Non-Prescription Usage of ADHD Meds at One University

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I recently was sent a fascinating article on “enhancement” uses of Adderall, Ritalin, and Dexedrine on the campus of one college. The article is

Alan D. DeSantis, Elizabeth A. Webb, and Seth M. Noar, Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach, Journal of American College Health 57:315-323 (Nov.-Dec. 2008).

I have not, yet, found a free version of the article that I can link to, but I highly recommend it.

The article discusses a two-pronged look at the use at a large university of ADHD medications by students who did not have a prescription for the medications. The study used two approaches. First, it surveyed 1800 students; then it conducted follow-up interviews with 175 students.

34 percent of the surveyed students reported using an ADHD medication without their own prescription. (Four percent of the surveyed students reported that they had prescriptions for such medications and were excluded from the survey.) The rate of use increased from 18% in the freshman year to 55% by the senior year. 39% of the male subjects used the drugs compared with 30% of the female subjects. 48% of the “Greek” students (fraternity or sorority members) used the drugs compared with 23% of non-Greek students.

Of those who had used the drugs without a prescription, 72% said they did so to stay awake to study, 66% said they did to concentrate on their work, 36% said they used them to help memorize things, 22% said it was to stay awake and have fun, and 12% said it was to make work more interesting. Seven percent said it was for the high and 5 percent for appetite suppression. (People could give more than one reason, so the percentages total far more than 100%.)

There have been other surveys of college student use of these medications, with a range of results. (This survey’s results are at the upper end for usage.) What made this article particularly interesting to me were the quotations from the interviews, as students talked about their motives for using the drugs, their acquisition of the drugs, and their perception of the results. Students found it very easy to get access to the drugs, particularly in libraries or in fraternity or sorority houses. Over ninety percent said they got the drugs from friends or significant others. Fifteen percent got the drugs for free; those who paid spent from $3 to $10 per pill, but people reported that those selling the pills did not do it for the money but as a service to their friends. The sellers were students with ADHD drug prescriptions whose prescriptions were based on daily use but who used the drug much less frequently. As one student reported, “It is easier than beer to get.”

Although there is little, if any, good evidence about the effects of these drugs on the performance of people who do not have ADHD, the students reported strong belief in their efficacy. And they reported a general lack of guilt, in part because it was being used for studying rather than getting high.

I have helped write an article about the use of drugs for cognitive enhancement. (Henry Greely, Barbara Sahakian, John Harris, Ronald Kessler, Michael Gazzaniga, Philip Campbell, Martha Farah; Towards Responsible Use of Cognitive-Enhancing Drugs by the Healthy, Nature 456:702-05 (Dec. 11, 2008)) Adderall, Ritalin, and Dexedrine are not harmless drugs and their widespread use, without prescription, has worrisome health implications. But the DeSantis article does help make the point that such uses are common. “The first thing that became evident during the course of our interviews was how prevalent the use and casual discussion of stimulants were on the college campus.” What, if anything, to do about illegal use of cognitive-enhancing drugs is a complex question, but that use is certainly both real and substantial.

– Hank Greely


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