If you wanted to get an Adderall prescription written for you while at the College, you would need to go through a person like Dr. John Young, who works at the Counseling Service of Addison County. He is the consulting psychiatrist for the College and is on the front lines of the complex issue of prescribing psychostimulants.
“It is one of the more complex assessments diagnostically,” he said. “The problem is that sometimes it is a diagnosis of desire — ‘I read a book, I tried someone’s Adderall and it worked for me, I think I have ADHD.’”
The problem with diagnosing ADHD is that there are few black and white cases and no blood test to confirm lack of focus. As a result, Dr. Young tries to get to know the patients and looks for red flags.
“You want a good reason, not just performance enhancement. When I meet with someone, I’m trying to get an idea of what they’re looking for, if they’re looking for treatment more broadly, and whether they’re willing to accept that there are a lot of different ways their problem might be addressed. The more they focus on this medicine, that’s a red flag for me.”
Young said he sees on average 10 Middlebury students a year looking for psychostimulants. Less than half he believed actually needed the medication.
“I once had a Middlebury student in my office stand up and slam the door because he didn’t get the medicine that he thought he needed,” Young said. “It’s a tricky thing because usually they’re suggesting it, and it’s very hard to talk people out of that because it is a simple answer, it’s something that works now.”
But for every student he declines to prescribe, there may be a doctor back in their hometown more than willing to prescribe them enough Adderall for them and their friends.
“There’s too much of it around, and people are being pressured by their friends to give it out. I guess it’s just part of things now, but I don’t have to like it,” Young said.
But for Oliver ’13, who graduated last spring with an economics degree, easy access psychostimulants were a common convenience during his time at the College, similar to coffee.
“I really use it for midterms and finals. There’s pretty much no work that can’t be helped by Adderall or any other stimulant.”
Oliver readily admitted that he showed none of the symptoms of ADHD and saw Adderall as a vehicle to get him where he needed to go.
“It’s just another tool that people use and will continue to use no matter how difficult you make it,” Oliver explained. “It’s the cost of doing business. You can’t breed this go-getter culture and not expect students to take advantage of their resources, whether it be coffee or Adderall. To me, they are both performance-enhancing supplements. Coffee is legal, but at the end of the day, it helps you get the paper done.”
Conventionally, Adderall and other psychostimulants are meant to level the playing field for students who are not able to focus and need the medicine. But Oliver does not buy that argument.
“I’m sure those people [with serious ADHD] exist, but I’m skeptical that the majority of people prescribed here actually qualify as people who would need the medication to level the playing field,” he said. “If we’re talking about my rationalization process, I’m thinking of me with it and me without it, and at the end of the day, I’m not going to feel bad because I know how many other kids do it. I don’t mind being on an unfair playing field and I’m not going to leave an advantage on the table.”
Oliver’s views on Adderall usage were seen as “worrisome and sad” to Dean of the College Shirley Collado. To her, psychostimulant abuse is a symptom of a larger problem.
“A major concern is the culture where students feel they need to take a drug like Adderall inappropriately,” Collado said. “It signals an inability as a person to press pause, slow down and make mistakes. I wonder what the long-term cost will be when I think about a Middlebury student if you fast-forward 25 years, what the impact of that thinking and rationalization is.”
With a Ph.D. in clinical psychology from Duke University and over 12 years working as a higher education administrator, Collado has a unique understanding about psychostimulant usage and the larger trends it suggests.
“We are all contributing to creating a high-intensity situation here. But Middlebury is only one version of a high-impact environment, and my worry is that for students who are learning to cope by taking a drug, what the trend is going to be for the long term.”
While most students the Campus talked to began their psychostimulant usage at the College, Collado pointed to a new wave of applicants who are being stimulated and pushed to their maximum from young ages.
“There’s a lot of evidence of how readily these medications have become,” she said. “Parents who are fine with getting their kids on medication when they are in middle school, trying to make their kids as focused as possible so they can get into a place like Middlebury.”
“Behind the story is the context of a new pharmaceutical reality that a lot of psychologists worry about. The drugs are legitimate ways of coping for students who really need it, but I’m worried about the culture that we are currently in where there is an abundance of these drugs,” she continued.
Every expert the Campus talked to was asked to respond to Oliver’s assertion that Adderall use was the cost of doing business at a place like Middlebury. Reactions were overwhelmingly of concern and alarm, except for one.
“I think that is very insightful,” said Assistant Professor of Sociology Rebecca Tiger. “Adderall helps you be better at what we are asking you to do. We ask you to do a ton of work, have a fit body, fit mind, do all sort of extra-curricular activities, engage in community service, and have a good social life. Adderall can help you with that, so what is so wrong with it?”
Tiger, who has taught classes on the sociology of drugs and deviance and social control, refused to weigh in on whether drugs like Adderall are good or bad, but was quick to note what she sees as hypocrisy in what is considered “bad.”
“What I find really interesting is that students would never compare Adderall to crystal meth,” Tiger explained. “For the students I’ve talked to, they always say: ‘well, it’s not crystal meth.’ But actually, yes it is. This isn’t about drugs, we’re talking about people. If I am a good, high functioning person, and I occasionally take Adderall, who cares? But if I am a poor, rural person who is out of work, then we really care if I am taking amphetamines and criminalize it. You guys are rarely criminalized for your drugs use.”
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For Tyler ’14, it was a slow, seamless transition from taking Adderall as a study drug once during his first-year to regularly taking it to study and party starting junior year. At first he just got a pill here and there from a friend, but as his use increased he transitioned to buying from a campus drug dealer. If he buys smaller quick-release Adderall, it is $1 for 2mg. Extended-release XR pills are discounted, but not by much.“Before, it was only when my friends had some, a crime of opportunity. Now, there’s a person I buy from. It’s expensive, but worth it to me.”
The numbers of students at the College using psychostimulants recreationally is unknown, and the estimates vary greatly depending on the anecdotal source. Tyler estimated that 50 percent of students who take it orally eventually try it recreationally.
“You can justify it as a study enhancer by arguing that it’s for work,” he said. “A lot of people get into the drug by justifying it that way, but the recreational use doesn’t have that safety net. Usually people don’t start snorting it until they have done it a couple times orally. It comes on slowly. You try it, you like it, then move on.”
Tyler said snorting Adderall makes him more attentive in conversations, allowing him to live up to social expectations. But despite his best efforts to keep the pills he buys for studying, Tyler said he ends up snorting more than he intends every month. The dealer he buys from usually sells out, so he has to go at the beginning of the month. In the beginning of March, he bought $60 worth — 120mg — but only used 50mg to study with.
“I’m like a goddamn child when I have it,” he said. “I can’t keep my hands off of it. Especially if it’s a night when we’re going out, I’ll just bust out the Adderall. I have to be strategic or I’ll pop them like candy.”
One of the biggest frustrations is that Tyler rarely snorts it all himself.
“It’s annoying to me when my friends just don’t want to go through the process of buying Adderall. I can’t fault them for it, because I am much better friends with the guys who sell it, so I’ll just go kick it with them and buy Adderall.”
Tyler’s monthly sojourns to his drug dealer put him in the minority of illicit users. Over 73 percent of the respondents obtained Adderall and other psychostimulants from either “Close friend/Sibling” or “Friend,” according to the 2013 report on psychostimulants by Ben Tabah ’13.
As his thesis has come to a head mid-way through the spring, Tyler continues to buy Adderall on the first and the fifteenth when needed. While he said he has come to terms with his own usage, he was unsure when asked whether he would let his kids be prescribed Adderall.
“If I had a child who showed symptoms of ADHD and was in a position to be prescribed Adderall, I would think long and hard about it. Not to say that I would or would not, but I would do a lot of research because an Adderall prescription is something that fundamentally affects your day-to-day interactions.”
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When you follow a group of students over the course of a semester, there are always nascent trends that do not have data to support and cannot be definitively proved. But among long-term prescribed students, there is a subset that has had enough, and decided that the side affects just are not worth the rewards.Going into his senior year this fall, Ben ’14 was juggling a long-term relationship with prescription stimulants. His brother and sister were both prescribed growing up, and he began taking psychostimulants in ninth grade. He was given Focalin and Adderall and brought it with him to the College, taking it regularly.
Insomnia and loss of appetite hit Ben particularly hard. He arrived at the College 5’10 and 150 lbs. and left at the end of his first year a skeletal 135 lbs. When he finally finished all his work, the battle to find a few hours of a sleep began.
“Nyquil was the only thing that could knock me out. I would write a stream of consciousness during those sleepless nights, writing things like ‘wow this Adderall won’t go away.’ Pages and pages. You get to the point where you just ask yourself what the hell your doing,” he said.
“People would always joke, ‘you like working, Adderall makes work fun.’ Try taking it for two days, then leaving the library wanting only to sleep and not being able to because your mind is racing and won’t stop.”
Ben would take a pill, enter the library, and exit ten hours later feeling as if his head was in a cloud.
“I felt at times like I was a guinea pig, and no one could really understand where I was coming from,” he recounted. “I started thinking when I turned in papers coming off my Adderall high, ‘who was doing that work? Me or the drugs? Am I really in control?’”
The long days and longer nights brought him to a moment of crises.
“I haven’t been able to get a handle on it,” he said late in the fall. “When my parents came up this past weekend, I told them not to ship me another bottle.”
As he progressed through his senior year, Ben began to learn how to cope without the drug. It was harder to do work, but he said the benefits far outweighed the cost, from smoking less weed to a reinvigorated sex life. But it remains a constant battle.
“My brain keeps telling me to call my mom, hop in the library, and just start knocking work out,” he said. “But I don’t want to do that right now. I’m at the point of deciding what I want to do with my life and what role Adderall is going to play in that life.”
During spring break, Ben took it sparingly to try and push through his thesis. He said it helped immensely, but the side affects were especially severe because he had no tolerance. Returning after break, Ben continued to lay off psychostimulants.
Ben is not alone in taking a hard look at long-term psychostimulant usage.
“They’re not miracle drugs,” said John Young, the Middlebury-based psychiatrist. “A lot of people find that in the long run, after the initial excitement wears off, it might not be more helpful than a cup of coffee.”
After graduating, Oliver went to work at an investment bank. While he used Adderall for his junior summer internship, he too has decided against taking psychostimulants.
“You want to be seen highly at work, but you can only do so much in one day, while one test in a math or economics test could be worth 40 percent of my final grade,” he said. “There’s no six-hour period of time at work where it will be worth 40 percent of my evaluation.”
But even if there are students re-evaluating the long-term worth psychostimulants, there will always be a project or midterm beckoning on the horizon, tempting students across campus.
“I’m the Dean of the College coming in and saying, ‘take a chill pill’ (no pun intended),” Collado said. “This is the time to invest in yourself away from your parents and have it be messy some of the time. It’s normal for students to explore drugs and all kinds of things in college, but if that is the normative culture that a student is walking into, that is highly problematic. My biggest concern is that you are equipped with the right tools, confidence and reflection so that you are not creating behaviors here that will be detrimental to your future as a person.”
The problem with living in the Adderall Generation is that you cannot just divorce yourself from these drugs altogether. As Ben learned, there is no such thing as cold turkey for students taking psychostimulants at the College. But you can learn to use the drugs responsibly and come to terms with their role here. For better or worse, from 30mg extended-release Adderall pills with breakfast to Saturday nights driven by neon blue and orange lines, we are living in the Adderall Generation.
“If you walked up to any random person on campus and offered them Adderall, not many of them would say no,” said Ben. “But I’m trying to find a way to live my life in a way that nobody understands. Kids who take Adderall regularly never talk … [but] we need to start talking and reflecting.”
Listen to Kyle Finck discuss this series on Vermont Public Radio.
Additional Reporting by ALEX EDEL, Layout Assistance by HANNAH BRISTOL, Graphics by EVAN GALLAGHER, and Photos by ANTHEA VIRAGH
