At Dartmouth, the street price of a 10 milligram pill of time-release Adderall is five dollars. Some providers, however, charge more during finals, when the demand for prescription study aids is higher, while some sell their entire supply in bulk for presumably an even bigger profit.

“I have from time to time had people approach me to sell off kind of bulk amounts of [prescription medications], so I can tell you what’s most popular,” an ’07 male said. “And I can tell you, time-release Adderall is easily the most popular [study drug on campus].”

Adderall is a central nervous system amphetamine-based stimulant that is most commonly prescribed to treat Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (A.D.D. and A.D.H.D., respectively). Other pharmaceutical medications prescribed to treat A.D.D. and A.D.H.D. include Dexedrine, Ritalin, Concerta, and Provigil, although Provigil is more frequently prescribed to treat narcolepsy.

According to a 2005 study conducted by Dr. Sean Esteban McCabe and colleagues from the University of Michigan Substance Abuse Research Center, out of 20 colleges polled, the participation in prescription stimulant abuse ranged from 0 to 25% of the student body. The study found that the rates were higher at more competitive, non-commuter schools in the northeast United States. Moreover, white students who belonged to fraternities and sororities and earned lower grades were the most likely demographic to abuse prescription stimulants. Finally, those students that reported prescription stimulant abuse in the past year were twenty times as likely to also report cocaine use in the same time period.

The exact number of Dartmouth students that abuse prescription drugs is unknown. Two years ago, the D reported that only 0.7% of students surveyed reported using study drugs, a significantly lower than the reported average of 6.3% for competitive, northeastern, non-commuter schools. Legitimacy of the survey results aside, it is important not to compare Dartmouth prescription drug abuse with national trends, but rather to illustrate the motivation behind abusing study drugs, and the lifestyle effects that these drugs may have on those who use or provide.

Several students reported infrequent to single-time abuse of prescription drugs.

“I only used study buddies once,” said an ’08 female. “Last spring I was having a horrible time concentrating. I had a five-page paper due in the morning and it was already 2 AM. My friend offered me two Ritalin and I figured that I had nothing to lose.”

Another female ’08 recounted a similar experience.

“I really wanted to get a paper done,” she said. “I was pretty stressed out. It wasn’t due the next day but I really wanted to get it done and out of the way, and someone offered [me Adderall], and I was like, well, I’ll try it, why not?”

The women’s similar nonchalant attitudes reflect the common belief that there is no danger in recreational use of these medications, since doctors so liberally prescribe them. One female ’08 recalled asking her doctor for Adderall, and explained that the process was almost humorously simple.

“I went to the doctor and complained that I couldn’t focus,” she said, laughing. “And he gave me a one page true or false survey, and I filled it out and he gave me a prescription.” The survey included questions such as “do you have trouble sitting still” and “do you have trouble focusing”.

“Basically,” she said, “it was the easiest thing in the world. Anyone can be prescribed A.D.D. medication if they want it.”

But Dr. Lynda Erinoff, former employee of the National Institute of Drug Abuse (NIDA) Division of Epidemiology, Services and Prevention Research, explained that “a drug or dose that a doctor orders for one person is not necessarily appropriate for another, and prescription abusers are potentially taking a serious risk.” According to NIDA, when “taken in high doses, stimulants can lead to compulsive use, paranoia, dangerously high body temperatures, and irregular heartbeat.” And while one-time or infrequent users may not be at risk for such complications, other students who more habitually abuse study drugs have reported experiencing at least one of these side-effects.

“I know a lot of people that just like it too much and just need it, need it every time they study after they use it the first time,” one ’07 male reported. “Personally, I used to pull all-nighters on caffeine, like freshman year, and I can’t do it anymore,” he said. “I tried last night. It doesn’t work anymore.” He reported experiencing a sharp increase in his tolerance to stimulants after a year and a half of somewhat infrequent use.

“I would say I use study buddies probably twice a term, and usually only if I have something more than a two-day period that is going to be just absolutely out of line,” he said. “I don’t rail [crush up and snort] them,” he added. “No, I don’t rail them. If one of those pills was meant to be taken nasally, then it would be effective that way and they would make it in a spray. But they’re not. They’re meant to ingest orally. And they’re actually very, very bad for you if you rail them. A lot of people don’t know that.”

Two ’08 males and one ’08 female admitted to having snorted study drugs in the past. One of the ’08 males explained that “if you’re trying to get it quickly for a shorter period of time, you snort it. It’s much more intense, but only for an hour.” Ingesting pills orally, he said, takes longer to kick in, but the effects last for several hours. “I use study buddies probably like once or twice a month, like, when I have something due that’s big,” he said. “I will like, sit down and devote eight hours to that day and try to finish it. In that time I’ll probably take three or four. Yeah, three or four fifteen milligram pills [of Adderall].”

Some students, however, abuse study drugs to the extent that they require the pills to function normally. An ’07 male reported that several of his friends abuse Adderall so frequently that they have trouble sleeping. “I know a lot of kids that rely on Adderall to wake them up, Xanax to go to sleep at night, and Adderall to wake them up again the next morning,” he said. He added that these students generally live in such a manner as a result of other addictions, such as to cocaine. “I know several people who would not have gotten through college without Adderall and Xanax because of their coke addiction,” he explained.

Another ’08 male reported knowing students who depend on study drugs to function, and sleeping medications, such as Xanax or Ambien, to fall asleep after a day of popping stimulants, or snorting cocaine. “It’s a terrible existence,” he said.

Interestingly, those I spoke with all expressed a degree of moral ambivalence about their actions. Some argued that abusing study drugs was no different, essentially, than taking caffeine pills before studying. Others disagreed.

“It is different because you can sustain yourself without sleeping for four days [on study drugs], and you can’t do that with caffeine. Provigil especially is really incredible for things like that,” an ’07 male said.

An ’08 female who provides her own prescribed Adderall to friends expressed indecision. “The only thing I can think of is that it bothers me sometimes how people use them,” she said. “Even though it sounds kind of hypocritical because I will sometimes give them to people, it’s bothersome that they can have such an easier time with work. It’s kind of like cheating, or like taking steroids during a sports event. It’s just something that will enhance your performance.”

Actually, abusing non-prescribed study aids is not a violation of the Academic Honor Principle, but maybe it should be. The Honor Principle holds that students must exhibit academic integrity in all their work. Those who abuse the drugs gain an unfair advantage over those who do not. Even if those who abuse the drugs receive the same grades, they are still able to budget their time more liberally. Excessive procrastination is no longer a G.P.A. death sentence.

At the same time, however, many students reported procrastinating more when they had access to study buddies. In the end, they didn’t turn in high-quality work, but were always able to complete it. “I don’t like that it probably pushes the academic envelope farther for some people,” an ’07 male said. “But I do feel like people don’t use it responsibly, so it’s the irresponsible people that use it to stay even.”

Senior Associate Dean, Dan Nelson, explained the college’s policy regarding the illicit use of study drugs. “If we received information about someone’s use of ‘study drugs’ such as Adderall and Ritalin in connection with academic work, we would not treat that as a violation of the Academic Honor Principle, which has much more to do with behaviors such as plagiarism, unauthorized collaboration, exchanging information on examination[s], etc.,” Nelson said. “We would address health and broader educational concerns, on an individual and/or community basis. And of course any illegal use of drugs also violates other College policies and state law.”

According to federal law, “distribution of controlled drugs within 1,000 feet of a University or school to persons under age 21 is punishable by twice the normal penalty with a mandatory one year in prison.” Prescription study aids, such as Ritalin, cannot simply be refilled; they must be re-prescribed. Distributing or abusing controlled substances, such as Ritalin or Adderall, is a felony. If a person is arrested three times for dispensing one of these drugs, she or he can be imprisoned for life.

Considering that not a single person I interviewed consented to providing his or her name or any identifying characteristics other than class and gender, it seems that they possess some awareness of the disciplinary consequences of their actions. Clearly, however, the potential consequences, both disciplinary and medical, are not enough to discourage many students from continuing to abuse and illegally provide these drugs. So what, then, is the motivation behind prescription drug abuse?

“A lot of people that take Adderall like to tweak out on it while they work,” one ’08 male commented. In addition to the benefit of actually enjoying the drug, “you’re a hell of a lot more productive,” he said. “Even the kids who don’t [normally do drugs], if they’re in a crisis, will probably take an Adderall. I mean, it definitely relieves study stress, because you feel like you’re on top of everything.”

Is the pressure to make the grade really so intense that students are willing to break the law and risk their health in order to do so? One ’07 male suggested that if professors were more lenient with deadlines, and better understood the intense time pressure that students feel as a result of the trimester system, students might be less likely to abuse study buddies. Perhaps more dialogue between students and professors about increasingly lenient policies, or between students and the administration about mental health and potentially unnecessary stress factors could help.

Throughout my interviews, it occurred to me that the student body shares a generally cavalier attitude regarding the illicit distribution and abuse of these medications, which is quite reminiscent of attitudes towards alcohol and other illegal drugs. However, the difference between the administration’s response to alcohol and drug abuse and to study drug abuse on campus is alarming. There seems to be a total lack of awareness of the study buddy situation’s magnitude. If the abuse of study drugs is indeed a health concern, as Dean Nelson explained, then perhaps it’s time the administration took a definitive stance considering the extent of the problem. Furthermore, with so many people uncertain about whether the use of study drugs is considered cheating, more dialogue about the Academic Honor Principle and the definition of “academic integrity” is necessary. During the course of my investigations, I learned two things: abuse of study drugs is a fact of life at Dartmouth; and that this abuse is of no concern.