Adderall: concentration comes with consequences

It's 10 p.m., the night before Julia's accounting final. The university junior has had five other exams this week, and zero time to study. There's only one way for her to learn all the information she needs for her exam, but staying up all night seems impossible—at least until she reaches into her purse for a small, blue pill.

She pops it in her mouth. Within 30 minutes, her brain's neural circuits are on fire. She's completely focused on her textbook, and will remain so for several more hours.

"You just get zoned in on whatever you're doing," Julia says. "Anything that you're studying is just way more interesting than it would be normally. I'm like, ‘Oh, this isn't terrible at all,' even if it's like statistics or accounting. It's just easier to focus on it, get it all done without straying from it."

    The feeling Julia describes is the result of Adderall, a drug that aids in concentration. In recent years, college students have hailed Adderall a "wonder drug" and have turned to it as a study aid at an unprecedented rate. A 2007 study from the University of Michigan's Substance Abuse Research Centerfound found that nearly 20 percent of college students take prescription drugs for non-medical reasons, with 7 percent reporting abuse of non-prescribed stimulants, such as Adderall.

According to Dr. Joe Frascella of the National Institute on Drug Abuse, the most troubling aspect about the prevalence of unmonitored prescription drug use is the danger people put themselves in by taking such drugs without the supervision of a doctor.

Before prescribing Adderall, an amphetamine, doctors typically assess patients for cardiovascular or neurological problems. In the absence of this protocol, recreational users can suffer serious consequences.

"There's death—that's the worst case," Frascella says. "But there are people who end up with strokes, people who have seizures, all kinds of medical complications."

Lauren, like many students, is somewhat aware of the dangers of taking unprescribed Adderall, but she continues to use the drug anyway.

"It's like a low-grade cocaine," says Lauren, a junior at the university. "It gives me confidence, puts me in a better mood—it's kind of a similar thing. You feel good when you're on it, but again, it's a drug. I don't want to abuse it."

According to Jeffrey Rosen, a psychology professor at the university, Adderall works by increasing the level of activity in the frontal cortex—the part of the brain right above the eyes. It also increases the amount of dopamine in the brain, similar to cocaine.Dopamine is a neurotransmitter that plays a key role in a person's ability to move and remain alert, even during generally uninteresting tasks such as studying.

People who have attention deficit hyperactivity disorder have an underactive frontal cortex, the brain's center for high-level processes such as problem solving and reasoning. They also have less dopamine naturally present in their brains than what Rosen calls "normals," or people without ADHD. This low level activity of the cortex results in a loss of focus. For those with ADHD, Adderall raises their dopamine levels to the point where they can concentrate on conversations or homework, but for people who don't have the disorder, it causes intense stimulation.

Students who are cramming for exams say that's not necessarily a bad thing. For Lauren, the drug is essential whenever she has to study for multiple tests or do several projects.

"I could never do it without Adderall, never," Lauren says. "I probably couldn't even really pull an all-nighter without Adderall."

She says when she is on Adderall, she loses all track of time, which she has found actually benefits her schoolwork.

"It makes the night go so fast," she says. "Before you know it, it's five, and the sun's coming up, and you know, shower and keep studying."

Rosen says there is a fine line between increasing one's ability to focus and over-stimulating the brain when using Adderall. Just as learning and memory are impaired by too little dopamine, they can also be impaired by an overabundance of it.

"If they take a little bit of it, they may actually help themselves because it will help them to focus and things of that nature, just like it does with ADHD patients or kids, so it may be OK," he says. "If you take too much, it's going to have detrimental effects."

By taking too much Adderall, people can effectively undermine their desired focus, leaving them on the the same neurological level as those who have ADHD, but aren't taking any medication, Frascella says. That scenario becomes more likely when taking the drug without a doctor's supervision.

Kaitlyn Noll, a fourth-year student at the university who has severe ADHD, takes Vyvanse as an alternative to Adderall, because it is less strong. For example, she says she felt nothing while on 30 mg of Vyvanse, but 30 mg is the largest single-dose pill available for Adderall.

"Vyvanse, yeah, there's some of the same aspects of Adderall, but it's not as potent," Noll says. "You don't feel jittery—it's more of an even thing. It's more assessing the ADHD. Adderall is just so, ‘Whoa.'"

The amphetamine salts in Adderall are to blame for the "whoa" factor, says Dr. Richard Kingsley, a psychiatrist at Alfred I. duPont Hospital for Children in Wilmington. Despite issues of safety and efficacy, students in a competitive university setting may feel compelled to take the drug, he says.

"There's so much pressure on campus for students to perform, and they're always looking for ways to enhance that ability," Kingsley says.

Adderall's stimulating effects can push blood pressure and heart rate into the danger zone, but for a college student who is trying to balance schoolwork with a social life and other commitments, the benefits of Adderall outweigh the fact that it effects the brain and body the same way that cocaine and methamphetamine do.