College students say nonmedical use of ADHD drugs helps them study

December 16, 2008
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ANN ARBOR—Undergraduates who illegally use ADHD medication without a prescription say it’s worth the risk for one key benefit: enhancing their ability to study.

More than 5 percent of students surveyed in a new study reported using Attention-Deficit/Hyperactivity Disorder, medication without a prescription during the past six months. Nine percent reported doing this since they began college.

The researchers were from the University of Michigan, Duke University and University of North Carolina at Greensboro.

“The nonmedical use of prescription stimulants among U.S. college students is now at its highest level in 15 years,” said U-M expert Sean Esteban McCabe. The findings, he said, reinforces the researchers’ previous work indicating more than 90 percent of nonmedical users in college obtain the prescription stimulants from friends.

A Web-based survey of 3,407 students was taken in spring 2007 at UNC-Greensboro and at Duke. Ninety percent of respondents who reported using the medication without a prescription during the past six months said enhancing the ability to study was the reason they most often took stimulant drugs such as Ritalin, Adderall and Concerta for nonmedical purposes. And nearly 90 percent of these students felt it was effective in helping them study.

Non-academic motives, such as “to get high,” were far less common.

Using ADHD medication without a prescription was more common among students who reported more frequent use of alcohol and other substances during the past six months. However, it was also more likely to occur among students who felt that concentration and attention was a problem for them. In fact, many of the students reporting nonmedical use had attention difficulties similar to students who reported a current diagnosis of ADHD.

According to the study, which appears in the online edition of the Journal of Attention Disorders, students perceived nonmedical use to be beneficial despite frequent reports of adverse reactions.

“Perception is not always reality,” said McCabe, a research associate professor at the U-M Substance Abuse Research Center and Institute for Research on Women and Gender. “Despite the respondents’ perceptions, there is no compelling evidence that nonmedical use of prescription stimulants is helping them perform better academically. On the contrary, evidence has shown nonmedical use of prescription stimulants represents a risky behavior and is usually a signal for a larger cluster of problem behaviors among college students.”

Adverse consequences reported by students included more than 70 percent who said nonmedical use of ADHD medications caused sleep difficulties, more than 60 percent reported that the drugs made them irritable, and more than 30 percent said the drugs gave them headaches.

College students who use stimulant medications without a prescription are often unaware of the stimulant’s potential for interaction with other drugs, McCabe said. They don’t benefit from clinical assessments and medical follow-ups.

Finally, one risk involves the potential to develop dependence on these drugs when taken nonmedically, he said.

Despite the side effects, more than 70 percent of students believed that using ADHD medication without a prescription had been positive for them. More than 70 percent said they “never” worried about becoming addicted to the medication.

The researchers noted that several past studies have shown more than 30 percent of students who illegally used ADHD medication did so to “get high,” but only about 2 percent of respondents said they frequently used nonmedical ADHD medication for that purpose.

“Learning about the benefits that students perceive from nonmedical ADHD medication use may inform efforts to prevent this behavior,” said David Rabiner, lead author and senior research scientist at Duke.

This study and others like it have shown that the practice was more common at colleges and universities with tougher admission standards. These studies also revealed that most students using nonmedical ADHD medication tend to be white, belong to a fraternity or sorority, have lower GPAs and engage in substance use and other risky behaviors.

The study’s other authors include E. Jane Costello, H. Scott Swartzwelder and Rick Hoyle, all professors at Duke University; and Arthur Anastopoulos, a professor at UNC-Greensboro.

A National Institute on Drug Abuse grant funded the study, which can be found at: http://jad.sagepub.com/cgi/content/abstract/1087054708320399v1

McCabe: http://sitemaker.umich.edu/umsarc/sean_esteban_mccabe__ph.d.__m.s.w.

Substance Abuse Research Center: http://sitemaker.umich.edu/umsarc/home

Institute for Research on Women and Gender: www.umich.edu/~irwg

Sean McCabeSubstance Abuse Research CenterInstitute for Research on Women and Gender