Over the last decade the popularity of using prescription stimulant medication, officially used to treat attention deficit hyperactivity disorder (ADHD), to help keep up with the academic responsibilities of college students has grown exponentially. We all know that college comes with challenges, as there are academic demands that can be overwhelming to college students as they teeter between their teenage years and adulthood. College comes with many new experiences, some empowering, and others misguided, but all life changing. Being considered “smart drugs” or “smart dope”, the social and medial influences have given stimulant medication the reputation of being “performance enhancers”, thought to improve concentration on schoolwork, help the user stay awake for prolonged periods of time and even achieve the feeling of euphoria or enhance the experience of other drugs. (Arria & DuPont, 2010). Currently, nonmedical stimulant medication is the one of the most misused and abused drug among college students, following only alcohol and marijuana, and continues to grow in popularity as it becomes more normalized by social, societal, and medial influence (Lakhan & Kirchgessner, 2012).
What is ADHD medication?
Some of the more common forms of medication used to treat patients with ADHD are Adderall and Dexedrine(dextro- amphetamine), and Ritalin and Concerta (methylphenidate). These medications are used to reduce hyperactivity, inattention, and impulsive or sporadic behavior in those who suffer from ADHD (Lakhan & Kirchgessner, 2012). Despite its potential for misuse and abuse, there is evidence that supports that those who are prescribed stimulant medication as a means to treat ADHD do see significant improvement in their ability to focus and feel more grounded in their day-to-day tasks (Lakhan & Kirchgessner, 2012).
All stimulant medications are considered Schedule II drugs because of their potential for abuse despite their effectiveness for the treatment of ADHD. These medications work by targeting the levels of dopamine and norepinephrine in your brain. These two neurotransmitters have critical roles in brain functions, as dopamine is used for reward-motivated behavior and feel-good responses, and norepinephrine is responsible for attention, alertness, and concentration. The stimulant medication blocks the reuptake of these neurotransmitters, which causes the effects and feelings to last longer and prolongs the ability of the user to stay focused (NIDA, 2014).
Is it addictive?
Well, the short answer is yes, people who abuse stimulant medication have the potential to become addicted. The reason is that when we take reuptake blockers to prolong the effects of dopamine and norepinephrine we develop a tolerance for higher levels of these neurotransmitters in the brain. When one uses a stimulant drug consistently or frequently the cellular functions need to change to accommodate the drug use. Therefore less of the neurotransmitters are produced, and when less is produced there is less to supply, leaving the user deprived of these sensations that the neurotransmitters are responsible for, triggering the need to take more and more to find the same effect, resulting in a dependence.
With something that has such a potential for misuse and dependence, why is it available to those who suffer from ADHD? Well, the answer is simple: They have doctors and therapists to help manage their medication and treatment. Dr. Nora Volkow, Director of NIDA, stated, “Studies to date suggest that prescribed use of methylphenidate in patients with ADHD does not increase their risk for subsequent addiction. However nonmedical use of methylphenidate and other stimulant medications can lead to addiction as well as a variety of other health consequences” (Older, 2009). Without the constant monitoring of the intake and effects of the medication by medical staff, nonmedical users put themselves at risk for not only addiction, but also side effects including psychosis, seizures, hypertension, tachycardia and other cardiovascular problems, and even sudden death. (Arria & DuPont, 2010)
Does it work?
So far we’ve reviewed what stimulant medication is, why it exists, why it is misused and its potential for addiction and other consequences of misuse, but does it work? Does it help people who do not have ADHD focus and perform better academically? Research has found little evidence in support of its effectiveness in improving academic performance. There has been minimal evidence to support that it may improve the performance of rote-learning tasks, which consist of repetitive recall by means of memorization, but has no effect on complex memory, which is the ability to understand complex concepts, correlate pieces of information, draw conclusions, and reason (Lakhan & Kirchgessner, 2012). Furthermore, to date there has been no evidence to support the effectiveness of improving cognitive function on the sleep-deprived (Lakhan & Kirchgessner, 2012)
Not only does evidence support the ineffectiveness in improving academic performance, but it also supports that users with lower GPAs are more likely to use than those with higher GPAs. (Arria & DuPont, 2010). Evidence supports an inverse relationship between nonmedical stimulant medication use and GPA, meaning that students with lower GPAs have a stronger history of stimulant use than higher GPAs. This study also supports a positive correlation between high alcohol and illicit drug users and their likelihood to use nonmedical stimulant medication, meaning those who heavily use drugs and alcohol recreationally are more likely to use nonmedical stimulant medication than those who do not.
It is without question that misuse and abuse of any drug has the potential to have devastating effects on the life of the user. However, the popular belief of nonmedical stimulant medication is that you will not get addicted, it will help you perform academically, and there are minimal risks. Despite the evidence to the contrary, nonmedical users continue to justify their own using and the use of other nonmedical users, but realistically, is that the right attitude to have? Stimulant medication is a Schedule II drug that not only contains amphetamines, which have a high potential for dependence, but also have qualities that are very closely related to cocaine. Many who misuse stimulant medication use it on an as-needed basis which does lower the risk of physical addiction, but dependence is still a high possibility: they will begin to rely on the nonmedical drug use to perform. At this point in our society there is little information of the consequences of nonmedical stimulant medication use, so it is imperative that people begin to look at the facts when considering following this trend that has misguided so many college students. Are the risks worth the reward? As evidence shows, it is unlikely that the nonmedical use will help improve performance, so consider the consequences carefully if ever confronted with this challenge.
Arria, A. M., & Dupont, R. L. (2010). Nonmedical Prescription Stimulant Use Among College Students: Why We Need to Do Something and What We Need to Do.Journal of Addictive Diseases,29(4), 417-426. doi:10.1080/10550887.2010.509273
Lakhan, S. E., & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects.Brain and Behavior,2(5), 661-677. doi:10.1002/brb3.78
NIDA (2014). Stimulant ADHD Medications: Methylphenidate and Amphetamines. (2014).National Institute on Drug Abuse. Retrieved January 2, 2017.
Older, S. (2009). NIDA study shows that methylphenidate (Ritalin) causes neuronal changes in brain reward areas: Similarities and differences compared to cocaine were found. PsycEXTRA Dataset. doi:10.1037/e512222009-001