Students are getting desperate. It's hell week, when every class seems to have midterms, papers and projects that overlap. Circle the library at the ungodly hour of 4 a.m. and witness zombie-like students drag themselves through midterm and paper prep surrounded by empty Red Bull bottles. It's the kind of academic intensity one may expect at Duke, but living through it is a whole different ballgame.
Case in point: hell week sucks and to the point where blue pills the length of a fingernail may seem like the only option for survival. When it comes to handling Duke's rigorous academics, some students will turn to attention deficit hyperactivity disorder medication like Adderall to make it through the night.
It's enough of a problem at Duke that the Office of Student Conduct changed the Duke Community Standard policy on the unauthorized use of prescription medication—particularly drugs used to treat ADHD— in 2011.
In the past, the use of such drugs without a prescription was considered a violation of Duke's drug policy, however since 2011, unauthorized drug usage is also considered cheating.
At the time the change was made, Stephen Bryan—associate dean of students and director of Student Conduct—told The Chronicle that students were the driving force behind the policy change.
"There is a perception—if not actuality—that Adderall abuse is rampant on campus,” Bryan said in a 2011 Chronicle article. “Enforcement is difficult, and the students who proposed this addition recognize this. They wanted to at least symbolically make a statement."
I decided to start my voyage to trace the prevalence of these drugs on campus with students. This turned out to be an illustrative example of just how easy it is to find Adderall. At 1 p.m. I sent a Facebook message to a couple of friends to see if they knew anyone who used the psychostimulant. Twenty-five minutes later, I had a list of more than a dozen people who could discuss their Adderall habits.
'Adderall makes work fun'
Freshman Lindsay* uses Adderall almost every week to help her finish paper assignments. She asks a friend with a prescription to procure the drugs who Lindsay describes as "nice enough to give it to you for cheap or free."
"I feel laser sharp when I use it, like I can literally do any assignment," she said. "I do not feel any smarter. It just gives me extreme motivation to get over that studying hump."
According to a 2009 study led by David Rabiner, associate dean of the Trinity College of Arts and Sciences and professor of psychology and neuroscience, 9 percent of the student body illicitly uses ADHD medication like Adderall, Ritalin or Concerta. It was this study that sparked conversations in the Office of Student Conduct Advisory Group, which eventually led to the 2011 drug-use policy change.
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The study, which surveyed 3,047 students at Duke and the University of North Carolina at Greensboro, found that 20 percent of users had taken ADHD medication more than 10 times in the past six months.
A July 2008 study led by Rabiner that examined more than 3,400 students in one public and one private university in the Southeastern United States found that the primary motivator for using ADHD medication was "to concentrate better while studying," with 41.4 percent of the respondents saying they use ADHD medication for this reason. Approximately 74 percent of respondents said they never use ADHD medication to get high.
Although Lindsay uses Adderall on a regular basis, some students opt to reserve ADHD medication for special circumstances.
Mark*, a sophomore, said he can count the number of times he has used "Addy" on both of his hands. He has used the drug to study four times, but has also used it "a number of times" to party.
"It's pretty easy to get, you just have to ask around a little bit, text a few friends. So many people are prescribed it nowadays, and it is not that expensive either," he said.
When asked how the drug made him feel, Mark responded that though the desire to procrastinate still remains, he is able to resist temptations more easily.
“The desire to get on Facebook or Reddit is still there, but it is much easier to say to myself, ‘No. You’re working right now. Continue working,’" he said. "I normally have a lot floating around in my head and Adderall helps me really bring all my ideas and thoughts into an organized and focused order.”
Adderall is not a "miracle drug" he said. One needs to have a desire to focus for the drug to make an impact. In addition to helping him focus, Mark added that he also enjoys painting and drawing while on Adderall.
"My ideas flow onto paper much more cohesively," he said.
Mark is not the only student who turns to Adderall for non-academic reasons.
Junior Ben* said he began using Adderall in high school and mostly takes it just to get high.
"I was a little more impulsive then and would do stuff like that on whims. I found that I enjoyed it not just because it keeps you up or let's you party, but because there's a certain confidence attached with the use," he said. "You could liken it to the extreme excitement and undefeatable feeling of a cocaine user. I just feel like my most calm and confident self."
Freshman Shaun* has used Adderall twice for schoolwork and said he got it from a dealer on campus. He added that there are "plenty of dealers" for Adderall at Duke.
All of the students interviewed said it was easy to procure pills; most obtained them through friends, one through “a dealer."
Fifty-five students reported getting ADHD medication from a student with a prescription, and 50 reported getting it from a student who did not have a prescription, according to Rabiner's 2008 study. Seventeen had reported purchasing it from a student without a prescription and only one reported that they had stolen ADHD medication from another student.
"For me Adderall makes work fun, which is also the unique danger that I see in it," Shaun said. "After doing it even once, you notice a difference when trying to work without Adderall. For me it's just a long, intense caffeine rush."
Rabiner's 2008 study found that non-medical ADHD medication use was more common among caucasians, males and members of the Greek system. Self-reported GPAs were lower among non-medical users and concerns about academic performance were higher.
When I asked these students whether they felt their usage of ADHD medication was unfair to students who actually need it, I received a wide range of answers.
Shaun disagreed with the concept that his usage would be characterized as unfair, implying that the prevalence of Adderall usage speaks to larger issues of academic structuring.
“No, I do not think it is unfair because if it is open to everyone, people can equally access a brain boost,” he said.
Mark also did not see an issue with using Adderall.
"I've always struggled with focusing and my attention span to some degree, and the drug helps me when I feel I need the help," he said. "My use doesn't affect others using the drug in any way, so why should it matter to them?"
Not all students agree with that sentiment, however. Lindsay said that she does find using Adderall to be unfair.
“Honestly, I do feel that it is unfair. My ex actually had ADHD and he always complained about how nothing worked for him to help him study," she added.
When asked whether they would use it after college, all of the students interviewed said they believed that they could function at an optimal and efficient level without it. Additionally, all the students interviewed said when it came to ADHD medication, they preferred Adderall.
Lindsay made a special point of mentioning the side effects of Adderall, noting that she feels “extremely irritable when coming down."
Director of Student Health John Vaughn said that stimulants like Adderall are generally considered very safe, but that mild side effects include raised heart rate and blood pressure, decreased appetite, sleep disturbance and jitteriness.
Bryan said any student found responsible for using Adderall without a prescription would face at least disciplinary probation.
"While we hear Adderall is abused, we have rarely handled a case of its improper use over the last few years," Bryan wrote in an email March 24. "As you might imagine, this is a difficult situation to identify."
Dean of Students Sue Wasiolek noted that a change in academic culture could explain why Adderall usage is popular among students.
"My observation is that students study more today than they used to," she said. "They, in many ways, are more deliberate about their academic choices and their academic plans. I think for some there is a higher level of stress associated with these plans."
Wasoliek added that a shift in mindset regarding work ethic could explain the desire to turn to ADHD medication.
"I also think there is, in the mind of not just many students but people in general, the belief that effort should equate to outcome," she said. "If that doesn’t happen then there’s a higher level of frustration. Sometimes the choices they make as a result of that are poor, and out of desperation.”
She added that this shift in mindset could cause students to turn to drugs out of distress.
“Many individuals at points in their lives are motivated to do things they probably wouldn’t do otherwise because of a goal they are attempting to achieve," Wasiolek said of Adderall usage. "Students sometimes get desperate.”
Speaking for myself, as much as I want to say I wouldn’t use it, I can’t.
*Editor's note: sources names were changed because of their use of illicit substances.