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stimulant use

Scary Smart: The Widespread Use of “Study Drugs” on American Campuses

Created November 16, 2016 by Brian Wu
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While the American college experience can be a time of great discovery and learning, the pressure to achieve academically is also great—especially for those bound for medical school, law schools or other highly competitive career tracks. This pressure has led to high levels of stress to perform well in school—and to the increased use of “study drugs” to help students live up to these expectations. However, while there are short-term advantages to be had with the use of stimulants in regards to study, these medications are dangerous when used out of context, and studies have shown that they actually are correlated to lower grade point averages. This article looks at the problem of stimulant use on college campuses, and also at what colleges can do to help mitigate the issue.

Defining the Problem
Before any measures can be taken to help solve the problem of stimulant misuse, it needs to be better understood and appreciated for the complex and widespread issue that it is. An understanding of the widespread nature of the problem, why it happens and what dangers are involved is therefore critical.

Incidence: How Widespread is this Use?
One issue which has researchers concerned is the apparent widespread use of “study drugs” among college students. The most popular drugs of choice to help enhance academic performance include those prescribed for conditions such as attention deficit hyperactivity disorder (ADHD) or narcolepsy, including Adderall, Ritalin and Concerta, among others.

Multiple studies have been done over the course of several years which indicate that this problem truly is widespread on American campuses, with estimates ranging 10-30% or even higher, depending on the study.

Why Does Drug Misuse Happen?
There are a number of factors which researchers believe contribute to this problem. Understanding them is key to coming up with solutions to help alleviate this situation.

Student Motivation and Risk Factors for Abuse
Understanding the reasons behind the use of stimulants is incredibly important before anything can be done to solve the problem. Multiple studies have been done on this topic, and in several surveys the top reasons that students reveal for use include:

● Improve grades and academic performance
● Improve concentration in class
● Enable all-night study sessions
● Lose weight (this is not as common)
● To use recreationally at parties

Research has uncovered, in particular, strong links between stimulant use and academic stress:

● Research from the National Council on Patient Information and Education which indicates that 1 in 4 college students has used illegal prescription drugs (like stimulants) at least one point in their lives.
● 2009 research sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) which surveyed 18-22-year-old adults found that full-time students were more than twice as likely to use stimulants as part-time or non-students.
● A 2006 study which revealed that, with most students who use stimulants, this habit begins in college as a means to enhance learning and pull all-night study sessions.

There are several risk factors for abuse that research has uncovered: studies have shown that stimulant abusers are more likely to be white, male, in the Greek system (in other words, a member of a fraternity or a sorority), and an upperclassmen. For example, a 2008 survey of over 1,800 students found that 34% of students had used stimulants and that the percentage grew higher with Greek system students (48%) and upperclassmen (49-55%).

Accessibility
One of the strongest factors which plays a part in stimulant use is its widespread accessibility. According to a 2003 report by the National Center for Addiction and Substance Abuse, between 1992 and 2002, the number of prescriptions written for stimulants to treat ADHD rose by 369% and in that year, 23.4 million prescriptions were filled.

Due to the number of overall prescriptions for these stimulants, both for teens and for adults, there is more of this medication available on campus than ever. Diversion on campus in the form of selling or sharing these medications is apparently easy: in one survey, 505 of students who have these drugs legally and by prescription have been asked to sell them or give them away, while another study found that 90% of students who do misuse get the medications from peers or friends.

Effects of Stimulant Use
The effects of stimulant use can be very attractive for college students. These drugs act on dopamine levels in the brain to stimulate mental processes and cause an increase in alertness, focus, and overall energy levels. Students use stimulants in order to enhance their abilities to study and retain information, and to focus and concentrate during tests. Because of the side effect of appetite suppression, some students will also use it as a means of losing weight.

Normalizations/Student Attitude
There is minimal stigma attached to the use of these medications in the ways that there are with alcohol, marijuana or street drugs. In a 2006 survey, students who used Adderall or other stimulants in order to increase their study skills were less likely to see it as illegal or risky. As a matter of fact, surveys have shown that students rationalize this behavior by seeing it as no different than drinking coffee or energy drinks or taking over-the-counter energy tablets.

Forms of Abuse
Misuse may take various forms. It might be a matter of a student who has legitimately been prescribed medication for ADHD who uses the medication more often, in a large dose, or in a different way than their doctor prescribed. It is also common for students to self-medicate with medications they have bought or borrowed from friends or peers. Using the drug compulsively or being unable to function without it are also signs that the medication is being misused or abused.

What Dangers are Involved?
One of the most important things to understand about the use of stimulants is how dangerous this habit can be.

The misuse of stimulants is frankly dangerous. It can lead to a dangerous increase in blood pressure as well as heart rate and respirations. This can put a student at a greater risk for heart attacks and strokes, some of which are fatal. The dangers are greatly increased when mixed with other drugs or with alcohol.

There are also behavioral problems associated with stimulant use. One study found that 90% of students who reported use of Adderall also had problems with binge drinking, and 50% of them had issues with overall heavy alcohol use. Also, these students were three times as likely to use marijuana and eight times as likely to use cocaine. In short, stimulant use is not a stand-alone problem, but part of a larger pattern of risk-taking behavior.

Schedule II Status
It is also important to understand that Adderall, Ritalin and other similar stimulants are classified as Schedule II drugs under the Controlled Substances Act because of their highly addictive nature and potential for abuse.

Due to the potential for addiction, there is also a potential for withdrawal symptoms if a student stops taking these medications all at once. Symptoms can include tiredness/fatigue, depression, and sleep disturbances. The severity of the withdrawal often depends on how long the medications have been taken and at what dosage.

Addressing Solutions
From the discussion above, it is apparent that the problem of stimulant use for academic enhancement is widespread, has a multiplicity of reasons, and can pose a danger to the health of the students who participate in this behavior. Discussing and implementing solutions to this problem is therefore very important.

Practicing Consistent Policies
At present, there is no consistent policy among medical schools (or other schools of higher learning) to deal with this problem, and many researchers have accused universities of ignoring the extent of the issue. Some universities, such as Wesley and Duke have banned (in 2010 and 2011, respectively) the use of stimulants to enhance academic performance as a form of cheating, and other colleges may follow suit. However, surveys have shown that even if these policies were enacted, the demand for stimulants on campus would still be high.

Debunking the Myths and Providing Support
Authors writing in the Journal of Addictive Disease believe that one of the most important aspects of student education is debunking the myths that surround these study drugs, including spreading the word that non-medical prescription drug users actually have lower grade point averages, and that the misuse of stimulants is often part of a larger problem that includes heavy alcohol use and/or use of other drugs.

Part of this debunking process, authors of this article note, should be an emphasis on the illegality of drug diversion, whether someone is buying or selling stimulant medications. Many students are not aware that is actually is breaking the law, so any educational/outreach program needs to include information on the legal consequences of this behavior.

Counselling
Colleges, therefore, need to promote awareness of these myths and the realities behind them and work with students, faculty, staff, and on-campus healthcare professionals to educate students on this issue, providing students with the health resources if a problem does arise. These resources should include counselling services, since emotional distress, abuse of other substances, and poor time and stress management play an important role in the onset of stimulant misuse. And because these problems can arise early in a student’s academic career, many researchers believe that the process of educating students on this issue should start with freshman orientation and continue through the entire undergraduate career.

To sum up, academic pressures and the desire to perform well in school have led a dramatic increase in “study drugs” on campuses across America: the ease with which these drugs can be obtained, the lack of stigma surrounding their use, and the fact that in the short term they can help with concentration and memory and make it easier to pull long study sessions. But the dangers that such use represents cannot be ignored and schools need to take a more active role in educating students on these dangers and on the resources that are available to help them overcome this issue.

About the Author
Brian Wu graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology. He is currently an MD candidate at the Keck School of Medicine (University of Southern California). He also holds a PhD in integrative biology and disease for his research in exercise physiology and rehabilitation. He is applying to psychiatry and is interested in doing a child psychiatry fellowship.

References

Accia, M. and DuPont, R. Nonmedical Prescription Stimulant Use Among College Students: Why We Need to do Something and What We Need to Do. Journal of Addictive Disease. 2010 29(4) 417-426

Blair, A. ADHD Stimulant Justification Among College Students. East Tennessee State University. 2013.
http://dc.etsu.edu/honors/172

Cook, H. Role Overload and Prescription Drug Use Among College Students. Butler Journal Of Undergraduate Research. (3) 1: 20-36

Taking Action to Prevent and Address Prescription Drug Abuse. National Council on Patient
Information and Education 2015.

Venegoni, L. Illegal Student Drug Use on the Rise, Not Addressed by Universities. USA Today
College. 2014.
http://college.usatoday.com/2014/11/18/illegal-student-use-on-the-rise-not-addressed-by-universities

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