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About Oregon daily emerald. (Eugene, Or.) 1920-2012 | View Entire Issue (May 2, 2005)
CRIfTION: Gmau&aL The number of prescriptions for Adderall is rising, as is the number of students using the drug for academic and recreational purposes BY EMILY SMITH NEWS REPORTER facts ne in 10 teenagers, is still under review, additional rare cases of drug-induced psychosis resulting in deaths 2.3 million nationally, have stood up in court. has tried Adderall and/or In Jan. 1999, University of North Dakota student Ryan Ehlis, 27, shot and killed Ritalin without a prescription, his five-week-old daughter and wounded himself after taking Adderall for a according to a recently released couple of weeks. 2004 Partnership for a Drug-Free According to court documents, Ehlis, who had taken Ritalin as a child for his ADHD, was having trouble with his studies and went to a psychiatrist who gave America study. Twenty-nine percent of those surveyed him a 30-day prescription of Adderall. said they have close friends who have abused Adderall Ehlis’ girlfriend, also the mother of his children, testified that Ehlis or Ritalin. stopped acting like himself the first day he took Adderall. After the first As the number of legitimate prescriptions across the week, he began to describe delusions and hallucinations. After he nation continues to rise, so too does the number of students ingested the remainder of the prescription, he began talking with God and his dead grandfather. Claiming to be acting on God’s or ders, Ehlis killed his baby before turning the gun on himself. illegally popping Adderall pills for academic and recreation al reasons. Most, including the University student arrested i The 2004 ADHD market was worth $2.6 billion in April for selling his Adderall pills to other students in his residence hall, aren’t aware of the severe criminal penalties and health risks associated with the drug. The drug is highly addictive, and the penalties for illegal possession and distribution are identical to those associated with drugs such as methamphetamine and heroin. In the early 1990s, many children were diagnosed with Attention Deficit Hyperactivity Disorder, and as those chil dren hit their college years, some are filling prescriptions for stimulants they no longer need and are selling the pills illegally as a study aid. Adderall's addictive nature Charges were dismissed after various doctors reported he was suffering from “Amphetamine-Induced Psychotic Disorder.” In 2002 Dawn Branson experienced an Adderall-related episode of psychosis in which she caused a car accident, killing her only child, according to a CBS report. In both cases, the victims said they were never aware of the possibility of psychosis. Cabrey said it is up to physicians, parents and caretakers to warn patients about potential risks, and Shire works directly with them. Stimulants are the most-researched ADHD treatment, and a 1998 Consensus Development Conference report on ADHD sponsored by the National Institutes of ent, A M § 8.6 million adults have ADHD in the United States REACTIONS TO AND RISKS OF ADDERALL 1 he number of Adderali XR prescriptions continues to rise, but the long-term effects and risks associated with the stimulant are shrouded by a veil of uncertainty, according to leading psychiatric experts, the U.S. Food and Drug Administration and Health Canada, the Canadian equiva lent of the FDA. The Drug Enforcement Administra tion has classified Adderali as a Sched ule II drug because of its highly addictive nature. Other drugs in this category in clude cocaine, methamphetamine and opi ates such as heroin. “There is a high potential for abuse” whether the person is taking Adderali to med icate ADHD or for other reasons, FDA spokes woman Susan Kruzan said. Adderali is a stimulant, manufactured by Shire Pharmaceuticals, that contains a combination of mixed amphetamine salts. Since being launched in 1996, both Adderali and Adderali XR, the newer, once-a-day version of the drug, are increasingly being prescribed to treat the symp toms associated with ADHD. The drug’s labeling contains an abuse warning stating: “Taking amphetamines for long periods of time may lead to drug addiction. ” According to the Partnership for a Drug-Free America study, nearly 50 percent of teens believe using prescription medications to get high is “much safer” than using street drugs. In a statement to the U.S. Congress in September 2000, Dr. Peter R. Breggin, director of The Center for the Study of Psychiatry and Psychology, said stimulants such as Adderali often become gate pic 1 in 10 teenagers have tried Adderali and/or Ritalin without a prescription Health confirmed that the short-term use of stimu lants is safe and effective. The side effects associated with Adderali affect people who do not have ADHD more severely than those who do, although occurrences | are present in both categories, University pharmacist Gregg Wendland said. Common side effects include insomnia, appetite suppression, stomach aches, mood changes, dry mouth, headaches and jitteriness. According to the FDA, Adderall’s more serious risks are sudden death, abuse po tential, worsening mental illness (psy chosis), possible decreased growth, weight loss and increased tics. “Animal studies have clearly shown that drugs like Adderali, the amphetamines kill brain cells at routine clinical doses,” Breg gin stated before Congress in 2000. At the same hearing on “Behavioral Drugs in Schools: Questions and Con cerns,” Patricia Weathers, a New York par ent of a child with ADHD, said that while her son was taking the stimulant Ritalin, he didn’t grow for three years. “When I took him off all the drugs, he grew three sizes in three weeks. That is a size a week,” Weathers said. “I will never know what kind of permanent dam Risks: • Sudden death •Abuse potential • Possible decreased growth and weight loss • Increased tics • Psychosis Side effects: • Mood changes • Insomnia • Decreased appetite •Jitteriness • Headaches • Stomach aches • Dry mouth Side effects are more severe in people who do not have ADHD. age it has done to my son. Numerous experts are concerned about high rates of misdiagnosis. Ac cording to NIMH, a comprehensive medical evaluation, including input from the parents and teachers, is neces sary for accurate diagnosis. According to the Surgeon General, the majority of children and adolescents re ceiving stimulant medication do not fully meet ADHD criteria. Dr. Fred A. Baughman told Congress that in April 1998 he wrote a letter to At torney General Janet Reno stating: “The biggest health care fraud in U.S. history is I the representation of ADHD to be a dis * ease and the drugging of millions of normal children.” He went on to say that disease equals physical abnormality, which is absent in the brains of children with ADHD. 1 fucori I According to the Surgeon General, be cause symptoms of ADHD re spond well to stimulants, and stimulants increase dopamine in the brain, the “dopamine hypoth esis” has driven recent research. Several reasons for misdiagnoses highlighted at the congressional hearing included an inability to read, fy problems at home and schools cutting out recess. Until the federal Child Medication Safe ty Act of 2003, a bill designed to ^ protect children and their parents P•from being forced into administrat ing psychotropic medication to at Itend school, there were various re ^ ports of teachers and other school staff pushing the diagnoses of ADHD in stu dents. * Patricia Weathers said her son’s diagno sis was based on a checklist and a short evaluation by a pediatrician, not a psychi atrist, after the principal told her to put the boy on psychiatric drugs. They put Weathers’ first-grade son, Michael, on the stimulant Ritalin. By the time he was in third grade, he was com pletely withdrawn. He began chewing on his clothes, paper and other things. Weathers said his behavior became more and more bizarre. When his mother showed research on the side effects of Ri talin to the principal, Michael was dis missed from school. “I hear lots of stories like Ms. Weathers’. I have heard lots of them in my state,” Schaffer said. “I have heard lots from oth ers around the country.” emilysmith @ dailyemerald. com way drugs because the same neurotransmitter systems in the brain affected by amphetamines, such as Adderall, are ^.oniroversy Surrounaing ADHD also affected by cocaine and methamphetamine. Breggin cited a study of University of California students that ADHD occurs in 3 to 5 percent of school-age children and is four times more showed people who were prescribed stimulants as children became prone to cocaine addiction as young adults. likely to be present in boys than girls, according to a report of the Surgeon General. “I haven’t seen any quantified data that outlines these cases of abuse,” Shire Pharmaceutical spokesman Shire Pharmaceuticals estimates the figure to be between 3 and 9 percent, with Matt Cabrey said. He did, however, say there “seems to be misuse” because of the inquiries he has been 66 percent of childhood cases continuing into adulthood, affecting 8.6 million receiving from the media on the topic of illegal use. adults in the United States. In 1999, the National Institute of Mental Health released the results of a 14-month study indicating The number of ADHD diagnoses jumped from 1 million in 1990 to more than that the use of stimulants is an effective way of treating the core symptoms of ADHD. 3 million in 1992. Former Colorado representative Bob Schaffer explained during Adderall affects the body for an average of five to seven hours, during which time it increases the 2000 hearing that the reasons for this can be found in a number of federal the release of dopamine, norepinephrine and reuptake blockade in the brain, according to “The incentives introduced during the time period. “In 1990, Supplemental Security Income, a Federal welfare program, was opened to allow low-income parents whose children were labeled with ADHD to be eligible for a cash benefit under the SSI program,” Schaffer said. “In 1991, the Department of Education made hundreds of special education dollars available every year for children labeled with ADHD and also for those in need of special education,” Schaffer told Congress. Adderall XR sales Clinician’s Practical Guide to Attention Deficit Hyperactivity Disorder.” The perils of taking Adderall Prescribed drugs are not without danger, and Adderall is no exception. On Feb 9, Health Canada suspended and withdrew Adderall XR from the Canadian market because of its “association with sudden unexplained death,” Health Canada spokeswoman Jirina Vlk said. There have been 20 deaths and 12 reports of strokes in patients “After that, modification schools could receive more than $400 per taking prescribed amounts of Adderall and Adderall XR, according to student under IDEA (Individuals with Disabilities Education Act) for each a Health Canada press release. Fourteen of the deaths and two of child diagnosed with ADHD. ” the strokes occurred in children. In the 24th Annual Report to Congress, IDEA reported a 28.5 percent jump “We are continuing to move forward with very positive in students ages 6 to 21 who were served for specific learning disabilities conversation,” Cabrey said. between 1991 and 2000. Shire and Health Canada are forming a drug “One possible explanation for the growth in this category comes from the states, committee that will provide additional findings which have reported that the increase is due in large part to the increased to Canada s minister of health. identification and provision of services to children with attention deficit disorder and While Adderall as a direct cause of death attention deficit/hyperactivity disorder, ” the report states. 2002 2003 Source: Shire Pharmaceuticals' 2003 and 2004 annual reports 2004 Graphic and page design by Elliott Asi Millions of dollars Grades by the Milligram Some students acquire Adderall to assist concentration during studying; others who have prescriptions sell pills for profit BY AMANDA BOLSINGER NEWS REPORTER hen classes got too hard, she felt she needed a way to keep up with everyone else in her highly competitive major. Her grades weren't cutting it, and Adderall, a stimulant prescription drug, seemed to be the easiest way to concentrate and get more out of her studying. But it wasn’t an easy a deci sion. The 18-year-old freshman has a heart problem that Adder all, a drug designed to control Attention Deficit Hyperactivity Disorder, could worsen. Yet the gamble is worth it for a higher GPA, she said. “It’s a type of meth, speed pretty much,” she said. “I have heart problems, so it’s a bad thing for me, but it’s self ish. You want your good grades at any cost, and my grades have improved a lot since taking Adderall.” Before coming to the Univer sity this fall, she had never heard of Adderall. But it soon became a con stant topic of conversation; it seemed like everyone was us ing it to study. “I heard people talking about it in my classes, saying it was the drug of choice and that it’s a drug that can help you concentrate,” she said. “So I decided to try it.” bne Knew oi many people us ing the drug without a prescrip tion, but it was harder to obtain than she thought. Everyone was using the drug, but no one would say where they got it or share their own. “I had to ask around,” she said. “Everyone had taken it be fore, but no one actually had it, and the people that did have it weren’t wanting to give it out. ” She kept asking and discov ered someone with a prescrip tion for Adderall who was willing to give her some pills. She got the pills for free but said they usually sell for around $2 per pill. “I know why people don’t give them out,” she said. “You have it and know you are go ing to need it later to study. It really does make your grades better, so you don’t give it away. I would pay up to $10 for a pill if I needed to.” Despite the popularity of the pill, she was nervous about us ing it for the first time. She never had used drugs before and had some misgivings about Adderall. “I’m really outgoing and very talkative,” she said. “I was real ly hoping that it didn’t make me go crazy and get all hyper. ” She tried it and was pleasant ly surprised, she said. She had no problems concentrating on her homework and was able to study for hours after taking one pill. Her focus remained on her books, and things that used to distract her, such as people coming and going, didn’t at iury tract her attention. “It directed my focus to my books,” she said. “When I start ed reading, that’s what I focused on, and when I started a prob lem, all I focused on was that problem and nothing else. Noth ing could divert my attention.” She takes one 5 milligram pill, which works for eight hours. She said she drinks a lot of water to keep the pill work ing, whereas many people she knows take more pills or a higher dosage. “I only take 5 milligrams; a lot of people I know take 20 or more,” she said. “I can’t even imagine what that would do.” Many people abusing Adder all become addicted. Side effects include a faster heart rate, high blood pressure and increased risk of stroke. While effects to her heart don’t worry her, she said, she does worry about becoming ad dicted, something she has seen in many people who use it. She only uses the drug during midterms, finals and when she has an important test. “I know a lot of peo ple who are addicted to it and can’t study at all without Adderall,” she said. “It’s definite ly not for everyday homework because it is so addictive. There is no way I would take it any oth er time besides midterms and finals.” A prescription for pills Freshman Eliza beth Wallace said she has been using Adderall to control her Attention Deficit Disorder tor tour years. She was diagnosed with ADD when she was young and was pre scribed Ritalin, which she took through middle school. She didn’t take medication for ADD again until her junior year of high school, when she was having trouble focusing and her grades began to drop. Then she started taking Adderall. “It removes distractions,” Wallace said. “It makes me able to function. Without it I would focus on outside con versations, which makes it re ally hard to pay attention in lecture classes.” With the abundance of Adderall sales on campus, Wal lace said many people who know she has a prescription as sume she doesn’t need it and will sell it. “I actually need mine,” Wal lace said. “People take it and ETim Bobosky | Photographer lizabeth Wallace, a University freshman, takes her Adderall prescription to help her study in the Knight Library. It removes distractions. It makes me able to function. Without it I would focus on outside conversa tions, which makes it really hard to pay at tention in lecture classes. Freshman Elizabeth Wallace, who is prescribed Adderall to control her ADD Danielle Hickey | Photo editor Oome University students, such as the student photographed, use Adderall without a prescription to help them focus when studying. It's a type of meth, speed pretty much. I have heart problems, so it's a bad thing for me, but it's selfish.You want your good grades at any cost, and my grades have improved a lot since taking Adderall. Non-prescribed Adderall user on side effects assume I don’t. I don’t get the same results as them. I need it to get normal grades.” Wallace currently takes a 25 milligram pill before her class es. She takes one in the morn ing and one in the afternoon and says each pill lasts four to five hours. She only takes the pill when she knows she will need it, and on weekends, she said she tries to take just one pill on Saturday to get her studying done in one session so she doesn’t have to take the medication on Sunday. Wallace said she is constant ly being asked to sell her Adderall, especially during midterms and finals. “It’s really hard to say ‘no’ to some people,” Wallace said. “It’s very, very illegal to sell, so I don’t do it. Most people respect it, but during finals week I had to lock my bottle up.” She said she feels bad for people who come to her saying they have reading to do, but she still refuses to sell the drug. “I can sell it for a lot. I have had peo ple come up to me and offer $20 for four or five pills,” Wallace said. “It’s tempting for a poor college kid.” She is thankful she has a roommate whom she trusts, but on short trips she has had pills “go missing,” even though everyone with her was a close friend. As far as she can tell, people who are selling the pills are peo ple with a prescription who need it or who were tested at a young age and don’t need the medica tion anymore. “It goes in phases, or you can outgrow it,” Wallace said. Wallace fills her prescrip tion at the University Health Center pharmacy once per month. Her prescription is for 60 pills per month, which is monitored closely. “It’s a Class 2, so every time the pharmacy fills it they have to speak to a doctor,” Wallace said. “One time I lost my suitcase and had to explain to the doctor. He gave me a prescription for exactly one week. They monitor pretty closely.” Wallace said she uses the pills as sparingly as possible for school work and usually doesn’t take the pills during the summer. “I don’t know if I like the medication,” Wallace said. “I feel like I’m not really me. On the medication I’m different. It’s meant to stifle hyperactivi ty, but sometimes I want to be hyper and giddy.” Controlling the drug Jerome Vergamini is a con sulting psychiatrist at the Univer sity. He said he sees more than 10 students each day at the health center, and up to half of those students have appoint ments related to ADD and ADHD. He frequently prescribes Adderall as a treatment to help students with ADD and ADHD to concentrate in classes and while studying. Adderall is a stimulant Class 2 narcotic drug that, when used by those with ADD and ADHD, helps to put up “fil ters. ” Vergamini described the conditions of ADD and ADHD as a disorder of distractibility and said that for students with ADD and ADHD, distractions such as noise in large lecture classes or people walking in and out of the library can make it nearly impossible to focus on the task at hand. “They have difficulty focus ing, staying on task, taking good notes,” Vergamini said. “The medications put up filters that are needed.” muiougn nuuerau is a simu lant, it slows down and focuses people with the chemical imbal ances that cause ADD and ADHD. People without ADD and ADHD who illegally use Adderall have a different experi ence. The drug keeps them awake and suppresses their ap petites, among other more seri ous side effects. “The problem is that with people who don’t need it and think they are studying well, it is probably less helpful than they realize,” Vergamini said. Those without ADD and ADHD can quickly develop a tol erance for the medication, need ing progressively larger doses for the same results. “It is a way to get high,” Vergamini said. “Some who abuse it crush it and snort it or put it in any orifice.” Vergamini said testing for ADD and ADHD has become more stringent as the pill has grown in popularity as a study aid. Vergamini said it is “ab solutely possible” for people to fake ADD to try to get a prescription, but the school has developed criteria to pre vent those people from getting the pills. “When we suspect a stu dent is faking we send them for a TOVA (Test of Variables of Attention), which they probably couldn’t fake,” Vergamini said. If a student has already been tested and diagnosed for ADD or ADHD, he or she can fill a prescription at the health center pharmacy with a writ ten doctor prescription. Prescriptions are most often given for one month at a time. Vergamini said he hears what he calls “pirate stories,” or stories about pills getting stolen or lost, but he isn’t swayed. “If you tell me you lost or spilled your pills, I tell you that you will just have to wait ‘til next month.” abolsinger@ dailyemerald. com
