Gavin balances the metal tray on his lap, completely focused at the task at hand. He grinds the three orange pills to powder—slowly, steadily—with the bottom of a heavy cocktail glass, while eight sets of eyes watch in eager anticipation. Sitting in the middle of the room, he is quite literally the center of attention—and loves it. He babbles excitedly without purpose or pause.
“Did you see that guy downstairs?”
“When are we leaving—wait, wait, where are you going?”
“Who sings this song?”
Someone tells a joke. Gavin giggles.
After about ten minutes of compulsive mincing, he uses the edge of a dollar bill to form thin, uniform lines of the white powder.
He says jokingly, “look, I’m using dirty money like a cokehead.”
But it’s not cocaine that Gavin and the eight other Brown seniors are about to snort for a late-night energy rush. It’s what many doctors refer to as “kiddy coke,” and it is sweeping the dormitories and libraries of colleges throughout the nation.
It’s called Adderall, and can be bought for as little as $3 a pill. But Gavin gets his supply for free, from his best friend Ben.
Adderall is an amphetamine, a fast-acting stimulant in the same chemical family as cocaine and the infamous crystal meth. But unlike those narcotics, Adderall’s legal.
A tablet prescription, it effectively curbs the restless tendencies of many hyperactive children. It makes it easier to function in social and educational situations, which is especially beneficial to kids who have trouble paying attention at school.
Before he started Adderall, no one ever told Ben he had a learning disorder.
“I was always a very good student, you know, always got my stuff done,” he said. “But, after I started taking the pill, I was smarter. I could read for a long time, and got really interested in what I read.”
Since the early 1960s, close to 200 studies involving more than 6,000 children have investigated the efficacy of stimulants like Adderall for the treatment of inattentive kids. And according to a 1998 review article in the Journal of the American Medical Association, the meds work: stimulants significantly reduced hyperactivity and increased focus in more than 70 percent of the children tested.
But why use a stimulant to decrease hyperactivity?
Dr. Ronald Cohen, a clinical neuroscientist who specializes in attention at Miriam hospital, said it’s because of the precise workings of the brain’s frontal lobe, the seat of our attentional processes.
“It may seem paradoxical,” he said. “But really, there’s an inhibitory system in the frontal lobes that tells you: stop, look listen. So the stimulant better activates this system, making kids less hyperactive.”
Today, Adderall is America’s most widely prescribed drug for Attention Deficit Hyperactivity Disorder (ADHD) (surpassing the better-known Ritalin in 2000).
ADHD is the most commonly diagnosed psychiatric disorder of childhood, according to the National Institute of Mental Health. The neurologically-based disability affects between three and five percent of school-age children—that’s three million kids nationwide—and it occurs three times more often in boys than in girls.
No one knows exactly what causes ADHD, but twin and cross-generational studies have shown that it does have a genetic component. In 1994, the American Psychiatric Association set specific criteria for the accurate diagnosis of ADHD, which include the persistent symptoms of inattention, hyperactivity, and impulsivity.
The diagnosis of the disability has been a controversial topic in the U.S. in the past few decades, mostly because there’s no blood chemical, no brain protein, no physical blemish of any kind that definitively marks an ADHD kid from any other squirmy elementary schooler.
Ben now believes that he was originally misdiagnosed with ADHD by a psychiatrist he saw for depression and anti-anxiety problems.
“He started asking me questions, like, ‘when you’re reading a long and boring book for school, do you put it down in the middle?’ and I’d say, ‘yeah, sometimes.’ And then suddenly I had Attention Deficit Disorder,” Ben recalled.
So Ben started taking Adderall. He now takes two orange pills, 20 mg each, as soon as he gets up in the morning. Because the drug is time-released, his body absorbs it slowly all day long. He usually feels it start to wear off by nightfall.
Since the early nineties, American doctors have diagnosed more and more cases of ADHD. According to a 2000 study from the Journal of the American Medical Association, the use of stimulants by 2- to 4-year-olds increased three-fold from 1991 to 1995.
Cohen partly attributes the increase on the pressures of modern society, where so much emphasis is placed on academic achievement.
“Parents are looking for reasons why their kid isn’t doing as well as the next-door neighbor’s kid,” he said. “There are many kids with mild attention problems, who are singled out because they are only getting B’s in school but may have the IQ potential to get A’s. So do you call it ADD?”
And because children diagnosed as toddlers often take the stimulants well into adolescence and adulthood, the number of college students who pick it up weekly at the local pharmacy is also on the rise, making the drug readily available on any college campus.
Attesting to this, the scientific journal Addiction published a study earlier this year that surveyed over 10,000 randomly-selected college students across the nation. The reports were telling: 6.9 percent of respondents admitted to non-medical use of prescription stimulants like Adderall, and at some colleges this number reached as high as 25 percent.
Why do so many college students seek out Adderall?
“They call it the ‘academic steroid,’ you know,” Ben explained. “I don’t think it’s usually recreational. It’s just a shortcut, a way for them to get by without working as hard.”
The survey also found that non-medical use was higher among males, whites, fraternity and sorority members, and students who earned the lowest grade point averages. Students abused the drug most at colleges with competitive admissions standards in the northeast.
At Brown, especially in this season of lengthy term papers and tough exams, it’s Adderall’s ability to increase focus and motivation that appeals to students under a lot of academic pressure.
Gavin, a senior English major, has used Adderall dozens of times at Brown to write long academic papers.
“You take it and half an hour later, all you want to do is write,” Gavin said. “You pretty much finish the task in front of you. It lasts for like 12 hours, so you get done whatever you need to get done.”
Because it’s a prescription given to children, many college students perceive it as harmless. But this is far from accurate. For those with ADHD, the drug’s side effects may include decreased appetite, insomnia, increased anxiety, and irritability.
“I don’t eat when I’m on Adderall,” Ben said. I can’t—it’s gross to see food, especially four or five hours into it. But then I get really hungry at night when it starts to wear off.”
And for those without ADHD, the drug can take an even harder toll. Dehydration, hot flashes, stomach pains, marked aggression and even personality changes are possible side effects, according to the National Institute of Mental Health.
What’s more, Cohen warned that users without prescriptions may have unknown pre-existing conditions that would make consuming the drug especially harmful.
Without taking a full medical history, he said, taking Adderall is like “playing Russian Roulette.”
“If someone is relatively stable they might not have a reaction to it,” he explained. “But if you give it to someone who has a predisposition toward schizophrenia or manic episodes, there’s a big risk of going over the edge.”
With the recent increased rates in U.S. Adderall prescriptions, many experts worry about the potential for abuse due to increased availability.
And worry they should. The Addiction survey of 10,000 students stated that 54 percent of undergraduates who were legally prescribed stimulants for the treatment of their ADHD had been approached to sell, trade, or give away their meds within the past year.
The same survey showed—unsurprisingly—that non-medical use of stimulants correlated highly with the use of other illegal drugs. Of those who admitted to non-medical use of stimulants, 84.6 percent also used marijuana, 51.7 percent used ecstasy, and 34.6 percent used cocaine in the past year.
The potency and dangers of Adderall’s non-medical use exponentially increase when it is snorted or injected because it enters the bloodstream directly. Snorting Adderall, like any stimulant, may cause damage to the nasal and sinus cavities, respiratory problems, irregular heartbeat, psychotic episodes, and even death by toxic shock.
Cohen explained, “Even though you’re taking the same amount of drug, more of it is getting into the blood, and quickly, so its as if you were taking a much higher dose.”
The term “kiddy coke” is an appropriate one, then, for Adderall is chemically very similar to cocaine. Both drugs block the brain’s natural dopamine receptors, elevating mood and alertness using the same mechanism as anti-depressants.
Gavin snorts it when he’s feeling sluggish before a long night of partying.
“When I snort it, he said, “it has more of an energy effect. You’re just wired and you want to talk and have a good time.”
Also like cocaine, the Adderall crash can be quite extreme.
“Coming down is the worst,” said Gavin. “You definitely can’t eat, can’t go to bed...I have to drink or smoke [pot] if I want any chance of sleeping. So you’ve got to make sure to do it only when you don’t have anything important the next day.”
With the large rise in Adderall use—both medically and recreationally—there is a growing fear of a new generation growing up addicted to these “study drugs.”
Though he takes Adderall exactly as his doctor recommends, Ben still worries about what the drug does to him.
“It’s a drug I’m addicted to now, not just something that I’m being prescribed. They tell you you’re not changing yourself, that it makes you more like your normal self, but I’m not the same person I was.”
Gavin, too, recognizes the dangers of Adderall addiction.
“There is that risk, yeah. I mean, 20 mg every three weeks is very different than Ben’s 40 [mg] a day. But I realized that in the real world I won’t able to just take an Adderall to get my work done. It won’t be as easy to get.”
Ben hopes for a time in the future when he will no longer feel Adderall dependency.
“This summer I want to switch to a new drug—Strattera—it’s not a stimulant,” Ben said. “I figure it’s a good time to get off now that I’m done with school, and yeah, I wonder what it’ll be like to get off of it. But I think it’s the right thing to do.”
If caught with non-prescribed Adderall at Brown, the administration would generally follow state mandates as if it was cocaine or marijuana.
But Brown policies on use and distribution would depend on individual situations, said Associate Dean of Campus Life Terry Addison.
“It is an illegal drug. The student would have a judicial involvement, an internal investigation,” he explained.
Addison also said that distribution of the drug is more egregious than mere consumption, and that the amount exchanged would be a factor.
“We would ask if it was it just a couple of pills or a hundred,” he said. “Were they giving it to their whole floor or just one or two of their friends?”
The punishment would be still more severe, he said, if the student was uncooperative or combative when apprehended.
Regardless of how effective or fun the prescription drug may be, students should realize that when used without a prescription, Adderall is ultimately an illicit drug like any other.
Beyond the risk of disciplinary action, there are serious and long-term physical dangers that far outweigh any short-term academic advantage or single night of energy.
So this exam season, think of your health and try a Red Bull instead.