This story was reported by correspondents Kristina Finn, Matt Kauffman, Kade Krichko, Samantha Laine, Sam Perkins, Mekhala Roy, Julia Swanson, Melissa Tabeek and Rachel Weiss. It was written by Lisa Chedekel.
Sixty-three percent of students at four Boston colleges reported taking prescription drugs within the last year, with one in four of them saying they took the drugs to get high, de-stress, enhance their focus, or for reasons other than the intended purpose, according to an informal survey conducted by the Boston Globe and Your Town.
The most common drug taken by the students was Adderall, used to control symptoms of attention deficit hyperactivity disorder (ADHD). Other drugs reported in significant numbers were Vicodin, a narcotic pain reliever, and cough medicine.
Of the students who reported taking prescription drugs, one-quarter said they took them with the intent of improving their performance academically, the survey found.
Illicit use of Adderall and other ADHD drugs on college campuses is a problem attracting increasing concern, in part because the stimulants pose a high potential for dependence or abuse and can increase the risk of heart attack, stroke and other serious side effects. The rise in medical prescriptions for stimulants such as Adderall and Ritalin has led to concern on the part of some clinicians.
Several studies in recent years have examined the use of prescription stimulants on college campuses, with experts warning that the off-label use of these drugs can be dangerous.
Dr. Timothy Wilens, a psychiatrist at Massachusetts General Hospital who is an authority on ADHD, said the drugs are showing up on college campuses because "they are available, and the culture is accepting of using them. Additionally, the perception of many students is that prescription medications are legal, not dangerous, not morally problematic, not really a drug of abuse, and everyone is doing it."
He noted that while the risk for serious adverse side effects is low for most college students, students who misuse stimulants are not screened for medical safety issues or followed by a physician.
"When used therapeutically, there is no systematic evidence of abuse or dependence developing," he said. "However, misusing the stimulants at inappropriate dosing may lead to substance dependence." Another danger is that students could face disciplinary action, or even criminal liability, for misusing the drugs, he said.
To conduct the surveys, anonymous questionnaires were completed by 192 students at Northeastern University, Boston University, Suffolk University and Emerson College. The survey is not representative of all Boston college students because participants were selected through an informal sampling.
The majority of surveyed students who said they did not obtain the drugs through their own prescriptions reported getting them from friends and family members, the survey found. Of the 161 students who responded to a question about whether they had mixed the drugs with alcohol, marijuana or other substances to enhance the effects, 11 percent said yes. Only 4 percent said they had snorted the drugs, and 4 percent said they believed they had become addicted to a drug.
A number of students who reported taking Adderall, Vyvanse and other ADHD medications said they did so in order to study for tests and final exams. Other students reported taking cough medicine and pain killers in order to get high.
In interviews, students gave varying reasons for using the drugs. A BU senior said he was using Adderall to study and party. An Emerson junior said she used Adderall “to regulate my behavior and maintain a feeling of focus and attention in terms of academics and things of minimal interest." A Northeastern senior used the drug to concentrate when papers were due on a tight deadline.
People with ADHD have an impairment of brain function that affects attention and often are prescribed stimulants such as Adderall, a brand name of amphetamine salts-based medication. The drugs, which act on pathways in the brain to improve a person's ability to focus and sustain functions, are classified as Schedule II controlled substances, meaning they have a high potential for abuse.
Side effects of Adderall include insomnia, abdominal pain, loss of appetite, seizures, tics and potentially hostile changes in mood or behavior, according to the FDA.
Several studies have examined the prevalence of illicit use of attention-deficit drugs on college campuses. A 2005 study found that about 7 percent of college students reported non-medical use of prescription stimulants over their lifetimes.
That national study, based on data from the Harvard School of Public Health College Alcohol Study, found that the highest rates of illicit use were on campuses in the Northeastern region of the U.S.; at schools with highly competitive admissions criteria; and on campuses with higher rates of binge drinking. The study also found that students who used prescription stimulants non-medically were more likely to abuse other substances, such as alcohol, marijuana, ecstasy and cocaine.
The study's authors recommended that colleges assess their own student bodies to find out whether the non-medical use of prescription stimulants represented a problem on their campuses.
"Any intervention aimed at reducing non-medical use will have to take into consideration that prescription stimulants are a highly effective and safe medication for most individuals with ADHD," said Sean Esteban McCabe of the University of Michigan Substance Abuse Research Center and lead author of that study. "Given the proven therapeutic efficacy of prescription stimulants for the treatment of ADHD, there is a need to balance the medical necessity of these drugs and the risk for non-medical use and abuse."
Wilens recommended that colleges improve education on the issue, both for students and those who work with them.
"Practitioners of college students need to spend time discussing the moral, legal, and medical concerns of misusing any prescription drugs," he said.
In a story last year in BU Today that examined the risks of Adderall, some students reported buying Adderall for about $5 for a 20-milligram pill, often from other students who had prescriptions for the drug.
Last month, NPR reported that many medications, including those for ADHD, are in short supply – a problem that led President Obama to issue an executive order Oct. 31 to help release more supplies. The hard-to-get drugs included Adderall and methylphenidate, the active ingredient in Ritalin and generic equivalents.
This story was reported by Northeastern University journalism student Kristina Finn, Matt Kauffman, Kade Krichko, Samantha Laine, Sam Perkins, Mekhala Roy, Julia Swanson, Melissa Tabeek and Rachel Weiss, under the supervision of journalism instructor Lisa Chedekel under an agreement with The Globe.