It was the night before his political science paper was due, and Nick had not begun writing. For the next 11 hours, he wrote 15 pages without stopping—no email, no Facebook—and all it took was 50 milligrams of Adderall.

Nick*, a senior, said he takes Adderall about once per semester in order to focus before large exams or papers. Nick has no prescription for the drug and has never been diagnosed with attention deficit/hyperactivity disorder, which Adderall is meant to treat. He said the pills have significantly improved his academic performance, though he does not feel dependent.

“Once you see the effects, it’s like, why not?” Nick said.

As the University enters finals week, some Duke students are popping a little orange or blue pill in hopes that the medication will help them focus for exams. Elizabeth Prince, assistant director of the Student Wellness Center, said that although Duke does not track such abuse exactly, she suspects that abuse at Duke is consistent with national trends, which indicate lulls in illegal usage of drugs like Adderall throughout the semester for undergraduates, with clear spikes at midterm and final exam periods.

Prince said that nationally, 30 to 40 percent of undergraduates use drugs for academic enhancement— without having a prescription—during midterm and final exam weeks. Administrators added that efforts to curb the abuse of Adderall and other similar drugs have been largely unsuccessful.

Nick—who was using Adderall at the time of his interview—took more than a dozen pills out of his pocket, noting that he intends to sell them. He said he typically purchases pills from those with prescriptions, whether they are friends or strangers. Cost per pill varies based on the dosage, strength and whether or not the pill is an extended-release formula.

Adderall, Concerta, Focalin and Ritalin are stimulants prescribed to control symptoms of ADD/ADHD. Students cite improved concentration and the ability to stay awake for hours at a time as positive side effects.

Mary*, a freshman, said she brought five of her brother’s short-acting Focalin pills with her to Duke with her parents’ permission. Mary has taken her brother’s medication on three occasions, including before her ACT exam in her junior year of high school. Last weekend, Mary took Focalin before reading 12 chapters of a textbook.

“[Focalin] just helps me read for long periods of time,” Mary said. “My eyes don’t get tired. It’s a short-acting pill, and there’s no come down, so you don’t feel significantly different. It’s just a little boost of energy.”

Michael*, a senior, said he has taken both Concerta and Adderall, mostly during exam weeks and before large assignments are due. He estimates that he knows at least 30 other students who have taken prescription drugs to enhance their academic performance.

“With Adderall there’s a little bit of a euphoric effect,” Michael said. “You feel smarter, so you have more persistence trying to work through problems.”

Dangerous misconceptions

Many students falsely believe that there is no difference between taking these prescription medications and drinking a cup of coffee, Prince said.

“[Students] don’t see the dangers that are tied into a medication that is prescribed by a doctor,” she said. “Typically people are monitored—you never know how your body is going to react at any time.”

Thomas Szigethy, associate dean and director of the Student Wellness Center, said these prescription drugs correct chemical imbalances in the brains of those with ADD/ADHD to improve their short-term memories. The use of Adderall or other drugs does not help students without ADD/ADHD retain information.

Prince added that as a stimulant, drugs like Adderall only help students with the disorder to stay awake—a fact that likely contributes to the drug’s misconception as an effective study aid.

“In actuality, you’re probably better off getting the sleep than studying because your brain will actually function better,” she said.

Some students, however, use Adderall and other prescription stimulants recreationally, though it is likely not as common among Duke students, Prince said.

There is, for example, Tom*, a senior who said he used to snort Adderall socially, purchasing pills from friends with prescriptions. Tom has never taken Adderall as a study aid because he was worried about dependence.

“I know people who failed out because they couldn’t find [Adderall] at the right time,” he said.

Szigethy said students who come into his office for drug abuse almost exclusively abuse stimulants, though he noted alcohol—a depressant—is the exception.

“We typically have much more Type-A personality people at Duke who are very driven and achievement oriented and competitive,” he said. “A depressant would take the [competitive] edge off.”

A recent Student Wellness survey found that 2.4 percent of undergraduates and graduate students combined have used a type of an amphetamine, which includes but is not limited to drugs like Adderall, at least once within the last year. Szigethy noted that it is nearly impossible to accurately measure prescription drug abuse on campus.

“You really don’t get a lot of prescription drug abusers taking surveys,” he said.

Academic integrity

The Office of Student Conduct amended the Duke Academic Integrity Policy in September to reflect that unauthorized use of prescription medications to enhance academic performance is cheating as well as a violation of Duke’s drug policy. There has been, however, no indication of improvements to student behavior as a result of this measure, said Stephen Bryan, associate dean of students and director of the Office of Student Conduct.

“[The policy changes have] been relatively inconsequential,” Dean of Students Sue Wasiolek added.

The Office of Student Conduct did not receive any reports of prescription drug abuse this semester, though it also did not receive any such reports last year, Bryan said. But based on conversations with students, Bryan said he understands prescription drug abuse to be a widespread issue.

Mary, the freshman, noted that students have been desensitized to its usage.

Nick, the senior who uses occasionally, said the low probability of being caught makes the administration’s policy change ineffective, as many students feel as though their behavior is without consequence.

The line between prescription medication and legal stimulants, such as caffeine, could be a gray area to many drug users, Szigethy said. He noted that caffeine was once considered cheating in athletics.

“Anything that is going to give you an edge over someone else that is not necessarily a fair edge could definitely be seen as cheating,” he said.

Not all abusers agree. Michael said prescription drug abuse should not be considered cheating and instead the drug should be available to everyone. He called illegal Adderall usage a victimless crime.

Tom, the senior who uses Adderall only recreationally, does believe prescription drug abuse gives those who use for academics an unfair advantage.

“We’re all competing for jobs and graduate school, and some classes are graded on a curve,” Tom said. “It just makes me feel like I have to work that much harder. It’s a source of pride to not have to do it for academic reasons.”

Correction: According to a Student Wellness survey, it is 2.4 percent of both undergraduate and graduate students combined that have used an amphetamine at least once within the last year. A previous version of this article stated that this was just undergraduates. The Chronicle regrets the error.

*Name has been changed for the source’s protection. The source’s class year is accurate.