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Pills become an addictive study aid

At colleges, students take a deadly risk by abusing ADHD drug

By MEGAN TWOHEY
mtwohey@journalsentinel.com
Posted: March 25, 2006

A tough math class prompted Rich to take the drug. The effect: "I could study for, like, eight hours straight," said the University of Wisconsin-Madison junior.

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Samantha, a Marquette University sophomore, popped it on the eve of a big history test.

"I stayed up all night," she said, "and totally zoned in."

For years, students have used coffee, NoDoz caffeine pills and other stimulants to help them through exams, papers and other demands of college.

Today, some students are taking a study aid that can be deadly.

Adderall, a medication for attention deficit hyperactivity disorder, or ADHD, has become popular among college students who don't have the disorder, according to students, college health officials and an emerging body of research.

Adderall is an amphetamine and works like cocaine. Those who use it can stay focused and awake for hours on end. Students with prescriptions sell it or give it away.

"If you can take a drug that allows you to stay awake through finals week and concentrate on relatively boring topics, you can see how the word would spread," said William Frankenberger, a psychology professor at UW-Eau Claire. He led a 2004 survey of students on a UW campus that found 14% had abused Adderall or another ADHD medication.

But using the drug without a prescription is dangerous. The federal government has classified Adderall under the same category as cocaine, opium and morphine, drugs with a high potential for abuse. It is illegal to sell it or use it without a prescription.

Side effects include insomnia, irritability and loss of appetite. In extreme cases, the drug can cause paranoia, hallucinations and heart attacks. Adderall and other ADHD medications have been reportedly linked to the deaths of 25 people in recent years. U.S. Food and Drug Administration advisers are recommending warnings on the drugs' labels.

Between the 1940s and 1970s, before their addictive properties were known, amphetamines were used to treat obesity, fatigue and depression, according to a 2005 report by the National Center on Addiction and Substance Abuse. Pilots used the stimulant during World War II to stay awake. Dieters used it to lose weight rapidly.

In the 1990s, amphetamines re-emerged. A growing number of children were being diagnosed with ADHD, a neurobehavioral disorder that makes people hyperactive and incapable of concentrating. Adderall and Ritalin, an amphetamine-like drug, were among the medications that were approved as effective treatments.

Between 1992 and 2002, the number of prescriptions for ADHD medications in the U.S. increased 369% to 23.4 million a year, according to the National Center on Addiction and Substance Abuse report.

In 2005, there were 31.8 million prescriptions for such medications, according to IMS Health, a pharmaceutical information and consulting company. The most popular was Adderall.

Colleges are now seeing waves of students who grew up on ADHD medication.

Some of the students don't need it, said Davis Smith, director of student health at Wesleyan University in Connecticut who has been gathering information about the use of ADHD medication for the American College Health Association.

Smith said aggressive pharmaceutical marketing campaigns and pressure from pushy parents have caused doctors to over-prescribe the drugs.

Eric Heiligenstein, clinical director of psychiatry at UW-Madison's health services, agreed.

"We have students who come in and say they got it just by asking for it at other clinics," he said.

When they don't need it, some students misuse their medication. So do students who are wary of becoming dependent. Instead of taking it twice a day, as often prescribed, these students only take it around exam time or in other high-pressure situations.

In 2000, UW-Madison surveyed 100 students with prescriptions for ADHD medication. It found that one in five misused the prescription regularly.

That has created opportunities for other students to get the medication, Heiligenstein said. Students with excess pills are often willing to sell them or give them away.

Abuse at competitive schools

A survey of students at 119 colleges nationwide found that, on certain campuses, up to 25% of respondents had misused ADHD medication in the past year. The survey, published last year in the journal Addiction, found that rates were highest at colleges that were competitive, those in the Northeast and those with high rates of binge drinking. Students with grade point averages of B or lower were two times more likely to use the drugs than students earning a B+ or higher.

Angie, a UW-Madison junior, said it's common for students to get Adderall from friends. She has paid $5 for a couple of pills. At other times, friends have given her the drug for free.

"Doctors are just handing it out," said Adam, a freshman at Marquette. "Friends are willing to give it away."

Doctors are supposed to review a student's medical history before prescribing ADHD medication. That's to make sure that they won't have a heart attack or another extreme reaction.

Students who get Adderall from friends have no idea how their bodies will react. Those interviewed for this story have had varied reactions.

Adam, the Marquette freshman, said Adderall gave him the energy to stay up all night. It also changed his attitude.

"It's almost like you enjoy the work," he said.

But the next day, he felt like he had an extreme hangover.

The effect on Rachel, a senior at UW-Madison, was much worse.

"Three hours after taking it, I started shaking," she said. "I felt like my heart was bouncing out of my body. I lost my appetite. I couldn't sleep for a full two days. It was a nightmare."

Rich, the UW-Madison junior, has taken Adderall for two years to study for tests. During that time his grades have improved. Today, he feels dependent.

UW-Madison's health center is seeing a growing number of cases like his.

"We see a blend of psychological and physical dependence," Heiligenstein said. "Students take it, get better results and feel like they can't go off. They say - I feel like I've built my whole GPA on this. How can I stop?"

Critics worry the drug is now being used like an academic steroid, creating an unfair playing field on college campuses.

But not everyone is popping it.

"I'll stick with caffeine," said Amanda Rosen, a freshman at UW-Madison, as she walked into the campus library, a chai tea in hand. "That way I'll know that I'm getting the grade."







From the March 26, 2006 editions of the Milwaukee Journal Sentinel
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