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Hot on Campus | August 29, 2012

Playing with fire

Adderall

Health experts warn the drug can be just as addicting, and as harmful, as cocaine or heroin

©iStockPhoto/hudiemm

Eddie Mora, the protagonist in the 2011 film Limitless, transforms from a struggling, pathetic writer to a brilliant, successful millionaire almost over night after taking a little pill offered to him by a friend. The pill gives him mental superpowers, allowing him to use 100 percent of his brain's capacity. Mora is suddenly able to focus intently on whatever he's doing. He can read twice as fast as normal and digest every intricate detail of his research. His brain is super-charged. But as Mora's dependence on the drug increases, unexpected side-effects outweigh the greatest of his accomplishments.

Mora's pill is fictional. But a very similar drug is making the rounds on college campuses, helping students get better grades and pushing the limits of what they can do on their own. Although it's become known as the "study drug" among high-achieving students, the pharmaceutical psychostimulant Adderall was never meant to give mental superpowers.

Because it's a prescription drug, many students think Adderall is harmless. Researchers estimate 30 percent of college students have used the drug at least once. But experts say the drug is highly addictive and can cause anxiety, exhaustion and rapid weight loss. The long-term effects of Adderall abuse can be just as crippling as an addiction to crack cocaine.

Adderall, manufactured by Shire Pharmaceutical, is designed to treat symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. The drug is composed of a group of amphetamine salts and works by increasing the amount of dopamine and norepinephrine in between synapses in the brain. Similar to other stimulant drugs, such as methamphetamine and cocaine, Adderall affects the mesolimbic pathway in the brain, which is associated with feelings of reward and desire. Because of the amount of amphetamine salts the stimulant possess, it has a high potential for abuse, according to the Drug Enforcement Administration (DEA).

"For people with ADHD, it gives the brain enough stimulation to reduce distractibility and allow focus," said Kevin Eames, a professor of psychology at Covenant College, in Lookout Mountain, Ga., who specializes in addictions. "Amphetamines cause a flood of dopamine, the pleasure chemical, into the pleasure center of the brain called the nucleus accumbens, creating a feeling of euphoria and high energy. As a consequence, it is highly addictive."

Adderall's ability to focus energy and concentration to a much higher level than normal makes it popular among college students driven to do well in school. Taking the drug enables students to stay up all night, stimulating the brain and causing a kind of "tunnel vision" that gives them intense focus.

But contrary to popular belief, Adderall does not improve complex thinking skills, said Lawrence H. Diller, a pediatrician and author of the book Running on Ritalin: A Physician Reflects on Children, Society and Performance in a Pill.

"For example, Adderall will not improve reading comprehension but will allow the user to go over the paragraph multiple times to obtain the answer... it decreases procrastination but will not turn the 'no' of a defiant student into a 'yes' for getting homework done," Diller said in an article published in The Harvard Crimson.

Because they take the drug for a "good" reason-to improve their performance at school or work-people who use Adderall often don't consider their behavior dangerous or wrong.

In a recent interview with The New Yorker, Anjan Chatterjee, a neurology professor at the University of Pennsylvania, coined the term "cosmetic neurology" to define the practice of using drugs created for specific medical conditions to strengthen ordinary cognition. He believes that it eventually will become as acceptable as cosmetic surgery.

"Many sectors of society have winner-take-all conditions in which small advantages produce disproportionate rewards," he said. At school and at work, the usefulness of being "smarter," needing less sleep, and learning more quickly are all "abundantly clear," he said.

While the stimulant can provide overnight success, it's far from harmless.

According to the Food and Drug Administration (FDA), the most common side effects in adults include anxiety, seizures, urinary tract infections, and weight loss. Cases of sudden deaths as a result of the drug have occurred across the board. Children ages 6-12 have been known to lose their appetites, experience extreme abdominal pain, nervousness, and fever. Adolescents between 13 and 17 years old have suffered from seizures, long-term suppression of growth and loss of appetite. The drug's weight-loss effects have led to its abuse as a diet pill, especially among teenage girls.

Adderall also can serve as a gateway drug for other stimulants, like cocaine and methamphetamines. And an addiction to the drug can prove just as harmful.

According to the FDA, Adderall abuse can lead to extreme fatigue, mental depression and the manifestation of amphetamine psychosis. College students who use Adderall in high doses as a performance enhancer during short periods of time, like exam week, have a higher risk of severe health problems, including paranoia or hallucinations.

The DEA classifies Adderall as a Schedule II controlled substance--the same legal category as cocaine and heroin. Because it is highly addictive, dependence is common and in many cases lethal. And because each person's reaction to it is slightly different, the amount that produces an overdose varies. The FDA reports that as little as 2 milligrams can produce severe reactions.

After taking the fictional pill in Limitless, Mora's life spun out of control. He suffered from blackouts, vomiting, high fevers and uncontrollable anger. Adderall addicts report similar problems--disconnecting from relationships and becoming a slave to their own drive for success.

Taking Adderall might help someone get an A on a test, but that good grade might end up costing much more than it's worth.

"Students who abuse Adderall are playing with fire," Eames said.

Ruth Gibson was a WORLD on Campus summer intern. This story is part of a series on Adderall abuse. Read the other stories: Addicted to success, Anything to get ahead, and Slow to respond.