(Note: Names have been changed to protect the identities of the individuals involved.)

John came back to the room with a bag of different colored pills and tablets. He seemed relieved to have finally found someone who was holding, as were Carl and Phil, his roommates. It was a process that spanned three days, but the guys finally had their drugs.

John immediately took the biggest one, a 36-milligram white pill, and gulped it down with an open can of Arizona Iced Tea that had been sitting on his desk for the better portion of the last month. Carl took the smallest dosage, just 10 milligrams, in the form of an orange tablet. He had no intention of gulping down the pill, as he began crushing it up under a credit card. Once it was ground finely, he shaped the dust into a line and vacuumed it up with his nose. He quickly dabbed a drop of water onto his thumb and snorted that up too in order to prevent the bitter “drip,” as they called it, when the remains of the snorted pill would fall into the back of their throats. His pupils dilated and he began to space out. The drugs were kicking in.

Phil was hesitant. He had never taken the pills and was nervous of what was to come.

“Don’t be such a loser,” John said. John had been taking the pills since high school.

While this sort of peer pressure seems primitive, it was effective, and Phil was subdued into taking the drug. Carl told him to snort it up so it would hit him quicker, and John endorsed the idea. Carl crushed up the light blue 20-milligram pill for Phil, which was ironically higher in dosage than what he had taken moments before. Phil had never snorted anything and awkwardly sniffed up barely half of the line. He cursed his friends and exclaimed that is was burning his nostrils as his buddies just laughed and dubbed him a “rookie.” Within minutes Phil was zipping around the room and praising the clarity he received from the pill. He proceeded to snort up the rest of his line, this time more like a “pro.”

It might have looked like the beginning of a wild night, but these young men, all students at Quinnipiac University, weren’t gearing up for a night out on the town. They were preparing for an all-nighter in the library, cramming for their first-ever finals week at college.

~

According to the National Institute on Drug Abuse, 20 percent of Americans over the age of 12 have admitted to abusing prescription drugs. In addition, 17 percent of high school seniors have admitted to abusing amphetamines, which are among the plethora of study drugs available to these adolescents.

Students making the transition from high school to college are often faced with the pressure of a higher workload and lengthier study sessions. This stress contributes to the use of study drugs. Engagement in the use of study drugs raises the issues of the ease of obtaining the prescriptions, the health risks involved with the drugs, the academic integrity questions posed and the billion-dollar industry the pharmaceuticals create.

According to Healthy Horns, a division of student affairs at the University of Texas at Austin, “the term ‘study drugs’ refers to prescription drugs used to increase concentration and stamina for the purpose of studying or cramming. Study drugs are prescription stimulant medications that are used improperly by a person with a prescription, or more often, illegally by a person without a prescription. These medications are used to treat Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD), which affect attention span, impulse control, self-discipline, and hyperactivity in the case of ADHD.”

The prescription drugs that are most often abused when studying are Adderall, Ritalin, Concerta, Focalin and Vyvanse. While using or buying these medications without a prescription is illegal, many students admit that it is fairly easy to get their hands on these drugs.

Raja is a student at Rutgers University where he is majoring in environmental business and economics with a focus of natural resources. Raja asked that he be identified only by his first name. Raja must study for exams that span both science and business, often laden with technical terms and high-level mathematics. He uses study drugs when he has a big exam.

“It is too easy for me to get these drugs,” Raja said. “I can simply ask one of my several housemates who are prescribed, or send a text to someone who I know usually has it.”

Many students share the same experience as Raja. A senior studying media studies at Quinnipiac University, who asked to remain anonymous (we’ll refer to him as the Quinnipiac source), also said he has no problem getting the drugs.

“I know a multitude of people to get them from and it would just take a quick phone call to get them,” the Quinnipiac source said.

***

In a survey administered via Facebook to Quinnipiac students, 48 percent of the 50 respondents reported using prescription drugs to aid their studies during their academic career. Of the students who reported using study drugs, 41 percent said they use Adderall primarily, while 11 percent reported using Vyvanse. No respondents reported using Ritalin, Concerta or Focalin.

In addition, 67 percent of respondents strongly agreed that is was easy for them to find study drugs. Also 20 percent said that they strongly agreed that study drugs aided them in achieving higher grades.

[media-credit name=”Kristen Riello/Chronicle” align=”alignnone” width=”266″][/media-credit]

Yet, 56 percent of the respondents said they felt using study drugs was detrimental to their health. Students reported having “anxiety, upset stomach [and an] inability to eat” or “mood swings [and being] extremely irritable and extremely sexual.”

According to Healthy Horns side effects of abusing prescription stimulants include irregular heartbeat, increased blood pressure, anxiety, paranoia, insomnia, suppressed appetite and impotence.

“I do think about some health risks when I take these study drugs,” Raja said. “I generally lose my appetite, which doesn’t make me feel too good after sitting for hours studying. I’m sure its not good for my heart health either. Lastly, I hate when I’m ‘coming off’ of Adderall. I tend to get anxiety, and have some difficulty sleeping, unless I drink a beer or two to take the edge off.”

***

The reasons that students use these drugs are fairly clear. Making the transition from high school to college includes a significant increase in course work. In addition, the responsibility to balance social life and schoolwork is now placed solely on the adolescent. In high school, a parent has the power to allow their kin to spend time with friends or deny this to them so that they can do work. At college, the students have to manage this themselves, which accounts for lots of procrastination and cramming.

According to a Huffington Post article entitled “Many Ivy League Students Take Study Drugs and Don’t Consider it Cheating,” almost one in five Ivy League students have admitted to misusing ADHD prescriptions. As far as why they abused the prescriptions, 69 percent used stimulants to write an essay, 66 percent to study for an exam and 27 percent used them to take an exam. In addition to these findings, it was concluded that students participating in varsity athletics or Greek organizations were more likely to abuse the drugs due to the additional stresses these extra-curricular activities put on the students.

***

Victoria E. Richards is an associate professor of medical sciences at Quinnipiac’s Frank H. Netter, MD School of Medicine and an expert on pharmaceuticals.

“Drugs like Adderall were first designed to treat conditions such as ADHD,” Richards said. “It is sort of a paradoxical situation that you would give a stimulant to control a hyperactive functionality. If a young individual has ADHD and are hyperactive you give them a stimulant and it levels them out. However for older people taking stimulants increases their attention and stamina.”

People often use study drugs with other drugs, which can have adverse side effects, according to Richards.

“When drugs are abused or misused, people tend to use other drugs, which can cause a complications,” Richards said. “Also there is an issue of how these people are obtaining them, which could be via the Internet, or other illegal markets. In those cases it can be a case of contamination, which can cause even worse adverse effects. There haven’t been a lot of long-term studies on the abuse of these drugs long term.”

When asked if students should just use coffee or energy drinks and harness caffeine to aid their studies, Richards provided a technical understanding on how stimulants affect different parts of the brain.

“Ritalin and Adderall work on a different part of the brain as opposed to caffeine,” Richards said. “Caffeine works on the adenosine receptor, whereas these drugs work with neuro-transmitters, such as dopamine, which have specific effects on the brain. Adenosine receptors have more of an indirect effect on the brain which is why when students drink coffee they don’t have the increased sense of focus they would with a study drug.”

But people can become dependent on study drugs.

According to a study at the University of Michigan, 23 percent of stimulant prescription drug abusers experienced depression. That depression is often linked to dependency and the users’ inability to feel the same without the drug.

“There have been studies that state in terms of addiction it depends on the dose and route of administration,” Richards said. “So in some of these drugs that are abused such as cocaine, when it is snorted, that enhances the addictive nature. However, there just aren’t enough studies to show the effects of snorting the study drugs.”

***

The issue of cheating is often associated with the use of study drugs, but many students don’t feel they are violating their academic integrity.

[media-credit name=”Megan Maher/Chronicle” align=”alignnone” width=”500″][/media-credit]

Alexander Jahani is a senior at Fordham University studying English and visual arts. He admits to using study drugs but said he does not think it is cheating.

“These drugs are essentially available to any person that puts an effort into finding them, whether it be through someone who is prescribed those pills and chooses to give them to others, or from someone that sells them,” Jahani said. “Students that are diagnosed with ADHD can’t automatically be considered to be cheaters. The effects aren’t drastically different for people that aren’t diagnosed with ADHD.”

Raja said he feels the same way.

“I’m simply using something to enhance my performance,” he said. “As long as I am not taking answers from the professors desk, using a test bank, looking over at someone else’s exam, etc., I am not cheating.”

But Richards disagrees.

“I can’t say that it is my personal feeling that it is cheating,” Richards said. “That can lead to other consequences when you might feel pressured as a student to take these illicit medications because you have to compete.”

Aaron Vigliotti, a senior with a triple major in finance, information technology and entrepreneurship at Syracuse University, has never taken prescription drugs to aid his studies.

“I do not see it as a form of cheating,” Vigliotti said. “As long as it helped you then it completes its purpose.”

***

Many schools across the nation ban the use of study drugs.

The penalties at Quinnipiac for being caught with a drug without a prescription can vary from one weekend off campus to dismissal from the university. The penalties are consistent with those applied for being caught with alcohol underage and marijuana possession.

David Barger , chief of public safety at Quinnipiac, has seen an upswing in the possession of study drugs without a prescription in the past few years on campus.

“This is very innocuous in a way because how do I know that you haven’t walked in here on Adderall?” Barger said. “I don’t, I have no idea. So it is a little bit more insidious than if you had just smoked some weed. I’d smell you and you’d walk with a bag of cool ranch Doritos. If you were drunk you’d be staggering in here glassy eyed. For prescription drugs I only really know if you are overdosing.”

Barger points out some of the risks of taking a drug for which a student does not have a prescription. Barger said if a student takes drugs without a prescription and has a bad reaction to it, Public Safety and the Health Center have a harder time helping the student because they won’t know what they took.

“It’s very important on a bigger picture for not me to know, for the health center to know, so that if I find you they can get the proper medical care administered to you,” he said. “And a lot of students don’t look at it that way.”

Barger said it is more difficult to create initiatives that cover the abuse of prescription medication.

“We focus certainly on alcohol as being the No. 1 problem. I think that also with alcohol you cast a wider net that covers marijuana and other illicit drugs,” he said. “The bigger problem is the script drugs because how do I reach you to talk about prescription drugs? How do I get across to you?”

Barger’s concerns are common across the nation with many universities struggling to find the right initiatives to prevent the abuse of prescription drugs on their campuses.

***

Some students actually need the drugs for their medical conditions. Dominick Tullo, a senior entrepreneurship major at Quinnipiac, was prescribed Adderall his sophomore year of high school during a physical checkup. Tullo mentioned to his doctor that he couldn’t focus and left with a sample and no specific diagnosis.

“There is absolutely a social pressure to sell them to people as soon as they are aware that you are prescribed,” Tullo said. “I think the worst part of this is fact people begin texting you asking for it and are making it seem like I promote the fact that I am selling it.”

According to data from the Centers for Disease Control and Prevention the number of children taking medication to treat A.D.H.D. has risen from 600,000 in 1990 to 3.5 million today. This in large part is thanks to the introduction of Adderall to the pharmaceutical market in 1994.

The market for prescription stimulants has also experienced an increase in sales from just under $2 billion in 2002, to well over $8 billion in 2012 according to research done by IMS Health.

Shire, the company that controls the market and produces Adderall, markets their products directly towards both parents and children. Additionally, the Food and Drug Administration has cited Adderall, Concerta, Vyvanse, and Focalin several times since 2000 for misleading advertising.

Tullo said he only takes the drug when necessary because of the side effects.

“It only helps in the short term,” Tullo said. “In the long term it has made it incredibly difficult to do things I am not interested in doing (i.e. school work) without using it.”