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The big drug bust at three North Carolina universities on December 17 is shining a harsh light on the use of drugs on college campuses. A network of more than 20 former students was charged with brazenly dealing massive amounts of marijuana and cocaine, as well as lesser quantities of psilocybin, LSD, Xanax, and other pills to current students through fraternity houses. The drug proceeds, over a several-year period, are alleged to exceed $1.5 million, with regular cash transfers to a primary drug supplier in California. Felony arrests have been ongoing.
As the fall semester closes on campuses around the country, after finals and term papers are behind them, many students will quit taking another pill, Adderall, that was not prescribed to them. Chances are they won’t be needing a prescription amphetamine-type drug to get through the holidays. They have all the alertness, focus, and motivation that simply hanging out with their family requires. Without the high pressure of school, enhancing these capacities with a prescription medication they received from a friend, acquaintance, or family member who has attention deficit hyperactivity disorder (ADHD) is unnecessary.
Though seldom the concern of the undercover police, undergraduate use of unprescribed stimulants, drugs like Adderall and Ritalin, is widespread. Studies during the past two decades have measured the extent of misuse, but different research designs and student samples yield a very wide range. A meta-analysis of studies published in 2015 estimated the rate of lifetime misuse at about 17 percent, though the authors stressed the considerable variation in the rates found by researchers—from 8 percent of students reporting ever taking a stimulant at one end of the study spectrum to 43 percent at the other. A 2012 study of 500 undergraduates that I was involved with at the University of Virginia found a 20 percent lifetime rate, with one-third reporting first use in high school. As in similar studies, the majority reported getting the drugs at little or no cost from friends or acquaintances with a prescription.
Some of these research studies have also looked into students’ motives for misusing stimulants. By far, the most common reasons reported have to do with academic performance. The primary motivation for the majority of students is to improve concentration, study more efficiently, and increase mental alertness and wakefulness. A much smaller group identify weight loss as their primary or secondary goal. As a kind of corollary to the “work hard, play hard” maxim, a not insubstantial minority also report recreational use to get high, increase tolerance of alcohol, and party longer (and this includes, incidentally, some with an ADHD diagnosis).
As these reasons suggest, the general context for stimulant misuse is the competitive academic environment. A student we interviewed, Dan, said that when he got to college, “the pressure of grades and to perform was so high” and the access to Adderall so easy that taking it “became a no-brainer.” Getting it free from a friend with a prescription, rather than from a “dealer,” certainly contributed to Dan’s sense that nothing was wrong. In fact, he insisted that his use was a good thing, even praiseworthy. He is not alone. Other students offered similar, ethical justifications for what they know to be illicit use.
The idea that such illicit use might be salutary rests on two background beliefs. First, students believe the drugs are safe, with few and minor side-effects. In fact, they reason—not unreasonably—that doctors would not be prescribing stimulants so frequently for ADHD if the drugs caused serious health problems. There is nothing untoward to worry about, they say, and often suggest an equivalence between Adderall and socially acceptable stimulants that students typically rely on, like coffee and energy drinks. Nobody fusses about those. Or if they do worry, as some students do, about dependency, they believe “responsible” use lowers or eliminates any risk. As a student we interviewed, Susan, a regular Adderall user, explained: “I don’t use it to get high, I don’t need it … and I don’t take it that often.” There is no ethical conflict. All is good.
Second, students are convinced the drugs “work.” Almost every student in the research studies and in our interviews claimed that the stimulants are highly effective. They can, they insist, concentrate better, think faster, work longer, study more efficiently, and approach schoolwork with greater confidence and less stress. How the drugs supposedly “work” is an interesting and complicated question, but the perception that they do makes the drugs seem like magic bullets for the challenges of academic competition and to meet the more general demand to optimize their performance.
To the conviction that the stimulants are safe and effective for study, students often add ethical justifications for their nonmedical use. In some cases, the necessity of fairness is invoked as justification. The idea that “everyone is doing it” is a common sentiment among illicit users, and some believe that since other students are taking drugs to get a competitive advantage, they have little choice but to “level the playing field” by doing likewise. More frequently, students justify their use in terms of how the drug helps them to improve or discipline their behavior and mental functioning toward good and noble objectives.
According to John, a student quoted in a research study, Adderall is not like “bad” drugs, such as those whose only purpose is to get high. For most students, he said, whose aim is “trying to get their work done so they can get through college,” Adderall “is kinda the opposite.” The point of taking it is “to make something out of yourself.” For John, the “bad” drugs are “for losers,” while “Adderall is for winners.”
Dan, whom we met above, strongly concurs. Adderall is a good drug, in Dan’s view, because it “makes you productive.” He attends a selective university and “towards the end of high school and the start of college,” he reflects, “I found myself less able to concentrate in my classes. I always seemed to feel like no matter how much work I did I couldn’t get a full effort in my academics.” He’d heard of students taking Adderall without a prescription and “figured it was worth it to try once.” He did, and like many students, has continued to take it (and in varying doses) at those points in the semester when he has a test or a paper deadline. He believes the Adderall helps him get better grades and, once again, meet the social ideal to “perform up to his potential.”
Similarly, for Susan, the student who emphasized responsible use. Her unaided schoolwork, she believes, does not reflect her true potential. She began using Adderall early in college. She was faced with a math test that, despite studying, she says, “I just felt like I couldn’t do by myself.” What she found, on that test and since, is that Adderall gives her an academic “edge.” Although she does not think she has ADHD, she does believe she “should be on it.” It also makes her feel focused and confident and augments her motivation: “It takes what you have to do” in school, she adds, “and turns it into a pleasurable experience.”
Other students stressed increased motivation and drive for schoolwork. Kristin, for instance, reports that Adderall both enhances her academic performance and helps with her boredom. Once she started using the drug, she found herself getting “really interested” in lectures that she had had no enthusiasm for previously. Still others noted help with the stressful multitasking of all their activities and demands, both in and out of the classroom, allowing them to accomplish more and build stronger résumés.
Kyle, a senior in college, who has used Adderall through all four years, provides a final example of an often-reported rationale. Unlike Susan, he does think he has ADHD, though he has never seen a doctor or been diagnosed by one. Like many, he has come to this conclusion by reasoning backwards from the beneficial effects he attributes to the drug. He first tried Adderall in his freshman year, when a friend with a prescription gave him one, and he experienced dramatic results: “I sat down and wrote a term paper in two hours and got an A on it.” Since then, Kyle hasn’t looked back. The Adderall “helps me concentrate and do my work better,” he reports, on tests, papers, and whenever his ordinary schoolwork needs a boost. For Kyle, this positive experience must mean he has adult ADHD, and his use of the drug is justified because it serves the fair and proper purpose of treating an undiagnosed disability.
As these justifications for psychostimulant misuse suggest, students do not see themselves as part of some drug subculture. Those are the “losers,” like the dealers being rounded up in North Carolina. These students have no desire to subvert social norms or performance expectations. Quite the contrary, they see themselves striving to meet them. And if enhancing and regulating themselves by drugs in order to improve their grade point average or get interested in school or manage their activities or live up to their potential or even succeed at a party is what is required, then that, it seems to them, is what being a winner demands.
