Christine, a second year communication major, said she tried Adderall for the first time last year because she was behind in her reading. A friend in her dorm told her about the drug and Christine — not her real name — said she was open to try it.
“I had about a bazillion pages to read and the situation was looking dire and then my friend was like, ‘Whoa, calm down. This will help you.’ And that was that,” Christine said.
Some students on college campuses know Adderall as a “study drug” because it helps one stay focused and awake for long periods of time. Addreall and other medications, such as Ritalin, Dexedrine and Cylert, are amphetamines prescribed to people afflicted with Attention Deficit Hyperactivity Disorder (AD/HD).
Jackie Kurta, Alcohol and Drug Specialist at Student Heath Services, said there is a growing concern among health educators for students developing a psychological dependence on drugs like Adderall.
“Students start out taking study drugs one time to study,” Kurta said. “The drugs work so well that the students begin to lose confidence in their own abilities to study without them.”
Study drugs are classified as stimulants. Stimulant drugs affect the brain by mimicking the body’s natural chemicals. The specific mechanism stimulant drugs use to target the brain is still unclear, said Alan Fridlund, an associate professor of psychology at UCSB.
“All AD/HD drugs work by increasing the turnover of certain neurotransmitters,” Fridlund said. Certain neurotransmitters — small molecules responsible for many brain functions — called biogenic amines are responsible for controlling response and inhibition instincts. Specifically, molecules such as dopamine, epinephrine and norepinephrine are regulated by stimulant medications.
“People with AD/HD are going around chronically understimulated and many sensations are not going through,” Fridlund said.
Understimulation manifests itself in many of the characteristics common to people with AD/HD. Fridlund said underactivity in areas of the pre-frontal brain is responsible for response inhibition and response selection. For example, understimulation in the pre-frontal areas may cause a person with AD/HD to have difficulty making everyday decisions.
“Stimulant medications are dramatically effective for people who are formally and accurately diagnosed,” Fridlund said.
Currently, there is no distinctive biochemical marker — no smoking gun test — to determine if someone has AD/HD. However, differences exist between the brain of someone with AD/HD and the brain of someone without.
“Something obviously is going wrong [in the AD/HD brain]; it is just unclear where it begins,” Fridlund said.
AD/HD has three classifications: inattentive type, hyperactive-impulsive type and combined type.
“Approximately three to seven percent of preadolescents have AD/HD, while the range can be much greater,” said Hani Talebi, an advanced doctoral candidate in clinical psychology.
There are numerous criteria for diagnosing AD/HD, such as frequent forgetfulness, aversion to tasks requiring sustained mental effort, excessive running or climbing or blurting out the answers before questions are finished. Talebi said certain pathologies might be present in some patients, while a different set of pathologies will be present in others.
“One of the difficulties for correctly determining whether a person truly has AD/HD is that the diagnosis is on a sliding scale,” Talebi said. “Two doctors with different backgrounds might have two different opinions.”
Talebi said the subjective diagnosis procedure creates tension within the clinical and pharmaceutical communities. He said some researchers think that AD/HD is overdiagnosed.
“There is reinforcement for physicians to prescribe AD/HD drugs and manufacturers often provide kickbacks for physicians who prescribe them,” Talebi said.
Sales of Ritalin — used in 80-90 percent of AD/HD cases — have increased 700 percent since 1991. Ritalin’s manufacturer has contributed nearly $1 million to AD/HD support groups since that time. Talebi said that this cycle was worse in the 1990s and a crackdown has since reduced it.
The Science of Study Drugs
AD/HD medications are designed to have a different effect than other stimulant drugs, such as methamphetamines and cocaine. These medications deliver a lower dosage over a longer time scale when accurately prescribed by a physician. Some of the key differences between Adderall and other prescription medications include a longer release time and a more effective chemical compound. Fridlund said prescription stimulant medications have a very low rate of addiction because of the extended release time.
Fridlund said addictive drugs commonly have a high rush potential, meaning that the body rapidly absorbs the drugs. A rush potential is the ability of a drug to provide a rapid high. This process is followed by a subsequent rapid removal, in which the drug user experiences a crash.
“When prescribed in appropriate doses, the rush potential of [AD/HD] medications is low,” Fridlund said. “When there is a high rush potential, addiction occurs.”
Withdrawal symptoms after stopping use and loss of control over intake usually indicate addiction.
Kurta said she is seeing more cases of students abusing prescription Adderall. Unlike marijuana or alcohol, where a user is visibly stoned or drunk, Kurta said Adderall users have an easier time hiding their usage — a fact that makes them less likely to seek treatment for dependency until they have developed a serious problem.
“People can go quite a while without disclosing use to their friends, professors or health educators,” Kurta said.
Often times, she said study drug use can escalate to other types of stimulant use, such as methamphetamines or cocaine.
Kurta said some of the serious cocaine addicts she helps to treat began their drug-using habits with study drugs.
“People abuse [study drugs] all the time,” said Ian Kaminsky, Ph.D., Director of the Alcohol and Drug Program at Student Health. “Students feel the pressures of college and are open to try [study drugs] a couple of times.”
Kaminsky said that students are often introduced to study drugs when they’re behind in their schoolwork or have an upcoming exam.
Christine said she currently uses study drugs several times each quarter to write papers and get through midterms and finals. She said many of her friends and people she knows also use study drugs occasionally.
“I think it’s a waste to use it for everyday homework,” Christine said. “Everyone I know that uses [Adderall] keeps it in moderation.”
Students obtain study drugs from other students with prescriptions for AD/HD or from their own prescriptions.
“I have a couple of friends with prescriptions who sell Adderall, instead of taking it themselves,” Christine said.
When stimulants are prescribed to AD/HD patients, the doses are unique to each individual. The common range for medications is between five and 40 milligrams. In order to determine the appropriate dosage, patients will usually undergo a trial period.
“[Patient specific dosages] introduce serious problems for sharing [medications],” Kaminsky said.
Another source of study drugs available to students is the Internet. Some online pharmacies offer drugs without a prescription or a doctor’s recommendation.
“Drugs from the Internet are especially dangerous,” Kaminsky said. “You never know what you really get.”
Kurta said educators at Student Health want students to know that there are options other than study drugs to aid in study skills. She said the UCSB campus offers stress management programs, campus learning assistance services and counseling though health educators.