Adderall Subtracts

There are only seven days until Christmas and it is two in the morning. O'Neill Library is packed. Students are memorizing note cards for a psychology exam, writing papers on Shelley and Keats, and trying to organize their thoughts to write 25 pages on the Crimean War.

For Molly*, a senior history major at Boston College, the task of focusing long enough to finish her final paper seems monumental. Thanks to the gift of a friend, a tiny blue pill makes it easier. Her 20th pill this semester, Molly says, "It gives me the concentration I need to stay up all night and write this. And if I get tired, I will just take another one."

The pill is Adderall XR, a psychostimulant, which is of the class of prescription amphetamines used to treat Attention Deficit Hyperactivity Disorder (ADHD). Adderall XR is an extended release pill, which means it does not impact an individual all at once, but doctors still consider it to have high potential for abuse and addiction.

At college campuses across the country, Adderall XR is being widely used by students who do not have ADHD, reported the Drug and Alcohol Dependence Journal in 2005. Students say it brings about more focused study, longer hours of cramming, and ultimately higher grades.

Although students across the country use it illegally, Adderall XR is not difficult to obtain. Shire Pharmaceuticals, which manufactures the drug, says that over 100,000 prescriptions have been dispensed since it was released to the market in 2001.

At BC Health Services, there have been 89 requests for prescriptions of Adderall XR since June 2007, says Nancy Baker, associate director of Health Services. "While we try to impress upon the students we prescribe Adderall to be very cautious with their drugs, we know that there is a lot of conversation out there about sharing medications," she says.

For some, it is as nearby as family. Sarah*, who is a psychology major, has always had trouble concentrating on her work. She gets the medication from her brother, who is prescribed Adderall to treat his ADHD. Sarah has been taking the drug since high school, and says that she is aware of how much of it she can handle. "With one pill, I am much more productive. But with two, I feel like I'm on speed," she says.

"I can't eat, my thoughts are going too fast, and I feel like I'm going crazy."

Although many students know where to find it, not as many know the side effects of the medication, which are amplified in people who do not need the drug. Laurel Eisenhauer, professor emeritus in nursing and drug therapy at BC, warns students against the dangerous effects. "A student who takes Adderall without ADHD will become hyper-excitable and there is even danger of a stroke. When they come down off the medicine, there is always a physical depression," she says.

Jane*, a double major who uses the drug to write the many papers assigned during finals, recognizes the feeling. "The next day, you feel like a house with termites. You feel hollow inside and physically exhausted. You know you just did something bad to your body," she says.

Jane is not alone in her age group. Recent data from the National Survey on Drug Use and Health indicates that an estimated 21 million persons aged 12 or older in the United States, or about 9 percent, have used prescription stimulants non-medically at some point in their lifetimes. The highest percentage of users comes from the 18-to-25 age group.

"I think college students are the biggest users," says Ali*, a straight-A student who has been taking Adderall since high school but significantly increased her usage at BC. "Here, it is easy to find and easy to hide. And it makes the demands of college a lot easier."

Non-medical usage of Adderall and other psychostimulants, such as Ritalin, are on the rise at college campuses. A recent study by the National Center on Addiction and Substance Abuse at Columbia found that the proportion of students abusing these stimulants increased by 93 percent between 1993 and 2005.

With an increase of this magnitude, doctors have begun to study why. Judith Shindul-Rothschild, Ph.D., who teaches Advanced Psychopharmacology at BC, notes the rate of success Adderall has in those who are prescribed it. "When students use it, coaches, teachers, parents, and the student themselves all report they are doing better," she says.

Ellen*, a cultural diversity major, also saw the effects of the stimulant. "I saw the difference it made for one of the girls in my class on a test. So now when she isn't using her prescription, I ask her if I can buy it," she says.

Diagnoses of ADHD are also growing in children, which leads to more Adderall prescriptions, more prevalence of the drug in schools, and - as these children grow up -on college campuses.

According to a recent report in Psychiatric Services, a journal of the American Psychiatric Association, ADHD-related doctors' office visits by children ages 3 to 18 have doubled between 1993 and 2003. The number of visits that included a prescription for an ADHD medication more than doubled, from 2.7 million to 6.6 million.

For those receiving these prescriptions, there are mixed feelings about sharing their drugs. John*, a student who takes Ritalin for his ADHD, says the abuse of stimulants by other students has made it difficult for him to get a prescription for a medication he desperately needs. "Every time I need a new prescription, I have to go into the doctor's office and pay a fee. The doctors are suspicious because so many kids fake needing it," he says.

Sam*, who is prescribed a 20 mg dosage of Adderall XR as needed for ADD, does not see a problem with it. "I think that it has a really good stimulant effect that all students should be able to have," he says. "Although, I think it might be counterproductive for someone who doesn't really need it."