Names have been changed to protect the identity of the sources.Two weeks ago, Carrie had a dilemma – she had a trade theory test the following day. Not only did she anticipate the test to be difficult, but Carrie also hadn’t studied for it at all. Lucky for her, she had a magic pill that would make her last-minute cram a little easier.
From past experience, Carrie knew that, in this case, the pill was just what the doctor ordered – just not by her own physician. Carrie, a senior international economics major, took a stimulant prescribed to a friend with attention deficit hyperactivity disorder.
Carrie’s illegal use of ADHD medication may not be so uncommon. Yvonne Giovanis, assistant director for Alcohol and Drug Education, said the usage of ADHD medications are the fastest-growing drugs on college and high school campuses and use is expected to be on the rise for the next several years.
Laura Crawley, assistant dean of Campus Life and health promotion, said several studies show widespread use of stimulants on college campuses across the nation.
“Generally, nine out of 10 people with Adderall or Ritalin, what have you – it’s going to be who it’s been prescribed for,” she said.
But Crawley cited a study at the University of Wisconsin that shows college students are exceptions to the rest of the population.
Out of about 1,000 students surveyed, 16.2 percent admitted to abuse or misuse of a methylphenidate, which includes name-brand drugs such as Ritalin and Concerta. Only about 10 percent of those students who admitted to abusing the drugs were actually diagnosed with ADHD, while 90 percent did not have a diagnosable illness. According to the Monitoring the Future study at a Midwestern university, this type of drug-usage was found to be the second most popular kind, after marijuana.
Abuse and Misuse
Crawley said students misuse drugs by taking them with alcohol, and those who do have ADHD misuse drugs by stockpiling until finals time, which is exactly what senior marketing major JÂsus* does.
After being diagnosed with ADHD in sixth grade, JÂsus took Ritalin every day in middle school and high school, but stopped in college. He said the drug made him lose his appetite and made him feel bad in general, so now he saves the prescription for finals time to take and distribute to his friends. While he took 20 milligrams of Ritalin a day in high school, he said, he usually takes 40 milligrams during test days.
JÂsus said students without ADHD sometimes use the drug more frequently or at a higher dosage.
“My friends who don’t have a prescription take more than I do,” JÂsus said.
Giovanis said when people who do not have prescriptions for stimulants take them anyhow, they are “abusing” the drug.
Crawley said as many as one in five college students have illegally used drugs such as Ritalin or Adderall.
She said the two most prevalent methods students abuse and misuse the drug are orally and snorting. The study showed that 55 percent of students swallowed the pills and 40 percent crushed and snorted the medication, mostly a method used for extended partying.
Crawley said about 50 percent of stimulant-users take them two to three times a year, more than one-third take them two to three times a month and 15.5 percent take them two to three times a week.
“I think the more frequent you’re using it, the greater potential you have to become addicted to it or to run into other problems with that if you get caught with it and you’re in the conduct system at that point or you’re being referred to a counselor or something,” she said.
Dr. Mary Ann Block, a family practitioner in Hurst, said the drugs go to nervous system receptor sites in the brain to keep focus. She said the drugs themselves are very dangerous.
“Just because these drugs were approved by the FDA doesn’t mean they’re safe, unfortunately,” she said.
“Ritalin is found to be more potent than cocaine and goes to the same receptor site. The drugs – like Ritalin and Adderall – are like speed.”
Giovanis said that because the drugs are highly and easily addictive, they manipulate the central nervous system, and those using the drugs, especially when not prescribed, experience an increase in heart rate, blood pressure and respiration.
“With proper medical supervision of those drugs, that’s when doctors will often change the milligram-dosage a person gets in order to minimize those side effects and make sure it’s maximizing the use of the drug,” she said.
Carrie said when she takes a stimulant, her heart races, she feels cold but still sweats, has difficulty going to sleep and gets dehydrated.
Besides a loss of appetite, JÂsus said, he tends to get agitated easily.
Giovanis said if someone used the medication to study, often, that person must also take it before the test as well.
Carrie said she usually takes 10 milligrams to study and another 10 right before the test because people who have prescriptions have told her to do so.
Also, Giovanis said, students might question their self-reliance with continued use of the medication.
She said students may ask themselves, “‘Do I want to know that I was able to study and remember this information and achieve that A, or am I going to wonder if it’s just because I took that pill?'” she said. “To take that one step further, ‘Do I want a doctor that made his or her way through college and medical school on Adderall giving me medical advice or performing surgery on me if they’re no longer on that drug?'”
Crawley said students use the drugs to “party” longer, focus on studying and tests, and curb their appetites.
While JÂsus said he knows of some students who use them to stay up and drink longer, he, Carrie, Giovanis and Crawley all agreed that studying and test-taking are the primary reasons TCU students take stimulants.
JÂsus said finals week is the time when most students use stimulants – and go looking for them.
“When it comes finals week, everyone’s knocking on my door,” he said.
Carrie said that although she does experience negative side effects, she is pleased with the medicine as a whole.
“I’ve had really good benefits,” she said. “I think I definitely perform better on tests.”
She said the medicine helps her to study when she is behind in a class and the test requires a lot of memorization. The medicine has given her more patience and allows her to take more care while taking a test.
Crawley said the side effect of loss of appetite appeals to females. She said because of the absence of some over-the-counter stimulant diet pills such as Fen-Phen, an ADHD drug offers an alternative. In fact, Giovanis said, some medications used to treat ADHD were originally introduced as weight-loss pills.
“I think that pressure for college women to not only be brainy, but also beautiful plays into it,” she said. “Some are scared to stop taking it because they might gain weight.”
While Carrie said she did not use the drugs to lose weight, she said the drugs do suppress her appetite and she has to remind herself to eat.
Crawley said students use drugs like Adderall and Ritalin because they do have the same effects as cocaine, speed and other illegal amphetamines but do not possess the same negative connotations as illegal drugs.
“It’s perceived to be safe,” she said. “Most students get in that place of, ‘well, it’s probably bad, but it’s not that big of a deal.'”
Giovanis said she thinks that age contributes to illegal uses of the medication.
“Part of it is that I think that the idea that students at a college are in that age-period where they really don’t think long-term negative things can happen to them – because you’re still growing physically, mentally and emotionally,” she said. “And life just seems full of possibilities.”
JÂsus said he has never really considered the dangers and consequences of misusing the drugs or handing it out to his friends.
Giovanis said JÂsus is not alone.
“Most students don’t reflect on the what-ifs,” she said.
According to a Medco Health Solutions analysis, ADHD diagnoses for adults 20 to 44 have doubled in recent years – a phenomenon that is contributing to the widespread use of stimulants, Giovanis said.
“Wherever there’s more prevalence, there’s more room for abuse because it’s more easily accessible,” she said.
She said that on TCU’s campus, there is not one central “dealer” of ADHD drugs, but rather, most people get them from their friends.
Crawley said that students who abuse the drugs get them from students who are prescribed. If students pay for the medicine, they pay anywhere from $1 to $5 a pill. Carrie said that TCU prices are comparable to the national standards with an average of about $3 a pill and $5 being the highest rate. JÂsus said during finals week is when the pills are the most expensive.
Although JÂsus said he distributes Ritalin to his friends, he doesn’t charge them because he usually has two or three bottles that he has stockpiled.
“I give people the amount they ask for as long as it’s not a ridiculous amount,” he said.
While most students obtain the drug from others, Giovanis said, she has heard of instances at TCU where students have read about ADHD and faked symptoms to doctors to get prescribed drugs.
Monica Kintigh, a licensed professional counselor for Mental Health Services, said she does not believe it’s easy to feign ADHD.
“It is a medical diagnosis that includes detailed intake interview including personal and family history, two to three hours of screening tests with an interpretation by a mental health professional, and a medical doctor’s examination and diagnosis,” she said in an e-mail. “Persons don’t suddenly become ADHD – there is always evidence from their personal and family history that confirms the diagnosis.”
Block disagreed, saying there is no physical indication for the illness.
“There is no objective medical test on ADD and ADHD,” she said.
Giovanis said because there is no medical test and doctors are limited on time spent with patients, a false diagnosis can happen.
“As much as we’d like to say it’s difficult to get a prescription, the reality is, there is no medical test to show whether you have ADD or ADHD,” she said. ” … I would imagine it’s easier than we’d like it to be to get a hold of Adderall or Ritalin,” she said.
Instead of taking stimulants as a study aid, Crawley suggests students start studying earlier. If someone has a problem with noise while taking tests, she said, he or she should be up front with the professor to arrange a different time or room in which to take the test. She also said enough rest will help students concentrate and coffee is a better, legal alternative to stimulant drugs. If a medication is being used to lose weight, changing lifestyles is a better method to shed pounds.