A 24-year-old college graduate commits suicide after becoming addicted to Adderall. A Vanderbilt University student jumps in front of a train after his Adderall habit spins out of control. A 25-year-old is seriously mauled after leaping into a tiger pen at the Bronx Zoo; his father reported that he was abusing Adderall.
It's no wonder that parents are concerned about teens and young adults abusing Adderall, a mixed-salt amphetamine, which is prescribed to treat attention deficit/hyperactivity disorder (ADHD). The number of children diagnosed with ADHD has skyrocketed in recent years: 11 percent of all school-age children have received an ADHD diagnosis, according to a recent study by the Centers for Disease Control and Prevention. And since 2007, sales of Adderall and similar stimulants have doubled from $4 billion to $9 billion. But at exam time, it's the unprescribed use of Adderall as a so-called "study drug" that's cause for concern.
"In my immediate group of friends, say 10, 15 people, I don't know anyone who hasn't taken it." –Michelle, 21-year-old nursing student
"I would say 30 percent of the students in my course are using it," says Michelle, 21, a nursing student at a California University, who asked not to be identified—her parents, who are in the medical profession, would not be impressed. "In my immediate group of friends—say, 10, 15 people—I don't know anyone who hasn't taken it."
The stats on Adderall abuse vary: The National Survey on Drug Use and Health found that 6.4 percent of college students said they had abused Adderall in the past year. But individual colleges report abuse rates as high as 43 percent. And the problem is not just among college kids: One in five U.S. high school students have taken either Adderall, Ritalin, Oxycontin, Percocet, Vicodin or Xanax without a prescription, according to the CDC.
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The rise in abuse represents a cultural shift, says Dr. Lawrence Diller, a behavioral/developmental pediatrician and family therapist in Walnut Creek, Calif., and author of Running on Ritalin. "This subculture of Adderall users in the older teen and young adult population is worrisome," says Diller. "I've never been against the use of drugs for kids who need them. Their use in children is safe, but the use in older children and teens worries me. We should worry that we've accepted that performance-enhancing drugs can be used across the board to maximize performance. So if you're an older teen or adult and your aspirations and goals don't match your talents and temperament, you become a candidate for Adderall."
Diller won't write prescriptions for college students unless they can prove they can take them responsibly. "College kids wouldn't call me from September through November. Then, in December before finals, they'd call me for pills. That's how most people use pills in college: intermittently, to cram for exams. But by giving them pills, I'm facilitating the ADHD lifestyle, which is to procrastinate and procrastinate, then cram. That sets them up for a lifetime of abuse."
Improving her performance is what motivates Michelle to pay around $7 to another student for a 30 mg pill to take around exam time. "Usually you can ask around and somebody will know somebody who has it," she says. Students who have a prescription often stockpile their pills; others report that they simply know the right thing to say to a psychologist to score a diagnosis and prescription themselves. "Grades are so important," notes Michelle. "With my program you can't get below a C in the class or you're going to get kicked out. There's a lot of pressure on us to succeed and do well. Nobody wants to flunk out."
Experts differ on the dangers of the drug. Data show that the number of deaths of children and teens on ADHD drugs is very low (lower, in fact, than you would expect from chance) and likely attributable to cardiac problems, says Dr. John T. Walkup, director of Child and Adolescent Psychiatry at N.Y.-Presbyterian/Weill Cornell Medical Center in New York. ADHD drugs also do not lead to the abuse of other substances, he says. "Long-term studies about appropriately treated ADHD patients show that stimulant drugs actually reduce the risk of addiction," he says. "People worry about whether these meds will turn into an addiction, but the best evidence suggests that treating ADHD is actually protective." Not only that, but the drugs don't give kids traditional "highs," Walker says, and can cause a "sour mood" and an "off feeling." Because of that, he says, kids who don't have ADHD aren't eager to take them on a regular basis.
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Zack, 21, a business management major at a California college backs that up. "I like to eat, and it makes you not want to eat very much," he says. "You feel weak if you haven't eaten. And at night I need my sleep, and Adderall makes you stay up really late." He says he takes half a pill to help him focus on his studies, and not often: "A couple of times in one week per semester. I only take it when I need to get motivated to get stuff done. It's about being focused." But this can also lead to an accidental side effect: "If you get super focused on something that is not your work, that can wind up being distracting," Zack says. "I've actually taken it then started playing video games, and you just can't stop. It's only good when you get into writing a paper and just can't stop."
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As common as it seems, Diller warns that Adderall abuse should not be taken lightly. "Amphetamines have been around for 80 years, but there has always been a core group of people who get in trouble with them," he cautions. "If you snort or shoot ADHD drugs, the effect is the same as meth. It's not the same physical addiction as heroin or alcohol. But when you crash after being up for three days, you feel horrible and you crave more amphetamines. These people act very erratically, very badly and are prone to high-intensity rage.
"Unless a person is closely managed on the drug, there could be tendency, even taking it orally, to get in trouble with it," Diller says.
If you're worried that your child is abusing Adderall, the first step is to ask. But other signs include erratic behavior: "Irritability interspersed with mild grandiosity," says Diller, as well as complaints of trouble sleeping, rigidity and insistence, all within the context of struggling to maintain an expected academic performance. Unfortunately, as Diller notes, most of these are difficult to distinguish from other extreme adolescent behavior.
