Wisconsin: ADHD Drugs On College Campuses
WASHINGTON (CBS) "Do you know what Adderall is? Do you know Ritalin? Do
you know now that Ritalin is a street drug? Do you understand that?" Tom
Cruises now infamous rant on the Today Show has been the brunt of many
jokes, but when it comes to Adderall and Ritalin, two prescription stimulants
used to treat ADHD, Mr. Cruise may not be so far off.
Adderall and Ritalin have in fact become "street drugs" at Americas
colleges and universities, where prescription stimulants often replace coffee
and CliffsNotes as the study aids for todays college students.
"Its very much like coffee, but its a little bit more intense," says
a Brown University student who has an Adderall prescription and who requested
that her name be withheld. She reports regularly selling her medication to
other students, most of whom wanted it to help them focus their schoolwork.
"People wanted it so often. People would pay almost anything," she
said. Her asking price was up to five dollars a pill. "I sold a lot more
than I took, thats for sure," she said, "It was like a bartering
thing, I had something people wanted and they had something I wanted."
Her experience is not uncommon. "In general, the illicit use of prescription
drugs is second only to marijuana in terms of being the most common form of
illicit drug use on college campuses," says Dr. Sean Esteban McCabe, interim
director of the University of Michigan Substance Abuse Research Center. According
to Dr. McCabes recent survey, 6.9 percent of American college students
have taken prescription stimulants illicitly, and up to 25 percent at certain
elite universities with high academic pressures and admission standards. More
than 50 college newspapers have already published articles describing Adderall
abuse on campus.
Unlike many prescription drugs, which may work only for people with a medical
condition, Adderall and Ritalin improve the focus of everyone. They work by
enhancing Dopamine and Norepinephrine pathways that are involved in attention
and are deficient in the brains of patients with ADHD. The drugs are identical
in most ways and they're equally popular on campus.
"I heard about somebody who was selling it, and since it was easily accessible,
I decided to try it," said a Vassar College student who preferred not
to be named. "It helped me concentrate; it helped me motivate to spend
a long time working on a project."
Because they are prescribed by physicians, medications like Adderall and Ritalin
often seem safer than illicit drugs and may therefore be more attractive to
students. "I dont think theres a cachet about doing Adderall
the way there is about doing coke," the Vassar student said. "You
dont need someone to do a line with you, and its not social like
marijuana."
Rather than taking the pill orally, some students attempt to increase the
buzz by crushing it up and snorting it. The Vassar student reported that she
knew people who "crushed it and snorted it and went all night together,
taking breaks and hanging out."
Abuse of ADHD medication can also begin even earlier than college. Jeremy
Wayne Swanson, a 21 year-old from Hudson, Wisconsin began abusing Ritalin in
Junior High School. Jeremy is part of another group of prescription stimulant
abusers -- those who obtain the drugs legally with a physicians prescription
to treat their ADHD. "I started not to like the feeling I got taking it
normally. I felt like a walking zombie," he said. "I would put it
in my mouth, walk out of the nurses office and then take it out of my
mouth, walk into a bathroom, and snort it."
Jeremy also sold his medication, making up excuses as to why he needed frequent
refills. "I was supposed to be doing 4 a day, but I was snorting about
10-15. People would come to me at all hours of the night and say ‘just
give me some, please, please, Ill give you anything."
For Jeremy, Ritalin was a gateway drug that he believes opened the door to
cocaine and methamphetamine addictions. After being caught at school with cocaine,
Jeremy entered rehab and then a halfway house. He has been clean since 2003,
and is now studying to become a drug counselor for others with drug addiction
problems. When asked what he would say to students now abusing ADHD medications,
Jeremy says he would "try to completely steer them away from it. You think
of it as harmless, but its really not."
Abuse of prescription drugs among teenagers, however, is on the rise nationwide.
A new report by the National Center of Addiction and Substance Abuse at Columbia
University found that teenage abuse tripled between 1992 and 2003. "Theyre
easily available," says Joseph A. Califano Jr., chairman of the center
and former U.S. secretary of health, education, and welfare. "Theyre
in every medicine cabinet in the country; theyre in every town in the
country."
The problem is likely to get worse. "As more and more kids are diagnosed
with ADHD, not only children but also young adults, there are going to be more
of these drugs available for college students to get a hold of," says
Dr. William Frankenberger, director of the Human Development Center at University
of Wisconsin-Eau Claire.
Many students believe these drugs help them focus on their studies, but there
is doubt as to their actual academic advantages. "People are better able
to pay attention for prolonged periods without getting tired and fatigued.
That is true for everyone," says Dr. Frankenberger. But this does not
necessarily indicate improved performance, he warns.
As stimulants, Adderall and Ritalin may interfere with normal sleep. Students
often feel like theyre better prepared, but dont do as well.
This is also true for patients who are prescribed the medications by physicians,
and there is some indication that children on ADHD medications may actually
fall further behind, says Dr. Frankenberger, perhaps due to sleep interference.
So what is the harm of using Adderall and Ritalin? If it helps everyone focus,
at least in the short term, then why not make it over-the-counter?
Amphetamines are highly addictive and easily abused. "The longer you
take them," says Dr. Frankenberger, "the more problems are associated
with your use, and the higher dose you take, the more prominent the side effects
become."
Adderall and Ritalin are serious prescription drugs with real risks and side
effects including nausea, loss of appetite, insomnia, and anxiety. The drug
information sheets also include a long list of negative drug interactions.
If a person is taking a drug with possible chemical interactions, there could
be serious consequences.
Adderall XR, the extended release version of Adderall popular on the college
scene, has already been banned in Canada because of possible links to cardiac
arrhythmias in children. The FDA looked at the same evidence as Canada, but
kept Adderall XR on the market. Doctors take extensive medical histories before
prescribing Adderall, and patients with possible cardiac complications are
not prescribed the drug. This is something that students taking it without
a prescription are unlikely to know.
Dr. Bruce Wright, Director of Health and Wellness Services at Washington State
University, also warns of possible long-term effects. "The brain has its
own kind of intrinsic reward system, so when something happens to us we feel
good," he says. "The parts of the brain that are responsible for
that are the same parts of the brain that drugs like Adderall impact. With
prolonged or frequent medication the brains own capacity to do that
decreases."
Perhaps of more immediate concern to parents is the indication that Adderall
abuse is often accompanied by other drug and alcohol abuse. Based on his survey,
Dr. McCabe believes that, prescription stimulant abuse "tends to be part
of a larger cluster of problem behaviors among college students, including
higher rates of other drug use and driving under the influence." Students
who had used a prescription stimulant non-medically in the past year were ten
times more likely to report marijuana use, twenty times more likely to report
cocaine use, and five times more likely to report driving after binge drinking.
Shire Pharmaceuticals, the makers of Adderall, have several programs geared
towards educating physicians, patients, parents, and college students about
the risks associated with Adderall. Matt Cabrey, a spokesperson for Shire,
says that the company has been focusing on educating physicians who prescribe
ADHD medications, the patients themselves, and the parents of those patients.
In addition, Shire recently initiated an education program designed specifically
to reach college students.
Mr. Califano says that the primary role of the pharmaceutical industry should
be to cut direct-to-consumer advertising. He also emphasizes the importance
of a public health campaign. "The responsibility is for the public health
officials," he says. "Weve gotten through with smoking, now
we need that kind of campaign for prescription drugs."
At WSU, Health and Wellness Services has developed tight protocols to carefully
monitor and limit the prescription of Adderall and Ritalin. "You cant
just come in and list the symptoms and get on Adderall," says Dr. Wright.
Dr. McCabe believes that "the first step is that colleges in the US can
become more aware. It may be that schools are able to provide programs to address
some of the underlying motives and students wont feel compelled to use
them in that way."
So is Tom Cruise right? Are Adderall and Ritalin really "street drugs?" For
some, yes. But, says Dr. Wright, "everything that can be abused is available
on the street." What does not fit in Mr. Cruises anti-medication
diatribe is the fact that Adderall and Ritalin are important and effective
medications for patients suffering from ADHD. Concern with the abuse and over-prescription
of stimulant medications must be balanced with the sometimes life-changing
successes that these drugs have for the people who actually need them.