A Silent Epidemic

There is a postcard view of the college campus instilled in our minds.Students walking in pairs across campus greens, on the way to class or to grab lunch; Roommates laughing, talking within the confines of their dorm room amidst Sublime posters and scattered clothes; A classroom full of students, hands raised and waving at the prospect of sharing their innovative thoughts; A student leaning in to kiss his girlfriend goodnight as he heads back to his room to write a 5-page English paper.The same student, returning to his room, opens a water bottle and pops a small blue pill into his mouth. Flash-forward to the wee hours of the morning – he’s still hard at work.If one of those scenes doesn’t quite fit onto your postcard, ask yourself: is it truthful to envision any college without imagining some students so overwhelmed, so exhausted they will take any help they can get merely to stay awake and focused long enough to finish their work?Or (gasp!) – are they just looking for a cheap, quick high?The cheapest, quickest acting drug of choice on many campuses is Adderall, a pharmaceutical stimulant that treats Attention Deficit Hyperactive Disorder and, in rare cases, severe depression. If you’re into slang terms, you may have heard Adderall being referred to as “Fatty Addy”, “study buddies”, “poor man’s cocaine”, “Addies” or “A+”. The high itself has been called “taking the A-Train”, after a Duke Ellington song of the same name.According to the National Institute of Drug Abuse (NIDA), Adderall contains a combination of amphetamine and dextroamphetamine. The high obtained from abusing the drug occurs because amphetamines have similar properties as speed and cocaine and causes intense bursts of energy. Psychological effects include enhanced mood, rapid talking, alertness and concentration, increased anxiety, wakefulness, hallucinations, insomnia, and euphoria. Some physical effects are tremors, enhanced body movement, nausea, dry mouth, itchy skin, quick breathing, and irregular heart rate. Often abusers will snort the pills (“bumping”) to achieve the high quicker, or take them orally in greater amounts.Similar ADHD medications include Adderall XR (extended release), Ritalin, Strattera, Dexedrine and Concerta – all of which are also popular on college campuses.According to Dr. Paul Cotton, Staff Psychiatrist at the Student Health and Medical Clinic, UVM follows the American College Health Association (ACHA) policy on the treatment of ADHD on campus, which includes “documentation of educational testing and requires a comprehensive evaluation” so as to prove that the student does indeed have ADHD and requires the medication.”Substance abuse is common and devastating; we don’t want to allow anything that could reduce a student’s ability to control their own use of substances,” Dr. Cotton said, in reference to UVM’s policy of honest ADHD treatment.The categorization of ADHD is incredibly comprehensive. In order to be diagnosed with the disorder, “Symptoms of inattention, hyperactivity, and impulsivity that cause impairments should be present before the age of 7, and must be present in more than one setting – school, work, and home,” Dr. Cotton said. This means that one cannot simply complain to their doctor about lack of focus and be awarded the medication – proof of ADHD is necessary, especially because many other disorders that have similar symptoms can be made worse if wrongly treated with an ADHD medication. This also probably means that if you’re misusing the medication, you’re getting it from a dealer who either has ADHD or who gets them from someone who does.So what is it about Adderall and other study drugs that make them so desirable? Dr. Cotton believes that the workload in college is so dramatically different than that of high school that it becomes extremely hard for students to make the transition and develop their own successful studying strategies. In essence, these students need some assistance.Much of the stress among college students has to do with a lack of time management skills – these pills help students focus during the few moments they find to study. “Some days you just have so much going on that the night is the only time you have to work. But by the time night comes around, I’m already way too exhausted. So for me, it’s either don’t do the work or take some Adderall and be wired for a few hours so I can do the work,” a second year UVM student said, who requested to be known only as J.F.”On average, I guess I’ll use [Adderall] a couple times a week. Maybe double that during midterms and finals, you know, ‘crunch time,'” another UVM sophomore (whom we’ll call Adam) mused.Then there are the dealers. I spoke to one, a first year male student (for legality reasons he wished to remain entirely anonymous) who was very open as to why he sells Adderall. “Its pocket money, basically, and I don’t think I really need [the medication] anymore. I feel like I’m fine without it. A few of the kids who I sell to say it really helps them focus, but the majority of them just want to get the buzz. I guess it’s a nice little buzz, and it’s cheap,” he said. This dealer sells the Adderall for around $4-6 a pill, but said he knew of one dealer who sells them for $2 each, and another dealer who sells Adderall XR for $7 each.Sometimes, however, these study drugs’ become more of an exchange between friends, costing nothing. This is appealing to frugal college students.”It depends on who you are selling to; some kids who come to me are close friends and I don’t even make them pay. It’s not really a money-getting drug, it’s just really abundant on campuses and I feel like most dealers don’t need it anyway, so they’re just getting rid of it because to them, it doesn’t really serve a purpose,” the dealer said.The dubious claim that the dealers no longer need the medication is fishy. ADHD does not disappear with age; it merely diminishes slowly over the years. Yet, despite claims to the contrary, the continued presence of the disorder is forgotten when one has a pocket full of ill-gotten bills – the money made, however small, is enough justification for dealers to quit their own prescriptions. Fiscal opportunity is no excuse in the eyes of the law, however.According to NIDA, the amphetamine and dextroamphetamine found in Adderall are classified as Schedule II controlled substances – a classification given to medical drugs with the highest abuse potential and dependency profiles.”I don’t feel like I’m addicted to it at all. I just know that I get more work done and I feel more creative when I’m on Adderall, so it’s hard for me to not take some when I know I have an important exam to study for or a really long, descriptive essay to write. I don’t know if my work would be as good if I tried to do it as exhausted as I am at night; it would just be so hard” J.F. said.Take notice: “It’s hard for me to not take some”. The lies are evident when J.F. is alternately claiming that she is not addicted and that she can’t resist downing a pill for an all-nighter. That inability to go without the drug, even for academic purposes, is addiction purest form.In the most severe of cases, student abusers can develop a psychological dependency on the drugs, causing them to lose faith in their own ability to do well and assume the advantageous effects of the drug (focus, inability to sleep, and energy) are what allow them to do so well in the first place. Those users who take the drugs for the high rather than the study help can fall victim to other, more physically addictive, components. “Adderall has obituating components because the users will crash when coming down from the high. They’ll feel it when it’s gone, so they’ll feel like they need more” said Dr. Cotton.”My friend and I went through an entire 30 pill prescription during the first long weekend we had this year. It was crazy. I didn’t expect it, but I felt really worn out that following Monday. I didn’t want to move, I was like, ‘What is going on, all I took was Adderall’, it was really weird” said a Vermont first year.Although it’s impossible to make the definite claim that taking Adderall and other study drugs will lead to harder drugs, the presumption that it increases the risk of substance abuse is true.”Illicit use of Adderall leads to post-use depression and the inability to function,” Dr. Cotton said. Functional impairment can lead to distorted decision making and sudden behavioral changes – opening up the door for users to be willing to try other substances and find themselves in need of any available fix.”I can say I’m not addicted, but I can’t say that for my friends who use it and I’m sure they might not agree that I’m not addicted either. Seriously, I think if you use it repetitively enough, you’re addicted. If you are defending using it, you’re addicted” said Adam.Adam’s thinly veiled claims don’t hold under scrutiny. Here is a student who admittedly uses ADHD medication for studying “two or three times a week”. How often is “repetitively enough”? He raises the possibility of self-deception explicitly – Adam knows he’s only fooling himself. If he’s not already in its grip, Adam isn’t far from the specter of true addiction.Walking through campus recently, I found myself catching the eye of the dealer I had spoken with. I offered a smile; he responded with a quick “I’m on my way to make a deal,” laughing uneasily. Immediately a barrage of thought hit me: maybe dealers can be addicted to dealing just as much as abusers can be addicted to abusing. Perhaps, for some people, the drug is necessary for achievement.Two ideas which offer no solace from the truth: there is a study drug epidemic at the University of Vermont. Unless taken seriously by students, it will continue its undercover rise quicker and more voraciously than anyone seems willing to admit.There’s no denying that college life is the most challenging portion yet of our ever burgeoning educational careers. Deadlines, term papers, midterms, presentations, exams; it all can be immensely draining. What students don’t realize is how substance abuse can empty the spirit and depress the mind. Imagine the weight of college life with a blue, ADHD riddled monkey ripping at your back.Either way, it was 9:15 in the morning when I saw my dealer friend; I’d say that’s quite early for a fixed study session.