This is your exam on drugs

Feature - Lena Yang
(Graphic by Lena Yang)

Drinking excessive amounts of coffee or Red Bull. Splashing your face with cold water. Taking a power nap.

Students pulling an all-nighter under the pressure of a deadline are well-versed in the techniques to rob your body of sleep.

But along with the conventional methods, some are turning to a new stimulant, one which some argue gives them an unparalleled ability to stay up and to focus, and which others would say is unequivocally dangerous as a study aid.

The use of prescription medication like Adderall, Concerta and Ritalin, intended for use by Attention Deficit Hyperactivity Disorder (ADHD) patients, has unquestionably made its way onto university campuses in Canada as students struggle to keep up with the demands of their education.

“The general issue of—we call it non-medical use of prescription drugs—is something that we’ve become increasingly concerned about,” said Dr. Robert Mann, a scientist with the Canadian Centre for Addiction and Mental Health (CAMH).

What does it do to your body?
Prescription medications used to treat ADHD are stimulants, a group of drugs used to increase brain activity. Adderall, for instance, is part of the amphetamine group, while Ritalin and Concerta fall under the category of methylphenidates.

The drugs help decrease hyperactivity symptoms in patients with ADHD. For people who use them non-medically, such as to cram for an exam or write a paper in a short period of time, they report increased levels of focus and ability to stay awake for extended periods of time.

“The people that do use it, they really like it. They just say they can sit down and focus for excessive periods,” said fourth-year Wilfrid Laurier University biology student James Gillen.

And as it turns out, they work much in the same way as illegal street drugs like meth and cocaine.

“I don’t think that that’s appreciated enough, that these drugs are not terribly different from those drugs in the street,” said Bruce McKay, an associate professor of psychology at Laurier.

“What most people don’t appreciate is that these street drugs we have today were actually last generation’s prescription drugs,” he continued. “And these prescription drugs we have today are now transitioning into street drugs and in 20 years from now, they will be all scheduled street drugs, and we’ll have a new generation of prescription drugs.”

While there can be side effects of using ADHD medication inappropriately—up to and including addiction—most students don’t perceive them to be dangerous. ADHD is a commonly diagnosed condition and the drugs aren’t hard to come by.

“I think it probably is true that the fact that these drugs are prescribable and are prescribable for a relatively common condition may lead to the perception that they’re a relatively safe drug,” said Mann, noting that without medical guidance on how to use them, use of the drugs can be hazardous. People using them recreationally don’t have the same awareness of how much of the drug to take or how often.

How common is it?
If you haven’t done it, you know someone who has. This is the common perception around prescription pill use for studying, but how accurate is it really?

“I’ve definitely heard about it, but I don’t think it’s a huge prevalence,” continued Gillen.

Trysta Fu, a first-year double degree student at Laurier and the University of Waterloo, suspects that it’s more common in upper-year students.

“Maybe not for first years, but when it gets to the times when it’s very intense, when the pressure’s really big, then they tend to rely on that, or else they might break down. I know a lot of students, they’d rather sleep than do the exam, but they couldn’t sleep or else they lose time to review, so they use the drug to push them through so they get more done,” she said.

Currently, there’s limited information on use at the post-secondary level in Canada. Research at a university level has been mainly concentrated in the United States, while Canadian research has primarily focused on secondary students.

The Ontario Student Drug Use and Health Survey by CAMH has collected data on students from grades seven to 12, finding that 1.4 per cent report using an ADHD drug for a non-medical purpose. Males have been reported as more likely to use them than females.

“We can’t really extrapolate into post-secondary because we don’t have the data, but the non-medical use does tend to increase with grade,” added Mann.
Research in the United States, McKay explained, has found prevalence rates at a range from approximately five per cent to 30 per cent, depending on the university. More competitive universities, where students face higher parental pressures, and are pushed to both study and party hard, tend to have higher levels of use.

McKay has collected some data at Laurier over the last five years by taking a survey of his students each semester.

“I wouldn’t say I’ve seen any appreciable increase or decrease over that five year period, and I would say the numbers that I’m seeing are consistent with the very low end of what other people have reported,” he said.

McKay has also found that people tend to perceive that their peers are using ADHD medications for studying far more than reported use indicates, which is similar to misconceptions of people using other types of drugs as well.

Legal implications

For students who engage in the buying or selling of prescription medication, there may be legal recourse.

According to Ontario Provincial Police Sergeant Pierre Chamberland, there’s no question —“It’s against the law.”

“If you’re issued a prescription medication as a result of a diagnosis that your legal medical practitioner has provided you, that prescription is for yourself,” he explained.

“And if you decide to sell that medication, then what you’re basically doing is you’re falling under the definition of trafficking, almost, in the sense that that substance is a legal substance, but it’s legal under certain conditions and those conditions being that they’re for the person who they are prescribed for.”

The use of prescription drugs is regulated under the Controlled Drugs and Substances Act. Amphetamines are listed as Schedule II drugs, while methylphenidate is considered a Schedule III substance.

The Act states that “Except as authorized under the regulations, no person shall possess a substance included in Schedule I, II or III.” A person who contravenes this regulation with a substance listed as Schedule III, for a first offence, may face charges of up to $1,000 and jail time. Likewise, a person found to be trafficking a Schedule III drug is liable to imprisonment.

In Waterloo Region, local police have laid less than two dozen charges in the past year as a result of ongoing investigations involving the buying and selling of prescription drugs; none, however, have involved university students.

Police will get involved, added Chamberland, when an investigation around prescription drug use brings them onto campus; unfortunately, sometimes this is after a serious incident involving injury or death as a result of drug misuse or abuse.

“I think the university’s perspective on this would be more around concerns of what the student was doing to themselves to perhaps harm themselves. If they’re doing anything illegal then that of course has another parameter to it,” said Deborah MacLatchy, VP: academic and provost at Laurier.

“I think the most important thing is to get the student to an appropriate health counsellor or physician, required to just talk about the risks of doing something like this. And certainly if the student has been shown to be doing something illegal, that’s different than doing something unethical.”

Is it cheating?

The ethics of using prescription drugs to study, however, is a major part of the debate. Is the use of study drugs considered to be cheating?

From the perspective of administration at Laurier, the answer is no.

“Is that any more of an advantage than somebody who ate well, slept well and went to class and did all the things right? Really, from my point of view, the concern is that they are using a substance that hasn’t been prescribed to them, for something that it wasn’t prescribed,” said MacLatchy. “Whether or not it gives them an advantage, I’m not quite sure that that’s something you could ever prove one way or the other.”

Julia Seidel, a third-year communications student at Laurier, agrees that it’s not cheating.

“It doesn’t make you a smarter person … it just helps you focus for longer, when other people might get distracted more easily or need to take breaks,” she said.

According to McKay, this perspective is consistent with what some medical research has shown. While some perceive that these drugs act as cognitive enhancers, actually making you smarter or better able to retain information, this is not the case for students operating at a normal mental state. Just like coffee or energy drinks, taking ADHD medication will just keep you up all night.

“If you haven’t studied all semester and your options are stay up all night and cram or get a good night’s sleep, you’ve got to make your own decisions about this, but these drugs will definitely keep you up all night. But will they make you smarter when you’re up all night? Will they make you better able to remember all night? Absolutely not,” he said.

Some students report that while the medication causes them to focus better, their attention may be centred on something unproductive. This, according to McKay, is because the drugs work in an inverted U shape — after time, your performance starts to get worse.

Because the drugs haven’t been shown to improve cognitive functioning, McKay doesn’t believe it can be seen as cheating. While students report consistently that the drugs help them, he explained that this is a result of the “false sense of confidence” the medication instills.

“These drugs inspire this overwhelming sense of confidence that takes away your ability to go, ‘you know what, I actually can’t stay up four days in a row.’

Because on the drugs you absolutely can stay up four days in a row, you’ll just have a psychotic break at the end and then lose the rest of the semester.”

Promoting safety

Universities and law enforcement have a common goal regarding student use of study drugs: keeping students safe.

“What we’re asking students to do is use that smarts, that intelligence that you possess to make the wise decisions to perhaps come up with better methods of studying that don’t entail illegal activity or health risk activities that could endanger their lives,” said Chamberland, adding that he understands the high pressures of exam times for students.

At a campus level, McKay sees education as the best way for the university to get involved. While education programming often tackles alcohol, tobacco and illegal drug consumption, campaigns addressing non-medical use of prescription drugs seem to be less common.

“I do think there’s a role universities have to play, because these drugs are physically harmful and they can be addictive. And that speaks to all kinds of physical health issues and mental health issues that can stem from the use,” said McKay. “And that’s where the university can play a role, in educating people that these drugs really don’t have the study-enhancing effects that they are supposed to have.”

MacLatchy’s advice for students at Laurier: figure out the root causes and get help.

“If they weren’t prepared enough, if they hadn’t time managed enough, taking too many courses, whatever it is, that they need to address those root issues rather than thinking that taking something like Ritalin is really going to help solve their ‘problems,’” she said.

“Go get help. Go to Health Services. Go to Accessible Learning. Go talk to an advisor that you trust. Speak to your peers, try to figure out what the root causes are.”

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