The potential for abuse

Faced with all-nighters, some Duke students are bypassing Red Bull, lattés and caffeine pills for something that works much more effectively--Ritalin.

While some students take this prescription drug for attention deficit hyperactivity disorder, studies show that the abuse of the drug has increased across the country. The Drug Enforcement Administration has listed methylphenidate, the generic name for Ritalin, as one of its Schedule II drugs, those with the highest potential for addiction and abuse.

Abusing Ritalin is not a foreign concept at the University either. Aron Grossman, a sophomore who transferred from Duke to Emory last year, says he knew about 10 to 20 Duke students last year who took the methylphenidate without a prescription.

"It's like speed. They snort it," he says. "I think most people take it not to go out and party but to stay awake and work even if they don't have ADD."

Jeff Kulley, a psychologist with Counseling and Psychological Services, says that is exactly how it works.

"Some [students] will use the drugs... to help them concentrate if they are tired or have a hard time focusing," Kulley says. "They'll use it similarly to the way a person might use caffeine pills... to enhance their concentration or studying."

But Ritalin and Adderall, an amphetamine also prescribed for ADHD, are not just study aids. They can also be used to get high.

"It's very similar in its action to cocaine when it's snorted," Kulley notes. The pills can also be taken orally, or ground up, mixed with water and injected intravenously, though insoluble fibers in the tablets can block small blood vessels.

"Those dosages are just like speed," Kulley says. "Many students are taking them nasally. The effects are much quicker, and a person is more prone to become addicted."

For students who are addicted, CAPS offers counseling, depending on the level of abuse. "If we catch it early enough that a person is not so psychologically dependent... then we can work with students around the issues," Kulley says.

However, if the withdrawal is quite severe, CAPS refers students to the Duke Addictions Program of the Medical Center.

For interested college students, addicted or not, there are plenty of opportunities to obtain the drugs on the black market. "A lot of students may have prescriptions themselves or have friends that have prescriptions, and they get it from them," Kulley says. "It's pretty difficult to get the drug prescribed in a university setting because of the awareness that they're abused."

That is certainly true at CAPS, which does not prescribe for ADHD, says Dr. Doris Iarovici, a clinical associate in the Department of Psychiatry and Behavioral Sciences. "People on a stimulant need to be monitored once a month; we focus more briefly on counseling here," Iarovici says. "The prescription drugs used to treat it have a high potential for abuse, and we were concerned about getting into that."

Grossman agrees. "I'm assuming [students are] just buying it from people who have a prescription," he says.

When other students at Duke found out that Grossman had a Ritalin prescription for his ADD, he says they started asking him for it. "Most people found out that I had ADD, and a lot of people came up and asked me for it," he says. "At first, when it was a friend of mine, I let her have it, and then after that, I didn't want it to get out of hand so I stopped giving it to people."

Grossman says students who approached him for Ritalin typically offered him one dollar per five-milligram pill.

While no one has approached him for Ritalin yet at Emory, Grossman says he would not be surprised if people soon started knocking on his door.

Some students don't even knock. Alexis Strong, a sophomore, says that she is familiar with both Ritalin and Adderall because her brother has ADD. "My brother had to hide his Adderall in his sock drawer [at Vanderbilt University] because it was getting stolen out of his room," she says.

"I haven't encountered [Ritalin or Adderall] all that much around campus," Strong adds. "I heard a mention of them during finals last year. A friend brought it up as something that they'd heard people on our hall talk about how it had helped them on finals."

Some students say they are not aware of psychoactives being used on campus, other than as prescribed for ADD. Senior Lauren Gallagher says she has a couple of friends who use Ritalin or Adderall for their ADD but that she does not know anyone who abuses the drugs. And Camber Warren, a first-year graduate student in political science, says he had never even heard of anyone using Ritalin to enhance concentration. "I know about them, but I don't know any person who takes Ritalin," he says.

But when crunch time comes to Duke during finals, the abuse increases. "I definitely know Ritalin and Adderall are abused a lot during finals," sophomore Anisha Sundarraj says. "I remember last year it was going for five dollars a pill or something ridiculous."

While the abuse of these drugs is clearly a problem at Duke, Kulley says it's difficult for administrators to identify. "It's pretty rare that a student comes into CAPS complaining of a drug problem," he says. "Usually students come in worried about sleeping at night or doing well in school, with anxiety... once you talk with them, you begin to see that abuse of drugs or prescription drugs are involved... I can't think of a single student that I've seen who came in because they were worried about drugs.

Short-term effects can still include addiction and psychological dependency, while long-term effects might be agitation and irritability, edginess, appetite loss, sleep problems, paranoia, and even psychotic breaks if a person takes high doses. Kulley says that similarly to cocaine, taking psychoactives can increase the chance of death dramatically for people with preexisting heart or cardiovascular problems.

--By Molly Nicholson