Studying off the label

To boost their focus in the classroom, some students are turning to drugs without a prescription. Others question the fairness of the practice.

Students’ non-prescription use of drugs scuh as Adderall is prompoting some University faculty and physicians to question when neuroenhancement becomes unfair

Students’ non-prescription use of drugs scuh as Adderall is prompoting some University faculty and physicians to question when neuroenhancement becomes unfair

Ian Larson

Mark often faced the decision of studying to earn an A or going out to party with his friends. In the end, Mark, a recent College of Liberal Arts graduate, who asked that his real name not appear in print, never had to make that decision, but he had to break federal law to make the grade. The answer to MarkâÄôs problem lay in a roommateâÄôs medicine cabinet: Adderall. âÄúThis stuff is all-American. ItâÄôs everything we value,âÄù he said. âÄúThe side effects are probably limited, it makes us more productive and itâÄôs focused on academics, making us better-functioning members of society.âÄù Mark isnâÄôt alone. Where students once relied on caffeine, some are now turning to more potent solutions such as Adderall. University of Minnesota studentsâÄô use of the drug as a study aid raises fresh concerns over the safety of nonprescription drug use, but some are questioning the fairness of neuroenhancement in classrooms where the difference between one studentâÄôs A and another studentâÄôs B may lie in a $5 pill. A cure for Facebook Possession of drugs without a prescription is against state and federal law, but at the University, nonprescription use of neuroenhancers lands in a gray area between policies. Illegal possession of drugs is against the University Student Conduct Code, but neither that code nor the academic misconduct policy specifically addresses neuroenhancing drugs as they affect academic performance. In the 2009 Minnesota College Student Health Survey, 7 percent of students at nine Minnesota colleges reported that they used prescription drugs without a prescription. The survey did not specify exactly which types of prescription drugs students were using. In other college polls, as many as a quarter of students have reported using neuroenhancers as a study aid. Lee Penn, an associate professor of chemistry, said she sees lots of students who have difficulty studying for tests. Penn recommends that students distance themselves from potential distractions when they are studying. That means no television, no cell phone and, if possible, no computer. âÄúI think, in general, people who [cram] end up trapping themselves into doing it by flittering away their time by staying on the Internet or Facebooking in an addictive fashion,âÄù Penn said. And thatâÄôs exactly the sort of distraction that Steve, a CLA sophomore, who asked that his last name not appear in print, said Adderall helps him block out. âÄúWhen IâÄôm studying without it, IâÄôll check Facebook and whatnot,âÄù Steve said. âÄúWhen IâÄôm on it, I donâÄôt even think about anything else. IâÄôm just focused on studying.âÄù âÄòA few calls awayâÄô Adderall, Ritalin and Provigil all belong to a class of drugs sometimes called neuroenhancers. TheyâÄôre often prescribed as a treatment for attention deficit disorder and attention deficit hyperactivity disorder, but they can be a boon in last-minute study sessions and for those who have more work than time. The drugs havenâÄôt been widely studied in people without ADD/ADHD, but physicians say their addictive potential is high. Dr. Gary Christenson, director of Mental Health Services at Boynton Health Service, said that element of uncertainty alone should give students pause. Users sometimes experience jitters, a loss of appetite and increased heart rate. In rare cases, the drugs can cause severe heart conditions and stroke. Thorough assessments for ADD/ADHD include tests of intelligence, short-term memory and planning. The tests detect over- and under-compensation to eliminate healthy individuals who are simply looking for a prescription. For physicians, prescribing neuroenhancers means striking a precarious balance between covering all those with ADD/ADHD while limiting the number of people with prescriptions who donâÄôt have the conditions. âÄúWe donâÄôt have X-rays for this,âÄù said Dr. Ken Winters of the University Department of Psychiartry. But those who want the drug have been known to circumvent the rigorous testing by going to primary care physicians who often donâÄôt have the time or the means to perform the methodical and expensive examination. âÄúIf you say the right symptoms âÄî everyone can figure that out by going on the Internet âÄî you might be able to convince somebody you have a problem,âÄù Winters said. âÄúFor ADHD you can do cognitive ability tests that help determine whether somebody really has an attentional problem or not. That probably isnâÄôt done often in a lot of clinics.âÄù Mark said his roommate was prescribed the drug while in high school âÄúbefore this Adderall panic.âÄù That roommate knew exactly what to tell his doctor in order to get a stronger dosage that had a higher street value, Mark said. âÄúHe doesnâÄôt really need them. He can study fine without them.âÄù Those with prescriptions can become targets for 11th-hour cramming, and there is an expectation that prescriptions will be shared, Mark said. âÄúItâÄôs kind of like being a freshman in the dorms who has a fake ID. YouâÄôre just expected to buy booze for your friends.âÄù But those who have prescriptions sometimes hide that fact so they arenâÄôt pressured into selling their drugs. An Institute of Technology junior, who asked that his name not be used, said he hides his Adderall prescription from friends because he doesnâÄôt want to be pressured into selling. Mark agreed that the precedent for selling can drive some with prescriptions underground. âÄúIf I had a prescription, I would probably keep it on the hush,âÄù he said. Even if those with prescriptions are hiding that fact, the drug is never more than âÄúa few calls away,âÄù Mark said. âÄúThereâÄôs definitely not a problem finding it at all.âÄù MarkâÄôs friends often asked him why he used the drug instead of planning and studying in advance âÄî instead of âÄúbeing responsible.âÄù âÄúWe donâÄôt want to,âÄù Mark said. âÄúWe want to kick it. We want to chill and then [study] at the last minute because we can.âÄù Scholastic arms race All the Adderall users interviewed for this story denied that the drug gave them an edge in the classroom. They all said Adderall simply allowed them to reach their full potential. âÄúIâÄôm not relying on it to get through class or anything,âÄù Steve said. âÄúItâÄôs not like you take it and you become smarter.âÄù Mark praised Adderall for giving him the energy to go through college without sacrificing free time or his social life for grades. âÄúAdderall was really rad because I could go out and party and have a bunch of fun pretty much every night of the week, and then the day before a test, or the day before a report, I would say, âÄòIâÄôm going to take some Adderall and crank it out.âÄô âÄù Christenson said that using the drug without a prescription should raise questions. âÄúStimulants give you a better ability to focus, a better ability to concentrate and theyâÄôre also energizing, so that would give an advantage to someone who, for all intents and purposes, had the same skills and talents.âÄù But some students and professors question the absolute fairness of the academic setting. One College of Design junior who has a prescription for Adderall said the drug âÄúdoes make things easierâÄù for users, but she said that whether it is fair is irrelevant. âÄúThere are some people that naturally are able to read things, like business textbooks, and focus the whole time,âÄù she said. âÄúI think [Adderall] levels out the playing ground, because the people that are able to do this stuff arenâÄôt the ones that are trying to take it.âÄù On the other side of the gradebook, professors said drugs may be a game-changer. âÄúWe shouldnâÄôt be talking about competitive academics, and yet we are because itâÄôs always about the bell curve,âÄù Penn said. âÄúMy gut response is that itâÄôs not fair.âÄù Penn said classes already tilt in favor of students with better education, but the introduction of drugs shreds any possibility of a fair assessment. âÄúPeople ought to be bringing a true and faithful representation of how hard they work to the exam situation, and if you take drugs that make it easier to take the test, itâÄôs not a true and faithful representation of who you are.âÄù From a medical perspective, Winters said Adderall use is morally ambiguous. âÄúThatâÄôs an ethical dilemma, and from a fairness standpoint, one could draw a line in the sand and say, âÄòThat isnâÄôt acceptable.âÄô âÄù The issue may be akin to a scholastic arms race. As students resort to more extreme measures, their peers may feel the need to do the same or risk lagging behind, Christenson said. âÄúWhy should someone feel compelled to take a medication and accept the potential risks of any medication that they take just because someone else is doing it?âÄù Christenson said.