College administrators worry that use of prescription stimulants is increasing

November 27, 2011

The American University junior never finishes her monthly prescription of instant-release Adderall used to control her ADHD. She says taking the medication daily might result in sleeplessness or the pills losing their effectiveness. So she shares the extras with friends who promise to use it as a study aid, not a party drug. She sells whatever is left to friends of friends for $5 to $10 each.

“I really try to avoid doing it because it makes me feel like a drug dealer,” said the student, who didn’t want her name used because sharing or selling prescription drugs can be a felony and a violation of university policies. If caught, she could get kicked out of school or face jail time, but she doubts that would ever happen.

For more than two decades, college students have illegally taken prescription stimulants such as Ritalin and Adderall to stay awake and hyper-focused while studying. As sales of medications for attention deficit hyperactivity disorder soar, administrators worry that illegal use also is increasing.

The White House Office of Drug Control voiced concern about the increase in its latest strategy report, which promises to introduce policies in the next few years that will target college students and a range of substance abuse issues.

But cracking down on study drugs is nearly impossible, said several college administrators who have worked on the issue as it has gained wider attention in recent years. Students who abuse study drugs don’t reek of marijuana or show the tell-tale signs of excessive drinking. They rarely end up in hospital beds or jail cells.

“People on Adderall don’t pee in the hallways,” said Daniel Swinton, president of the Association for Student Conduct Administration and an assistant dean at Vanderbilt University. Study drugs are “kind of a silent issue. Everyone’s aware of it, but I think we’re all focused on the more prevalent one — alcohol.”

Hard to catch

During an average school year, a major local university typically will respond to hundreds of cases involving alcohol, dozens involving drugs and only a handful, at most, involving prescription stimulants, according to a Post analysis of statistics from area schools.

At more than a dozen major universities in the Washington region, there were nearly 1,400 drug-related cases during the past two school years. Of those, only three dozen were related to prescription drugs, most of which were ADHD medications.

When students using study drugs are caught, it is often in connection with another crime. University of Maryland police had three cases involving prescription stimulants in the past two years. Last spring, an officer investigated the smell of pot in a residence hall and found a student with marijuana and Adderall. During traffic stops in December 2009 and February 2010, officers found pills when they searched cars.

When misused, prescription stimulants can cause an irregular heart beat, panic attacks and in rare cases death, especially when mixed with alcohol or other drugs. These prescription medications are similar to cocaine and can be addictive. But experts say there is little evidence of a widespread medical crisis or growing rates of addiction.

In the past decade, University of Virginia students have made about 16,000 visits to the emergency room. Only a handful of those visits involved stimulants, said James C. Turner, executive director of U-Va.’s Department of Student Health and former president of the American College Health Association.

“Maybe they just use it once to stay up late to study, but they’re not becoming chronic users,” Turner said.

It’s difficult to pinpoint the amount of illicit use taking place, as studies often use different measures that result in a wide range of results. Most college substance-abuse policies now include the words “prescription drugs,” and many schools educate students about the dangers of study drugs during orientation or health seminars. They also are trying to identify the issues that drive abuse, such as excessive stress, poor study skills or too much partying on school nights.

At some schools, including American, parents are told to check in with their students during midterms and finals and ask questions about how they manage stress. At U-Va., students are told that if they need drugs to make it through their homework, they should get tested for ADHD or a learning disability. Duke University declared that illegally using prescription stimulants is academic dishonesty.

Other schools are targeting potential dealers. At George Washington University, students with ADHD prescriptions are told to purchase a safe for their dorm room.

Academic steroid?

Students who want to try the drugs usually don’t have to look far for a classmate with a prescription. Millions of children and adults have received a diagnosis of ADHD. Last fall, 5 percent of incoming college freshmen had the disorder, according to the Higher Education Research Institute.

Without prescription drugs, many of these students might not have made it to college. In the 1980s and ’90s, Ritalin became the first ADHD drug to gain renown. But most of today’s college students are more familiar with Adderall, an amphetamine introduced in the United States in 1996 that comes in a variety of generic forms with different names. Sales of ADHD medications have increased from $4 billion in 2006 to $7.2 billion last year, according to IMS Health, a health-care information company.

For many students, college is an ongoing experiment in risk assessment. As they contemplate popping one of the illicit drugs, they probably weigh the potential benefits (hours of laser-like focus) against potential consequences (getting in trouble or getting hurt).

“I think that’s the calculation that a lot of college students are making,” said Molly Young, 24, a New York writer. “It can be really helpful. That’s the truth.” Young said she often took extended-release Adderall without a prescription when she was an undergraduate at Brown University. Her pills mostly came from friends, although she also ordered some online.

While some students flaunt the fact that they take study drugs, others hide it. Young said she told very few people at Brown about the habit because, “there was something shameful in conceding that you needed chemical help.”

One of the many nicknames for ADHD medications is “Ivy League crack,” and “The Onion,” a satirical news publication, once published a piece about Harvard University presenting an honorary degree to the drug.

But the average user is often a below-average student, according to a study by the University of Maryland’s Center on Young Adult Health and Development. The center surveyed 1,250 students and found that those using stimulants had a grade-point average of 2.82, lower than the non-user average of 2.96. Users also studied two hours less per week, socialized three and a half hours more and missed more classes.

Such evidence suggests that some students party so much they fall behind academically, and turn to study drugs in an effort to catch up. So, are these students cheating? Are ADHD pills a kind of academic steroid?

Some colleges have begun to pose these ethical quandaries in hopes they will curb study-drug abuse in a way that health warnings and legal threats have failed.

This fall, the Duke University Office of Student Conduct added another bullet-point to its list of things that are considered cheating: “the unauthorized use of prescription medication to enhance academic performance.” If the office learns that a student might have violated the policy, the charge would go through the disciplinary process and, if warranted, a punishment would be assigned.

The student newspaper’s editorial board largely backed the decision, comparing a scholar on stimulants to a football player on steroids. But it cautioned that stimulants are only symptoms of a bigger problem — unhealthy academic competition.

“Students see their peers as direct competition for job offers or spots in graduate and professional school,” wrote the Duke Chronicle staff. “With this mind set, many students strive not only to do well themselves, but also to do better than their competitors — that is, their classmates.”

Jenna Johnson writes about Maryland politics, including the General Assembly, the administration of Gov. Martin O'Malley and the 2014 election.
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