In times of academic crisis, some turn to a quiet nook in the library and some snacks, while others blast their “One Direction Top Hits Playlist” in hopes of cranking out that essay. However, as we grow up, we start seeking out adult solutions to adult problems. On college campuses across the country, some perceive taking a pill as the “adult solution” to tight deadlines and large workloads. Normally used to hinder hyperactivity, some college students use Adderall to help them hunker down. But can popping this pill produce more harm than good?
You may have heard that Western doctors “push pills.” Everyone knows the visit to the doctor’s office all too well: the nurse taking your weight and blood pressure, and the doctor visiting you for 10 minutes max. Then you get prescribed a pill that can supposedly solve all your problems.
The practice of prescribing amphetamines has been used in American medicine since the 1920s, but grew most popular in the 1930s, where it was used to elevate mood, create a rapid increase in energy and increase awareness of surroundings.
During World War II, the U.S. military gave soldiers Benzedrine, the first true amphetamine commonly known as “go pills” to soldiers to amp them up for battle. After the war, another amphetamine, Obetrol, was highly popular among women to help them stay thin due to the drug’s appetite-suppressing effects.
However, in the 1970s, the Food and Drug Administration stepped in with strict regulations, and the drug plummeted in popularity. Over 20 years later, however, a pharmaceutical executive Roger Griggs decided to tweak Obetrol into a new drug: Adderall. He aimed to target it at a new market, patients with narcolepsy and ADHD, which is arguably the most under-diagnosed and under-treated of all psychiatric disorders, although some would say the exact opposite.
For patients with a legitimate diagnosis of ADHD, amphetamines like Adderall can produce a calming effect. When Adderall works the way it should, it triggers neurotransmitters in the prefrontal cortex, the part of brain responsible for executive functioning, and subsequently improves one’s concentration and focus.
According to Adrian Millman, M.D., there are a couple of different theories with regard to why this is the case.
“Part of the hyperactivity in ADHD is due to mental boredom, and ticks and twitches are ways of people with this disorder trying to stop themselves from falling asleep. Using a stimulant helps them become and remain more awake,” said Millman.
The drug then triggers dopamine in the basal ganglia, which keeps you calm and alleviates hyperactivity and impulsivity. However, for patients with other conditions, Adderall can be extremely dangerous.
Dr. Nicholas Sikaczowski, a psychiatrist from Peace Behavioral Health here in Miami explains that people with ADHD have a dopamine shortage, and for people without ADHD “they would still get increased dopamine release, but since they don’t have the dopamine deficit,they are more likely to have side effects.” He continues, explaining that “Since [Adderall] has similar neurochemical effects as cocaine, just less euphoria, as it is working largely on similar molecules.”
As a patient is screened for ADHD, most psychiatrists simultaneously screen patients for mood disorders before prescribing a drug like Adderall. For a patient with bipolar disorder, this drug may trigger a manic episode or psychosis.
Then why do most students that take Adderall without a prescription? Does Adderall really turn students into academic powerhouses? Do more people have ADHD than we think?
Peer Prescriptions
Even though most scientific studies have found that Adderall usage can derail individuals who don’t have ADHD, this reality simply doesn’t tie into most students’ experiencies. According to most students, Adderall “works,” and the market for the drug is increasing at the speed of light. Because of this, some students take advantage of the opportunity in a different way: dealing.
According to an anonymous student at the University of Miami who is prescribed Adderall for their ADHD, most students at UM do not buy it off the streets. This same student chooses to sell his medication for a variety of reasons.
“The reason I sell [Adderall] is because I come from a household where income is on the low-end, and affording things like rent and food and tuition and all that is a little bit more difficult. So I [sold Adderall] on top of working a couple of other jobs,” said the anonymous dealer.
When asked how much money this student made, they divulged that their Adderall selling income was “anywhere from the low-end of $100–200 a month to upward of $1,000.” But how is it possible that campus dealers don’t get caught? How do they keep it under wraps?
“The way that I go about new clients is kind of iffy. I started doing it on my floor freshman year, so it was mostly people I met in person on the floor or people who were friends with people on the floor,” said the dealer.
When asked about what kind of people the seller’s clients are, they explain there is a wide range, probably because Adderall usage is so normalized at UM. However, many different reasons cause students to turn to Adderall: the most common being schoolwork.
“I get a lot of procrastinators,” the dealer said. “Which is how I operate anyway, so there’s no judgment there. [I get] a lot of business school kids.”
They added that a lot of people turn to Adderall during times of intense stress or burnout — such as exam week — to give them the final push they need to cross the finish line.
A Versatile Vice
Adderall is a little more than the “study drug” as lot of people see it as. The dealer explained that he gets a lot of people who are so-called “preppier” and “fraternity or sorority type people.”
An anonymous girl in a sorority, who is a frequent Adderall user, is addicted to the way the drug makes her feel when going out.
She said that on Adderall, she becomes “more of a present person” and more invested in conversations. “I don’t care. I’m active and social and having a good time.”
As we all know, most social events in university involve alcohol, and when asked if she had ever experienced mixing the two, she advised others to go forward with caution regarding this particular brew. She explains that when mixed with low doses of Adderall, the alcohol’s sedative effects tend to overpower the mind and body but, at higher doses, she explains that she either wouldn’t even be getting drunk or, on the flip side, may black out in five minutes and vomit.
Dr. Sikaczowski explains why this is. “Adderall, since it is a stimulant, inhibits, some of the feeling of being drunk or intoxicated. Since it lasts shorter than alcohol, someone can feel like they’re not intoxicated, and when the Adderall wears off, they can hit a wall and pass out in the street.” This may also translate to “blacking out.” Simply put, they can go from not feeling very intoxicated, to being very intoxicated.
He also explains that when people die of stimulants, it is usually because of dehydration from alchohol mixed with a stimulant like Adderall. So tread with caution.
Rewinding to the effects of low doses versus high doses, she explained her experience with the two.
“[At] low doses, I am awake. I feel like I have had a cup of coffee and am more focused,” she said. She explains the sensation as feeling “very centered.” However, at higher doses, the effects can be unpleasant. For reference, the average Adderall dose is 20 mg but at one point, this female student was taking 70 mg at once, in part because of her eating disorder, which spurred her Adderall use during her junior year of high school.
“I started taking it to suppress my appetite,” she said. In fact, she ended up losing 60 pounds in four months. As part of taking this extremely high dosage, she recounts how she felt “very hyper, out of control and twitchy. My heart felt like it was almost cramping and beating out of my chest.” Aside from becoming an academic weapon at first, consistent Adderall usage is a slippery slope.
Aside from becoming an academic weapon at first, consistent Adderall usage is a slippery slope. “All stimulants are addictive,” said Millman. “In the traditional way they increase dopamine, and that feeling may lead to addiction, but for other people they find themselves more productive, better in relationships and this leads to unhealthy habit forming.”
Millman further explained that, almost ironically, Adderall usage runs even more rampant in graduate degree programs, such as medical school.
He recounts that “there were certainly a bunch of my med school peers who got questionable diagnoses of ADHD during their time of study.” He notes that medical students tend to have a lot of confidence and, because they are so knowledgeable on the effects of this drug, they can go about taking them more responsibly and without any risks, avoiding habit forming addiction. “Which couldn’t be more wrong,” he added.
Running Off Reserves
Because the drug is being abused more and more, there have been multiple regulations put in place regarding how one can obtain the drug.
According to the student dealer who is prescribed the drug, “[people used to be prescribed Adderall] through primary care, but now you have to see a psychiatrist, be evaluated, and then they fill out the prescription. But if you get it prescribed in a different state, you can’t have it filled in Florida because it is a controlled substance.”
As appealing as it may seem making upwards of $1000 a month, “the punishments are the reasons I stopped,” the dealer said.
“According to the statute of limitations, I think I can be punished for it 3 years after I’ve done it. It’s a large fine and potential expulsion from the university, but I don’t think there is any jail time associated with it,” said the dealer. However, under federal law, one could face up to 20 years in prison.
Irrespective of Adderall abuse in the U.S., the global Adderall shortage for those with genuine need for the medication is not something to be ignored. Due to the shortage, many street dealers have stopped selling, as they need the drug for themselves. In more severe cases, they’ve had to dial down their prescription and take it less than the prescribed amount, in fear of running out during times of need.
Dr. explains that, in his opinion, big online companies — the ones you may see T.V. commercials for, may be in part responsible for this shortage. He says “I believe its being overprescribed. For 30% of my patients with ADHD, the pharmacy doesn’t even have it in stock.”
“Large online corporations prescribe addy to almost everyone who asks for it,” he states.
But is Adderall truly as dangerous as it seems? Does the drug have the potential to be fatal? According to Millman who works in the emergency room, becoming “critically ill from abusing Adderall is uncommon in the ER” and he has never seen a case of Adderall toxicity. Furthermore, at UM, most students would say that Adderall usage is typically seen as safe.
According to the anonymous sorority girl, if someone overhears another discussing their Adderall usage, the most common reaction isn’t disgust or judgment. The usual response is instead, “Want to share?”
words_veronika valia. photo&design_valeria barbaglio.
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This article was published in Distraction’s Fall 2023 print issue.
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