In 2012 over 116,000 people were admitted to rehabilitation facilities for the abuse of amphetamines (Adderall Addiction and Abuse). Amphetamines are stimulants that are used to treat the nervous system by affecting chemicals in the brain and nerves that help to control hyperactivity and impulse (Amphetamine Uses, Dosages, Side Effects & Warnings). Amphetamines are often used to treat attention deficit hyperactivity disorder, also known as ADHD. Amphetamines prescribed for the treatment of ADHD include but are not limited to Adderall, Concerta, Focalin, and Strattera (List of Amphetamines). 

A 2008 study estimated that upwards of thirty-four percent of college students used ADHD stimulants illegally (DeSantis). The same study found that eighty-one percent of interviewed students believed that an addiction to ADHD medications was not at all, to only slightly dangerous. The abuse of ADHD medication is rising on college campuses and is hard to control. Many students believe that there are little consequences to abusing these substances; however, the effects of college students taking unnecessary ADHD medication can lead to addiction, create lasting mental problems, and serve as a gateway drug leading to more severe addictions and consequences. 

According to the Nation Institute of Mental Health, Attention-Deficit/Hyperactivity Disorder, also known as ADHD, is a “brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.” Signs and symptoms of the disorder include, but are not limited to: not appearing to listen when spoken to, not being able to follow instructions, being forgetful in everyday activities, fidgeting and squirming, being constantly in motion, and nonstop talking (Attention Deficit Hyperactivity Disorder). Medicine is the most common treatment for ADHD; however, psychotherapy and education training also exists as options. Medication for ADHD falls under two categories: stimulants and non-stimulants. Stimulant medications are prescribed more often as they take effect in the body more quickly (Lilienfeld). However, stimulant medications have more side effects than non-stimulant medications. Psychotherapy options are also available to treat ADHD, such as behavioral therapy; however, behavioral therapy alone takes much more time and dedication to helping reverse effects of ADHD. In Addition, the child, parents, therapist, and teacher must be aware of the techniques need for the therapy and implement them into the child’s everyday life twenty-four hours a day, seven days a week, for the treatment to be most effective. In many cases the effort, time, and communication need to rely solely on behavioral therapy as a treatment option for ADHD is a nearly impossible standard.

Stimulant medications used to treat ADHD works by increasing dopamine, neurotransmitters, and blood flow to the brain (Berchelmann). One doctor described it saying, children with ADHD are constantly self-stimulating themselves, and by giving them the stimulant medication it reduces the need to self-stimulate. Stimulant medications, such as Ritalin, help to increase motor control and cognitive functions. This meaning that, medication will fine tune the way users brain send signals to their muscles and limbs, as well as the way the brain its self-concentrates, thinks, and feels. The medication increases the brain's access to dopamine, which in turn allows for the ability to concentrate and increases the brain's pleasure and reward center (Oremus). Simply put, the drug lets users stay alert and focused. Users with ADHD need medication to perform as a body without the condition would. However, in a user without ADHD the medication fine tunes the way the brain performs by enabling cognitive functions allowing users to work more efficiently. The added use of ADHD medication on a subject with ADHD allows their mind to reach healthy levels of dopamine, whereas without the medication their dopamine levels may be lower, then the average healthy individual of a comparable age (Koplewicz). The added use of ADHD medication on a subject without ADHD allows their brain to gain access excess levels of dopamine, further raising their dopamine levels from that of a normal and healthy level. Kollins, a doctor at the Duke ADHD Clinic, described the difference between the effects of the medications on a user with ADHD and a user without the disorder saying that “patients accurately diagnosed with ADHD are coming into the game at a different baseline as far as what’s going on in their brain, the drugs…. [bring] them back up to a level playing field… For somebody without ADHD, because they’re already functioning at that level, it’s going to take them a little bit higher" (Oremus).

Because of the difference in brain fictionality, ADHD medication use without the disorder is often likened unto that of athletes taking steroids. The drug is used to gain an unfair advantage. How great the advantage is dependent mostly on the task at hand because the stimulant allows the user to hyper-focus on a task (Oremus). Hyper-focus is described as “a person’s concentration becom[ing] laser fixated on a particular event or topic” (Maucieri). One user said that the drug use useful to get through philosophy homework, but if she took the drug in her dorm room then she would spend hours focusing on her eyebrows (Oremus).

With about one out of ten children in the United States diagnosed with ADHD and prescribed medication, the drug is readily available (Oremus). In an eight-year period, there was an increase in ADHD medication prescriptions for teenagers of about 133% (Setlik). In 2013 a little bit less than ten percent of individuals between the ages of four and seventeen were diagnosed with ADHD (Is Ritalin a Gateway Drug?). In a self-reported survey, it was found the most common way for nonprescription users to gain access to the drug was through peers with a prescription (Lakhan). In addition to the medication being readily available through friends who have a prescription, gaining a false prescription is relatively easy, as users only need to fake the symptoms of ADHD to “get a fix.” Because there are few tests that can be run to determine if a patient has ADHD doctors rely on observation of the patient, as well as teacher and parent observations if the patient is a minor. One academic study found “ninety-three percent of students could acquire Adderall prescriptions by faking symptoms” (Baker). 

A study analyzed the American Association of Poison Control Center's National Poison Data System, from 1998 to 2005 (Setlik).The analyzation found that from 1998 to 2005 ADHD medication abuse rose by seventy-six percent. The study also analyzed the increase in calls to poison control for amphetamine-related cases versus other cases. The results were an increase of amphetamine related cases, “out of proportion to other poison center calls.” These observations would suggest that in 2005 there was a rising problem with ADHD substance abuse. Now, the American Association of Poison Control Center has released its annual report for 2015 which shows that stimulants are still among the top twenty-five substances categories that are at the greatest rate of exposure in adults over twenty years old, as well in the substance categories with the largest number of fatalities (Mowry). From 2000 to 2006 the misuse of stimulant medication rose from 3.6 percent to 5.4 percent (Lakhan). The abuse of stimulant medications has increased so that it second only to marijuana among undergraduate college students. 

However, studies have shown that ADHD medication does not affect learning in those without the disorder, but that recognition, retention, and recall were enhanced (Lakhan). “Data suggest[s] that when people are given rote-learning tasks, their performance is improved by stimulants.” A 2009 study, focused specifically on the effects of Adderall, found that the amount of enhancement depended upon the user's baseline performance, meaning that the drug was more effective on those with a lower baseline of performance than those with a higher baseline of performance. However, a 2011 study conducted by Looby an Earleywine found that most of the college students reactions to ADHD medications were because of the placebo effect (Looby). The placebo effect is an improvement in the condition of a patient that occurs in response to treatment but cannot be considered due to the specific treatment used (Placebo Effect).While studies so far have shown the medication does not significantly affect the learning of those without the disorder, it does allow students to hyperfocus on tasks, which it why is it so often used as a “study drug.”

Though on college campuses ADHD medication is mostly abused as a “study drug” its second highest use is to get “high.” ADHD medications, specifically Adderall, has often been referred to as the poor man’s cocaine when utilized for this purpose. Many ADHD medical stimulants work by rapidly releasing dopamine in the brain causing users to receive an “instant ‘high’ and an intensely gratifying euphoria” (Morton). The effects of these drugs are similar to that of cocaine. Patients receiving both drugs reported feeling a similar “high.” Whereas cocaine takes four to six minutes to start affecting the user ADHD medical stimulants, such as methylphenidate and amphetamines take four to eight minutes to effect the user. The rapidness of effects of these drugs plays into the abuse potential. Because of the “high potential for abuse, with use potentially leading to severe psychological or physical dependence,” these drugs have been assigned a level two status, by the Federal Drug Administration, under the Controlled Substance Act (DEA / Drug Scheduling). Substances in the level two category include but are not limited to cocaine, OxyContin, Adderall, and Ritalin. In contrast, level one drugs include, but are not limited to, heroin, LSD, and marijuana, as they are “substances or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse.”

Whether being used as recreationally as a “study drug” or to get “high,” Amphetamines, like Adderall, can leave lasting damage to the brain. This damage rarely occurs when used correctly as properly prescribed by a doctor. Professor Daniel Fatovich, a professor of emergency medicine, at the Royal Perth Hospital and the University of Western Australia conducted tests on patients who came to the emergency room of Royal Perth Hospital with amphetamine related cases (Fatovich). Fatovich used a magnetic resonance imaging machine, or MRI, to look for brain abnormalities. Over twenty percent of recreational users of Amphetamines had brain abnormalities. The most common of these abnormalities were spots on the brain called unidentified bright objects, or UBOs. The UBOs most likely formed from the drug restricting blood vessels from letting oxygen get to the brain, and there for killing the brain cells. These UBOs can cause problems with cognitive functions in later years in life, causing dementia and strokes. Professor Fatovich put it simply, saying,  “If you see pictures of people before and after using….it clearly shows that they are aging on the outside,  but we’re forming the view that not only is it again you on the outside, it’s aging you on the inside.” While UBOs are a natural occurrence, they are most commonly seen in seniors. Amphetamine abuse causes UBOs to occur at a much younger age.

Large doses of ADHD medications, both methylphenidates, like Ritalin, and amphetamines, like Adderall, can lead to “visual hallucinations, delusions, anorexia, flattening of affect, and insomnia” (Lakhan). In addition, large doses of both medications could result in myocardial infarction or heart attack. In 2005 there was a reported case of a fifteen-year-old male who had a heart attack after consuming two twenty milligrams tablets of Adderall. In 2009 there was a reported case of a twenty-year-old male who has a heart attack after consuming two fifteen milligram tablets of Adderall XR. In 2011 there was a reported case of a nineteen-year-old female who was rushed to the emergency room after consuming thirty Adderall tablets, of unknown strength, with a heart disease called Cardiomyopathy. Heart problems are a common side effect of abuse of ADHD medications, because of the abnormally elevated level of dopamine in the body, as well as the constriction of the blood vessels. Chronic abuse results in a psychosis that shows paranoia, hallucinations, and violent behavior (Baker). 

Both methylphenidates and amphetamines have been studied as gateway drugs; thought amphetamines are more prevalent then methylphenidates. Gateway Drugs are defined as “a drug (as alcohol or marijuana) whose use is thought to lead to the use of and dependence on a harder drug (as cocaine or heroin)” (Gateway Drug). While gateway drugs “may not pose too many significant dangers in their own right, [they] would be both noteworthy and worrisome if they…pav[ed] the way for substance abuse” (Is Ritalin a Gateway Drug?). One of the reasons ADHD medications, specifically those that fall under amphetamines, like Adderall, are considered gateways drugs is because they have similar chemical compositions of cocaine and methamphetamine (Baker). The biggest difference is that cocaine and meth are processed more quickly by the body and allow users to experience a more intense feeling. However, they are metabolized exactly how an amphetamine would be. In other words, once the initial “high” wears off users are simply consuming amphetamines, the main ingredient in Adderall.  It is speculated that amphetamine abusers go on to try “harder drugs” in order “to determine other types of ‘highs’” (Barretta). In addition to the dangers that amphetamines present on their own, according to the National Survey on Drug Use and Health, in 2013 college students abusing Adderall were three times more likely to have used marijuana, which is a class one substance, under the FDA (Barretta).

The problem for many begins in college with as many as three out of four millennials having illegally tried Adderall (Baker). Millennials are those “born after 1980 and the first generation to come of age in the new millennium” (Millennials). In addition, two out of every three users who have illegally taken Adderall first tried it in college (Baker). One of the reasons it is so prevalent on college campuses is because students believe they need to take it to get ahead (McHugh). One user who attends Boston University said that many of her peers the use of ADHD medication as absolute harmless. As part of an interview with NBC News reporter, Rich McHugh, four students admitted that the problem is our of control. Charlotte Lieberman, a former abuser of the substances, relayed her experience using the drug to reporters at Cosmopolitan, stating that she has taken over four times the recommended daily dosage at one time during her college career. Alan Schwarz, author of A.D.H.D Nation, and NewYork Times reporter,  told McHugh “colleges have had their heads in the sand for so long…because they don’t really mind their students getting good grades.” In addition, Schwarz declared that no one is pushing back against this. The Boston University students agreed saying the colleges know this is happening, and if they do not, they are being willfully ignorant. When asked if he would do it again knowing the terrible side effects one user said he could not give an answer. “I see it wreaking havoc on my friends,” he said, “but at the same time, if I have to do it, I’ll do it.”

Many college, and even high school students are abusing ADHD medication, specifically amphetamines because they do not know the risks involved, ignore the risks, or believe the end justify the means. While some universities are beginning to “crack down” on the issue they are few and far between (McHugh). Some universities are not allowing their health centers to prescribe ADHD medications or fill prescriptions, others are only dealing with the medication with a parents consent, but these universities are scares. While many people know that this abuse is happening among college students, it is an issue that is not talked about, and in some cases encouraged.  

 Of corse, there are those that are not against the illicit use of ADHD medications. An argument is “too many people are already taking them, and the users tend to be educated and privileged people who proceed with just enough caution to avoid getting into trouble” (Talbot). Some argue that taking neuroenhancers, like ADHD medication,  is not like an athlete taking steroids, but like a person getting plastic surgery — instead of altering your body you are altering your brain. Some believe that if people are properly informed of the risks and benefits, then they can accurately decide what they want to put into their bodies. However, that being said, the problem lies in that the public is not being properly informed. While those legally on the medication, with a legitimate medication or not, are informed of the risk by their doctors who prescribe the medication, only a small percent of abusers have a prescription. Furthermore, there is little research on how the drugs affect a person without ADHD, and therefore user who gained an illegal prescription through falsifying symptoms would have different risks from someone who took medicine with the disorder. 

The risks involved in taking methylphenidates and amphetamines or other stimulating ADHD medication are present for those with and without the disorder. Abuse is possible in both scenarios, though statistically speaking those with the disorder are less likely to abuse their prescription (Lakhan). The abuse of ADHD medication is rising on college campuses and is hard to control. While opioid usage has gone down in collage aged students, the use of stimulants has increased (McHugh). Many students believe that there are little consequences to abusing these substances or the consequence is so small that the end justifies the mean.  However, he effects of college students taking unnecessary ADHD medication can lead to addiction, because the drug lets the brain receive excess dopamine, giving users a “high.” Illicit use of ADHD medication can also create lasting mental problems by creating a psychosis, or an extreme mental disorder in which thought and emotions are so impaired, and contact is lost with external reality (Baker). The psychosis can show paranoia, hallucinations, and violent behavior.  

The overuse of ADHD medication, specifically amphetamines can even serve as a gateway drug leading to more severe addictions and consequences due to similar chemical makeup in amphetamines and methamphetamines; as well as the nature that those who take ADHD medication illegally are also statically more likely to take other illegal substances. In addition to the personal risk, users take on when they make the decision to illegally take and abuse ADHD medications they are also hurting those with the disorder that need the drug (Lilienfeld). The effect of the medication depends on where you start on the spectrum. For example, someone with ADHD may start at negative five, and the medication brings them to zero, where someone without ADHD may start at zero, and the medication brings them to five. This creates an unfair advantage for students without ADHD and penniless those with ADHD. For this reason, slowly, colleges are starting to ban the use of ADHD medication, not only for its illegality but also ethically as they see that it as cheating (McHugh). 

While the ultimate decision to take the medication or not to take the medication lies with the user, it is imperative that they know the risks they are undertaking when they decide to take the drug, orally, by swelling a pill; snorting, by crushing the tablet and injecting it through their nose; or by injecting, by melting the pill and injecting it into the blood stream with a needle (McHugh). Not only are their risks legally, with it being a class two substance making it a federal offense to sell, give away, or take the medication, but there are lasting mental effects that can alter users personals when taken in large does over an extended period, that in extreme cases can lead to death.
