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College students who take drugs such as Ritalin and Adderall for attention deficit hyperactivity disorder without a prescription for the medications are doing so primarily to help themselves study or do better academically, and most of these students feel that the drugs accomplish those goals, according to new research.
With a growing number of students arriving on campuses with prescriptions for the drugs, many health officials in higher education have been worrying about the increased use of the drugs without a prescription, sometimes in combination with other controlled substances, as a growing (and dangerous) campus vice. The new study -- published in Journal of Attention Disorders -- was designed to determine the most important factors cited by students for using the ADHD drugs without prescriptions, and whether students were satisfied with the performance of the drugs in achieving their goals. The perceived success of the drugs in helping students shows why this drug use may be difficult to combat, the authors write.
The study was based on a Web survey of 3,407 students at Duke University and the University of North Carolina at Greensboro, and was conducted by researchers at those two universities as well as the University of Michigan, with support from the National Institute on Drug Abuse. The study found that 8.9 percent of respondents had used ADHD drugs without a prescription while in college and that 5.4 percent had done so in the last six months. (The study focused only on those who had used the drugs without prescriptions, not those who had prescriptions but exceed their dosages or used their drugs in other ways inconsistent with medical care.) The drugs are generally given or sold by other students -- some of them the prescription holders and others not. Theft of the drugs from prescription holders is rare.
Those who use ADHD drugs without prescriptions are more likely than students as a whole to be white, belong to a fraternity or sorority, have lower grade-point averages and engage in illegal substance use and other risky behaviors.
While previous studies have suggested that students have both academic and social motivations for using the drugs, this research says that academic performance is the key issue. While the study found some use for non-academic reasons, those were a much smaller factor. Students were mostly seeking academic gains, but outside of class.
Reasons for Using ADHD Drugs Without Prescriptions
| Reason | Always | Often | Sometimes | Rarely | Never |
| To concentrate better while studying | 41.4% | 19.9% | 12.0% | 12.0% | 14.0% |
| To be able to study longer | 26.3% | 21.0% | 16.1% | 13.4% | 23.1% |
| To feel less restless while studying | 26.7% | 14.4% | 12.8% | 11.7% | 34.4% |
| To concentrate better in class | 8.1% | 9.7% | 10.8% | 10.8% | 60.5% |
| To feel less restless in class | 5.4% | 5.4% | 8.1% | 11.4% | 69.7% |
| To keep better track of assignments | 6.0% | 4.3% | 7.0% | 13.0% | 69.7% |
| To feel better | 3.2% | 2.7% | 9.7% | 13.0% | 71.5% |
| To get high | 2.2% | 3.8% | 10.2% | 9.1% | 74.7% |
| To prolong the intoxicating effects of alcohol or other substances | 1.6% | 3.8% | 6.5% | 8.6% | 79.6% |
| To prevent other students from having an academic edge over me | 1.1% | 1.6% | 8.0% | 4.3% | 85.0% |
| To lose weight | 1.1% | 1.1% | 7.0% | 5.4% | 85.5% |
In terms of understanding why discouraging this type of drug use may be difficult, the survey found that most students using the medications are finding that the medications help them achieve their desired purposes. And those with academic goals were more likely than others to have their goals achieved.
For the questions on whether the drugs were effective, only students who said that the reason was at least "sometimes" related to their using decision were included. So only those who generally wanted to concentrate while studying were asked if they were able to do so after using the drugs.
Percent of Students Reporting That ADHD Drugs Helped Often or Always With Various Goals
| Reason for Drug Use | Percentage Saying They Were Helped |
| To concentrate better while studying | 89% |
| To be able to study longer | 89% |
| To feel less restless while studying | 81% |
| To concentrate better in class | 87% |
| To feel less restless in class | 74% |
| To keep better track of assignments | 75% |
| To feel better | 64% |
| To get high | 59% |
| To lose weight | 38% |
Further complicating efforts to discourage this drug use is that only some students experience adverse impacts of ADHD drug use -- and even then, the students don't generally experience these effects all of the time.
Adverse Effects Reported by Students Using ADHD Drugs
| Effect | Always | Often | Sometimes | Rarely | Never |
| Headaches | 1.7% | 4.4% | 12.2% | 15.0% | 66.7% |
| Stomach aches | 0.6% | 3.3% | 13.9% | 16.1% | 66.7% |
| Irritability | 7.2% | 13.9% | 23.9% | 17.2% | 37.8% |
| Sadness | 2.8% | 3.9% | 9.4% | 8.9% | 75.0% |
| Reduced appetite | 23.9% | 20.6% | 18.9% | 6.7% | 30.0% |
| Sleep difficulties | 15.6% | 22.8% | 21.1% | 12.2% | 28.3% |
| Dizziness | 1.7% | 4.4% | 12.2% | 16.7% | 65.0% |
| Social difficulties | 0.0% | 2.2% | 5.0% | 11.7% | 81.1% |
The research was led by David Rabiner, associate research professor and director of undergraduate studies in the Department of Psychology and Neuroscience at Duke. The other authors of the study are E. Jane Costello, professor of medical psychology at Duke; H. Scott Swartzwelder, clinical professor of psychiatry and psychology/neuroscience at Duke; Arthur Anastopoulos, a psychology professor and director of the ADHD clinic at UNC-Greensboro; and Sean Esteban McCabe, research associate professor at the Substance Abuse Research Center and Institute for Research on Women and Gender at the University of Michigan.
