The following is a guest post by Saint Jude Retreats, a non-12 step non-treatment alternative to traditional drug and alcohol rehab. The program concentrates on self-directed positive neuroplastic change and positive self-change as an alternative to traditional alcohol and drug treatment.
For more on Adderall, check out Episode 98, where we cover Adderall on and off-label, plus pros and cons.
Adderall: The Off-Label Study Drug
Receiving a college degree used to be achieved through hard work, determination and strong work ethic only. Now in 2014, with the rising cost of college education and the appeal of binge drinking and partying, students are feeling that pressure to work harder to obtain better grades, all while balancing an active social life. Students are now turning to prescription drugs for recreational use or to improve their overall work performance, which has led to the trend of off-label use of Adderall among stand out students looking to increase their chances of attending college with competitive admission standards.
Understanding What Adderall Is
Adderall is an amphetamine comprised of several different amphetamine salts that increase focus and concentration. Adderall is commonly used to treat “Attention deficit/hyperactivity disorder (ADHD) which is a chronic disorder characterized by inattention, hyperactivity, and impulsive behavior. Persons with ADHD often struggle with low self-esteem troubled personal relationships and poor performance in school or at work.” 
Unlike drugs such as cocaine, meth and heroin, Adderall is used more among teens and young adults in college as new means of concentrating on school work. Adderall has served this purpose for some time. According to the article Abusing Adderall, “Historically, amphetamines have served other purposes beyond treating ADHD. For example, amphetamines were used in the trenches of World War II to increase alertness and fight fatigue. More recently, Adderall and medications like it are being used illicitly as a study aid, a party drug or to lose weight.” 
Many children are diagnosed with ADHD at a young age and remain on Adderall through adulthood. However, some students are diagnosed later in life. According to the National Alliance on Mental Illness, on average about “25 percent of college students with disabilities are diagnosed with ADHD”, “while more than half of students with ADHD were first diagnosed on their college campus.” 
The Increase Demand For Adderall
With the increasing amount of ADHD diagnosis comes a much greater demand for Adderall prescriptions. Since the mid-90’s when Adderall’s popularity steadily began to rise prescriptions for this drug have nearly tripled. In 2012, “the demand for the drug—originally meant to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy—was so high that patients were turned away from their local pharmacies and the DEA eventually had to increase the drug makers’ annual amphetamine allotment to combat the shortage.”  This increase of prescription on college campuses makes Adderall very easy to obtain by any type of college student, regardless of age.
The University of Maryland recently completed a study involving the responses of 26 student researchers. The study is based off of their’ perceptions of non-medical use of prescription stimulants by their peers.  These student researchers individually reported on what they have heard or observed regarding off-label prescription drug use on their campus. An important part of this study revealed that students believed that Adderall was most often used due to it’s accessibility, “better reputation, less emotional ups and downs, stronger effects, and works best.” [4,5]
Who Uses Adderall and Why?
The overall understanding of Adderall among students makes it a drug used for multiple reasons such as non-medical general use, to help as a study aid or added to alcohol for recreational use. To many students taking Adderall, it is not much different than taking aspirin. With the general attitude of “every other person I know is on Adderall,” adolescents are more likely to use a drug that is socially acceptable–even if still illegal.
As far as off-label use of Adderall is concerned, there are generally two types of students who are misusing the drug. One type is typically the student who enjoys the partying lifestyle and may be misusing alcohol or others drugs as well. On average “users of Adderall are more often white, male, members of fraternities or sororities, and have lower grade point averages.”  On the other hand, hard working students in highly competitive degree programs can also be Adderall users.
According to a study completed by the Journal of Medical Internal Research, medical and dental schools, report abuse rates of stimulant ADHD medications ranging from a low of 8.1% to a high of 43%.” The research additional sites; “Given high academic expectations and competition in college settings, some students turn to prescription stimulants like Adderall as a study aid to improve concentration and increase mental alertness. Rates of nonmedical use or abuse of ADHD drugs tend to be higher at colleges and universities where admission standards are higher as well. A contributing factor to abuse of ADHD drugs is attention difficulties and the notion that these drugs can help with academic success.” 
However, students under high levels of academic stress, have discovered Adderall long before their college careers began. According to the Boston Globe article, more and more teens use pills to lift grades, “At high schools across the United States, pressure over grades and competition for college admissions are encouraging students to abuse prescription stimulants, according to interviews with students, parents and doctors. Pills that have been a staple in some college and graduate school circles are going from rare to routine in many academically competitive high schools, where teenagers say they get them from friends, buy them from student dealers or fake symptoms to their parents and doctors to get prescriptions.”
Adderall is one of the cheapest pills available to college and even high school students, with heroin being a close runner-up. This is one of the main reasons Adderall is among the most commonly misused prescription pills. Students report paying on average “between $2 to $3 per 10mg or $4 to $5 for 20mg or may get pills free from friends.” , These drug deals, are happening on and off college campuses regardless of strict substance use policies.
The Perception That “Adderall Can Fix It All”
While Adderall is a popular choice among students, there is no guarantee it will work for everyone who takes it. Not to mention, like any drug, Adderall can have side effects since most amphetamines are stimulants which can cause insomnia, heart palpitations, and loss of appetite. In the Huffington Post article, Adderall: America’s Favorite Amphetamine, James Kent quotes, “Adderall use may help some of these students, but it can be detrimental to others, though no formal studies have been conducted to show how pervasive non prescription Adderall use is among students and what effect, if any, it has on overall academic performance.” 
College student’s perception of Adderall have become more public, as well. Most students casually talk about off-label use of Adderall without knowing much about the drug. The growing perception of Adderall, however, is that it primarily aids as an effective study tool increasing the ability to focus, multitask and increase overall grades and GPA. The general belief among college students is that Adderall can be a positive learning tool that possess more benefits than negatives.
Adderall and off label brands are people increasingly popular discussion among college students, especially on social media outlets. Between the years 2011 and 2012 the word “Adderall” in some association was tweeted close to 214,000 times, and peeked around the time of year when finals would be taken.
According to the same study completed by Brigham Young University, “rates of Adderall tweeters were highest among college and university clusters in the northeast and south regions of the United States. 27,473 mentioned an alternative motive (eg, study aid) in the same tweet. The most common substances mentioned with Adderall were alcohol (and stimulants), and the most common side effects were sleep deprivation and loss of appetite.” 
While students may think that joking about taking a drug over the internet is innocent enough, it could jeopardize their future career unintentionally. According to the University of Wisconsin Stout, “Posting evidence of illegal or unprofessional behavior on social networking sites may also have a long term impact on your professional opportunities. A 2009 CareerBuilder survey of over 2,500 employers found that forty-five percent admitted routinely screening applicants by accessing social networks that the prospective employees think are ‘private’.” 
Preventing Future Adderall Use
It’s certainly hard to prevent young adults from using Adderall to seek an advantage in their academic career. Some students begin taking pills by choice, some may continue to take them to avoid physical withdrawal symptoms or are fearful their grades may drop without the influence of Adderall. Regardless of the reasons, parents can certainly begin looking for drug use signs as a student approaches their junior and senior years in high school, especially if under a high amount of pressure and stress to get into the right college or juggling numerous extracurricular activities. Noticeable physical symptoms can range from extreme alertness or focus, dilated pupils, paranoia, weight loss/lack of appetite or sleeplessness (insomnia).
It’s important to speak to students about pressure and stress early on, while explaining to them that drugs are a temporary quick fix solution. Working hard in the traditional means will provide them with a long term competitive edge, and confidence to know that their individual hard work pays off, without the extra help.
Sources: Scattarelli, J. (n.d.). Abusing adderall. Retrieved from http://www.stuorg.iastate.edu/ethosmagazine/adderall.html  Tolleson ‐ Rinehart, S., Massie, S., & Hughes, J. (2007, July 17). What every parent should know about off ‐ label use of ADHD medications. Retrieved from http://www.aap.org/en-us/professional-resources/practice-support/quality-improvement/Quality-Improvement-Innovation-Networks/Documents/Parent_Ed_Tool_Lit_Review.pdf  Smith-McDowell, K. (n.d.). Easing the transition to college for students with ADHD. Retrieved from http://www.nami.org/Template.cfm?Section=top_story&template=/contentmanagement/contentdisplay.cfm&ContentID=152624&title=Easing the Transition to College for Students with ADHD  Zadrozny, B. (2013, December 02). 7 things you need to know about Adderall. Retrieved from http://www.thedailybeast.com/articles/2013/12/02/7-things-you-need-to-know-about-adderall.html  Wish , E., Falls, B., & Nakamura, E. (2005, May 02). 1 college students’ perceptions of non-medical use of prescription stimulants by their peers . Retrieved from http://www.cesar.umd.edu/cesar/pubs/20050302.pdf  Hanson, C. (2013). Tweaking and tweeting: Exploring twitter for nonmedical use of a psychostimulant drug (Adderall) among college students. J Med Internet Res. , 15(4),
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636321/ Schwarz, A. (2012, June 10). More teens use pills to lift grades. Retrieved from http://www.bostonglobe.com/news/nation/2012/06/09/more-teens-use-pills-lift-grades/XDhadn8ncmbCa4o5ElpYPK/story.html  Kent, J. (2013, May 09). Adderall: America’s favorite amphetamine.  The effect of alcohol and other drugs on your professional identity. (n.d.). Retrieved from http://www.uwstout.edu/services/aspire/protect-your-professional-identity.cfm