The first time Casey Schwartz took Adderall was as a sophomore at Brown University. “My friend pulled two blue pills out of tin foil and handed them to me,” she wrote in The New York Times Magazine. An hour later Schwartz was in the basement of the library in “a state of peerless ecstasy” with the world falling away, “in untrammeled focus, absorbing the complicated ideas in the texts in front of me, mastering them . . . making them a part of myself. Or rather, of what I now thought of as myself, which is to say, the steely, undistractable person whom I vastly preferred to the lazier, glitchier person I knew my actual self to be …”
Schwartz, of course, wasn’t the only college kid chasing an academic edge with Adderall. On some campuses, up to 35 percent of students admit to using drugs like Adderall or Concerta, according to Lawrence Diller, M.D., a member of UC San Francisco’s clinical faculty, who has prescribed these drugs and studied their effects for more than three decades. The off-label use of prescription stimulants has become the second-most-common form of illicit drug use in college. (Only marijuana is more popular.)
As it turns out, the “study drug” hasn’t stayed tucked away behind library doors and bookshelves. The off-label use of Adderall among college athletes to sharpen focus and boost energy has surpassed the classic performance enhancer, anabolic steroids, according to a 2013 NCAA study that surveyed 21,000 students. College athletes who face the additional stress of physical performance view Adderall-like drugs as a way to up their game, on and off the field. And use is leaking into sports across the board. Twenty percent of men’s lacrosse players reported using without a prescription. Wrestling and baseball were also high on the list.
And it’s not just elite athletes popping pills. While there was an increase in amphetamine use among players in Division I and II athletics, the highest spike was in Division III sports.
What sometimes confounds these statistics is that some college athletes may legitimately be prescribed drugs like Adderall for Attention Deficit Hyperactivity Disorder. Sixteen million Adderall prescriptions were written for adults ages 20 to 39 in 2012, according to QuintilesIMS, an information-and-technology-services company that gathers health-care-related data. Because close to 20 percent of college students “approach ADHD diagnostic requirements” it’s often difficult to suss out who legitimately needs stimulants for medical reasons versus those taking it for a competitive edge. However you slice it, these drugs are changing hands and spilling into everyday life on campus.
A clever nickname clouds the issue
Studies indicate that around three quarters of students abuse Adderall (and other similar drugs) for academic purposes—to help them stay awake, focus, or pull an all-nighter before a big exam—and therefore don’t consider it as dangerous as other Schedule II drugs like cocaine or opioids. They also don’t consider the risks -- either because they’re unaware of them or, since Adderall is FDA-approved, they believe there are none. This slightly blasé attitude has been assimilated by some parents and college administrators, who treat Adderall as if it were just amped-up caffeine.
But every drug comes with risks, and Adderall (as well as other ADHD drugs) has more than many. The most common side effect is insomnia, which of course appeals to students who want to stay awake. Short-term studies of Adderall, conducted by the manufacturer, found that the drug caused gastrointestinal problems, blurred vision, increased body temperature, increased blood pressure, increased heart rate, reduced circulation, and irritability. In rare cases, Adderall could cause hallucinations, cardiac arrest, and even death for those with a heart condition. According to a 2006 study published in Clinical Therapeutics, the likelihood of these risks occurring increases if Adderall is used off-label and at higher than recommended dosages – which often is the case among abusers.
Spilling from college playing fields into professional sports
With Adderall so popular among college students, “it doesn’t surprise me” that the trend has spilled into the realm of professional sports, University of Colorado director of sports medicine Eric McCarty told The Denver Post. Though Adderall is banned by Major League Baseball, the NBA, NFL, and Major League Soccer – allowed only with a therapeutic-use exemption (TUE) under a doctor’s supervision -- that hasn’t seemed to dampen the flurry of suspensions for its use.
Even with prohibitions in place, athletes still turn to drugs like Adderall. Tom Nalen, who anchored the Denver Broncos’ offensive line for the better part of 14 seasons, gets why. The NFL is a grind, he says, and life in the league can get exhausting. “I can see the benefits, because sometimes you don’t feel like playing football,” Nalen told The Denver Post. “It heightens your awareness and gets you ready to play a football game if you’re not feeling good, or you’re tired.”
“Adderall can [also] be of value during training when an athlete is trying to acquire information and skills that are instrumental,” said Dr. James Giordano, Professor of Neurology and Biochemistry and Chief of the Neuroethics Studies Program at Georgetown University Medical Center. “It may allow an athlete to gain knowledge and skills more quickly and with somewhat greater ease.”
What’s more, there may be decreased pain perception, increased aggression and in some doses, a feeling of euphoria. An added bonus: if you’re looking to trim down, you can count on Adderall to cut your appetite.
Another reason for Adderall’s appeal in the NFL: Because NFL drug policy doesn't allow the league to say which drug caused a player to fail a test, players can publicly report using Adderall to cover-up for other, more frowned-upon performance enhancers.
The risk of dependency
“While true ‘addiction’ appears to be uncommon at therapeutic doses, the likelihood of physical dependence becomes greater at higher or repeated dosing. Many who use Adderall and other psycho-motor stimulants become psychologically dependent,” said Dr. Giordano.
Even after discontinuing use, the long-term effects of Adderall are unknown. “It is an open question whether every brain returns to its original settings once off the drug,” Schwartz wrote in The Times.
A more winning approach
The vast majority of coaches, sports psychologists and players don’t view drugs like Adderall as a long-term winning approach. Long hours of practice, mental conditioning and fierce workouts remain the pharma-free building blocks that hone an athlete’s skill on the field.
“There are a variety of strategies that can help athletes increase arousal and intensity in the moment,” said Trent A. Petrie, Ph.D., a professor in the Department of Psychology at University of Northern Texas and Director of the Center for Sport Psychology. Petrie adds that positive self-talk (“You can do this!”), positive mental imagery (e.g., picturing yourself energized and ready to compete), even a quick bout of physical exertion to get the heart pumping all enhance performance naturally.
“Coaches and athletic trainers should be [closely] monitoring their athletes, emphasize playing ‘clean’ and providing training opportunities -- for instance sport psychology -- to help athletes develop a mentally tougher approach to training and competing,” said Dr. Petrie. “A well-trained mind remains a powerful tool for high performance.”