The New York Times has an article about how students across the country are facing pressure to perform well in school that they have started to rely on performance enhancing drugs
He steered into the high school parking lot, clicked off the ignition and scanned the scraps of his recent weeks. Crinkled chip bags on the dashboard. Soda cups at his feet. And on the passenger seat, a rumpled SAT practice book whose owner had been told since fourth grade he was headed to the Ivy League. Pencils up in 20 minutes.
Are you a student who has used prescription drugs like Adderall or Ritalin to do better in school? Or do your classmates use them? Share your experiences anonymously, or read what others have written.
Should doctors prescribe fewer stimulants for teenagers, to try to limit the number of young people abusing these drugs for an academic edge?
“No one seems to think that it’s a real thing — adults on the outside looking in. The other kids in rehab thought we weren’t addicts because Adderall wasn’t a real drug. It’s so underestimated,” said a recent graduate of McLean High School in Virginia, who was given a diagnosis of A.D.H.D. and was prescribed Adderall.
The boy exhaled. Before opening the car door, he recalled recently, he twisted open a capsule of orange powder and arranged it in a neat line on the armrest. He leaned over, closed one nostril and snorted it.
Throughout the parking lot, he said, eight of his friends did the same thing.
The drug was not cocaine or heroin, but Adderall, anamphetamine prescribed for attention deficit hyperactivity disorder that the boy said he and his friends routinely shared to study late into the night, focus during tests and ultimately get the grades worthy of their prestigious high school in an affluent suburb of New York City. The drug did more than just jolt them awake for the 8 a.m. SAT; it gave them a tunnel focus tailor-made for the marathon of tests long known to make or break college applications.
“Everyone in school either has a prescription or has a friend who does,” the boy said.
At high schools across the United States, pressure over grades and competition for college admissions are encouraging students to abuse prescription stimulants, according to interviews with students, parents and doctors. Pills that have been a staple in some college and graduate school circles are going from rare to routine in many academically competitive high schools, where teenagers say they get them from friends, buy them from student dealers or fake symptoms to their parents and doctors to get prescriptions.
Of the more than 200 students, school officials, parents and others contacted for this article, about 40 agreed to share their experiences. Most students spoke on the condition that they be identified by only a first or middle name, or not at all, out of concern for their college prospects or their school systems’ reputations — and their own.
“It’s throughout all the private schools here,” said DeAnsin Parker, a New York psychologist who treats many adolescents from affluent neighborhoods like the Upper East Side. “It’s not as if there is one school where this is the culture. This is the culture.”
Observed Gary Boggs, a special agent for the Drug Enforcement Administration, “We’re seeing it all across the United States.”
The D.E.A. lists prescription stimulants like Adderall andVyvanse (amphetamines) and Ritalin and Focalin(methylphenidates) as Class 2 controlled substances — the same as cocaine and morphine — because they rank among the most addictive substances that have a medical use. (By comparison, the long-abused anti-anxiety drug Valium is in the lower Class 4.) So they carry high legal risks, too, as few teenagers appreciate that merely giving a friend an Adderall or Vyvanse pill is the same as selling it and can be prosecuted as a felony.
While these medicines tend to calm people with A.D.H.D., those without the disorder find that just one pill can jolt them with the energy and focus to push through all-night homework binges and stay awake during exams afterward. “It’s like it does your work for you,” said William, a recent graduate of the Birch Wathen Lenox School on the Upper East Side of Manhattan.
But abuse of prescription stimulants can lead to depression and mood swings (from sleep deprivation), heart irregularities and acute exhaustion or psychosis during withdrawal, doctors say. Little is known about the long-term effects of abuse of stimulants among the young. Drug counselors say that for some teenagers, the pills eventually become an entry to the abuse of painkillers and sleep aids.
“Once you break the seal on using pills, or any of that stuff, it’s not scary anymore — especially when you’re getting A’s,” said the boy who snorted Adderall in the parking lot. He spoke from the couch of his drug counselor, detailing how he later became addicted to the painkiller Percocet and eventually heroin.
Paul L. Hokemeyer, a family therapist at Caron Treatment Centers in Manhattan, said: “Children have prefrontal cortexes that are not fully developed, and we’re changing the chemistry of the brain. That’s what these drugs do. It’s one thing if you have a real deficiency — the medicine is really important to those people — but not if your deficiency is not getting into Brown.”
The number of prescriptions for A.D.H.D. medications dispensed for young people ages 10 to 19 has risen 26 percent since 2007, to almost 21 million yearly, according to IMS Health, a health care information company — a number that experts estimate corresponds to more than two million individuals. But there is no reliable research on how many high school students take stimulants as a study aid. Doctors and teenagers from more than 15 schools across the nation with high academic standards estimated that the portion of students who do so ranges from 15 percent to 40 percent.
“They’re the A students, sometimes the B students, who are trying to get good grades,” said one senior at Lower Merion High School in Ardmore, a Philadelphia suburb, who said he makes hundreds of dollars a week selling prescription drugs, usually priced at $5 to $20 per pill, to classmates as young as freshmen. “They’re the quote-unquote good kids, basically.”
The trend was driven home last month to Nan Radulovic, a psychotherapist in Santa Monica, Calif. Within a few days, she said, an 11th grader, a ninth grader and an eighth grader asked for prescriptions for Adderall solely for better grades. From one girl, she recalled, it was not quite a request.
Should doctors prescribe fewer stimulants for teenagers, to try to limit the number of young people abusing these drugs for an academic edge?
“If you don’t give me the prescription,” Dr. Radulovic said the girl told her, “I’ll just get it from kids at school.”
Keeping Everyone Happy
Madeleine surveyed her schedule of five Advanced Placement classes, field hockey and several other extracurricular activities and knew she could not handle it all. The first physics test of the year — inclines, friction, drag — loomed ominously over her college prospects. A star senior at her Roman Catholic school in Bethesda, Md., Madeleine knew a friend whose grades had gone from B’s to A’s after being prescribed Ritalin, so she asked her for a pill.
She got a 95. Thereafter, Madeleine recalled, she got Adderall and Vyvanse capsules the rest of the year from various classmates — not in exchange for money, she said, but for tutoring them in calculus or proofreading their English papers.
“Can I get a drink of water?” Madeleine said she would ask the teacher in one class, before excusing herself and heading to the water fountain. Making sure no one was watching, she would remove a 40-milligram Vyvanse capsule from her purse and swallow it. After 30 minutes, the buzz began, she said: laser focus, instant recall and the fortitude to crush any test in her path.
“People would have never looked at me and thought I used drugs like that — I wasn’t that kid,” said Madeleine, who has just completed her freshman year at an Ivy League college and continues to use stimulants occasionally. “It wasn’t that hard of a decision. Do I want only four hours of sleep and be a mess, and then underperform on the test and then in field hockey? Or make the teachers happy and the coach happy and get good grades, get into a good college and make my parents happy?”
Madeleine estimated that one-third of her classmates at her small school, most of whom she knew well, used stimulants without a prescription to boost their scholastic performance. Many students across the United States made similar estimates for their schools, all of them emphasizing that the drugs were used not to get high, but mostly by conscientious students to work harder and meet ever-rising academic expectations.
These estimates can be neither confirmed nor refuted because little data captures this specific type of drug misuse. A respected annual survey financed by theNational Institute on Drug Abuse, “Monitoring the Future,” reports that abuse of prescription amphetamines by 10th and 12th graders nationally has actually dipped from the 1990s and is remaining relatively steady at about 10 percent.
However, some experts note that the survey does not focus on the demographic where they believe such abuse is rising steadily — students at high-pressure high schools — and also that many teenagers barely know that what they often call “study drugs” are in fact illegal amphetamines.
“Isn’t it just like a vitamin?” asked one high school junior from Eastchester, a suburb of New York.
Liz Jorgensen, a licensed addiction specialist who runs Insight Counseling in Ridgefield, Conn., said her small center had treated “at least 50 or 60” high school students from southern Connecticut this school year alone who had abused prescription stimulants for academics. Ms. Jorgensen said some of those teenagers landed in rehab directly from the stimulants or, more often, grew comfortable with prescription drugs in general and began abusing prescription painkillers like OxyContin.
A spokesman for Shire, which manufactures Vyvanse and Adderall’s extended-release capsules, said studies had shown no link between prescribed use of those drugs and later abuse.
Dr. Jeff Jonas, Shire’s senior vice president for research and development, said that the company was greatly concerned about the misuse of its stimulants but that the rate was very small. “I’m not aware of any systematic data that suggests there’s a widespread problem,” he said. “You can always find people who testify that it happens.”
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