By Stephanie Rudolph
Features Editor
Should Adderall be against the honor code? Is it a steroid for the mind? The answers are not clear, but the need to seek them out is. The illegal use of prescription drugs, both for an academic edge and recreation, is fast becoming a staple of college culture. Haverford does not look to be above the fray.
Several years ago one of the most talked-about pharmaceuticals was Ritalin, used to treat Attention Deficit (Hyperactivity) Disorder, AD(H)D. Nowadays, discussion of potential abuses has moved from elementary and middle schools and found a new home in colleges and universities. Another drug for the treatment of ADD/ADHD-Adderall-has recently been claiming the spotlight, as more and more students use the drugs as study aids.
An article published in the Journal of American College Health in 2000 found that 16.6 percent of students at the Massachusetts College of Liberal Arts had taken non-prescribed Ritalin, while 53.4 percent of students knew someone who had taken it. According to student accounts, Haverford may not be all that different. But Adderall usage at Haverford is not just a health concern-many students have expressed concern over the Honor Code implications of using unprescribed ADD/ADHD medication.
The primary Honor Code related concern is that use of ADD/ADHD medication might constitute cheating because, while drugs like Adder all make those with ADD/ADHD focus at a “normal” level, the drugs might give those who do not have ADD/ADHD a competitive advantage. Although the effects of Adderall and other ADD/ADHD medication on individuals who do not have ADD/ADHD are unknown, some argue that these drugs can be a “steroid of
Adderall, Ritalin, Coffee, Haverford, and the Honor Code
the mind,” inducing a state of hyperfocus which may aid in studying and test-taking. Others argue, however, that ADD/ADHD medicine does not increase the ability to focus for those who do not have the disorder. Rather, it simply works as a stimulant that induces wakefulness much like coffee or Red Bull (a high caffeine-drink). Despite this debate, the effects of Adderall on nonADD patients still remain uncertain largely because clinical trials ethically cannot include those without the disorder.
Adderall (mixed-amphetamine salt) and Ritalin (methylphenidate) are two of the most common drugs used to treat ADHD/ADD. Both are central nervous system stimulants. There are several other, newer, and perhaps less familiar drugs, including Concerta, which is very similar in composition to Ritalin, and Straterra, a norepinephrine reuptake inhibitor, which is a non-stimulant. These drugs, when used by ADD/ADHD patients, usually enable them to focus and function at a normal level. For patients with ADHD (hyperactivity), these stimulants actually have a calming effect. The physiological and psychological effects include a faster heart rate, higher blood pressure, wakefulness, increased focus, appetite suppression, and euphoria (increased levels of monoamine neurotransmitters). According to the Drug Enforcement Agency, “misuse of these medications may cause short, intense periods of high energy.”
With the differences in individual brain chemistry, coupled with a lack of understanding of ADHD itself, there is a wide range of reactions to these drugs. Researchers still do not know the mechanism of these drugs in the brain in relation to ADD/ADHD, nor do they know the longterm effects. There is also a diverse range of individual toxicity tolerances.
Ritalin, Concerta and Adderall are all Schedule II controlled substances, as specified by the DEA-in the same category as opium, OxyContin, and cocaine. These substances have been identified by the DEA as having a “high potential for abuse,” and are more highly regulated than the average prescription medication. However, according to an article in Scientific American, when taken at the correct dosage these stimulants rarely result in dependence, and euphoria usually only occurs at higher dosages or through alternative methods of administration, the most common being intravenous or intranasal. Most ADD/ADHD drugs can be abused in a recreational and academic sense.
According to Mark Coffey, Substance Abuse Educator at Haverford, the adverse effects of Adderall and Ritalin, combined with their potential for addiction, make these drugs of particular concern on campus, even if only a few students are using them. Coffey states, “It’s a problem when students use medication that’s not prescribed.” Coffey is primarily concerned with health risks, and the potential for a destructive, although unintended, “pharmacological cycle.” Coffey explains that Adderall use, even when its immediate effects have worn off, still interferes with normal sleep cycles, causing some users to try to “counteract the stimulant with depressants,” such as sleeping pills, marijuana, or alcohol. In order to counteract the depressants they turn to stimulants again. In addition, Coffey notes that side effects, such as suppression of appetite, and the potential for building tolerance are unhealthy in the long-term. He emphasizes that when non-prescribed, these drugs simply aren’t worth the costs to one’s health.
According to Coffey, no students have come to him about the abuse of these stimulants, and Haverford does not have any statistics concerning non-prescribed usage. Coffey does note that other college substance abuse counselors in the area, including University of Pennsylvania and Villanova, have noticed an increase in the non-prescribed use of these drugs. In 2002 a nursing student at University of Pennsylvania conducted a study to determine the prevalence of illegal prescription drug use at the university; 29% of students admitted use, and Ritalin was the most common drug used. In a quiz titled “How Good of a Penn Kid Are You?” that appeared in the University of Pennsylvania’s newspaper, The Daily Pennsylvanian, the author allocated the highest number of points to those who said that they took Adderall over coffee and Red Bull in order to pull an all-nighter. Although the quiz was light-hearted, it does suggest that use of prescription medication as study aids is being incorporated into campus culture.
Given the widespread use at other colleges, there is no reason to believe Haverford is any different. Although many students are reluctant to come forward, one Haverford student who has been diagnosed ADHD and takes prescribed Concerta says that he gives it out only a few times a year to friends who ask him for it. His friends usually ask for it when they need to cram or pull an all-nighter. Although he recognizes that distributing Concerta is illegal, he has no qualms with doing so: “It’s a friendly thing to do for a friend who needs it for schoolwork.” Although he distributes the drug to friends, he qualifies, “no one takes my Concerta for just a [recreational] drug.”
In many cases, the potential for distribution and abuse of this drug his high. The student prescribed Concerta explains that he does not even have to sacrifice his own use of the drug when he gives his Concerta out because he always has more than he needs. “I have a sh-tload of pills.. always… I guess I can fill it [my prescription] as much as I want,” he says. He also notes that even for those who do not have ADHD, it is not hard to get a prescription: “Getting the prescription is a joke… 1 truly need it, but anyone could easily bullsh-t the test they give you [to determine if one has ADD! ADHD].” He says that his test consisted of a written questionnaire that asked him to rate certain personality attributes such as “how often do you daydream?”
“I could have made up the whole test,” he says. He does not feel that it is against the Honor Code to distribute Concerta partially because his doctor explained that those without ADHD are not as affected by it. “I get a greater benefit than those guys do,” he says. Even if this is true (the effects of these medications on those without ADD/ADHD remain unclear in the scientific community), it is unlikely that most students who do take non-prescribed ADD/ADHD would continue to do so if their effects were indeed nonexistent.
Other students with ADHD are less willing to give out their prescription. One student who was approached by a friend asking for some pills said she was scared to give them out, citing health concerns. She explains that everyone’s dosage is different and she was afraid that it might affect her friend adversely. “Sometimes I got sick when they were still testing out my dosage,” she remembers. Her doctor strongly encouraged her not to distribute her pills: “I am afraid to give it out because my doctors have told me it’s dangerous.” She also notes that her pills are expensive and she wouldn’t want to waste them. Unlike the student prescribed Concerta, she does not have an unlimited supply of pills.
The use of non-prescribed Adderall and other such drug use was brought to the attention of Honor Council earlier this year by Jane Carlen, ‘06, Sophomore Representative to Honor Council. “A couple of my friends were talking about it and there was lot of disagreement and I thought it would be interesting for Honor Council to discuss it,” explains Carlen. Honor Council members emphasize that they are not trying to police the use of Adderall; rather, it is the responsibility of Honor Council to raise these types of issues. Liz Bacon, ‘04, co-chair of Honor Council said that Honor Council has taken no official stance on the issue. Carlen herself has mixed feelings about the issue but thinks that it is probably not a violation of the Code except in situations where individuals are taking a timedtest while on non-prescribed Adderall (assuming that Adderall does increase focus for those without ADD/ADHD). Jacob Rabinowitz ‘06, Sophomore Representative to Honor Council thinks that the community needs to carefully consider this issue: “I wouldn’t make it against the Code but I think it’s something to think about.”
Some Honor Council representatives feel they need more information before they can make any decisions about non-prescribed Adderall usage and how it relates to the Honor Code. Oleg Nudelman, ‘05, a Junior Representative to Honor Council, says that he had never even heard of abuse of these drugs until Honor Council brought up this issue. Honor Council members agree that asking the question, “Are study aids against the spirit of the Code?” will elicit neither easy nor clear-cut answers.
Dean of the College Joe Tolliver believes that, “Honor Council will get into a thicket that they won’t be able to get out of if they pursue this particular drug.” Dean Tolliver does recognize the dangers the drug presents. “It’s not a good idea to use somebody else’s prescription drug and you can get in trouble for that but… I don’t think [Honor Council] should be confronting over Adderall. I also think it’s going to be hard to prove.” Regardless, Tolliver believes “The community has a responsibility to talk this up and to bring it out in the open about people selling their prescriptions to others.”
Jason Wool, ‘04 admits to taking nonprescribed Adderall occasionally for academic purposes. He does not believe that using the drug is against the Honor Code nor does he believe Honor Council has a right to police students’ usage of the drug. He first started taking it when he was studying abroad in his junior year at Oxford University in England where he was required to write two papers a week. In order to manage the amount of work, he often had to pull all-nighters and used Adderall to help him stay up and study. According to Wool, in England people are much more laid back than Americans about prescription drug use. “[Adderall] is better than coffee and it’s better than espresso… it’s energy,” he says. Wool likes Adderall because he experiences fewer side effects than with caffeine; he doesn’t feel as jittery and doesn’t have the urgency to urinate as frequently as when he drinks coffee. Although the lack of side effects is nice, he notes, “There is no real great reason to use Adderall …. It’s acceptable, it’s potent, and it’s quick.”
Although Wool recognizes the inherent health risks in taking Adderall (or any non-prescribed drug), he does not believe that taking the drug is against the spirit of the Honor Code: “It’s not that the work that they [people who take non-prescribed Adderall] produce subsequently is better than the work they would otherwise produce, but it eases the process of the all-nighter or a long paper.”
The Adderall debate has not only sparked discussion about the Academic Honor Code but has also provoked dialogue about the nature of academic competition and grading at Haverford. Many students think that using Adderall gives those who take it a competitive edge especially on timed-tests. Amie Roe, ‘06, who is planning to start a support group for students dealing with mental disorders, says, “Adderall is meant to level the playing field and gives people the capacity to focus who wouldn’t otherwise have it.” Roe believes that unprescribed Adderall use is against the spirit of the Honor Code because it gives those without the disorder an edge. Rabinowitz agrees with Roe; assuming that Adderall is significantly effective in enhancing focus for those who are not ADHD/ADD, Rabinowitz believes Adderall is against spirit of the Code. He says it is illegal, not readily accessible (although he notes that it may not be so hard to get), and a significant health risk. “I shouldn’t have to do those things to compete,” Rabinowitz argues. Nudelman says that some students justify the use of Adderall by arguing that Adderall is no different than other stimulants which can help people study including Red Bull, coffee, and caffeine pills; however, Nudelman points out that unlike Adderall, these are legal and readily available to everyone who needs to cram or study.
In response to those that claim that Adderall provides a competitive edge to those who do not deserve it, Wool contends that Haverford is not about competition: “We aren’t supposed to be competing with each other, we are supposed to be here for the sake of learning.. if [grades are what] matter to you, then you work hard but you don’t worry about other people and their grades. I don’t believe you can blame hypothetically your own bad grade on your tests on someone else’s Adderall use; it seems like a scapegoat.”
Roe disagrees with the basis of this argument, “If you’re using these drugs, it’s not a personal [educational] gain issue-you’re just trying to cram a few extra hours in [of studying].” Nudelman also sees Haverford’s academic climate from a different perspective than Wool: “Competition is something that is underground at Haverford. We really don’t know how to deal with it …. a lot of us come from competitive high schools and it’s hard to break out of that.”
Wool points to the fact that the academic environment here is inherently stressful, rendering Adderall legitimately helpful: “There is a certain way that the academic environment is stressful enough that people medicate themselves.. It’s a necessary evil of a high intensity academic environment like Haverford.” Roe, however, notes that in her experience people usually take it when they have to cram because they have slacked off, gotten high the night before, or stayed out late the night before and are too tired to study. “People only use it when they are literally f-cked over or in a bind:’
Wool also believes that Honor Council has neither the right nor the ability to police Adderall usage. “There is no way they can regulate this or enforce this and if they did it would be moving more towards a big brother type thing… an infringement on our privacy.” Wool adds, “the punitive aspects of the Honor Code are expanding more and more,” and students are moving away from interpreting the code “as a loose-knit system that we should strive for.”
Wool is not alone in his fear that Honor Council will attempt to police personal affairs such as Adderall usage; however, Honor Council considers this a misconception and explains that they are just trying to promote awareness and dialogue. Because Honor Council is fairly divided on the issue of whether Adderall usage constitutes a violation of the spirit of the Honor Code, it is unlikely that Honor Council will take any unified action or even a formal stance on the issue.
Aside from the Honor Code and academic competition debate, as someone who has a family and personal history of mental illness, Roe strongly believes that the illegal use of Adderall contributes to the stigmatization of individuals with mental disorder and illness. Additionally, Roe contends that the use of non-prescribed ADHD/ADD medicine trivializes those that do need it. Roe says that her exposure to mental disorder and illness has made her particularly sensitive to stigmatization, and the abuse of non-prescribed ADHD/ADD medicine only contributes to the problem. Students often make casual comments suggesting that someone who is acting in a careless or stupid way “needs Adderall” or “is so ADD.”
Aside from finding non-prescribed Adderall usage offensive, Roe believes that using it is against the spirit of the Honor Code: “If you have that innate ability [to focus] and you choose not to respect yourself in that way, than that is terribly wrong and against the spirit of the Honor Code.”
The GO board’s high activity on the Adderall thread is a testament to the community’s interest in the subject, and Honor Council is hoping that this will spill over into a forum in which some of these concerns may be addressed. With both the prescribed and non-prescribed use of ADD/ADHD medicine on the rise, it is likely these debates will continue as similar drugs continue to be developed and widely prescribed to high school and college-aged students.
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Editor's note: Articles that appear in the Last Word section are works of satire.
December 8th, 2008 at 12:36 am
I take Adderall because I have ADD. I got my BS degree WITHOUT the drug and I had a C average. I then started to go back for my Masters now and started taking Adderall in June of 2008 and I am SHOCKED at the vast difference in how well I am able to concentrate, study and actually retain the information I spend hours studying. In the past, before the medication, I would study just as hard for just as long and retain very little. But now my grades are already in the A/B category. For me, Adderall brings me up to the level that others without ADD can be at with just hard work and effort and therefore levels the playing field.
If you use it and you don’t need it, your test scores aren’t a reflection of how smart you are, or how well you behaved responsibly by studying, or by doing all your work, or really understanding the concepts, or especially how worthy you are of the job your degree gets you. Your grade is really a reflection of how good the cheat method is that you used over another. So that ‘A’ someone may get is an ‘A’ for the method of cheating they used (hidden notes, copying from another student, using Adderall) rather than their true worth.