In the chase for the ultimate high, students are indulging with a deadly duo
It was a Thursday night — better known among young drinkers as “Thirsty Thursday” — and the three young women, all students from UND, were getting ready to go out.
Dressed in skin-tight jeans, a pink crop-top and high heels, a 20-year-old shoved a vodka bottle in her purse and reached for a second bottle — this time, out of the medicine cabinet.
Out of the orange little bottle, she took out to colorful tablets labeled “Adderall XR.” It’s a drug used to treat attention-deficit hyperactivity disorder, and she had recently gotten a prescription for it.
Using a credit card and a knife handle, she crushed the pills into a fine powder and arranged the powder in three straight lines on the kitchen counter.
“Let’s get blacked out tonight,” one of the other women said.
As if on cue, the three reached into their bags for dollar bills, rolled the bills into tight tubes and snorted the Adderall powder.
They’re part of a trend among college students in Grand Forks and across the nation: taking Adderall and other prescription stimulants before drinking alcohol to enhance the “buzz” and to stay awake to drink longer. Health care officials worry it could have dangerous effects on the students’ health.
Several UND students, including women and men, agreed to interviews with the Herald on condition of anonymity. The newspaper granted their requests to better understand and report on the trend of mixing drinking with prescription drugs.
Adderall works by increasing the levels of dopamine, a chemical in the brain associated with pleasure, movement and attention, according to the National Institute of Drug Abuse. The drug often is prescribed to help a person suffering from ADHD focus and maintain concentration.
As a stimulant, its effect is the opposite of alcohol, which is a depressant.
Using the two in combination can cause irregular heartbeats and upset stomachs, according to Dr. Christopher Boe, an emergency room physician at Altru Hospital in Grand Forks. “We see psychotic features — almost like schizophrenia — where the patient is anxious, extremely uncomfortable, and has headaches and a decrease in motor skills.”
Dr. Mark Christenson, medical director of Student Health Services at UND, agreed that combining Adderall and alcohol can alter the user’s mental state, even cause seizures.
He added that when people use Adderall to stay up longer to drink, they also put themselves at risk of alcohol poisoning. “You could go into a coma.”
It’s a “recipe for disaster,” he said.
But it’s a relatively common occurrence, according to drug experts in Grand Forks.
“We see more people using other people’s medications, in general, not just Adderall but Oxycontin, pain pills, whatever they can get,” said Deborah Davis, supervisor of the alcohol and drug unit at the Northeast Human Service Center.
Young people are giving or selling Adderall to friends and acquaintances, she said. “There’s a lot of pill use out there; it’s not that hard to get off the streets.”
Sgt. Travis Jacobson at the Police Department said Adderall “is quite popular among college students, especially females.” He said, “It also suppresses the appetite, they’re kind of getting ‘two-for-one’ — they can stay up late and they lose weight.”
Possession of controlled substances without a prescription is a felony, he said. But “it happens all the time” that police officers interact with people who “have one or two tablets in their pocket without a prescription,” he said.
The National Institute on Drug Abuse, a division of the National Institutes of Health, says that “the increased abuse of prescription stimulants is a cause for concern.” Adderall, in particular, tends to be popular with students at college and high school levels, academic professionals, athletes, performers and older people because they see it as a “cognitive enhancement.”
“Those under age 25 are particularly vulnerable to dual abuse” of Adderall and alcohol, NIDA said.
The National Survey on Drug Use and Health taken in 2006 and 2007 found that full-time college students are twice as likely to abuse Adderall compared to their counterparts not in college. At the time, 6.4 percent of college students age 18 to 22 were abusers compared to 3 percent for those in the same age group not in college.
Further, the survey found that 90 percent of abusers engaged in binge drinking the month before the survey was taken and 55 percent engaged in heavy drinking. Binge drinking means having five or more drinks in two hours for men and four or more drinks for women. Heavy drinking means having more than two drinks a day on average for men and more than one drink for women.
Male students were more likely to be Adderall abusers at 6.9 percent compared to female students at 6 percent.
The 20-year-old student interviewed by the Herald said she has been prescribed Adderall since her freshman year in college.
The medication helps her wake up, feel more organized and “engage in what I’m doing,” she said. “It helps me understand and focus on what’s going on.”
But she also takes Adderall before partying.
“Sometimes, when I’m drinking, I get tired more easy,” she said. “Or, if I’m already tired, I’ll take it, so I can stay up longer and drink,” she said.
A 21-year-old male UND student the Herald interviewed agreed.
“I work late nights, so when I get off I’m usually pretty spent. Adderall is just a nice pick-me-up, it keeps me going,” he said.
“It helps you get through the night and... get drunk faster and harder,” said his friend, a 20-year-old male student.
The UND students said snorting Adderall has its pluses and minuses as far as partying is concerned.
“Snorting it is different than when you take it orally,” said the 20-year-old male student. “When you snort it, it’s like cocaine. You just want to drink and party. It’s really quick, you can feel it in, like, 15 minutes. It suppresses everything, like your hunger and stuff. It’s way easier to drink.”
“When you’re snorting it, you don’t need to take as much as you do when you’re taking it orally,” said the female student.
But they pay the price the next day.
“When snorting Adderall, your hangover is really bad the next day,” said the female student. “From people I’ve talked to, it’s really only from snorting that you get a really bad hangover.”
She said she prefers just drinking. “Honestly, I would rather just consume the alcohol. For me, taking Adderall is just me not wanting to pass out early. I don’t necessarily get a great feeling taking them together.”
She said she’s aware that combining Adderall and alcohol is drug abuse. “I definitely know that it’s bad for me and sometimes it freaks me out, but I guess I just choose to do it anyways.”
‘The main drug’
How big a problem is Adderall and alcohol at UND?
The female student said she thinks it happens “a lot,” certainly a lot of her friends do it.
“Several people will ask me each night if they can have some of my Adderall while drinking, especially day-drinking, because you can go through the night if you take Adderall, instead of just passing out early,” she said.
“A lot of college students are prescribed to it. If you know anyone who (has a prescription), it’s pretty easy to convince someone to sell it to you,” she said. “It’s crazy how many people are willing to pay to get Adderall.”
“Doctors are handing it out like candy, and it’s just so easy to get that it’s kind of second nature,” the 21-year-old said.
“I’d say at our age, Adderall is the main drug kids abuse,” said his friend, a 22-year-old male student. “I can tell you this: I could not tell you where I could find any hardcore drug, I don’t know where I could find meth or cocaine or anything like that, but I could tell you in a heartbeat where you can find Adderall.”
The female student said people have told her they pay $2 to $3 per Adderall pill. The drug is also used to help students study, she said, and she’ll get offered $5 to $10 per pill as finals week approaches.
It’s “surprising” to her how many people use the drug without knowing how they will react to it, she said. “It makes me nervous, every time I give it to somebody it scares me because, what if it reacts wrong with their bodies and they die or something?”
James Murphy, a counselor at the UND Counseling Center, said students may not fully grasp the legal consequences of possession.
“I think students are unaware of the illegality of (sharing Adderall) — or the degree of the illegality of it,” he said.
They may also underestimate the medication’s potential to be addictive, he said. “What scares me is, it starts out as an unhealthy coping mechanism that they’re starting to rely on — to get a paper done — rather than developing healthy study habits,” he said. “It starts out as abuse, and turns into addiction.”
At UND, Christenson said Student Health staff members have procedures to make sure only students with ADHD receive Adderall prescriptions.
They’re only prescribed a month’s supply at a time and can’t get another sooner than 25 days after the last prescription was given, he said. Students must also visit the Student Health office physically to get a prescription, he said.
“We have students sign a contract every year, to scare them a little bit and to remind them on a yearly basis of the consequences of selling (the medication),” Christenson said. “It’s a felony.”
Staff members check a national pharmaceutical notification registry, which logs patient prescriptions. That way a student wouldn’t be able to go to another clinic to get another prescription, he said.
In addition, UND also educates students about Adderall.
“Students who have a legitimate medical need for Adderall for treatment of ADHD disorders are warned of the dangers of mixing it with alcohol and these medications are prescribed to only students who have been assessed and diagnosed appropriately,” Jane Croeker, UND’s director of health and wellness promotion, said in an email to the Herald.
The university enlists students to teach other students about the risks of abusing alcohol and other drugs, she said. They reach out through social media, posters, presentations, games and other activities, she said.
She hasn’t personally heard of any reports of UND students mixing Adderall with alcohol, she said.
“The vast majority of UND students are smart enough not to engage in illegal, nonmedical use of prescription drugs, and they are aware of the increased dangers of mixing medications with alcohol,” she said.