America's Study Buddy

Pulling an all-nighter isn't what it used to be. College students of past generations used coffee as a way to get through a sleepless night of studying. Now students are starting to fall in line with the rest of America in trying to find a medical solution to their problems.

Stimulants are being bought, sold and used by college students illegally across the country as a way to focus for long periods of time while doing school work. With an increase in prescriptions written every year, stimulants are becoming more common in the student population, despite possible health issues that the drugs may carry.
           
Mommy's little helper

Adderall is a stimulant that has helped people with Attention Deficit Hyperactivity Disorder (ADHD) since the early 1990s. The drug helps those who have trouble focusing to stay more attentive for longer periods of time. While it might seem like the drug is every parent's savior, or "mommy's little helper" as the slang term goes, Adderall does come with health concerns.

In February 2005, Health Canada, the Canadian version of the Food and Drug Administration, suspended all sales of Adderall after manufacturer Shire Pharmaceuticals connected 12 sudden deaths in American children to the drug between 1999 and 2003. It took seven months before Health Canada decided to lift the ban.

In the United States, the FDA voted 8 to 7 to put a black box warning on Adderall, a warning that appears on prescription drugs that can cause serious adverse effects.

People who use the drug without a prescription are put at an increased risk for side effects. Increased heartbeat, excitability, loss of appetite, and insomnia are all among the more common side effects that Adderall abusers face. However, those aren't the only effects a user has to be concerned about.

"A person that uses Adderall non-medically over a long period of time will face some more serious effects," says Pam Abamont, a registered pharmacist in Ithaca. "The drug can cause long term damage to the heart, an increase in blood pressure, and other cardiac issues."

A billion dollar black box business

Despite the possible health concerns, Adderall has seen a yearly increase in sales dating back to the mid-1990s. According to the National Center for Health Statistics, between 1997 and 2002 the number of children diagnosed with ADHD increased by 1.1 million diagnoses from 3.3 million cases to 4.4 million. As a result, the number of prescriptions has risen steadily over that time. 

In February 2006, the FDA revealed that 78 million prescriptions were written for ADHD drugs between 1999 and 2003. Prescriptions for these drugs have reached a value of over $3.1 billion a year. It has gotten to a point where spending on ADHD drugs is now higher than the amount of money spent on antibiotics and asthma drugs combined.
           
Statistically speaking

A study done in 2005 to examine the prevalence of non-medical use of prescription stimulants among U.S. college students. The results broke down the characteristics where non-medical stimulant use was most common.

The study showed that approximately 6.9 percent of college students have reported using prescription stimulants for reasons other than medical assistance. Students attending schools in the Northeast were found to have higher stimulant abuse rates than students in any other part of the country. Furthermore, Caucasian students were found to use the drug at a much higher rate than minority students, a very interesting statistic in the Ithaca area, where Ithaca College has an 86 percent Caucasian student body. 

"Non-medical use of prescription drugs is currently second only to marijuana as the most common form of illicit drug use on campus," says Sean McCabe, a professor at the University of Michigan and co-author of the study.       

If these statistics hold true in the Ithaca area, 416 of the 6,029 students at Ithaca College are using Adderall and other stimulants for purposes other than treating ADHD. Looking at the city of Ithaca as a whole, a combination of student populations at Cornell University and Ithaca College would create a student body of 19,503. Of those students, 1,345 are using Adderall without a prescription.

The study also shows that students who have used stimulants for non-medical reasons also have used other hard drugs; 84.6 percent reported using marijuana in the past year, 51.7 percent reported using ecstasy, and 34.6 percent reported using cocaine. These numbers show a drastic increase compared to students who have not used stimulants non-medically; a 53 percent increase in use of marijuana, 45 percent increase in use of ecstasy, and a 32 percent increase in the use of cocaine. 

John R. Knight, associate director of medical education at Harvard and co-author of the study, believes that those statistics have no other option but to increase in the future.

"New strategies will be needed to address the increase in non-medical use of stimulant drugs," he says. "Abuse of stimulants is continuing to rise while use of other illegal drugs is dropping."

If at first you don't succeed . . .

Five times a week Tori* will wake up and take an Adderall pill to start off a day of studying and classes. A student at a major university in upstate New York, Tori says the Adderall helps her academically. She attributes the effect to a higher GPA this semester than her previous two semesters, both spent without extensive use of the drug. 

It took two tries for Tori to get a prescription for Adderall. The first time she visited a psychiatrist she had to take a test consisting of 100 questions and, after answering the questions honestly, she was refused the prescription by the doctor.

"After the first psychiatrist said no I went to another," Tori says. "After a couple of questions he wrote me the prescription."

Tori isn't the only person she knows using Adderall to help academically. A member of a sorority on campus, Tori says that almost all of the girls in her sorority use Adderall. This is a common case, with students of fraternities and sororities seeing a 10 percent increase in use compared to students who do not participate in Greek life.

       
The Price of Good Grades

Despite the increase in prescriptions mentioned above, some students can’t go to a doctor and come away with a bottle of pills. In that case they are forced to find another student with a prescription who is willing to sell them the drug.

Vicki*, also a student at a major university in Upstate New York, has been providing students with Adderall for the past two semesters. Her friend from home has had a prescription but has decided not to use the drug. Instead, she gives the pills to Vicki who in turn sells the drugs on campus for $4 a pill. They sell 25 pills per bottle, netting a profit of $100 dollars for each prescription.

Vicki doesn’t only sell the drug; she also uses it for academic assistance. Like Tori, she is a member of a sorority where most of her sisters use Adderall as well. While most of the time the drug helps her study, Vicki admits that it comes with its issues.

“It helps you academically, but it also makes you feel okay about life,” she says, “but one time I took it for about 10 days straight and at the end I started freaking out; crying and hyperventilating."

That won’t keep Vicki from using the drug to maintain better grades. “A lot of bad things can come with [Adderall],” she says. “But overall it’s something that I’ll keep taking."

A Pill for Every Problem

Non-medical use of prescription stimulants among U.S. college students is now at its highest level in 15 years. Also, non-medical use of prescription stimulants is more prevalent among U.S. college students than among their peers not attending college. While this is a troubling statistic, little can be done to stop students from using the drugs for reasons outside of treating ADHD.

“Any intervention aimed at reducing non-medical use will have to take into consideration that prescription stimulants are a highly effective medication for most individuals with ADHD,” says Sean McCabe, “Given the proven therapeutic efficacy of prescription stimulants for the treatment of ADHD, there is a need to balance the medical necessity of these drugs and the risk for non-medical use and abuse.”

John Knight sees another possibility for the high use of stimulants non-medically.

“This is the first generation to be subjected to pharmaceutical advertisement through the media, providing direct messages to patients,” he says, “What this does is give the current generation the idea that there is a pill for every problem.”

While Knight admits that there are many people who take the drug to treat a medical problem, creating a better life for themselves because of the stimulant, the increase of prescriptions is also putting the stimulants in the hands of students who are abusing the drug while looking for help in the classroom.

It appears that Adderall is converting from “mommy’s little helper” to a student’s best friend.

Updated in mid January 2007