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Article of Interest - Medication

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Abuse of the Stimulant Adderall is Prevalent Among Students, Who Use it as a Study Aid
Kara Hughett, Jacksonville Times-Union, January 9, 2006
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Ron Woodall began taking Adderall when he was 11 years old. He had already been diagnosed with attention deficit hyperactivity disorder and had the usual signs: His attention was everywhere and his grades were lousy.

When he got to college, he found out there was a lot of interest in his pills. Friends began asking for them.

"Some kids take it to write a 15-page paper in a night," the 23-year-old Jacksonville resident and recent Florida State University graduate said. "I take it just to be normal."

The pills have reportedly become increasingly common on campuses around the country as students use them and other prescription amphetamines, such as the ADHD drug Ritalin, to stay awake for studying and, sometimes, partying. There are reports of Adderall selling for $5 to $10 a pill and of students crushing and snorting it to get a faster, more extreme effect. The drug can produce a dramatic dependence, and it can cause withdrawal symptoms for users who sell their pills instead of taking them.

"I've sold it before because I needed the money, but it's not worth it," Woodall said. "It was a ways and means to pay my bills."

"There becomes a huge market for it around midterms and finals," said Hope McLaughlin, a licensed clinical social worker who has a private practice in Jacksonville that specializes in adolescent substance abuse.

McLaughlin said 70 percent of her caseload is high school students who self-report their drug abuse. This group and other factors point to Adderall frequently being abused for studying and to offset the effects of other drugs, she said.

To begin with, there's much more Adderall and similar drugs around today.

There was a dramatic increase in attention deficit diagnoses in the late '80s and early '90s. Those children are now in college.

There are more controlled drugs in circulation. According National Center on Addiction and Substance Abuse, prescriptions written for controlled substances increased more than 150 percent from 1992 to 2002, almost 12 times the increase in population in that period.

The center also found last year that only 6 percent of the 158 Web sites selling medications required a prescription.

"It somehow and someway gets prescribed and the parents give their child the responsibility of taking it," said JoAnn Chaney of Gateway Community Services, a non-profit substance-abuse treatment service agency. "The kids then take it to school and sell it."

About Adderall

According to the Attention Deficit Disorder organization, Adderall is a combination of dextroamphetamine and amphetamine that was first developed and marketed more than 20 years ago as a weight control drug called Obetrol. It was approved by the FDA as a treatment for ADHD in 1996. A stimulant, it increases the flow of dopamine and norepinephrine into the extraneuronal space and an increased ability to focus for extended periods of time.

Andy Davis, a junior at the University of North Florida, said he now has a prescription for Adderall but used to get the drug from friends. He looked for the drug to offset his attention deficit disorder during heavy study times in his first two years at the school. He'd take one a day, and friends would give him four or five pills for amounts ranging from free to $2 a pill.

"It was pretty easy," he said. "It's not that difficult to get a prescription, really." According to a University of Wisconsin-Madison survey taken six years ago, about one-fifth of students who were prescribed an attention deficit drug such as Adderall either sold it, shared it with friends or abused it.

Adderall isn't the only prescription drug being abused. Adderall and Ritalin provide a buzz; synthetic opiates such as Percocet and Vicodin mellow things out. And, like so many others, Adderall can be addictive if abused, Jacobs said.

"It's a Schedule II drug for a reason," she said.

Adderall is a stimulant that ultimately controls the central nervous system, allowing users to maintain focus of their thoughts and actions. The government classifies it as a Schedule II drug because it has a high potential for abuse, and this abuse can lead to severe psychological or physical dependence.

People with ADHD can end up paying a price for selling their pills, said David Goodman, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. Users tend to suffer withdrawal effects when not taking their medication, and they relapse into the effects of ADHD.

"I've gone three or four weeks without it and it was horrible," Woodall said. "You build up a tolerance to it and you need it more and more."

Earlier this year, Canada pulled Adderall XR, an extended-release version of the drug, off the market after regulators became concerned about possible side effects including sudden deaths, heart-related deaths, and strokes. But in August it was cleared to be sold again in the country.

Though there are reports of abuse from around the country, it's wise to keep things in perspective, said Kevin Modglin, coordinator of alcohol, tobacco and other drug prevention at UNF.

"Every couple of years, there's a new issue with another drug," he said. "A couple of years ago it was Oxycontin. Before that it was Ecstasy. But even when we have good solid data on their use, it's really minor."

According to a 2003 study at UNF, he said, less than 2 percent of the students had tried Oxycontin and less than 7 percent had tried Ecstasy. He said no one has reported Adderall abuse to him.

Michelle Jacobs, a psychiatrist at the University of Florida's Student Health Care Center, is on the prescribing end of it. She said Adderall is probably the most commonly prescribed attention deficit medication for the college age group. Younger patients, she said, don't handle Adderall as well.

A few years ago, she found out that two of her patients, both athletes, were giving away their Adderall. So she stopped the prescriptions.

"There are other red flags," she said. "If someone says that they need a new prescription because their pills were stolen with their backpacks, well, backpacks do get stolen around here. But that will work for me one time."

And it's difficult for students to come in and fake the attention deficit symptoms to get an Adderall prescription, she said. They have to have a long background of treatment or, if the diagnosis is recent, they'd need testing.

Kara Hughett is a student at the University of North Florida. Times-Union writers Roger Bull and John Timpe contributed to this report.

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