Use of ADHD drugs as study aid raises concern on campuses
By Rick Montgomery
Of college kids, up to one third may be using them
ANSAS CITY, Mo. (MCT) A University of Kansas freshman took a break from shooting hoops with friends outside his dormitory to talk about what some students call "study pills."
As final exams approached last semester, he took a couple doses of a prescribed stimulant called Adderall. "But all they did was make me feel nervous," said the chemical engineering major. "I'm off of it now."
He still has a vial of leftover pills he used for his attention issues in high school. And that's why he asked that his name not appear in this article: He didn't want to be pressed by dormmates to supply them with an illegal focus boost for upcoming finals.
The controlled stimulants that many college students seek, if only for a momentary edge, carry familiar brand names such as Adderall, Vyvanse, Focalin and Ritalin. They're all standard drugs for treating attention deficit/hyperactivity disorder, often successfully.
Their misuse, however, is thought to be on the rise at campuses nationwide creating a potentially serious health hazard and trips to the emergency room for students not diagnosed for ADHD.
The extent of the problem is anyone's guess. Because of what experts consider a lack of reliable research, illicit dealing of ADHD drugs either is infrequent on campus or something so commonplace as to be the college crowd's best-kept secret.
DeSantis has analyzed several years' worth of surveys of Kentucky undergraduates to conclude that at least one-third of the student body has taken ADHD medication without prescriptions. Another 8 percent use the drugs legally under a doctor's supervision, he said, and half of them provide pills to other students.
The incidence of use appears to be higher among Kentucky seniors and juniors than for younger students, DeSantis added.
Assessing a variety of surveys, a 2008 study published in the Journal of American Child Adolescent Psychiatry offered a not-so-precise range of 5 percent to 35 percent of college-aged people taking attention-deficit stimulants not prescribed for them.
A University of Missouri survey found a usage rate in between.
About 12 percent in a sample of Mizzou students admitted to using controlled stimulants or painkillers, prescribed or illegally, said Kim Dude, director of the University of Missouri's Wellness Resource Center. "Eighty-five percent of the students don't use any of that."
But she does agree with the KU freshman don't let on if you've got attention-deficit pills.
"We urge students and their parents from the start: Don't tell anybody," Dude said. "They'll run into peer pressure to sell it or give it away" to other students.
This month, data-miners at Brigham Young University issued a study that tracked Twitter references to study pills.
Searching keywords such as "Adderall," "college" and "cramming" over a six-month period, lead researcher Carl Hanson allowed, "We don't have all the answers" on the frequency of legal use or abuse. But the study did conclude that tweets about the drug were heaviest among students in the U.S. Northeast and South, and lightest among students in the Plains and Southwestern states (including California).
Also, the report summary stated, "Tweets about Adderall peak sharply during final exam periods."
Said Hanson: "I'm concerned about the social norm-ing thing. If students perceive (taking stimulant medication) as normal because it's talked about and tweeted a lot, they'll take the risk."
Katharine Beach became addicted when she was a KU student.
"It's sad how many doctors would fill prescriptions for me," said Beach, 26 and now clean.
Diagnosed with attention deficit disorder when she was 18, the medication at first helped her focus and stay awake to study. But after she started drinking heavily, Beach chose to give up booze and find a new fix.
"It's called cross-addiction," said Beach, who graduated last year with a degree in applied behavioral science.
Student health services at KU required her to jump through too many hoops before filling prescriptions. ("They're onto students who want something quick," she said.) So relying upon private medical clinics in Lawrence, Kansas City and her psychiatrist in Colorado, Beach procured five times the recommended dosage of Adderall to keep her buzzing.
"Everyone around me knew I didn't drink anymore … but (that) something else was going on," she said. "I'm positive I would've switched to cocaine or maybe meth down the road."
Her health insurance carrier got wise and stopped funding her prescriptions. Her parents caught on after Beach maxed out their credit card. She entered treatment and works today at a University of Colorado rehabilitation center, helping addicts.
Millions of Americans have taken prescribed ADHD medication often intermittently without experiencing negative side effects. But an under-30 generation raised on the practice might not be aware of the dangers of taking even modest dosages without a thorough diagnosis, said psychiatrist Tahir Rahman of the MU School of Medicine.
"If you're depressive or have bipolar disorder, taking a drug such as Adderall could be throwing gasoline on a fire," Rahman said.
Nationwide, the number of emergency room visits related to abuse of ADHD drugs rose to 31,224 in 2010 -- more than double the number recorded five years earlier, according to a federal report released in January.
Such ER visits by people ages 18 to 25 nearly quadrupled in that time, the Substance Abuse & Mental Health Association reported.
It is not known how many of those patients were college students.
"I hear students talk about it all the time," said Kate Baxendale, a junior studying journalism at the University of Missouri-Kansas City. She and another student wrote about the problem in the university newspaper after agreeing to not identify stimulant users by name.
Baxendale has never taken Adderall, she said, but others in her dorm have sold it. "At a time like this (finals week), they can sell for $20 a pill," she said. The sellers ration their prescribed medication because they need some for themselves.
The university's health services do not have medical doctors to prescribe controlled stimulants, so students taking them must get the drugs elsewhere.
Colleges around the country are tightening their procedures to limit student access to stimulant medicine.
"Some campuses have outright stopped prescribing stimulants," said Stacy Andes of the American College Health Association. Others, including KU, require students to present copies of at least two diagnostic tests given by doctors or mental-health professionals.
The drugs easily can be obtained off campus in most college towns, said DeSantis of the University of Kentucky. A clinic or family practitioner may ask patients to fill out a questionnaire that asks if they have trouble focusing or completing assignments.
"For the most part, students (seeking medication) know how to answer those questions," DeSantis said.
Downing Adderall to perform better on tests raises questions beyond medical ones: Is it the educational equivalent of using steroids to cheat in sports? Are students who choose not to use stimulants, or those who can't afford them, chasing degrees at an unfair disadvantage?
Psychiatrists debate whether the drugs do much at all to help people not diagnosed with ADHD, other than to keep them awake so they can cram for tests.
Girding up for finals in a library study room at UMKC, Govinda Koirala wrinkled his nose when asked if he would ever consider a pharmaceutical boost.
"I drink coffee," said the junior studying mechanical engineering. "And the latest I stay up studying is 11:30" p.m.
His secret to academic success? "Just relax. Sleep well. Do what's good for your mind."
Must work. Koirala is pulling a 3.91 grade-point average.
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