0 0 0 a a 4B d W5ednesday, March 13, 2013 The Statement tu By Ian DiIlitng}am how students on campus misuse stimulats J ts not so much peer pressure as peer acceptance." "Because it's so accepted among a lot of people," Kinesiology fresh- man Andrew said. "You don't see any harm in doing it." Within the increasingly competitive college environment, where students are being pushed to achieve socially, academi- cally and professionally, academic "per- formance enhancers" are being widely abused. Across the nation, students turn to these stimulants in an attempt to gain a mental edge. Prescribed in various forms like Adder- all and Ritalin to treat conditions like Attention Deficit Hyperactivity Disorder, amphetamines and methylphenidates are the most common 'study aids' abused on campuses. For about $5 per pill - $10 during finals week - students buy these drugs from dorm mates, study partners and even fam- ily members. Like many of his fellow students, Andrew said he often struggles to keep up when he has multiple projects and exams to worry about each week. When these projects start to stack up, Andrew takes Adderall to help him get through a long day in the UGLi. Despite serious legal consequences for taking Adderall - or any similar medica- tion - without a prescription, Andrew feels the risk is worth it. "I find so far that it's extremely ben- eficial," Andrew said. "Some people feel like there's a negative connotation around Adderall just because its not an open, legal drug ... If I could only do one drug the rest of my collegiate career, it would most like- ly be Adderall because I feel that the aca- demic upside to it is so significant that it can only help." Since coming to the University he has taken the drug five or six times while studying. "It's pretty common during finals sea- son," Andrew said. "It doesn't necessarily improve your work, it just makes you focus more. It doesn't make you smarter, you can just get your work done faster." When he feels the need to "really get work done," he buys Adderall from a friend who is prescribed the drug for ADHD. It has a positive effect on his work, making him act "normally" but with high produc- tivity levels. "It's impossible to detect," he said. "If I'm sitting next to you in the library and we're both doing work, but I'm doing my work a little bit faster and a little less dis- tracted, nobody will be able to notice." Andrew said he didn't feel pressured into taking Adderall, but the prevalence of the drug on campus dissuaded his worries. "It's not like people are pressuring you to do it, you just don't see any downside to doing it," he said. "I think it is a dangerous problem." Robert Ernst, medical director at Uni- versity Health Services said UHS pre- scribes stimulant medications to help students with ADHD and Attention Deficit Disorder. For these students, stimulants are extremely beneficial, because they increase alertness, focus and energy. However, given the well-known poten- tial for abuse - especially on college cam- puses - UHS does not diagnose students with ADHD or ADD. Instead, they rely on the diagnoses and treatment plans devel- oped by outside physicians. Students can only obtain a prescription from UHS with a confirmed diagnosis from their own phy- sician and a history of successful treat- ment with stimulants. While some physicians with more expe- rience feel comfortable diagnosing ADHD with only a patient history, others rely on surveys or questionnaires developed to help physicians diagnose the disease. "Increasingly, (physicians) are believ- ing that students can give the right answers on a survey to make it sound like ADHD," Ernst said. "It was because of sit- uations like that we decided we didn't feel comfortable making that diagnosis based upon this survey." For students diagnosed outside the Uni- versity, Ernst said UHS still takes precau- tionswhendistributingthesemedications. "This is as controversial as it gets on col- lege campuses, and many colleges' health services have a 'just say no' approach to this," Ernst said. "We don't look our role to make the diagnosis and treatment, but welcome the oppc to establish continuity relationshi students who have an established sis and are already stable on a regil Even for students who demon legitimate need for medication, ar prescription is required to obtai pills. Stimulants are classified as S II drugs in the U.S. under the Co Substances Act. The U.S. Drug E ment Administration heavily r these drugs based on their poten abuse. "Any time you have a Schedule trolled substance, you are going. to have a lot of (legal precautions)," Gwedolyn Chivers, director of the UHS Pharmacy, said. In recent years, some physicians have started diag- nosing students with ADHD and Attention Defi- cit Disorder once they get to college, despite the fact that these disorders should manifest by the age of seven in most patients. This _ inconsistency "con- founds" many col- lege health service clinicians, Ernst said. "We feel uncom- fortable malt- ing the diagnosis, because it's just not the general notion that people pres- ent as adults, although that's incrc becoming the situation - adding concern that these are being used t the drugs or used for competitive tage instead of for an established sis," Ernst said. Students taking Adderall withou scription - or who take the medic performance enhancer, instead o ment for a condition - risk a range to serious side effects, includingc ing sleep, affecting appetite -tw common side affects - and heart tion. "I've seen students come in an ent with cardiac arrhythmia and d after a couple of follow up questio they had borrowed a couple Adder lets from a friend," Ernst said. Controversy arose in Februar at it as Richard Fee, a student at Greensboro Col- si initiate lege in North Carolina, died after becoming of artunity addicted to Adderall and other medica- r ps with tions, which were repeatedly prescribed m diagno- despite protests from Fee's parents that he e ment." did not have ADHD. According to The New strate a York Times, Fee's addiction may have con- m monthly tributed to his suicide, though "few people s n more who misuse stimulants devolve into psy- h chotic or suicidal addicts." t chedule Some students feel it's safe to take sa ntrolled another person's prescription, since their (t Enforce- friend with the prescription does not expe- egulates rience any side affects. Ernst said every fu atial for patient responds differently, so students ca are putting themselves at great risk by tak- II con- ing these drugs. d "If I'm sitting next to you in the library and we're both doing work, but I'm doing my work a little bit faster and a little less distracted, nobody will be able to notice." - Kinesiology freshman Andrew easingly Andrew said he felt "no significant p to our alteration" in his physical well-being on p :o divert Adderall. While on the drug, he said he of advan- sometimes forgets to eat or drink, so he diagno- keeps a water bottle and snack nearby, just p in case. a at a pre- one of the most severe symptoms of s ine as a the drug - which is intended to keep the f treat- body focused - was that Andrew found it oz of mild difficult to sleep after taking the drug. In re disrupt- contrast, once the drug wore off, Andrew tI to more experienced a "crash" - he counteracts ty palpita- with a cup of coffee. ti The UHS physicians are aware that id pres- many students prescribed these medica- e lisclose, tions do not take them on a consistent c ins, that basis, creating the potential for a surplus. m rall tab- When students come in asking for the re maximum quantity of pills, Ernst said he p y when and other physicians will often become tI uspicious and enter into a "negotiation" ver the medication to "come up with a ealistic quantity," where they try to deter- ine how many pills a student really needs ach month. "We know that students don't take these edicines all the time when they're pre- cribed, and when someone is reliable for a igh quantity, we start (to) wonder if this is o create a surplus for distribution," Ernst aid. "Afterthree to five visits, we can start o) feel pretty comfortable negotiating." Ernst is seriously concerned about the uture for prescription drugs on college ampuses. "I do believe the misuse of prescription rugs will continue to become an increas- ing prevalent prob- lem - and I think college campuses will be 'ground zero' for that type of behavior." Students misus- ing prescription stimulants not*only face physical side effects, but also expose themselves to major legal con- sequences if caught. When asked about these consequences, Andrew was uncon- cerned. He could not remember a sin- gle case of someone being arrested or even questioned for prescription- drug abuse. "I guess it's a 'strength in num- bers' type situation ... I'm not the only erson using it, there's so many other peo- le. One person is not going to get singled ut," he said. Diane Brown, University Police spokes- erson, said campus police very rarely rrest and prosecute individuals for pre- cription drug abuse. In 2011, there were only 102 drug arrests n campus - compared to 314 alcohol elated arrests or citations - according to he University's most recent annual safe- y report. It's not known what amount of hose arrests relate to Adderall. There is currently one drug recognition xpert in the University Police. In most ases, however, the University Police's nain responsibility is to assure students eceive proper medical attention when rescription drugs present a danger to heir health, Brown said. For the purposes of the article, some student names have been changed or omitted.