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<DIV>We used amphetamines in college way back in the 50s for exactly the same
thing..late night studying or finishing assignments before deadlines because
we’d put everything off till the last minute. I sure wasn’t unique in my
habits, and this was Baylor University where we didn’t drink, smoke, or even
dance (in public,) but we did use those little pills. I don’t think much
has changed here. Everybody used them, either to keep awake or lose
weight, or both. </DIV>
<DIV> </DIV>
<DIV>Sue H. </DIV>
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<DIV> </DIV>
<DIV style="BACKGROUND: #f5f5f5">
<DIV style="font-color: black"><B>From:</B> <A title=art.deco.studios@gmail.com
href="mailto:art.deco.studios@gmail.com">Art Deco</A> </DIV>
<DIV><B>Sent:</B> Sunday, June 10, 2012 6:23 AM</DIV>
<DIV><B>To:</B> <A title=vision2020@moscow.com
href="mailto:vision2020@moscow.com">vision2020@moscow.com</A> </DIV>
<DIV><B>Subject:</B> [Vision2020] Risky Rise of the Good-Grade
Pill</DIV></DIV></DIV>
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<DIV class=timestamp>June 9, 2012</DIV>
<H1>Risky Rise of the Good-Grade Pill</H1><SPAN>
<H6 class=byline>By <A class=meta-per title="More Articles by Alan Schwarz"
href="http://topics.nytimes.com/top/reference/timestopics/people/s/alan_schwarz/index.html"
rel=author>ALAN SCHWARZ</A></H6></SPAN>
<DIV id=articleBody>
<P>He steered into the high school parking lot, clicked off the ignition and
scanned the scraps of his recent weeks. Crinkled chip bags on the dashboard.
Soda cups at his feet. And on the passenger seat, a rumpled SAT practice book
whose owner had been told since fourth grade he was headed to the Ivy League.
Pencils up in 20 minutes. </P>
<P>The boy exhaled. Before opening the car door, he recalled recently, he
twisted open a capsule of orange powder and arranged it in a neat line on the
armrest. He leaned over, closed one nostril and snorted it. </P>
<P>Throughout the parking lot, he said, eight of his friends did the same thing.
</P>
<P>The drug was not cocaine or heroin, but Adderall, an <A class=meta-classifier
title="Recent and archival health news about amphetamines."
href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/amphetamines/index.html?inline=nyt-classifier">amphetamine</A>
prescribed for <A class=meta-classifier
title="In-depth reference and news articles about Attention deficit hyperactivity disorder (ADHD)."
href="http://health.nytimes.com/health/guides/disease/attention-deficit-hyperactivity-disorder-adhd/overview.html?inline=nyt-classifier">attention
deficit hyperactivity disorder</A> that the boy said he and his friends
routinely shared to study late into the night, focus during tests and ultimately
get the grades worthy of their prestigious high school in an affluent suburb of
New York City. The drug did more than just jolt them awake for the 8 a.m. SAT;
it gave them a tunnel focus tailor-made for the marathon of tests long known to
make or break college applications. </P>
<P>“Everyone in school either has a prescription or has a friend who does,” the
boy said. </P>
<P>At high schools across the United States, pressure over grades and
competition for college admissions are encouraging students to abuse
prescription stimulants, according to interviews with students, parents and
doctors. Pills that have been a staple in some college and graduate school
circles are going from rare to routine in many academically competitive high
schools, where teenagers say they get them from friends, buy them from student
dealers or fake symptoms to their parents and doctors to get <A
class=meta-classifier
title="In-depth reference and news articles about Getting a prescription filled."
href="http://health.nytimes.com/health/guides/specialtopic/getting-a-prescription-filled/overview.html?inline=nyt-classifier">prescriptions</A>.
</P>
<P>Of the more than 200 students, school officials, parents and others contacted
for this article, about 40 agreed to share their experiences. Most students
spoke on the condition that they be identified by only a first or middle name,
or not at all, out of concern for their college prospects or their school
systems’ reputations — and their own. </P>
<P>“It’s throughout all the private schools here,” said DeAnsin Parker, a New
York psychologist who treats many adolescents from affluent neighborhoods like
the Upper East Side. “It’s not as if there is one school where this is the
culture. This is the culture.” </P>
<P>Observed Gary Boggs, a special agent for the <A class=meta-org
title="More articles about Drug Enforcement Administration, U.S."
href="http://topics.nytimes.com/top/reference/timestopics/organizations/d/drug_enforcement_administration/index.html?inline=nyt-org">Drug
Enforcement Administration</A>, “We’re seeing it all across the United States.”
</P>
<P>The D.E.A. lists prescription stimulants like <A
href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000166/">Adderall</A> and <A
href="http://www.vyvanse.com/">Vyvanse</A> (amphetamines) and <A
href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000606/">Ritalin</A> and <A
href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000223/">Focalin</A>
(methylphenidates) as Class 2 <A
href="http://www.deadiversion.usdoj.gov/schedules/index.html">controlled
substances</A> — the same as cocaine and morphine — because they rank among the
most addictive substances that have a medical use. (By comparison, the
long-abused anti-anxiety drug Valium is in the lower Class 4.) So they carry
high legal risks, too, as few teenagers appreciate that merely giving a friend
an Adderall or Vyvanse pill is the same as selling it and can be prosecuted as a
felony. </P>
<P>While these medicines tend to calm people with A.D.H.D., those without the
disorder find that just one pill can jolt them with the energy and focus to push
through all-night homework binges and stay awake during exams afterward. “It’s
like it does your work for you,” said <A
title="Web page with William giving his story."
href="http://www.nytimes.com/interactive/2012/06/10/education/stimulants-student-voices.html#/submit#3">William</A>,
a recent graduate of the <A
href="http://www.bwl.org/RelId/33637/ISvars/default/Home.htm">Birch Wathen Lenox
School</A> on the Upper East Side of Manhattan. </P>
<P>But abuse of prescription stimulants can lead to depression and mood swings
(from sleep deprivation), heart irregularities and acute exhaustion or <A
class=meta-classifier
title="In-depth reference and news articles about Psychosis."
href="http://health.nytimes.com/health/guides/disease/psychosis/overview.html?inline=nyt-classifier">psychosis</A>
during withdrawal, doctors say. Little is known about the long-term effects of
abuse of stimulants among the young. Drug counselors say that for some
teenagers, the pills eventually become an entry to the abuse of painkillers and
sleep aids. </P>
<P>“Once you break the seal on using pills, or any of that stuff, it’s not scary
anymore — especially when you’re getting A’s,” said the boy who snorted Adderall
in the parking lot. He spoke from the couch of his drug counselor, detailing how
he later became addicted to the painkiller Percocet and eventually heroin. </P>
<P>Paul L. Hokemeyer, a family therapist at <A
href="http://www.caron.org/">Caron Treatment Centers</A> in Manhattan, said:
“Children have prefrontal cortexes that are not fully developed, and we’re
changing the chemistry of the brain. That’s what these drugs do. It’s one thing
if you have a real deficiency — the medicine is really important to those people
— but not if your deficiency is not getting into Brown.” </P>
<P>The number of prescriptions for A.D.H.D. medications dispensed for young
people ages 10 to 19 has risen 26 percent since 2007, to almost 21 million
yearly, according to IMS Health, a health care information company — a number
that experts estimate corresponds to more than two million individuals. But
there is no reliable research on how many high school students take stimulants
as a study aid. Doctors and teenagers from more than 15 schools across the
nation with high academic standards estimated that the portion of students who
do so ranges from 15 percent to 40 percent. </P>
<P>“They’re the A students, sometimes the B students, who are trying to get good
grades,” said one senior at Lower Merion High School in Ardmore, a Philadelphia
suburb, who said he makes hundreds of dollars a week selling prescription drugs,
usually priced at $5 to $20 per pill, to classmates as young as freshmen.
“They’re the quote-unquote good kids, basically.” </P>
<P>The trend was driven home last month to Nan Radulovic, a psychotherapist in
Santa Monica, Calif. Within a few days, she said, an 11th grader, a ninth grader
and an eighth grader asked for prescriptions for Adderall solely for better
grades. From one girl, she recalled, it was not quite a request. </P>
<P>“If you don’t give me the prescription,” Dr. Radulovic said the girl told
her, “I’ll just get it from kids at school.” </P>
<P><STRONG>Keeping Everyone Happy</STRONG> </P>
<P>Madeleine surveyed her schedule of five <A class=meta-classifier
title="More articles about the Advanced Placement program."
href="http://topics.nytimes.com/top/reference/timestopics/subjects/a/advanced_placement_program/index.html?inline=nyt-classifier">Advanced
Placement classes</A>, field hockey and several other extracurricular activities
and knew she could not handle it all. The first physics test of the year —
inclines, friction, drag — loomed ominously over her college prospects. A star
senior at her Roman Catholic school in Bethesda, Md., Madeleine knew a friend
whose grades had gone from B’s to A’s after being prescribed Ritalin, so she
asked her for a pill. </P>
<P>She got a 95. Thereafter, Madeleine recalled, she got Adderall and Vyvanse
capsules the rest of the year from various classmates — not in exchange for
money, she said, but for tutoring them in calculus or proofreading their English
papers. </P>
<P>“Can I get a drink of water?” Madeleine said she would ask the teacher in one
class, before excusing herself and heading to the water fountain. Making sure no
one was watching, she would remove a 40-milligram Vyvanse capsule from her purse
and swallow it. After 30 minutes, the buzz began, she said: laser focus, instant
recall and the fortitude to crush any test in her path. </P>
<P>“People would have never looked at me and thought I used drugs like that — I
wasn’t that kid,” said Madeleine, who has just completed her freshman year at an
Ivy League college and continues to use stimulants occasionally. “It wasn’t that
hard of a decision. Do I want only four hours of sleep and be a mess, and then
underperform on the test and then in field hockey? Or make the teachers happy
and the coach happy and get good grades, get into a good college and make my
parents happy?” </P>
<P>Madeleine estimated that one-third of her classmates at her small school,
most of whom she knew well, used stimulants without a prescription to boost
their scholastic performance. Many students across the United States made
similar estimates for their schools, all of them emphasizing that the drugs were
used not to get high, but mostly by conscientious students to work harder and
meet ever-rising academic expectations. </P>
<P>These estimates can be neither confirmed nor refuted because little data
captures this specific type of drug misuse. A respected annual survey financed
by the <A href="http://www.drugabuse.gov/">National Institute on Drug Abuse</A>,
“Monitoring the Future,” reports that abuse of prescription amphetamines by 10th
and 12th graders nationally has actually dipped from the 1990s and is remaining
relatively steady at about 10 percent. </P>
<P>However, some experts note that the survey does not focus on the demographic
where they believe such abuse is rising steadily — students at high-pressure
high schools — and also that many teenagers barely know that what they often
call “study drugs” are in fact illegal amphetamines. </P>
<P>“Isn’t it just like a vitamin?” asked one high school junior from
Eastchester, a suburb of New York. </P>
<P>Liz Jorgensen, a licensed addiction specialist who runs Insight Counseling in
Ridgefield, Conn., said her small center had treated “at least 50 or 60” high
school students from southern Connecticut this school year alone who had abused
prescription stimulants for academics. Ms. Jorgensen said some of those
teenagers landed in rehab directly from the stimulants or, more often, grew
comfortable with prescription drugs in general and began abusing prescription
painkillers like OxyContin. </P>
<P>A spokesman for Shire, which manufactures Vyvanse and Adderall’s
extended-release capsules, said studies had shown no link between prescribed use
of those drugs and later abuse. </P>
<P>Dr. Jeff Jonas, Shire’s senior vice president for research and development,
said that the company was greatly concerned about the misuse of its stimulants
but that the rate was very small. “I’m not aware of any systematic data that
suggests there’s a widespread problem,” he said. “You can always find people who
testify that it happens.” </P>
<P>Students who sell prescription stimulants to their classmates focus on their
burdens and insecurities. One girl who sells to fellow students at Long Beach
High School on Long Island said: “These kids would get in trouble if they don’t
do well in school. When people take tests, it’s immediately, ‘Who am I getting
Adderall from?’ They’re always looking for it.” </P>
<P>Every school identified in this article was contacted regarding statements by
its students and stimulant abuse in general. Those that responded generally said
that they were concerned about some teenagers turning to these drugs, but that
their numbers were far smaller than the students said. </P>
<P>David Weiss, superintendent of Long Beach Public Schools, said the survey his
district used to gauge student drug use asked about only prescription
medications in general, not stimulants specifically. </P>
<P>“It has not been a surface issue for us — we’re much more conscious of
alcohol or other drug use,” Mr. Weiss said in a telephone interview. “We haven’t
had word that it’s a widespread issue.” </P>
<P>Douglas Young, a spokesman for the Lower Merion School District outside
Philadelphia, said prescription stimulant abuse was covered in various
student-wellness initiatives as well as in the 10th-grade health curriculum. Mr.
Young expressed frustration that many parents seemed oblivious to the problem.
</P>
<P>“It’s time for a serious wake-up call,” Mr. Young said. “Straight A’s and
high SAT scores look great on paper, but they aren’t reflective measures of a
student’s health and well-being. We need to better understand the pressures and
temptations, and ultimately we need to embrace new definitions of student
success. For many families and communities, that’s simply not happening.” </P>
<P><STRONG>Fooling the Doctors</STRONG> </P>
<P>During an interview in March, the dealer at Lower Merion High reached into
his pocket and pulled out the container for his daily stash of the prescription
stimulants Concerta and Focalin: a hollowed-out bullet. Unlike his other
products — <A class=meta-classifier title="More articles about marijuana."
href="http://topics.nytimes.com/top/reference/timestopics/subjects/m/marijuana/index.html?inline=nyt-classifier">marijuana</A>
and heroin, which come from higher-level dealers — his amphetamines came from a
more trusted, and trusting, source, he said. </P>
<P>“I lie to my psychiatrist — I expressed feelings I didn’t really have,
knowing the consequences of it,” he said, standing in a park a few miles from
the high school. “I tell the doctor, ‘I find myself very distracted, and I feel
this really deep pain inside, like I’m anxious all the time,’ or something like
that.” </P>
<P>He coughed out a chuckle and added proudly, “Generally, if you keep playing
the angsty-teen role, you’ll get something good.” </P>
<P>Christine, a junior sitting nearby, said she followed the well-known lines to
get her drugs directly and legally, a script for scripts. “I’m not able to focus
on schoolwork,” she said in a mockingly anxious voice. “I’m constantly looking
out the window.” Although she often uses the drugs herself, snorting them for a
faster and more intense effect, she said she preferred to save them for when her
customers crave them most. </P>
<P>“Right before everybody took the PSATs, a bunch of kids went to the bathroom
to snort their Addies,” she said. </P>
<P>This is one of the more vexing problems with stimulants in high schools,
experts said — the drugs enter the schools via students who get them legally, if
not legitimately. </P>
<P>Older A.D.H.D. drugs required low doses every few hours, and schools, not
wanting students to carry the drugs themselves, had the school nurse hold and
dispense the pills. Newer long-lasting versions like Adderall XR and Vyvanse
allow parents to give children a single dose in the morning, often unaware that
the pills can go down a pants pocket as easily as the throat. Some students said
they took their pills only during the week and gave their weekend pills to
friends. </P>
<P>The mother of one high school freshman in Westchester County said she would
open the kitchen cabinet every morning and watch her son take his prescribed
dose of Ritalin. She noticed one day that the capsule was strangely airy and
held it up to the light. It was empty. </P>
<P>“There were a few times we were short in the month, and I couldn’t understand
why,” recalled the woman, whose son was in eighth grade at the time. “It never
dawned on me until I found those empty capsules, and then I started discovering
the little packets of powder. He was selling it to other kids.” </P>
<P>A number of teenagers interviewed laughed at the ease with which they got
some doctors to write prescriptions for A.D.H.D. The disorder’s definition
requires inattentiveness, <A class=meta-classifier
title="In-depth reference and news articles about Hyperactivity."
href="http://health.nytimes.com/health/guides/symptoms/hyperactivity/overview.html?inline=nyt-classifier">hyperactivity</A>
or impulse control to present “clinically significant impairment” in at least
two settings (school and home, for example), according to the Centers for
Disease Control and Prevention. Crucially, some of this impairment must have
been in evidence by age 7; a proper diagnosis for a teenager claiming to have
A.D.H.D., several doctors said, requires interviewing parents, teachers and
others to confirm that the problems existed long before. </P>
<P>Many youngsters with prescriptions said their doctors merely listened to
their stories and took out their prescription pads. Dr. Hilda R. Roque, a
primary-care physician in West New York, N.J., said she never prescribed
A.D.H.D. medicine but knew many doctors who did. She said many parents could
push as hard for prescriptions as their children did, telling her: “My child is
not doing well in school. I understand there are meds he can take to make him
smarter.” </P>
<P>“To get a prescription for Adderall was the Golden Ticket — it really was,”
said William, the recent graduate of Birch Wathen in Manhattan. </P>
<P>A high school senior in Connecticut who has used his friend’s Adderall for
school said: “These are academic <A class=meta-classifier
title="Recent and archival health news about steroids."
href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/steroids/index.html?inline=nyt-classifier">steroids</A>.
But usually, parents don’t get the steroids for you.” </P>
<P>As with the steroids taken by athletes, the downside of prescription
stimulants appears after they provide the desired short-term competitive
benefits. This was the case with a recent graduate of McLean High School in
Virginia, one of the top public schools in the Washington area. </P>
<P>Late in his sophomore year, the boy wanted some help to raise his B average —
far from what top colleges expected, especially from a McLean student. So he
told his psychologist what she needed to hear for a diagnosis of A.D.H.D. — even
gazing out the window during the appointment for effect — and was soon getting
30 pills of Adderall every month, 10 milligrams each. They worked. He focused
late into the night studying, concentrated better during exams and got an
A-minus average for his junior year. </P>
<P>“I wanted to do everything I could to get into the quote-unquote right
school,” he recalled recently. </P>
<P>As senior year began, when another round of SATs and one last set of good
grades could put him over the top, the boy said he still had trouble
concentrating. The doctor prescribed 30 milligrams a day. When college
applications hit, he bought extra pills for $5 apiece from a girl in French
class who had fooled her psychiatrist, too, and began taking several on some
days. </P>
<P>The boy said that as his A-minus average continued through senior year, no
one suspected that “a kid who went to Bible camp” and had so improved his grades
could be abusing drugs. By the time he was accepted and had enrolled at a good
but not great college, he was up to 300 milligrams a day — constantly taking
more to stave off the inevitable crash. </P>
<P>One night, after he had taken about 400 milligrams, his heart started beating
wildly. He began hallucinating and then convulsing. He was rushed to the
emergency room and wound up spending seven months at a drug rehabilitation
center. </P>
<P>To his surprise, two of 20 fellow patients there had also landed in rehab
solely from abusing stimulants in high school. </P>
<P>“No one seems to think that it’s a real thing — adults on the outside looking
in,” the boy said. “The other kids in rehab thought we weren’t addicts because
Adderall wasn’t a real drug. It’s so underestimated.” </P>
<P><STRONG>‘No Way You’d Notice’</STRONG> </P>
<P>The Sklar family lives near the top of a daunting hill in Ardsley, a
comfortable suburb north of New York City. Ardsley High School sends dozens of
graduates every year to Ivy League-caliber colleges. When students there use
Facebook, they all know that its founder, Mark Zuckerberg, once walked the same
halls. </P>
<P>At their kitchen table after school last month, Dodi Sklar listened as her
ninth-grade son, Jonathan, described how some classmates already abused
stimulants — long before SATs and college applications. An accomplished student
who said he would never join them, Jonathan described the ease with which he
could. </P>
<P>“There’s no way you’d notice — that’s why so many kids are doing it,” he told
his mother. “I could say I’m going for a run, call someone I know who does it,
get some pills from them, take them, come home and work. Just do it. You’d be
just glad that I was studying hard.” </P>
<P>His mother sighed. “As a parent you worry about driving, you worry about
drinking, you worry about all kinds of health and mental issues, social issues,”
she said. “Now I have to worry about this, too? Really? This shouldn’t be what
they need to do to get where they want to.” </P>
<P>Asked if the improper use of stimulants was cheating, students were split.
Some considered that the extra studying hours and the heightened focus during
exams amounted to an unfair advantage. Many countered that the drugs “don’t give
you the answers” and defended their use as a personal choice for test
preparation, akin to tutoring. </P>
<P>One consensus was clear: users were becoming more common, they said, and some
students who would rather not take the drugs would be compelled to join them
because of the competition over class rank and colleges’ interest. </P>
<P>A current law student in Manhattan, who said he dealt Adderall regularly
while at his high school in Sarasota, Fla., said that insecurity was a main part
of his sales pitch: that those students “would feel at a huge disadvantage,” he
said. </P>
<P>William, the recent Birch Wathen graduate, said prescription stimulants
became a point of contention when a girl with otherwise middling grades suddenly
improved her SAT score. </P>
<P>“There was an uproar among kids — some people were really proud of her, and
some kids were really jealous and mad,” he recalled. “I don’t remember if she
had a prescription, but she definitely took more than was prescribed. People
would say, ‘You’re so smart,’ and she’d say, ‘It wasn’t all me.’ ” </P>
<P>One sophomore at <A href="http://www.hw.com/">Harvard-Westlake School</A> in
Studio City, Calif., is unsure what his future holds. Enrolled at one of the top
high schools on the West Coast, he said he tried a friend’s Adderall this
semester but disliked the sensation of his heart beating rapidly for hours. He
vowed never to do it again. </P>
<P>But as he watches upperclassmen regularly abuse stimulants as they compete
for top college slots, he is not quite sure. </P>
<P>“Junior and senior year is a whole new ballgame,” the boy said. “I promised
myself I wouldn’t take it, but that can easily, easily change. I can be
convinced.” </P>
<DIV class=articleCorrection></DIV></DIV><BR clear=all><BR>-- <BR>Art Deco
(Wayne A. Fox)<BR><A href="mailto:art.deco.studios@gmail.com"
target=_blank>art.deco.studios@gmail.com</A><BR>
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