It's hard not to notice the signs of crunch time on campus.
Frist turns into a 24-hour study space, the C-store constantly restocks its soda supplies and Red Bull advertisements at the U-Store exclaim, "Turn your ZZZ's into A's." The phrase "all-nighter" becomes a regular part of conversation. For many Princeton students, the pressure runs so high that caffeine just doesn't cut it.
Prescription amphetamines like Ritalin and Adderall, commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD), are increasingly being used as study aids by students without ADHD who want to be able to work harder and longer.
"David," a current senior at Princeton, began using the 'study drug' during high school. A top student at a competitive East Coast prep school, David began having trouble concentrating his senior year, and his work just kept piling up.
One of David's classmates, having been diagnosed with ADHD, began to supply his prescription Adderall to friends who either wanted the drug to stay focused, or just to get high. David had long been convinced that he suffered from ADHD, but was never diagnosed. His mother had prevented him from consulting a doctor, refusing to believe that her son suffered from a learning disability. Thus, when the opportunity to obtain Adderall presented itself, David decided to give the drug a try. And the drug had "an amazing effect."
"I did some of the best work I've ever done," David said.
Once at Princeton, David initially attempted to refrain from using the drug. He used Adderall only once during his first two years of college, resorting to Red Bull and caffeine in order to stay focused and awake.
Enter junior papers. Last fall, David found himself particularly pressed for time — and, as per usual, struggling to maintain attention. David eventually managed to scrounge some Adderall up from a friend at Georgetown. And once again, "[Adderall] really got the ball rolling," David said. While some students like David find outside suppliers, many others turns to fellow students.
According to a few student sellers on campus, the average price for one Adderall pill is about five dollars, but the price depends on the dosage size and the discretion of the seller. The Adderall pill is available in various dosages, including 10 mg tablets, 20 mg tablets and capsules. Even though many sellers report high business around midterm period and finals reading week, there is a steady demand throughout the year. Adderall is usuallly consumed orally, but some student users said they have tried to inhale the drug in hopes of speeding up and heightening its effects.
Last spring, David was confronted with yet another junior paper, and acquired some Adderall XR from a friend at Princeton. An extended relief form of Adderall, Adderall XR affects the user gradually rather than "hitting [them] all at once," David explained. Though David found its effects to be much more lackluster than those of Adderall itself, he still used the drug to help him overcome his JP mental roadblocks.
Study Drugs at Princeton: The Motivation
Fascinated by the factors that drew Princeton students like David to Adderall, Allison Arensman '04 decided to make performance-enhancing drugs the subject of her senior thesis. An independent major in bioethics, Arensman conducted a web-based survey as well as personal interviews with Princeton students in order to assess the reasons behind the use of illicit study drugs among Princeton undergraduates.
From her research, Arensman concluded that while studies of illicit stimulant use tend to describe it as "recreationally motivated," the motivation for use at Princeton is overwhelmingly academic. Though Arensman found some overlap between drug use intended for pleasure and drug use provoked chiefly by stress, she emphasized that at Princeton, "use of [attention-enhancing drugs] is really anything but recreational and the majority of illicit users are not using these drugs to get high, but to get ahead."
The numbers
Out of a pool of 395 respondents, only 14 (four percent) had been diagnosed with ADD or ADHD; of these, 11 had received drug-based treatment, with Ritalin and Adderall as the most popular prescriptions.
Of the 384 students remaining, 34 students reported having illicitly used a methyl or amphetamine drug — a number equal to about 8.9 percent of the undergraduate population. Twenty-seven of these students said their use was "only academic," three percent said "only recreational" and the remaining four said it was "both recreational and academic."
Arensman found that of the 11 students with prescriptions for Adderall or Ritalin, five had been asked by friends or roommates to give away or sell their pills, and four of those had agreed.
The top motivators for use were stress and fear of failure, with the most common reasons being "writing a paper" (30 of 34 respondents), "studying for a test" (21 respondents) and "reading" (10 respondents). Other reasons included wanting to "concentrate in class" and "recreational purposes." Three of the 11 students with prescriptions for Adderall and Ritalin admitted to using their medication "recreationally" on occasion by crushing and snorting pills.
Illicit use was much higher among males (12.4 percent) than females (roughly seven percent), a significant difference in light of Arensman's "almost perfectly gender-balanced" respondent pool.
Differences also appeared according to the kind of high school attended. Only six percent of those who attended public school reported illicit study drug use, compared to 13 percent of private school graduates and 36 percent of boarding school graduates. In addition, illicit use was higher among students from the West Coast (with 17 percent of West Coast students reporting use) and the Northeast (11 percent) than from all other regions combined (six percent). The use of legal study aids, however, such as coffee, caffeinated soda and caffeine pills, is much more prevalent.
Legal habits
A 1996 Center for Science in the Public Interest study found that four out of five college students make caffeine consumption a daily habit, and anecdotal evidence suggests Princeton is no different. U-Store clerk Val Celiant says store sales of caffeinated drinks "go up dramatically" during exam periods (see "Caffeine Without the Calories").
"Diet Cokes and Red Bulls, those are big finals crunchers," Celiant said. "[Students] just love that stuff — especially the Diet Red Bull."
Whereas Celiant normally restocks empty shelves once a day, during finals week, he has to restock Diet Cokes two or three times daily. Even then, the overwhelming demand sometimes forces the U-Store out of Diet Coke entirely. "We're all out of the one-liters. There's none left in the building," Celiant said.
Celiant said students usually come in to buy caffeine and stimulants at six or seven in the evening, and that when he asks them how they feel, they often report feeling "stressed, pressed for time."
Tim Nguyen '08 knows the bite of that pressure only too well. During exam period last year, Nguyen recalled, "I took breaks to eat, to go to the bathroom, and every two hours I took a ten-minute break to read something. That's it."
Nguyen fueled his studying marathon with Vivarin, caffeine pills he bought at the U-Store. "I was in the U-Store getting shampoo. I was looking at the shelves, and I saw this [Vivarin packet], and I thought, hmm, I might need this sometime," Nguyen said.
Nguyen took four pills over a twelve-hour period, more than is advised by the product instructions. He soon felt the effects of forced insomnia.
"After about thirty, thirty-five, forty hours I start getting auditory hallucinations," he said. "I hear people in the hall and when I go to check, nobody's there."
"I always look very haggard, to say the least," Nguyen admitted. "On Dean's Date, [my friend] said 'You look like death!' "
Nguyen said that despite the pills' side effects, he plans on using them again. "It's good to know that if I need it, that it's there," he said.
The struggle of just keeping up
University Chief Medical Officer Daniel Silverman said some students maintain a harmful caffeine addiction in part because it is hard for others to detect or deter it. "If you drink twenty cups of coffee a day, nobody's going to slap handcuffs on you for visiting the coffee bar," he said.
Moreover, at Princeton, using study drugs can seem like "something [you] need just to survive," he said. "It's not even about getting ahead, it's just a struggle even to stay up. You feel that if you're not doing endless hours of work and constantly producing things, you're not even going to be average."
During reading period and exams, the McCosh Health Center witnesses an increase in students seeking help for anxiety, stress and exhaustion. "Sometimes we'll suggest that people stay overnight," Silverman said.
"Around Dean's Date students start feeling anxious — many can't concentrate because of all the stress and the pressure," he added. "A lot of students start wondering if they have attention deficit disorder."
"Really, it's about giving yourself permission," he said. "What concerns me is when someone feels they can't even take an hour [to relax]. When you're exhausted, take a nap. It's not a sign of weakness or the moral decline of America."
David acknowledges that there are harmful side effects associated with the use of Adderall, but he's not someone with time for napping. According to the Attention Deficit Disorder website, side effects include loss of appetite, insomnia, headaches, dizziness, nervousness, nausesa, hallucinations, high blood pressure, addiction and feelings of suspicion and paranoia.
And while David would prefer to acquire Adderall from a doctor, he still plans to use the drug, regardless of whether or not he is able to obtain a prescription. David is jealous of the students who can simply sit down and work effectively for hours on end, and wishes that he, too, had this ability.
But as long as he doesn't, he'll continue to pay the price. — This article was reported by Elyse Graham and Jorge Aguilar.
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