Jack*, a UA physics sophomore, knocked on a door, which was opened to reveal a cramped and dimly lit dorm room. Michael*, a fine arts freshman, led him through his room, movie posters filling the walls and bottles of alcohol scattered throughout. Michael opened a desk drawer and produced a prescription bottle filled with orange capsules.
“I just need two,” Jack said. He had a midterm coming up and said he needed something extra to help him study.
Michael then placed two capsules into a Ziploc bag and handed it to Jack. On the capsules, in black script, was written: ADDERALL XR 20 mg.
Michael has a prescription for Adderall to treat his Attention Deficit Hyperactivity Disorder, and he sells extra pills on the side at $5 each.
Michael has cycled through some 20 different ADHD medications by doctors since he was diagnosed with the disorder at the age of 7. About a year and a half ago, his doctor prescribed him Adderall for the first time. Adderall is an amphetamine commonly prescribed to ADHD patients to help improve their concentration.
Some students use Adderall without a prescription as a way to boost their academic performance, especially when they feel they’re falling behind, said Lynn Reyes, an alcohol and other drug prevention specialist with Campus Health Service.
“They’re in trouble; finals are coming up,” Reyes said. “So they think, ‘I’ve got to pull an all-nighter. I’m going to try some Adderall.’”
Adderall use is not an uncommon part of the college experience, with 31 percent of four-year students reporting having taken the drug without a prescription at some point, according to a 2012 study in the Journal of American College Health.
In the annual Health and Wellness Survey conducted by Campus Health in 2013, 6.6 percent of UA students admitted to using Adderall or similar ADHD medications without a prescription in the past 30 days, and 13 percent said that they had used it the past year.
The only substances with higher abuse rates among UA students are alcohol and marijuana, Reyes said.
Unlike alcohol and marijuana, recreational use of Adderall is not nearly as common. The study in JACH showed that about 75 percent or more of college students who use Adderall use it to help them academically.
Adderall is a stimulant, not unlike coffee, said Keith Boesen, director of the Arizona Poison and Drug Information Center.
“We use caffeine to wake ourselves up and help us concentrate,” Boesen said. “Adderall takes that to the next level.”
Prescribing a stimulant to those with ADHD may seem like a puzzling choice, but the stimulation from Adderall actually has a calming effect on people with ADHD.
“It helps people working with those parts of the brain to focus and be able to pay attention, particularly in school, where we find a lot of the early diagnoses [of ADHD],” Reyes said.
This makes the drug appealing to college students looking for something to help them concentrate or stay awake.
Obtaining Adderall through Campus Health is not easy, Reyes said. While Campus Health will continue to prescribe ADHD medications to students who have a prescription from a family doctor, it will never begin prescriptions for students who simply walk in and say they have ADHD.
“Campus Health does not start people on ADHD meds because we don’t have the staff to assess that particular disorder,” Reyes said. “So, what we do when someone feels that they need that, we give them referrals … so that they get assessments.”
Some students turn to friends, or friends of friends, to get them Adderall instead.
Michael’s doctor warned him before he went off to the UA to keep his Adderall safe, saying others would come asking for it.
A few months ago, in his first semester at the UA, Michael’s friends learned of his Adderall prescription, and asked if he would consider selling it. He went online and researched the price of Adderall and discovered that he could make some extra money off of his prescription.
“I thought, ‘I have surplus, so why don’t I profit from it?’” Michael said.
He receives a package from home once a month containing his prescription, which consists of 30 pills, one for each day of the month.
The pills he doesn’t take, he sells — to friends, acquaintances and even strangers.
“For me, it’s not like I need it every day to function. Some people need it to function,” he said.
He doesn’t take his daily pill on the weekends when he drinks because the two don’t mix well, and on some days he wakes up and doesn’t feel he needs to take it. Slowly, a surplus accumulates, and he has enough to begin selling.
After he started selling to his friends, they began referring others to him. He estimates that during finals week last semester he made about $250 from selling his Adderall.
Michael said that he knows what he is doing is illegal. Adderall is classified by the Food and Drug Administration as a Schedule II controlled substance, which indicates it carries a high risk for abuse, and places it in the same category as cocaine and methamphetamine.
The UA Student Code of Conduct prohibits the unauthorized use, sale, possession or distribution of any controlled substance.
Under Arizona state law, Adderall as an amphetamine is considered a dangerous drug, and possessing a dangerous drug is a Class 4 felony. The sale or transfer of a dangerous drug is a Class 2 felony.
That section of the Code of Conduct covers many different drug offenses, said Kendal Washington White, dean of students and assistant vice president for Student Affairs.
The Dean of Students Office does not track each drug case it handles with the specificity necessary to determine how many cases have involved Adderall, according to White, but about 95 percent or more of those cases involve marijuana usage.
Most drug cases handled by the University of Arizona Police Department also involve marijuana usage, according to Brian Seastone, UAPD chief of police.
Michael said that he takes steps to avoid getting caught. He doesn’t give out his name to strangers who are referred to him, and he trusts his friends to not give away his name.
Amanda*, a film and television freshman, is one of those friends.
Amanda first tried Adderall last semester when finals week came around, taking three pills during the week to aid her studying. Now, she takes it every time she has to study for a major test or when she has a paper due.
“I have a really, really hard time focusing on my work, just in general,” she said, “so when I need to actually focus, I take it.”
Amanda said that she feels the Adderall does help her perform better academically.
“I definitely would not have been as prepared for my exams [without Adderall],” she said. “I can guarantee that.”
Despite the idea that Adderall helps students perform better, the study in JACH also suggests that nonmedical use of Adderall is associated with poorer academic performance.
When doctors prescribe Adderall, it’s done with caution and fine-tuning to put the patient on the proper dosage, Boesen said. When students get their Adderall from someone with a prescription, they often don’t know how much they’re supposed to take or they add other stimulants to it, such as energy drinks or coffee.
“It’s an incredible amount of stress on the body,” Boesen said. “It’s this chemical stress that keeps our body in fast forward and puts a great deal of stress on the heart.”
That stress can lead to overheating, seizures and even heart attacks, Boesen said.
“There’s this perception that if it’s a prescription medication, it must be safe,” Boesen said. “And it’s not. It’s only safe if it’s taken appropriately.”
Reyes said that the most common problems she sees with the misuse of Adderall are the negative short-term effects it has on students. The negative effects are similar to that of drinking too much coffee, Reyes said.
“You’re being overstimulated so you think, ‘That will really keep me awake,’” Reyes said, “but overstimulation just makes people feel sick.”
Amanda said that she hasn’t felt any major side effects from using Adderall, other than a bad headache.
“A headache is kind of worth being able to get everything done,” she said.
Like any drug, Adderall also carries the risk of dependency, Reyes said, but it’s not something she sees often.
“The students that I see here just want a quick fix,” Reyes said.
Amanda said that one of her friends has grown concerned about her Adderall use, but she doesn’t feel dependent on it, and she plans to keep taking it as she needs it.
Michael also finds no problem embracing the Adderall culture. The opportunity to make some extra money is all the incentive he needs. Recently, he’s started selling edible marijuana as well.
Michael said that when he arrived at the UA last August, he had no idea he would be in the position he’s in now. Although sometimes he feels guilty about selling Adderall, he isn’t planning on changing his lifestyle any time soon.
“I don’t think I feel guilty enough yet to stop,” he said.
— Editor’s note: * denotes a name that has been changed due to the sensitive nature of this article.
— Jazmine Foster-Hall contributed reporting to this article.