Not Another Adderall Story

By Nancy Mucciarone

Lauren Matthews* sat at her desk in her Duke University dorm room, reached a bony finger into a plastic Ziploc bag, and pulled out a small blue pill. The college sophomore had only eaten a few ice cubes and half of an apple that day, and as her stomach churned she pressed a credit card down on the pill, crumbling it into powder. Using an edge of the card, she pushed the powder into a thin line and then rolled a five dollar bill into a tight tube. She pulled her stringy blonde hair behind her protruding shoulder blades, brought the bill to her nose, and inhaled hard, snorting that night’s dinner into her nostril.

Within minutes, a sweet familiar drip appeared in the back of her throat as the powder circulated through her sinuses. She relaxed back in her chair while the energy boost kicked in and her appetite checked out. The hunger pains disappeared and her heart started to race. As it had every day for the past month, Adderall helped Matthews suppress her appetite and further fuel her eating disorder.

Twenty percent of undergrads abuse Adderall, the college wonder drug, to study, cram, or focus. But increasingly a different segment of the college population is abusing the drug—the 10 percent who suffer from clinical or near-clinical eating disorders. Adderall use is the newest vice to shed pounds, and Matthews isn’t the only college student who has snorted a blue streak to get thin. “Most of the information we get about Adderall abuse for weight loss right now is anecdotal,” says Dr. Sharon Chirban, an eating disorder specialist from Boston. “But it’s definitely up, by 30 percent at least in my practice.”

Adderall first came on the market in 1996, aimed at treating attention deficit hyperactivity disorder (ADHD), attention deficit disorder (ADD), and narcolepsy. When used properly the drug increases dopamine, a chemical that controls alertness, cognition, mood, and working memory, creating a normal brain chemistry for those who actually have a dopamine imbalance. But for students who do not have a dopamine imbalance, the drug carries an extremely high risk of abuse and addiction. And according to a University of Maryland study, Adderall is the third most accessible drug on college campuses.

“The abuse begins when people see those with ADD or ADHD focusing while taking Adderall and they want the same effects,” says Dr. David Kipper, author of The Addiction Solution: The New Paradigm in the Medical Treatment of Addiction. “They think people with ADD have an academic edge, but the drug actually calms down people who have the dopamine deficiency. It acts as a stimulant much like cocaine for people who don’t have the deficiency by increasing the heart rate and decreasing the appetite.”

Julia Powell, a University of New Hampshire senior, bought her first Adderall pill sophomore year from a friend with a prescription. Powell says she instantly felt more alert and finished a term paper in a mere hour. “It was like nothing I had ever felt before,” Powell says. “It changed my life and I knew I needed to have it.”

Powell began to purchase Adderall for $5 a pill whenever she had work to do, and she had no problem finding them. Eventually, though, the high she felt slowed down and she needed a larger dose to feel the effects. Soon, she was taking three pills a day.

Within a few months, Powell dropped 20 pounds.** Her hair grew thin, nails yellow and brittle. She ate nothing all day. And on the rare occasion when the Adderall wore off, Powell drove to McDonald’s for a binge of french fries and Big Macs before taking another heavy dose to increase her metabolism.

For people biologically predisposed to disordered eating, the study drug idea of Adderall leads to a bigger problem. While these students may begin taking Adderall to help them concentrate, those prone to eating disorders continue taking the pills for the appetite suppressant. “Even for people who may not have really been aware that they ever had an eating disorder, Adderall may be enough to really bring out the eating disorder in a way that the person never experienced before,” says Dr. Kimberly Dennis, medical director at Timberline Knolls Treatment Facility.

When Powell’s dealer’s prescription ran out early one month, she panicked and decided to take matters into her own hands. “I knew all the symptoms of ADD and I needed my own prescription, so I went to my doctor and told her that I was having trouble concentrating in class, and that keeping focused was becoming more and more of a struggle,” she says. “There was no hesitation in prescribing me, so I was all set.” With a new prescription, Powell had all the Adderall she wanted at her fingertips, a destructive addition to her already-destructive eating habits—signed, sealed, and delivered from her doctor.

The doctor fake-out story has become a college fable in its own right. But without a scientific test to determine a psychological need for Adderall, doctors prescribe the drug to almost anyone who complains of trouble concentrating and focusing. “More attention needs to be paid by the professionals before prescribing, because it’s given very freely,” says Janice Styer, a clinical coordinator of Adolescent Addiction Treatment at Caron Treatment Centers. So freely, in fact, that in 2004 alone, doctors wrote 7 million prescriptions for Adderall, a number that’s increased astronomically in the past 10 years, says Dr. Dennis. The prescription offers solace to those in denial of their drug abuse and disordered eating. “A lot of my patients don’t see it as illegal and they make it okay by saying that it’s actually prescribed,” Styer says. “But the weight loss is addicting for them. When we take the Adderall away you would think we’re cutting off their arm.”

Once an Adderall prescription aids in weight loss and sustains an eating disorder, it becomes emotionally addictive. With the high potential for abuse, even those with a doctor-monitored prescription can take too much. And because Adderall affects the brain chemistry, it can induce psychosis, paranoia, delusions, and obsessive-compulsive disorder—psychological problems that usually appear in early adulthood. It can also cause high blood pressure, stroke, heart attacks, seizures, hair loss, dehydration, and even death in some cases. Anyone who takes Adderall risks the side effects, but those who take it abusively or illegally risk the harshest problems. “Without knowing or considering your genetic predisposition, you could be playing with fire,” says Dr. Kipper. These risks don’t even include the implications of an eating disorder on its own, which can cause anything from malnutrition, swelling, and dehydration to low blood pressure, liver failure, and death. The combination of the eating disorder and drug abuse can also lead to the use of other fatal stimulants, like cocaine. Because of the similarities between cocaine and Adderall, users often take the two stimulants as a symptom of the eating disorder. And, since drug dealers cut cocaine with other substances, the habit becomes even more deadly.

After snorting and swallowing Adderall to facilitate her anorexia, Matthews began to use cocaine as well. She lost a significant amount of weight. And just like Powell, her thick hair thinned, and her nails turned yellow and weak. The popular athlete retreated to solitude, only socializing with fellow users. She spent her days drifting in and out of sleep, and by night, binging on Adderall, sometimes taking up to six times the amount recommended for those who actually need the drug. “I thought I needed coke or Adderall to prevent weight gain,” Matthews says. “I was scared.”

Finally, after two years of emotional addiction, impulsive behaviors, and self-destruction, she was diagnosed with anorexia “in the most brutal way possible.” She was snorting Adderall off her bathroom counter when her sister walked in and, given Matthews’s serious weight loss, demanded she get help. Matthews took a medical leave from Duke and went to rehab at the Carolina House. Although rehab was a struggle at first, Matthews says that it was the best thing that could have happened to her. “I don’t know what I would have done had my sister not found me,” she says. “I know now that drugs should never be used to lose weight. We’re taught to equate skinniness with happiness, and nothing could be farther from the truth.”

*Names of the students in this article have been changed to protect their identities.

**The weights of individuals mentioned in this story have been removed; both doctors and eating-disorder experts advise avoiding including the weights of those who suffer from this disorder because it can act as a trigger and/or “inspire” others.