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Monday June 14th

Mounting pressures fuel sale and use of ADHD medication

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With final exams on the horizon, some students will be looking for an extra advantage over their classmates. For many, the academic edge will come with a pill bottle and a price tag.

“When you think of people buying drugs, you think of people in alleys and the stoners in class, but it’s becoming the kids that want to do well on a test that are trying to get into grad school or just trying to write a paper,” said Amy, a UNC sophomore whose name has been changed to protect her privacy.

Adderall and other stimulants used to treat attention deficit hyperactivity disorder are becoming popular study tools for college students, opening up a saturated new market for students like Amy.

About 60 percent of college students were offered non-medical prescription stimulants during their time in college, according to a study by the University of Maryland. About 30 percent of college students have used prescription stimulants during their time in college, the study found.

Amy is prescribed both Adderall and Vyvanse for her ADHD and has been selling Adderall since high school.

“Someone was trying to find it, I mentioned I had a prescription, and it was just an easy way to make money,” she said. “I don’t take the Adderall that often, unless I am going to pull an all-nighter, so I do sell that pretty regularly.”

Amy said in her experience, students will buy as much Adderall as she’s willing to sell at a minimum of $2 or $3 a pill. She said her prices vary depending on who she’s selling to, what type of Adderall it is — immediate release or long-acting — and the level of demand.

“The price goes up around exam time when people are trying to get it.”

It’s common, even easy, to buy and sell Adderall at UNC, she said.

“People do this, definitely,” she said. “It’s really easy to get a prescription, so there’s a lot of people that can sell it.”

Tricky business

Amy said she’s known friends to trick their way into a prescription for Adderall, for the purpose of recreational use or sale.

“They’ll tell their parents that they’ve been having problems focusing in school,” she said. “And so they’ll go see their pediatrician, or their doctor, or see a psychiatrist and act distracted and walk out 10 minutes later with an Adderall prescription.”

But Mary Covington, director of UNC Campus Health Services, said that’s no longer a concern at UNC.

In Aug. 2013, Campus Health implemented new policies regarding stimulant medication, and Covington said she’s confident the new protocols prevent the type of fraud that Amy described.

“For someone to come in and say, ‘I think I have ADHD’ and expect to get a prescription, is not founded on what needs to happen,” Covington said.

For students to walk out of Campus Health with a prescription for ADHD medication, they must first complete a series of psycho-educational tests, such as IQ and academic and attention testing.

“There was a time ... that people would come in and say, ‘I think I have ADHD,’ just by history, and say, ‘This happens to me; this happens to me; this happens to me, therefore I have it,’” Covington said.

The battery of tests combats that, she said. They are administered by a psychologist and take several hours to complete, but Covington said they ensure the medication gets to the right people.

Covington said students also sign a Stimulant Medication Contract, which outlines that obtaining stimulant medication through fraudulent means is a criminal offense and a violation of the UNC Honor Code.

“It’s also a criminal offense and a violation of the Honor Code to alter prescriptions for student medications and to give or to sell these medications to others,” she said.

Once a student is prescribed ADHD medication, he or she is required to appear for follow-up consultations every three months to maintain the prescription.

Covington said some schools don’t prescribe ADHD medicines altogether because of the potential for abuse and drug dealing.

“By having it standardized in what we’re doing ... we all feel more comfortable with the process,” she said.

Covington said the number of ADHD medications filled by Campus Health has been steady at an average of 2,682 per calendar year since 2012. Campus Health enforces a no-replacement policy and strict limits on the number of pills that can be administered at one time.

Difficult to track, sanction

Randy Young, spokesman for the Department of Public Safety, said while he realizes prescription stimulant abuse occurs on campus, it’s not something the department deals with frequently. His office doesn’t track drug violations based on specific drugs.

“We understand it is used by individuals, especially at high stress times,” Young said. “It’s something that’s out there, but we don’t really come across it.”

Ultimately, he said, DPS responds to complaints from the community, and prescription stimulant abuse typically wouldn’t warrant a complaint.

Young said even if DPS came across prescription stimulants in combination with another offense, there would have to be probable cause to think the drugs weren’t legitimately prescribed before taking any further action.

Lt. Josh Mecimore, Chapel Hill Police Department spokesman, said Chapel Hill officers experience similar barriers in identifying prescription stimulant abuse.

He said having medication without the prescription could lead to criminal charges. While there aren’t specific data to support trends in drug sales, he said, a wide network of occasional sellers poses a problem in enforcement.

Though only about 5 percent of college students are prescribed ADHD medications, about 60 percent of those students will sell or give away their medications, according to the University of Maryland study.

“If you’re only doing it here and there, that may make it harder for us to catch,” Mecimore said. “But that doesn’t mean you won’t get caught.”

‘No academic benefits’

While the prevalence of ADHD medication has mostly plateaued in the last couple of years, students still see it as widely used, said Amelia Arria, the director of the Center on Young Adult Health and Development at the University of Maryland.

“If you were to ask your student population how many people have used it in the last year, you might get estimates of nearly three-quarters of students having tried this drug,” she said. “Whereas in reality, it’s probably about 10 to 20 percent, so they’re way overestimating.”

The misperception of popularity is caused by non-medical users exaggerating their experiences with Adderall and other stimulants, Arria said.

“People who use are really vocal and tell stories, and those stories among college students get repeated,” she said. “They’re not going to tell you a story about failing an exam after they took Adderall.”

Adderall gets mixed into the partying culture on campuses because non-medical users typically don’t use stimulants in isolation of other drugs and alcohol, she said. Non-medical stimulant use is likely the result of a longer-term process where a student drinks, smokes, skips class and then needs a perceived study boost.

Arria said even those students who do try Adderall don’t use it often, with the vast majority of users taking it infrequently, if not only once.

“What you find is that they use it infrequently, during times of exams, or for the purported reason that it helps them study or concentrate, which actually doesn’t appear to be true.”

Arria said non-medical stimulant users tend to have lower grades in the long run because they often devote less time to academics, thinking Adderall will be a shortcut.

“It doesn’t get them smarter, like we are not at that point,” Arria said. “For people without ADHD, there’s really no academic benefit to it. They’re not getting better grades.”

Arria said Adderall is also used secondarily to get high and to party more.

I got hooked on it’

Amy said UNC students approach her to buy Adderall for any number of reasons.

“It cuts your appetite, makes you feel not hungry. When you take it when you’re drinking, you don’t feel as drunk, so you can drink more,” she said. “But on college campuses, it tends to be for studying or weight loss.”

Amy said her own reasons for use have varied, but now it’s mostly for study help.

“I like how it feels in general. You feel, like, more focused and clear,” she said. “But also for studying, like UNC is really hard and pulling all-nighters seems to have been a pretty regular part of my college experience so far, and it’s hard to do that without something beyond coffee.”

Amy said she now sells regularly to three people, but she once had a larger customer base. She’s scaled back after becoming addicted herself.

“I got hooked on it pretty bad,” she said. “If you like it, it’s really easy to end up liking it too much if you keep doing it.”

She compared the effects of Adderall to those of cocaine. The two drugs share a Drug Enforcement Agency ranking with regard to the potential for abuse or dependence. Adderall and cocaine are listed under the second most dangerous class of drugs.

And yet, Amy said demand for Adderall remains high.

“I don’t like selling them because I don’t like giving it to other people for them to possibly get hooked on it, but sometimes you need money.”

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