The Competition Drug

Roger Cohen

THIS is America's college town par excellence. Kids from all over the world flock to Boston to learn. I have a son who is a freshman here. Last autumn, as he entered school, I listened to warnings about the dangers of binge drinking. I think they missed the point. The real epidemic involves so-called smart drugs, particularly Adderall, an amphetamine prescribed for attention deficit hyperactivity disorder (A.D.H.D.) but so freely available as to be the pill to take whenever academic pressure requires pulling an all-nighter with zero procrastination to get a paper done.

"Just popped an Addie, so I'm good to go" -- this sort of pretest attitude has become pervasive. Conversations with several students suggested Adderall was always available, costing from $2 to $5 a pill. Adderall has become to college what steroids are to baseball: an illicit performance enhancer for a fiercely competitive environment. What to say to doctors to get a prescription is now so widely known among students -- "It's like my thoughts are channel-surfing and I can't stop" -- as to have become a kind of joke.

"If there are no A.D.H.D. symptoms prior to college I have a very hard time writing a prescription," Jill Kasper, a pediatrician, told me. "But if somebody wants a prescription for Adderall, they can find someone to give it to them." The problem is that Adderall is dangerous, a Class 2 controlled substance like cocaine. While it has helped countless A.D.H.D. sufferers, it can also lead down a dark road of dependency, ever higher doses, fight-or-flight anxiety levels, sleeplessness and depression.

Here, in his own words, is the Adderall story of Steven Roderick, 24, a smart, soft-spoken, lost senior studying health science at the University of Massachusetts Boston:

I started taking it my first year in college. My performance had always fluctuated a lot. It was hard to pay attention, even in classes I was interested in. I was getting D's. I felt something had to change. Adderall flies around campus. The first time I took it I wrote a paper for an astronomy class that was out of this world. I could not believe it -- I was so inspired it made me want to be a doctor! I thought -- oh my God! -- this is the whole problem. You have the ability. You are intelligent. You just don't have the link between intelligence and the capacity to be productive. The pill is the link. I felt literally unstoppable.

I went to the doctor, said I'd like to give Adderall a try. There were no diagnostic procedures. Doctors give in too easily. I did not think there could be a risk later on. I started on 20 milligrams. I went from D's and F's to straight A's. But your brain adapts, you have to increase the dose, and by 2011 I was up to 45 milligrams. In the spring of that year I started to feel Adderall was my best friend and my worst enemy at the same time. Because I could not sleep I went to see my psychopharm, and she prescribed me Ativan to sleep. That worked O.K. for a while. But I really ran into trouble last year. I was up to 65 milligrams, and then during finals went to 80, even 120, milligrams, and I was just locked into this Adderall-Ativan cycle. My doctor seemed scatterbrained. She'd prescribe something but not follow up.

It's a complicated dependency. I mean I never took Adderall to get high, never took it in a way that was not academically oriented; and I think there's a distinction between dependency and addiction, taking something for a purpose or for a rush. But I feel awful. My baseline anxiety level would be most people's highest anxiety level. The drop of a pin makes me spin around. I am living at home. My parents are clueless, and it is hard to discuss with them, although my Mom helps me now. I alternate between 'on' and 'off' states -- I come off the Adderall, take Ativan and sleep for days. I miss appointments. I know I need to go to the appointments, but I wonder if I will be functional enough.

Adderall suddenly turned its back on me. It enabled me to focus, got me to a higher place academically. But then I could no longer rely on it. I was on my own. And although I have less than three credits to go, I may have to withdraw from school because I have not been able to make it to enough classes. "Look, I am in a culture that constantly justifies the means to an end. So how do we persuade people not to take it? All you hear is how impossible it will be to get a job when you get out, and you are going more and more into debt, and you think without this I won't be top of the class. With other drugs you know you are ruining your life. But Adderall manipulates you into thinking you are doing what is needed to have a great life.

Posted by Jeff Henriques at March 6, 2013 5:52 PM
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