Editor’s Note: To protect their identities, sources’ *names have been altered.
It was during his junior year at St. Thomas Aquinas High School in Overland Park, Kan., when Chris Turner* first had an urge to try something different.
He was a successful student, at least by his standards. He passed his classes and had plans to attend K-State after graduation.
But still, something felt different. He felt behind, and he wanted an edge.
By then, Turner knew about Attention Deficit Hyperactivity Disorder, or ADHD. The condition intrigued him, and Turner frequently thought he might suffer from the disorder, but he never consulted a doctor to ask questions or seek a proper diagnosis.
“[I] wasn’t able to stay focused during classes,” he said. “There were 30 people in each class, which was kind of a lot coming from smaller classes in previous [years]. There was more to divert your attention, and so when you hear about people beginning to get diagnosed with ADHD and hear about the symptoms, then you kind of start to think that it might be something that you might have.”
Above all, he felt he could do better, and though he tried he never found an answer for his lack of attentiveness and motivation in the classroom.
In his junior year of high school, Turner’s close friend approached him and offered him a dose of Adderall for the first time. The small capsule was a prescription-strength amphetamine-based stimulant used by children and adults to combat the symptoms of ADHD.
The offer was simple and intriguing to Turner. Others used it and he thought it gave them the edge he was seeking, and so he accepted the offer.
“I was like ‘Yeah sure,'” Turner said. “So I did, and then just noticed I was about a thousand times more involved in my classes for the rest of the day.”
There was no doubt in his mind the pill had helped. In fact, Turner said he used Adderall a few more times throughout the remainder of his high school career, even though he still never saw a doctor.
The exchange he made with his friend at St. Thomas was illegal, and Turner said he knew it, but it didn’t bother him. To him, the use of Adderall was an academic aid, not drug abuse.
“I think it was purely academic,” he said.
With the drug, he had found the answer he was seeking, temporarily at least. It was a powerful tool to combat his distractions.
As Turner would soon learn after graduating high school, Adderall is extremely popular with several other students for the same reason it helped him.
When Turner arrived for his freshman year at K-State in the fall 2008 semester, he pledged to a fraternity house on campus, and immediately was drawn into the social and academic atmospheres of college life.
He had only taken Adderall a few times in high school and didn’t plan on using it again unless he received a proper prescription.
But it didn’t take long for the stress and pressure of college to trigger the thought of using it again.
And it didn’t help that Adderall was even easier to obtain at K-State.
Though he said he didn’t plan to use it again, Turner’s workload quickly piled on and he sought the extra edge.
“It just happened,” he said. “I just heard about people using it and how much it helped them with their homework, and so I kind of tried it again. I figured I had a six-page paper due two days later and was just like ‘All right I’ll just take it just for this paper.'”
Living in a fraternity house provided Turner the chance to use Adderall almost as often as he thought he needed to. But he had to pay for the pills this time, which cost him about $5 to $10 apiece.
The accessibility amazed him.
“It was probably like a one-phone-call-away kind of thing,” he said. “You kind of know who has it, so it’s very easy to get ahold of.”
The fraternity house is where he met Tim Parkin*, also a sophomore. Parkin didn’t have a prescription for Adderall either, but curiosity and the accessibly within the fraternity house and on campus allowed him to take advantage of the drug with relative ease.
“I knew there were a couple of people within my fraternity that were doing it,” Parkin said. “I tried it a couple of times and it was something that was beneficial for me.”
Together the two of them bought doses of Adderall from members in the fraternity house and around campus whenever they felt they needed an extra boost in their studies or homework.
“It was just for studying for tests usually,” Parkin said. “I took it a couple of times a week before tests or busy weeks.”
It’s a habit that has become increasingly common on college campuses across the nation. According to a July 2005 New York Times article, a study focusing on college campuses showed as many as 20 percent of students report using Ritalin or Adderall for academic assistance.
“I have noticed and been able to observe the tendency or the increase in prescription medication to manage all types of behavior,” said Travis Linnemann, professor of sociology and graduate student in sociology. “Stimulants such as Adderall tend to be the most common one, and it just makes sense that as kids transition from secondary education to post-secondary education that they would come to college and they might be presented with the opportunity to abuse these drugs more readily.”
Parkin, who began using the pill during his sophomore year at K-State, said he immediately noticed the effects.
“There was definitely a difference,” he said. “My tests, I felt better prepared for. With that being said, I was at a point that spring semester when I was on it, I used it as a crutch. It made me feel good because I was actually studying more and I felt motivated to do it.”
Linnemann said students often use school to justify their abuse of Adderall.
“I think some of the deviance related to it is reduced when you think about in terms of doing something pro-social,” he said. “Using this drug not recreationally in a deviant manner to get high or do whatever else, but to be able to accomplish an acceptable task reduces at least some of the cultural consequences of it.”
THE LEGALITY, A CONSTANT BATTLE ON CAMPUS
Even though he didn’t have a prescription, Turner was never worried about the legality of his involvement with buying and selling Adderall.
And he’s not alone.
According to a study conducted by the Psychology Health and Medicine Journal in August 2002, 35 percent of college undergraduates at one university reported to have tried prescription amphetamines without a proper prescription.
That statistic doesn’t surprise Turner.
“I think it’s more casual than a regular kind of illegal drug,” he said. “I would say 75 percent of the people that use it illegally, use it for academic purposes instead of recreation. That is probably one of the biggest differences.”
Ronnie Grice, K-State police chief , said controlling the distribution of Adderall and other prescription drugs throughout campus is difficult. The campus police have received very few reports of illegal use of Adderall, which creates a difficult scenario for officers.
“Adderall is a difficult drug to detect abuse in,” Grice said in an e-mail interview. “We are aware of the illegal use, but have taken very few reports. They are easily concealed from roommates and family, odorless and can be perceived as prescribed drugs.”
But if students are caught, the penalties are harsh and even include prison time. Those who are actually caught by law enforcement illegally selling Adderall to students face the same punishment as selling any other illegal drug in the amphetamine category.
Adderall is considered a schedule-two, controlled-substance drug under the U.S. Drug Enforcement Agency’s five level list, with engaging in the buying or selling of schedule-one drugs considered as the highest offense. Other drugs categorized as schedule-two include cocaine, morphine and methamphetamine.
It’s a tough system that Linnemann said many students are not aware of.
“In those cases the rationality of our drug system is designed to get street level dealers of all drugs,” Linnemann said. “It files everybody under the same kind of rubric and doesn’t have any way of being flexible.”
After using the pill for some time and becoming familiar with its effects, both Turner and Parkin said they wanted to make the process legal.
During his sophomore year, after using Adderall illegally for three years, Turner sought medical help.
“The reason I wanted to get a prescription was to kind of make it official,” he said. “It wasn’t even necessarily to go there for a prescription, it was to go and see if I actually had ADHD, and see if I could make it legal or legitimate.”
But what he discovered during his appointment with his psychiatrist was the diagnosis process was much different than he anticipated.
THE FUZZY DIAGNOSIS PROCESS
Turner discovered there is no universal method of testing for ADHD, despite the sharp increase in diagnoses. Studies show the diagnoses of ADHD have increased 3 percent per year from 1997-2006.
Typically patients like Turner will encounter a simple question-and-answer session with a therapist where they discuss their symptoms in the classroom or daily life.
At his medical office in Topeka, Bob Alan said he makes sure to fully evaluate his patients when diagnosing ADHD, often meeting with his patients several times.
“What I’m looking for in the diagnosis is obviously a deficit of attention,” Alan said. “I kind of reverse those words a little bit. So I’m checking the ability of the kid to pay attention and also I always look at how the family interacts with the child; that is going to get a lot of detail and how the ADHD plays out at home.”
During his visit with a psychiatrist, Turner said he openly discussed his previous experience with Adderall, and was surprised at the ease of which he received his diagnosis and eventually a legitimate prescription for Adderall.
“If you have a Mountain Dew you will have all of these symptoms,” Turner said. “It’s kind of shady I would say.”
It’s a situation that Linnemann, who worked for 10 years as a high-risk probation officer in Riley County, said he has rarely seen with any other drug.
“It’s really different,” he said. “I don’t know of any other drug that is that difficult to develop a diagnosis or treatment.”
A study conducted by the U.S. Department of Health and Services found that 4.5 million children ages 3 to 17 years of age have been diagnosed with ADHD. Boys were more than twice as likely as girls to be diagnosed with the condition at 11 percent, while 4 percent of girls were likely to be diagnosed.
It’s the increase in diagnoses that has stemmed a feeling of familiarity and is fueling the trend of abuse on college campuses, Linnemann said.
“I think that it is so common and so often used and ingrained,” he said. “We prescribe so many more psychotropic and behavior management drugs in this nation compared to other nations. I think we have normative value or normative standards for it.”
THE DANGEROUS SIDE EFFECTS
Taking Adderall does come with its costs. The small pill has some heavy side effects that come with it, some might be more severe than the typical user expects.
According to a New York Times article and a study conducted by the American Journal of Psychiatry, “sudden death” has been reported as one of the rare side effects of Adderall use among children and adults.
Most of these sudden death cases were seen in children who had suffered cardiac abnormalities before taking Adderall, however there were still a small number cases of sudden death in children who did not previously suffer from heart conditions.
According to a report from Psychiatric News, there were 20 reports of sudden deaths associated with Adderall use, 14 of which were children, while six were adults. In the United States, 12 children were victims of sudden death.
Adderall is not banned in the United States, but the FDA did issue a formal warning addressing this rare phenomenon in the use of Adderall.
More common side effects of Adderall use include weight loss, dizziness and trouble sleeping.
Parkin said his doctor discussed these side effects with him during his initial visit.
“He just wanted to check on some things, but was a bit hesitant,” Parkin said. “I guess somewhat reluctantly, but he said, ‘This is how it is going to be, but I guess we can try this out,’ but he did offer alternatives.”
Adderall has had an effect on both Turner and Parkin’s lives and after initially experimenting with Adderall, they have both received legitimate diagnoses and prescriptions for their conditions.
They now face the temptation of selling the drug themselves, as they both have a constant supply. But it’s part of living with a label of ADHD.
“I don’t want people coming up and asking all the time if they can buy,” Parkin said. “But I will do it for the financial benefits, and so they can see the benefits themselves.”
It’s the same process both Parkin and Turner went through themselves when curiosity led them to discover their condition. Now, medicated school looks different, in a good way.
But it is clear there needs to be an education process provided to college students across the nation to combat the abuse of prescription medication, and according to Linnemann, education is the answer.
“Combining clear, non-exaggerated information about the risk of any drug and making that available to all students and allowing students, once they are educated or informed, to make their own decisions,” Linneman said.