Editor’s Note: Names of sources connected with illegal Adderall use were changed.
Three times a day, she pops the pill. Yellow extended release for the morning. Blue instant release at lunch, then at night.
Junior psychology major Elise Alvizu’s Adderall prescription helps treat her attention deficit hyperactivity disorder. But she knows other IU students are taking the medication without a prescription.
Adderall is tucked away in dorm room dressers and discussed openly in lecture halls. When tests and papers pile up, the pill stimulates concentration on schoolwork and blocks out distractions.
“Everybody has this advantage now that they have Adderall,” Alvizu said. “You can get so much done.”
One in seven students at IU has taken the pill without a prescription in the last six months, according to the 2013 Indiana College Substance Use Survey conducted by the Indiana Prevention Resource Center. The same study shows illegal Adderall use at IU has remained relatively steady for the last three years.
“I get asked (for Adderall) all the time, and it gets awkward,” Alvizu said, explaining she never sells. “I could be making a ton of money. It is really appealing, obviously, but prescription drug selling is dangerous.”
The Food and Drug Administration classifies Adderall in the same category as cocaine and methamphetamine. In Indiana, possessing Adderall without a prescription is a class D felony, and selling is a class B felony. Despite its illegality and University attempts to teach stress management, Adderall abuse persists on campus, as it has for more than a decade.
With one pill’s quick benefits and often no immediate health or legal consequences, student attitude toward illegal Adderall use is apathetic — a culture of “I don’t care.”
“It’s widely abused on campus,” said IU Police Department Deputy David Hannum, who works in narcotics. “I could give you 10 bucks and tell you, ‘Go out to buy Adderall’ and you’d be back in 30 minutes. That’s how easy it is.”
GETTING THE PILL
Since Adderall’s release in 1996, young adults have become the fastest growing prescribed population. Obtaining an Adderall prescription is a long process at IU. Students must be diagnosed with an attention deficit disorder, either through their own doctor or the IU Health Center.
“We have a very detailed and careful screening for students who have focusing problems,” said Nancy Stockton, IU Health Center director of Counseling and Psychological Services.
During the Health Center screening process, students meet with a counselor and a psychiatrist who can prescribe the medication. In a 2010 study, only 12 percent of students who initiated the screening were assessed as having ADHD.
“I think the process is rigorous enough that it is challenging to get a prescription under false pretenses,” Stockton said. “Are we ever fooled? I’m sure it happens, but we try to be careful.”
A questionnaire at his doctor’s office was all it took for sophomore Dustin Law to receive a prescription.
“I just went to my doctor in my hometown and told her that I had focusing issues and that college work was a lot harder to keep up,” Law said.
The ease of getting a prescription from some family doctors adds to the general proliferation of Adderall, said Jennifer Reiter, a pharmacist with Bloomington Hospital In addition, an Adderall prescription can leave a student with extra pills.
“When people are prescribed Adderall, especially in college, they may only need it to study, so they may not use it all,” Reiter said. “It’s not something you have to take every day.”
Sarah Phillips is an anthropology professor who recently completed a study on illegal prescription drug use at IU.
Her study indicated that most IU students abusing the drug get it from other students who have legal prescriptions.
For about $5, students can find the pill from friends and friends of friends, Deputy Hannum said.
Joe*, a junior, said his extra 15 pills a month often make their way to friends. He credits the pill, which he was prescribed in elementary school, with helping him make it into the Kelley School of Business.
“I’m at a disadvantage if I’m not taking it, because I have ADD,” he said. “It levels the playing field.”
He said he sells when his customers have an upcoming test or project.
“Of course it’s going to help them do better. Is it fair? I’m not one to say,” he said. “You’d be focusing harder, but it’s not going to give you the answers.”
He mainly sells to his fraternity brothers, but he doesn’t give out the pill every day, and he doesn’t usually charge friends.
“Sometimes I feel bad saying no to someone. It’s hard to not accept their money, too,” he said. Joe explained if he refuses to sell the pill, his friends are annoyed.
“They’re like ‘Wow, what an asshole.’”
Joe said he doesn’t feel responsible for his customers.
“A, it’s their own choice,” Joe said. “B, they know what they’re getting into. C, pretty much everyone has done it before.”
HOW IT WORKS
As a psychostimulant, Adderall generates a temporary improvement in mental function. Its chemical structure is similar to both methamphetamine and ecstasy, said Jennifer Babchuk, a neuroscientist who completed her master’s thesis on the effects of Adderall. Adderall is thought to work by restoring the balance of neurotransmitters, namely dopamine, in the brain.
Scientists generally agree that people with ADHD have low levels of dopamine, Babchuk added.
“The overall theory is that by stimulating dopamine it would increase attention and decrease distractibility,” she said.
For someone without an attention deficit disorder, Adderall still has a stimulating effect, resulting in euphoria and increased concentration.
“If any of us took it once or twice we are going to have more energy and focus,” Stockton said.
The increased brain stimulation can also lead to insomnia and anxiety in the long term, as well as an elevated heart rate and blood pressure in extreme cases. More common side effects include a loss of appetite, dry mouth, nervousness and mood changes.
As an FDA Schedule II drug, Adderall also has a high risk for dependence and addiction.
“If I wanted to, I know I could get addicted to this,” said Katie*, a resident assistant who used Adderall without a prescription twice this semester. With one day to write a nine-page paper, she used Adderall as a “last resort.”
Legal user Michaele Gambrall plans to stop taking the drug after graduation, because she said she hates the side effects of feeling shaky and nervous.
“I feel like I’m coming off a drug,” Gambrall said about her Adderall wearing off. “Anyone who is taking it, prescribed or not prescribed, is susceptible to any of the different side effects.”
Alvizu said the drug improves her mood and makes her more interested in her surroundings.
“I personally really like it,” Alvizu said. “I think I am just overall more organized and efficient when I’m on Adderall.”
Phillips found that students generally weren’t worried about the negative effects of the drug.
“Frankly, there’s not a lot of concern by students about the long-term health effects,” Phillips said, referring to the study’s preliminary results. “Even though students reported side effects, like difficulty sleeping and lack of appetite, they still didn’t seem to be concerned.”
WHY IT’S TAKEN
Katie first took Adderall during spring finals week her freshman year.
“The coffee wasn’t doing it anymore,” she said.
Steve*, now a graduate student, tried Adderall as an undergraduate.
“My roommate had a prescription,” he said. “I knew that taking this would make me focus and retain knowledge for class.”
He said he currently uses Adderall about once a semester, often after putting off long papers.
Mary*, a sophomore, remembers taking the pill as a freshman watching the Little 500 race, when she was exhausted and needed to stay awake. She first turned to Adderall for schoolwork after she had studied for eight hours and couldn’t remember a word she read, she said.
“I was just kind of like, I need to do something,” Mary said. “I might as well just see if Adderall works.”
Now, there’s about one week each month that she uses Adderall every day.
Both Katie and Mary pressure themselves to maintain a B-average while juggling other activities.
“Students with the highest GPA tend to report that they don’t use psychostimulants,” Phillips said. “Those in the 3.0-3.4 GPA range had the most use. That perception that it must be the lowest GPA students who are struggling to hang on did not show up in the study.”
Katie said the transition to college made schoolwork more difficult. She believes she has an attention deficient disorder that has yet to be diagnosed.
“Now that I have so much free time that I can either go hang out or do my homework later, I feel like there are so many more distractions,” she said. “Hopefully in a job it will be a lot easier to motivate myself. When I’m doing accounting for three hours, I’m not motivated.”
Phillips said one difference between IU users and other universities is that IU students seemed to investigate the drug before taking Adderall.
“I definitely did some research,” Steve said. “You have to understand that you are taking a drug. It’s something chemically created. If you look at it logically, it’s still not legal, but I know what I’m doing.”
Office of Alternative Screening and Intervention Services Director Jackie Daniels said most of the students she has worked with see Adderall as harmless.
“I really think they were kind of disconnected from the Adderall being a stimulant and messing with your brain chemistry,” Daniels said. “They think, ‘It really helps for finals, because you have a lot of difficult tests.’”
The more dangerous aspect of the drug is combining it with alcohol, when the stimulating effects of Adderall keep a student awake and unaware of how intoxicated they truly are.
The population of students combining alcohol and Adderall is smaller — 6.7 percent of Indiana college students mixed alcohol and stimulants in the last six months, according to the 2013 Indiana College Substance Use Survey.
But the problem is serious, Daniels said.
“With alcohol and Adderall it’s an antagonistic affect,” she said. “One is trying to pull you down, the other to pull you up.”
Even if students don’t plan to use the drug with alcohol, it could unknowingly be in their system when they drink at night, she said.
Katie said that as an RA she would be unlikely to reprimand her residents for taking Adderall to study — but if they combine the pill with alcohol, they cross a line.
“Being on Adderall and drinking is just not a good thing, because you don’t realize how drunk you are feeling,” she said. “If it was something like this where they are putting themselves in severe danger, I’m going to step in.”
Deputy Hannum hears a lot about student Adderall abuse. But gathering enough evidence for an arrest is a different story.
“If they’ve taken the pill, it’s too late,” he said. “There is a lot of it going on that we can’t catch.”
When he does find Adderall, it’s usually during another search, in the pocket of a person who has been pulled over or in the dresser of a dorm room being searched for
marijuana, he said.
Hannum began work in narcotics with IUPD in the 1980s, returning to the department in 2001. Adderall was already on campus and being abused by the time he returned, he said.
“It’s something new every time you turn around,” Hannum said.
He now issues citations for illegal Adderall use or sale several times a semester.
Selling a pill is a class B felony, while possessing it without a prescription is a class D felony.
“It’s not worth the risk, but they do it every day,” he said.
The legal process for a student convicted of illegal possession or sale of Adderall is especially strict in Indiana, said Director of Student Legal Services Randall Frykberg.
He added that he believes students don’t take the legal consequences seriously.
“Anyone selling it is a full-out felon drug dealer in the eyes of Indiana,” Frykberg said.
“That’s what scares me. You are on the same level as selling baggies of meth.”
Joe said getting caught selling doesn’t cross his mind.
“I’m not worried about getting caught at all because there are just so many places you could get it,” he said. “I’m not selling it in the dorms to random kids.”
Following an arrest, the county prosecutor could charge a student through the Monroe County Court system. Even if the student was not charged with a felony, the arrest would remain on public record.
IU receives a report from police and conducts an internal justice process through the Office of Students Ethics, which decides the consequences of the violation.
There is no clear census on whether students think illegal Adderall use is “cheating,” Phillips said.
“Some students clearly think it’s cheating, but at the same time it’s become so normalized, so accepted, that there’s not a lot of stigma attached to it,” Phillips said.
A fall 2013 OASIS study showed that 39.7 percent of IU students approve or strongly approve of taking amphetamines, including Adderall, once or twice. Only 17.7 percent approved of taking them regularly.
Katie said the pill is like a protein shake before a workout.
“I still have to do the work,” she said.
Steve said Adderall is a tool that allows him to improve a paper he is working on.
“It’s a personal performance enhancing drug, he said. “I can put out my best work knowing that I can take Adderall to concentrate.”
Psychostimulants don’t help people learn new information or perform tasks that involve creativity, but might improve retention of previously acquired information, according to a July 2010 article in the academic journal Neuroscience and Behavioral Reviews.
“If they’re cheating, I’m cheating,” Gambrall said about illegal users. “Just because I’m prescribed to it, doesn’t mean they don’t need it. People who really abuse it are the kind of people who are procrastinating staying up all night anyway. I don’t see them as law offenders.”
Alvizu explained she doesn’t think using Adderall is cheating because it’s not a “miracle pill.”
“I can do all the things I do on it without Adderall,” Alvizu said. “Its not like I’m learning three languages in one day. It just helps me get my homework done.”
During finals week, students slump in exhaustion on Indiana Memorial Union couches. Starbucks overflows with freshman cramming with notecards and seniors flipping through study guides.
Phillips’ study confirmed the common conception that Adderall use increases around exam time.
However, Stockton said the Health Center does not offer any specific education programs about Adderall before finals.
“We do a lot of increased stress management and get ahead of a need for Adderall,” she said.
She said one of the difficulties in any health campaign is reaching the intended
audience — in this case potential Adderall users.
“I think it’s an uphill challenge,” Stockton said.
The subjects in Phillips’ study said they would be resistant to University educational campaigns against Adderall abuse.
“They said, ‘Please don’t do that to us,’” Phillips said.
Curbing illegal use requires changing student attitude, Daniels said.
“The way we look at it now, it’s socially acceptable to take Adderall to study,” Steve said. “It’s under the table, but also completely accepted. It’s something that can be seen as over the counter and pretty much is.”
Joe laughed as he recalled a poster he saw on campus reminding students Albert Einstein didn’t take Adderall.
“That’s not going to stop anyone.”
Follow reporter Megan Jula on Twitter @meganjula.