

Molina also fears that the mentality will trickle into students’ adult lives. “If a student becomes accustomed to accomplishing difficult milestones by using the crutch, how are they going to handle life after college?”

“What does it say about students and our society that they ‘need’ performance-enhancing drugs?”