7 Yes Times Have Changed: The Top Three Drugs Abused and Available on College Campuses Today: Beer, Pot….and Adderal?

Current college student talking about friends’ struggles and temptations with ADHD medication.

 
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7 Yes Times Have Changed: The Top Three Drugs Abused and Available on College Campuses Today: Beer, Pot….and Adderal?

People used to ask me the difference between a psychologist and a psychiatrist. I used to joke: “I don’t deal drugs.” I was half-joking, only half-joking. Now, it doesn’t seem so funny.

As a clinical psychologist, I often used to get a line from parents that essentially things now were the same as when they were kids. Growing up is growing up, no matter what generation you’re talking about. On one level that is true. On another level, young people are being more pressured to perform at a high level, and are therefore more stressed than I think our generation ever was.

Sure on one level there was “sex, drugs and rock ‘n roll’ then and in today’s generation, there is still “sex, drugs and rock ‘n roll”.

Yet, there are distinct differences. We won’t even consider the economy as one difference. On the simplest level the stakes have risen and mistakes are broadcasted to the world. Many of those teenage transgressions of our youth stayed teenage transgressions. There was no one with a cell phone camera or video circulating what happened at the party when it got a little over the top and sending it to millions online. There weren’t social networking sites circulating pornographic images of all ages, seemingly suggesting that it is all okay and normal. Similarly, there was no underground market of ADHD medications being abused and dealt in high schools and on college campuses across the nation. There are large discrepancies between ‘then’ and ‘now’.

When it came to drugs it seemed clearer. Back then, drugs were drugs and the kids who did drugs were easy to identify, or so it seemed. Sure there were kids who overlapped and did drugs when you didn’t completely expect it. Yet, whether you like it or not, the phenomena of Blink noted by Malcolm Gladwell in his book by that name occurred then and occurs now. People do make split second judgments about people. Often we are wrong. Yet, the terrain was different.

When it came to drugs, those judgments made in the blink of an eye seemed easy, now, not so much.
If you were underage you knew drinking was illegal. People took risks. Often they knew whether they were high risks, sometimes they didn’t. Deaths related to college hazing and drinking rituals come readily to mind.

Often the people who smoked pot were easy to identify, as well as the users of many other drugs. Often they knew the risks. That was part of the reason those drugs were illegal. They entered at their own risk, so to speak.

Prescription drugs present an altogether different scenario. The Miami Hurrican student newspaper captures this well at this link: http://www.themiamihurricane.com/2008/09/17/college-students-use-abuse-adhd-drug-adderall/#.1

College students are feeling pressure and to ‘deal with the workload’1 are abusing Adderall and other ADHD drugs:
“I think that sometimes these are the most overstressed people that need the extra concentration the most to deal with the workload,” said Robert, an unprescribed 21-year-old University of Miami Business Law major from Delaware, who spoke to The Miami Hurricane under the condition of anonymity.1

One of the most interesting comments to that article was a student named Patrick who stated the following:

“I’m 24 am I’m addicted to Adderall. Although never diagnosed as ADD/ADAD I’ve been prescribed to Adderall for 10 years. I was never addicted to the drug until I began college. Ever since then, I have become an Adderall fanatic. I used to give away the pills I didn’t use, but now I can’t spare to loose a pill. It’s pathetic. I used to be ashamed of being ADD, but now I’m ashamed of being addicted to an ADD medication.”1

Prescription drugs are legal for the intended user. Doctors prescribe them to the intended user. So it seems reasonable that people would assume that they are less dangerous than illegal drugs. Yet, it is illegal to take a prescription drug without a prescription. The professional who wrote the prescription presumably provides oversight of your use of the drug, reducing side effects or medication interaction. It should be obviously illegal to sell these drugs without the proper credentials. Yet, the seemingly professional medical approval and mental health professional approval of the use of these drugs appears to give tacit approval for their use and blurs the boundaries between therapeutic use and abuse. It seems acceptable to abuse the use of prescribed ADHD medications by trafficking them to non-prescribed individuals. The risks are not properly considered when these drugs are abused in this way.

That the abuse of prescription drugs such as ADHD medications is this rampant and their availability ranks just after alcohol and pot bothers me as a parent. It makes me utter a heavy sigh. As a professional, it is beginning to irk me. It is especially irksome because WE, professionals, are substantially contributing to this problem. From either position, I am disgruntled.

Yes, in 2006 the results of a qualitative survey of university students found that after alcohol and marijuana, the prescription stimulants Adderall and Ritalin are perceived to be the most easily available drugs misused on campus. ADHD medication abuse is a part of this generation’s “sex, drugs, and rock ‘n roll”. I don’t remember that EVER being a part of my youth.

“Methylphenidate is among the top 10 most frequently reported controlled pharmaceuticals stolen from licensed handlers. There is a significant diversion of methylphenidate. A 1994 national survey indicated that more high school seniors in the US abuse methylphenidate than are prescribed it legally.”2 In other words people steal methylphenidate and sell it.

The study’s authors said that the results show a widespread availability of prescription drugs on college campuses. Now I am moving beyond the sigh and I am starting to get vexed.

So are things different for kids today? Yes, when we were in high school and college, Adderall and Ritalin were not among the top 4 drugs abused by kids. That is different….

You can really start to get worked up about this if you start asking questions:
1. Do we even have research on how these drugs will affect kids in the long term? (I will discuss this in later blog posts, but basically the answer is no.)
2. By the way, are you aware that most of these drugs used with kids did not go through an FDA approval process for the use on kids? Typically, once a drug is approved for use with an adult through an FDA approval process, a physician, through his own individual judgment can start prescribing the drug “off label” for kids for purposes for which it wasn’t originally intended. Yeah, that one is kind of mind-blowing.
3. What is the role of the financial incentive for the prescription use and even the illegal abuse for dealing these prescription drugs? Everyone is making some money here, but the health dangers are more negative than the financial ‘gain’ may be.
4. If there weren’t many people making money off of these transactions, would all of this be happening?
Additionally, as noted in my previous blog posts, anywhere from 5% to 20% of the kids on college campuses have abused an ADHD medication, like Ritalin, Adderall, and Concerta. Keep in mind these are not the kids diagnosed with ADHD. Therefore, this is the percentage range of college students that are ADHD drug abusers.

So, parents need to be aware of the white elephant in the room, which I will discuss in my next blog post….
Yes, this is different than when I was in school, what do you think?

Give me a comment and feel free to ask me questions on this topic.

Dr. Charles Shinaver

1 Galinana, Ramon “College Students Use, Abuse ADHD Drug Adderall” Sept 17, 2008, The Miami Hurricane. http://www.themiamihurricane.com/2008/09/17/college-students-use-abuse-adhd-drug-adderall/#
2 Recent Advances in Understanding the Abuse Potential of Methylphenidate (Ritalin) Rush, Ph.D., CR, Stoops, WW, Kelly, TH, Ph.D., Glaser, MD., Ph.D, P. A.E. Hays, L. R. MD, MBA, Department of Behavioral Science, Dept. of Psychiatry and Department of Psychology University of Kentucky. (Supported by grants from the National Institute on Drug Abuse (DA 10325 and DA 12665)

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