Simon Essig Aberg
Approximately 2.5 million Americans are prescribed prescription stimulants such as Adderall or Ritalin to treat Attention Deficit Hyperactivity Disorder (ADHD).1 ADHD is a brain disorder that makes it difficult to concentrate and increases impulsive behavior.2 Prescription stimulants help to reduce these symptoms. However, many people use these drugs for non-medical purposes and without a prescription, especially college students who buy them from a friend with a prescription.1
The use of drugs like Adderall and other so-called “study drugs” has skyrocketed over the past two decades. One reason is that the Food and Drug Administration (FDA) approved a version of the drug, Adderall XR, which lasts much longer than other prescription stimulants. Another reason is that more young Americans are diagnosed with ADHD and this results in more prescriptions. In fact, over the past decade, the manufacturing of prescription stimulants has increased by a whopping 9 million percent!3
How many of these pills are used to treat ADHD? A study of more than 10,000 college students from across the country found that more than half of students with an Adderall or other ADHD drug prescription were asked to sell the medication to peers and friends.4 Almost every student who abuses these drugs in college gets the drug from a friend or classmate with ADHD.1 One study of students at Bates College, a small Maine liberal arts college, found that one in every three students had abused Adderall at some point.5 In contrast, a national study of 10,000 students found that approximately 7% had abused “study drugs,” although the percentage varied at different colleges.4 Whether the typical abuse rate is 7% or 33%, or something in between, the extent of the problem is alarming.
People who abuse Adderall and similar drugs tend to have several characteristics in common. For example, a disproportionate number are white, in college, and belong to a fraternity or sorority. Because these drugs are commonly used to help students focus on reading or studying, abusers tend to have grade point averages of a B or lower.4
Causes and Common Justifications
Not surprisingly, around three quarters of prescription stimulant-abusers use the drug for academic purposes—to help them stay awake, focus, and study before a big exam.1 However, ADHD medications do not make students ‘smarter.’ It may help them focus and stay awake, but abusers should not expect the drugs to help with more complex learning such as writing better papers or studying for college-level exams.6
Prescription stimulant abuse may also occur for social reasons because students want to stay up later than they would otherwise. Some students claim that taking Adderall makes them more talkative and better company. Additionally, about a third of students have taken to get high or experiment. Most of those that take the drug for this reason are men. These experimenters usually only use the drug to get high a few times, whereas regular users tend to use stimulants for academic purposes. Approximately one in five women who take the drug do so to lose weight.7 Because Adderall and other stimulants reduce appetite, some abusers see it as a means to simultaneously study and stay in shape. However, taking these drugs to reduce appetite is unhealthy for a number of reasons, especially because the body does not get the nutrients that it needs.
Many students with an Adderall or other ADHD prescription believe that distributing the drug is legal and a good way to make money. However, these drugs are Schedule II drugs, meaning the Drug Enforcement Agency has labelled it highly addictive. The minimum sentence for distributing a Schedule II drug like Adderall is five years in prison.4 Very few students are aware of this and it is not commonly enforced.
Why “Study Drug” Abuse is a Problem
Students often do not feel guilty after abusing Adderall and similar drugs because they believe they are self-medicating for an attention deficit disorder or do not consider the drugs to be as dangerous or illegal as other Schedule II drugs, such as cocaine or opioids. Educators, however, may need to decide if the abuse of “study drugs” is comparable to an athlete using steroids, and if more attention should be paid to the prevention and punishment of illegal prescription stimulant use. Even though these drugs do not make students smarter, does using them the night before the test to stay up cramming give a student an unfair advantage the next day? Even if the advantage is not greater than caffeine, should it be treated differently if the drug was illegally obtained?
Every drug comes with risks, and Adderall and other ADHD drugs have more risks than many other commonly used medications. When physicians prescribe a patient that has ADHD a drug like Adderall, they should carefully weigh the risks against the benefits it provides. Students who abuse these stimulants often do not consider the risks of the drug either because they are not aware of them or they assume that, as an FDA-approved drug, there are no risks. The most common side effect of Adderall and other stimulants is insomnia, which appeals to students who use it stay awake. In short-term studies of Adderall’s safety, conducted by the manufacturer, they found that the drug caused gastrointestinal problems, blurred vision, increased body temperature, increased blood pressure, increased heart rate, reduced circulation, and irritability. While these effects are minor for most young people, if a student has a heart condition, Adderall could be deadly. In rare cases, Adderall can cause hallucinations, cardiac arrests, and even death for people with a heart condition. The likelihood of these risks occurring increases if Adderall is used without a prescription and at higher than recommended dosages, as often is the case among abusers.8 Similarly, a study of Ritalin found that the drug significantly increases risk for heart arrhythmia, and, for users with pre-existing heart conditions, may lead to serious conditions like heart failure.9
The attitudes of parents, students, college administrators, and law enforcement towards Adderall and Ritalin abuse have been ambivalent; since they are used for studying, they are often assumed to be just a little different than caffeine. However, if students have serious attention issues, they should see a doctor for a medical diagnosis instead of asking a friend to illegally use Adderall or other prescription stimulants. At the very least, students need to be aware of the serious risks that can occur; although the most serious are rare, that doesn’t matter if it happens to you or someone you care about. Parents, health care professionals, counselors, and college administrators should be sure to include Adderall and other “study drugs” in any conversation about the dangers of substance abuse.
All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.
- DeSantis AD, Webb EM, Noar MS. “Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach.” Journal of American College Health 2008. 57(3):315-323. ▲
- The National Institute of Mental Health. “Attention Deficit Hyperactivity Disorder.” March 2016. ▲
- Varga MD. “Adderall Abuse on College Campuses: A Comprehensive Literature Review.” Journal of Evidence-Based Social Work 2012. 9:293-313. ▲
- McCabe SE, Knight JR, et al. “Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey.” Society for the Study of Addiction 2005. 99:96-106. ▲
- Graff Low K, Gendaszek AE. “Illicit use of psychostimulants among college students: a preliminary study.” Psychology, Health, and Medicine 2002. 7(3):283-287. ▲
- Lakhan SE, Kirchgessner A. “Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.” Brain and Behavior 2012. 2(5):661-667. ▲
- Teter CJ, McCabe SE, et al. “Illicit Use of Specific Prescription Stimulants Among College Students: Prevalence, Motives, and Routes of Administration.” Pharmacotherapy 2006. 26(10):1501-1510. ▲
- Spencer TJ, Abikoff BH, et al. “Efficacy and Safety of Mixed Amphetamine Salts Extended Release (Adderall XR) in the Management of Oppositional Defiant Disorder With or Without Comorbid Attention-Deficit/Hyperactivity Disorder in School-Aged Children and Adolescents: A 4-Week, Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled, Forced-Dose-Escalation Study.” Clinical Therapeutics 2006. 28(3):402-418. ▲
- Shin JY, Roughhead EE, et al. “Cardiovascular safety of methylphenidate among children and young people with attention-deficit/hyperactivity disorder (ADHD): nationwide self controlled case series study.” British Medical Journal 2016. 353:1-8. ▲