John* found himself in a bind last week - he had a test coming up in less than 24 hours, and he had yet to start studying. Friends he complained to at the gym suggested he pop an Adderall. By the end of his workout, he had a little orange pill and what he believed to be the solution to his problem.
With finals approaching, more and more students are turning to prescription drugs, particularly Adderall, to improve their concentration and enhance their study habits.
"(Adderall) can help people improve grades," said Dr. Steven Lipsius, clinical professor of psychiatry and behavioral sciences at GW. "It's a very legitimate drug when properly prescribed."
Adderall treats Attention Deficit/Hyperactivity Disorder and was approved by the Food and Drug Administration in 1996. It is a variation of the amphetamine Dexedrine and a milder form of Ritalin, also used to treat ADD/ADHD. The stimulant increases the levels of dopamine in the Central Nervous System and can create a sense of euphoria.
Lipsius said Adderall has its roots in Belgium, where cyclists would use the drug to stay awake for all-night bicycling races. Racers stopped taking the drug because the extreme doses "caused them to go psychotic," he said.
Lipsius said Adderall can be addictive, leading to dependency and more serious effects including restlessness, insomnia and, in rare cases, psychosis.
A lucrative business
John, like many first-time users, found himself turning to Adderall because of its accessibility on campus; he obtained the pill through a web of only three people. John said his first exposure to Adderall was successful and that he would use it again if it were available.
"Prescription drugs have been on campuses for quite some time," said Brian Hamluk, director of the Center for Alcohol and Other Drug Education.
He added that the problem is growing because "more students are prescribed drugs than ever before; therefore, the potential for abuse is greater."
Amphetamine prescriptions - mostly for Adderall - have skyrocketed from 1.6 million in 1996 to six million in 1999, according to a 2001 PBS "Frontline" report. And in a report released by IMS Health, a company that surveys drug trends, Adderall ranked 59 out of the top 200 most newly prescribed drugs that year with more than 4,000 new prescriptions.
More frequent users like Mike,* a GW senior, obtain pills regularly from other students who hold prescriptions for Adderall. Mike explained that doctors who write prescriptions for it are easy to find, making the drug more accessible to students.
Brian,* a GW sophomore, said a close friend was able to exaggerate symptoms of ADD in order to obtain a prescription.
"I know students who use it, supposedly because they have ADD, but I know they can function normally without it," he said.
He added that the friend does not, however, redistribute his prescription to others.
Students who sell the drug around campus to regulars like Mike or first-timers like John can turn a large profit. Pills normally run between $5 and $10 each. And although distributing Adderall can be a lucrative business for students, the consequences can be serious.
"Students may be charged with providing and/or distributing illegal drugs," said Tara Woolfson, direct of Student Judicial Services, in an e-mail last week.
Although students can obtain Adderall with relative ease, cheaper over-the-counter drugs and household stimulants, including the caffeine pill NoDoz and coffee or Diet Coke, can be delivered to a student's door by services such as Campus Snacks. But Mike said any sort of caffeine rush cannot compare to the high Adderall provides.
"Once you study with Adderall, studying under normal circumstances by comparison (is harder to do)," he said.
During one night of drinking and partying, Mike wanted a more intense high but did not turn to illegal recreational drugs. Instead, he chose to snort five lines of Adderall to get the buzz he desired.
One pill usually lasts three to six hours, depending on the strength of the dose. The medication takes about 30 minutes to become effective, so he alternated between ingesting and snorting the pills to maintain a constant high. Mike said he regrets his decision that evening and no longer uses the drug recreationally.
"I could not fall asleep or calm down, even though I was physically exhausted," he said. "I took some downers to counteract the high and eventually I fell asleep at four in the afternoon the next day."
Adderall is a central nervous system stimulant that increases levels of dopamine in the CNS. Dopamine released in the brain creates a sort of reward for the body when experiencing something pleasurable, creating a sense of euphoria. Cocaine and other amphetamines increase dopamine levels in the brain as well.
Adderall is more potent than caffeine but less potent than amphetamines, according to the National Institute of Drug Abuse Web site. And while it treats hyperactive children and adults who struggle with concentration, many people abuse it for "appetite suppression, wakefulness, increased attentiveness and euphoria."
In addition, stimulants such as Adderall can increase heart rate and blood pressure, constrict blood vessels, and increase glucose in the blood. Abusers will not develop a physical dependence with a risk of withdrawal. But a person can begin taking them compulsively and in increasing amounts, resulting in dangerously high body temperatures, irregular heart beat, cardiovascular failure or even lethal seizures.
"Unless it's been prescribed by a doctor, you shouldn't be taking it," Lipsius said. "At the least, it causes restlessness, anxiety, speeds up your heart rate and can cause headaches."
The Drug Enforcement Administration classifies all controlled substances into five "schedules" based on medical and non-medical use, addictiveness and abuse potential.
Schedule I drugs are non-medical, such as LSD, heroin and cocaine, while Schedules II to IV are medical. Alan Alexander, group supervisor for the DEA's Diversion Control Program in D.C., said Adderall and other drugs like Ritalin are considered Schedule II drugs.
"It's based on abuse, primarily," he said. "Schedule IIs can be the most addictive (medical) drug and the strongest in the medical field."
Other Schedule II drugs include narcotics and painkillers like Oxicontin and Percocet. Schedule V drugs include over-the-counter cough syrups, usually containing Codeine.
John was able to talk openly about Adderall at the gym. Users, some of whom affectionately refer to the drug as "Addy," do not view it as negatively as some illegal drugs. Many others students said they believe using Adderall is not a dangerous practice when done in moderation.
"I only use it when I put something off, and it's due the next day and I know I have to be up all night," freshman Stanley Kuo said. "I've only used it once or twice, but I know other people that use other drugs in addition to Adderall, and I look down on them."
Alexander said he thinks the perception of the drug must be changed.
"It's not more OK to abuse drugs because you can buy them as a prescription," he said. "It's dangerous and it's wrong, and that's the message you need to get out."
Lipsius said that although many students abuse the drug, he is unaware of research that has proven it to be a gateway drug. However, some students who are regular Adderall users also use illegal drugs, particularly marijuana.
"I only started using (Adderall) when I came to college," said a freshman who wished to remain anonymous. "A lot of pot heads do it."
Other students said they do not believe it's right to take study drugs to get an edge in the classroom.
"I think it is a sign of insecurity," sophomore Bradley Glanzrock said. "They feel they need some excuse."
Although the problem is not specific to GW, Hamluk said that CADE has had instances of prescription drug abuse and is aware of the problem.
He declined to provide numbers but said CADE is addressing the problem "through educational initiatives, specifically by the peer education program."
The Counseling Center is also available to students in need of help for prescription or other drug addictions.
*Due to the subject matter of this article, names have been changed to protect students' privacy.