It was late at night in the library of a major state university. A sophomore named Mia was having trouble staying awake. “I was drinking Red Bull and 5-hour Energy, and my friend said, ‘Stop drinking that, just have an Adderall,’ and she gave me one of hers,” the student told her college newspaper. Mia thought about it for a half-hour, then popped the pill.

After that, Mia (not her real name) says she took the stimulant once a week for at least a month–buying the drugs illegally from a friend for $5 to $7 per pill. Short-release pills helped her through a few hours of homework. Extended-release pills fueled all-nighters.

Surge in So-Called Study Drugs

Across the U.S., nearly one in six college students now say they’ve used stimulants like Adderall, Ritalin, or Dexadrine–drugs normally prescribed for Attention Deficit Hyperactivity Disorder (ADHD)–without a prescription, according to a recent, national survey by Ohio State University. Seventy-nine percent used them to study, according to The College Prescription Drug Study of 19,539 undergraduate, graduate, and professional students from 26 institutions across the United States. But others just like how the drugs make them feel.

Like Mia, most didn’t look far to find the drugs. About 79 percent got them from a friend. “One of our major findings is how many students who misuse prescription drugs are getting those pills from fellow students,” Anne McDaniel, executive director of Ohio State’s Center for the Study of Student Life and the principal investigator of the CPDS, said in an interview when the report was released. “A vast majority of our survey respondents aren’t keeping their medications in a locked, secure place and that’s worrisome.”

The non-prescription “study buddy” use of ADHD drugs is so commonplace among college students that nearly 62 percent said they’d been offered some at one time or another in a 2012 University of Maryland study of 1,253 students. Half admitted to trying them.

What most don’t know: Recent research shows that study drugs can have serious side effects. They’re often used by students with undiagnosed ADHD or substance-abuse problems. And they don’t really work.

Emergency Room Visits on the Rise

Plenty of college students think taking someone else’s prescription ADHD meds is safe. Among the stimulants used as study drugs are amphetamine and dextroamphetamine (Adderall, Adderall XR, and generics), methylphenidate (Concerta, Methylin, Methylin ER, Metadate CD, Ritalin, Ritalin SR, Ritalin LA, and generics) and lisdexamfetamine (Vyvanse). In a 2016 national survey, 38.5 percent of 19- to 22-year-olds said they didn’t think the regular use of amphetamines and related drugs was harmful.

But prescription stimulants carry a significant risk for physical and psychological dependence, drug experts warn, especially for people taking them without a prescription and a doctor’s guidance. “The health risks include cardiovascular problems, addiction, and psychiatric comorbidities,” says lead researcher Lian-Yu Chen, M.D., PhD., now an Assistant Professor at Institute of Epidemiology and Preventive Medicine, National Taiwan University.

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The side effects can also be serious— irregular heartbeats, increased blood pressure, restlessness, anxiety, nervousness, paranoia, headache, dizziness, insomnia, dry mouth, loss of appetite, diarrhea, constipation, and even impotence. If you’re not taking this medicine under the care of a doctor, you might not expect these effects and they can be scary and unsettling, driving some to the emergency room.

In fact, between 2006 and 2011, emergency-room visits for non-prescription amphetamines rose 156 percent, according to a Johns Hopkins University study that looked at drug-related emergency room visits at 250 hospitals across the US. Calls to Poison Control Center hotlines rose 76 percent. And while the number of prescriptions for ADHD drugs dropped somewhat during that time, illegal use of the drugs increased by 67 percent.

The Adderall Myth

Plenty of students use study-buddy pills to stay alert, focused, motivated–and to get “smarter.” Meanwhile, a growing stack of research suggests study drugs don’t even really work. And University of Rhode Island researchers say the drugs could negatively affect academic performance.

In a 2018 study, 13 college students without ADHD took a 30-milligram dose of Adderall or a placebo and then took a series of tests to gauge changes in brain function, reaction time, and emotions. The Adderall group got a big mood boost and some improvement in attention and focus. But that didn’t help skills important for studying and writing papers like reading comprehension, reading fluency, and working memory. “Contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students,” the researchers concluded.

As one college student described the study-drug experience to a reporter from her college newspaper, the pills can be a big distraction. “They do help you study, but the side effects were the worst part,” the young woman related. “They caused me to fidget a lot, causing me to bite my nails and nail beds, pick at the dead ends of my hair … and my personality would completely change. I would go from happy, talkative Kirsten to zombie girl, talking to no one.”

Study Drugs and Undiagnosed ADHD

When Timothy Wilens, MD, chief of Child and Adolescent Psychiatry at Mass General Hospital for Children (MGHfC), took a close look at college students who mis-use stimulants, he and his team made a surprising discovery: They were nearly twice as likely as non-users to have diagnosed or undiagnosed ADHD. Stimulant mis-users were also more likely to have other substance abuse problems than non-users, their 2016 study in the Journal of Clinical Psychiatry found.

“Given that 1 in 4 have ADHD and that screening for ADHD is relatively easy, I would strongly advocate that youth who are using stimulants non-medically be screened,” Wilens says. In the study, users were more likely than non-users to have been easily distracted or had trouble paying attention as children. As young adults, they had trouble following directions and didn’t like to do things that required them to pay close attention.

In a 2017 study of 100 college-age study drug users and 198 non-users, Wilens’ group found no differences in the IQs of the two groups. But study drug users scored higher on tests of trouble with working memory, planning and organizing, initiation (getting work started) and inhibition (self-control). In the pressure-cooker environment of college, taking study drugs may be an attempt to overcome real mental obstacles. “Our findings, in conjunction with the literature, lend credibility to the notion that stimulant misusing college students may be self-medicating attentional difficulties, executive dysfunction, and academic impairment,” the researchers write. For parents and school staff, study-drug use could be a red flag that a young adult needs help with ADHD.

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Last Updated: Aug 17, 2020