It is a growing epidemic across college campuses. Students are popping pills to get an academic edge. The drug is Adderall, a prescription drug that is illegally abused by many students to study. Only the consequences can be deadly.
The pill gives college students the ability to pull all-nighters, study for days with only a few hours of sleep. It is a stimulant that makes the heart pound, blood rush and can provide a feeling of euphoria.
"It's pretty common now and days," said Devon Fehn, a junior at the University of Maryland.
Adderall has been successfully used to treat attention deficit hyperactivity disorder or ADHD. It has also been abused: snorted like cocaine or mixed with alcohol and a cocktail of other drugs. But on college campuses, it is most often used to help students concentrate on studying. Students call it the smart drug or steroids for the brain.
"Adderall, yeah, it's very popular, everyone uses Adderall," said one student who did not want to be named.
Doctors say no doubt the drug does what students report, improving concentration, alertness and sustained attention. If that were all it did, the drug would be given to everyone. But it's the risks with Adderall that make it a bad idea. University of Maryland senior Marcello Morinigo is among the believers.
"I heard the benefits of it, that it helps you stay up all night, for long periods of time, focus. So if other people are doing it, why not do it too?" he said.
He is not the only one. The college grapevine is filled with stories from students claiming to ace exams on Adderall or other ADHD stimulant drugs.
"I know people that use it to cram for a test or stay up late. It helps people focus for a couple of hours," said Katie Savercool, a college senior.
The popularity has spurred an illegal marketplace where friends share their meds, sell it, or some even fake symptoms to doctors to get their hands on it.
A study in the journal, Addiction, found as many as one in four college students abused Adderall, using it without a prescription. But for all its reported upsides, the downsides can be severe.
"Stimulant medications increase the risk of having a seizure. They increase the risk of having an irregular heartbeat, the kind of irregular heartbeat that is potentially lethal," warned Dr. Suena Massey, a professor and psychiatrist at George Washington University Medical Center.
Massey will not prescribe Adderall or other stimulants for students until she conducts a thorough examination. It is required even if students or their previous doctor says they have been prescribed the drug. Once students begin taking the medication, it requires careful monitoring for any signs of potentially lethal side effects.
"Adderall is the mixture of several stimulant compounds," she explained. “The primary ingredient is amphetamines. It's the same drug used in methamphetamines, cooked up in meth labs.
“Amphetamines are very addictive, highly addictive. Just as addictive as any other controlled substance.”
Adderall is a schedule two controlled substance, in the same category as cocaine and the pain killer oxycontin. They are tightly controlled by drug enforcement because of the high risk for abuse and addiction. Adderall carries a "black box warning," the most severe for a prescription medication. Anyone caught selling or giving it to someone without a prescription can wind up in prison.
There is a misperception that because the drugs are prescribed and come from a pharmacy, they are safe, not like a street drug.
"I remember in our hallways, people would walk around and ask if you have ADHD, Adderall or something," recalled one Maryland junior student.
In 2005, Shire Pharmaceuticals, the creator of Adderall, reported 20 sudden deaths from the use of its extended version of the drug: Adderall XR. Most of the victims had undetected heart conditions. The tricky part for anyone who takes these stimulants without a prescription is not knowing if the person that has a lethal reaction will be you.
"The potential benefit of probably getting a little more work done probably doesn't justify the risk of sudden death," said Dr. Massey.
The pressure for the drug is so high, some who suffer from ADHD hide the fact they use it. Dr. Massey counsels her patients not to share their prescriptions with anyone because of the harmful side effects.
Josie Krauss, a senior art major, says people have been known to ask for her medication.
"Of course, all the time. I actually need it. So if I give it out, I don't get to study as well,” Krauss said.
She has been on ADHD medications since the seventh grade.
"I don't abuse it. I don't sell it," she said.
Shire Pharmaceuticals is aware its stimulant drugs are misused, but claims it is a small percentage of the total marketplace.
Company spokesperson Matt Cabrey told FOX 5, "There is some distorted misperception that it's okay to do this. It's not appropriate because it's illegal and it's dangerous and people shouldn't do it."
Shire has an educational campaign for colleges on the dangers of stimulants and monitors reports of abuse as required by federal regulators. Since 2002, prescriptions for Adderall, Adderall XR and its generic equivalents have jumped from eight million then to more than 18 million last year. It is an increase of 106 percent. Given the demand lately, it has been hard to get.
"I just got my prescription filled and I couldn't find it. And we had to go to drug store to drug store to find it,” Krauss said.
This fall, the FDA reported a shortage of Adderall and its generics. A call to 10 pharmacies throughout D.C., Maryland and Virginia found only three that had the drug, but in limited supply or dosage. Shire blamed the backlog on a delay getting the base ingredient, amphetamine, which is regulated by federal drug enforcement. It had nothing to do with the illegal demand. Shire's spokesperson denies profiting off Adderall's abuse.
"This is not a benefit to Shire or the pharmaceutical industry or a company that makes, markets or sells ADHD medications," said Cabrey.
Students seem focused on the drug's benefits, undeterred by the potentially deadly consequences. Students say a single pill typically sells for $5 or $6, but demand soars during exam period, some students reporting up to $20 a pill.
"There's a lot of competition between students and you know at the end of the day, your grade is going to make the difference when it comes to the job market," said Morinigo.
But it may be a high price to pay. Troubled actress Lindsay Lohan's family blamed her downward spiral on Adderall, claiming she got hooked when she was misdiagnosed with ADHD. That may be one reason the drug has also earned the nickname "college crack."
CDC - High School Use
Shire - A Parent's Guide To Being AWARE - Bringing Focus To ADHD