Dear Dr. Wes & Marissa: Do you believe Adderall is being abused by college students? Can this abuse lead to more serious problems later on?
Dr. Wes: Absolutely. And it's not limited to college students or that particular medication. We see this problem in high schools and junior highs and with Ritalin-based products as well. It's one reason clinics need to be very careful writing these prescriptions for teens and young adults. When our office prescribes any medication to teens, we have a very frank talk with their parents about the potential for abuse or dependency. With college kids, we have the same conversation, and we stay vigilant for signs of abuse. To understand the problem, one has to realize that these medications are stimulants, known commonly as "speed" when abused. They are similar to methamphetamine, though less potent if they are taken orally, as they are supposed to be.
Reasons for stimulant abuse can vary from dangerous (enjoying the high they create) to pseudo-sensible (using them to improve focus for studying or testing). Any reason is a bad one, however, because misuse can lead to significant health concerns and addiction. The only people who should be on these medications are those who have legitimate diagnoses of ADHD or some other disorders, such as hypersomnia.
I have seen many young people and adults with ADHD helped immensely by these medications. I've also seen folks misuse these medications with very negative consequences. For the non-ADHD crowd, these medications can cause anything from anxiety and sleeplessness to mania (extreme energy, excitement or arousal), and even paranoia and full-blown psychosis. Physically, abuse can create heart problems and unhealthy weight loss. In people with a tendency toward bipolar disorder, these risks are even greater. This is why psychiatrists and nurse practitioners always try to rule out bipolar disorder in kids and adults with symptoms of ADHD, and why they usually start patients on lower doses of these medications to be sure they don't make things worse rather than better.
A major allure of stimulants for college kids and teens is that they do help one focus their attention, stay up later and get more work done. That's great until one realizes that during a fairly short period of time they become addictive when not used as prescribed by a doctor. If you're asking this question because you have abused or want to abuse stimulants, I'd ask you to think again.
The other interesting thing about stimulants and studying is that you don't always turn out as good a product as you think. This is because the manic state they cause makes you grandiose and elaborate. I recall one of my teachers sharing that she'd used amphetamines before a big oral exam in college. On the very first question, she recalled offering amazing insight that her professors surely would be talking about for years to come. Then the lead professor turned to her and said, ": that's all very nice, Ms. Jones, but what did it have to do with the question we asked?" She flunked the exam.
Marissa: When I was in junior high, three of my friends got in trouble for sharing one of their prescriptions for Adderall. The problem with kids using pills only has gotten worse since then, and I don't think I am exaggerating when I say this.
I know people who hardly ever come to school without having taken something. I've been offered dozens of different kinds of pills. Some people are just "generous," and others are looking to sell them and make a profit. Even when I had my wisdom teeth removed, people were asking if they could buy the hydrocodone that I had received for the pain.
Prescription pills are more enticing than any other drug, in my opinion, because they are easy to conceal, and often it's impossible to tell whether a person has taken them. There's no scent, no bloodshot eyes, nothing. One of the biggest dangers of pills is that because it's so easy to get away with, teenagers don't take the repercussions seriously. Sure, it's fun now to be able to take pills and be high, but what about when you go off to college or get a job? How long before it really messes up your life and your ambitions?
I believe schools don't take the issue of drug abuse as seriously as they should. It goes on every day, and no one seems to notice. I believe that what students actually report using and the number of students that are caught are way lower than the number of students actually taking prescription pills. It can be anyone - the person with straight A's and the person who is flunking all of her classes. We need to start taking this issue more seriously or it will only get much worse.
Next week: A 15-year old girl asks the golden question of the teen years: Should I be this moody? Or is something wrong with me?
Contest: Last call for essays to compete for Marissa's job. Deadline is May 1. Read the challenge question online at www.ftimidwest.com, and e-mail your answer to firstname.lastname@example.org.
- Dr. Wes Crenshaw is a board-certified family psychologist and director of the Family Therapy Institute Midwest. Marissa Ballard is a Lawrence High School senior. Opinions and advice given here are not meant as a substitute for psychological evaluation or therapy services. Send your questions about adolescent issues to email@example.com. All correspondence is strictly confidential.