Using stimulant drugs to study
1) Dear Alice,
I have a large amount of course work, which is combined with a job and extra-curriculars, and while I want to succeed in all of them, I find that I simply don't have enough time, even though I currently sleep only 4 or 5 hours a night. I mentioned this to a group of my friends here at school, and it turns out they all take stimulants to help them manage jam-packed undergraduate life. The pills are called ADDERALL and PROVIGIL. I have acquired some for myself, but before I take them, could you tell me if either has serious health risks? I do not have any other health problems or take any other medications. A few of my friends tell me that they sometimes stay awake for as long as 3 or 4 days. If it is reasonably safe, that would be great! Thank you.
No time for sleep
2) Dear Alice,
Given the fact that this is a top-notch school, it's total hoo-ha that you haven't included any info on all the non-hard core, but still illegal, "study stimulants." Is all this ADDERALL gonna do me permanent damage or what?
awaiting your response,
Dear No time for sleep and awake,
Juggling academics, jobs, extracurricular activities, a social life, and other responsibilities may be challenging and even impossible at times for many students. So, it makes sense that many are curious about substances that supposedly allow someone to manage all of these priorities more easily. Some people may try prescription drugs (such as Adderall and Provigil) in the hope of boosting their alertness, concentration, attention, and memory. In fact, amphetamines such as Adderall (generic name: amphetamine-dextroamphetamine) are among the most misused substances in the world, and their illicit use is even more widespread among college students. While some folks may claim that these sorts of drugs can power them through all-nighters, these drugs also come with quite a few serious risks and are illegal to take without a health care provider's prescription and supervision. College- and university-aged students are more susceptible to misuse, mostly due to the high amounts of stress and pressure they face in their studies and social lives. Furthermore, while people could perceive these medications as "helping" them academically, current research suggests otherwise. But fear not, there are plenty of ways to manage and prioritize commitments. But first, it might help to talk a bit about the uses and risks of the prescription medications you both mentioned.
Amphetamine-dextroamphetamine is commonly used to treat attention-deficit hyperactivity disorder (ADHD). Amphetamine-dextroamphetamines help folks with ADHD concentrate and be more productive when used as prescribed. When used in non-recommended doses, amphetamine-dextroamphetamines may result in physical and psychological dependence, where stopping use could lead to withdrawal symptoms. Additionally, it may cause some side effects including anxiety or depression, increased heart rate, insomnia, dizziness, and diarrhea or constipation. Amphetamine-dextroamphetamines may also cause more serious side effects such as irregular heartbeat, increased blood pressure, seizures, and hallucinations. If you experience any of these, it's recommended that you see a health care provider immediately.
Amphetamine-dextroamphetamines affect people differently. For individuals who have ADHD, these prescriptions make the neurotransmitter dopamine more available in the brain. Dopamine is associated with the motivation and reward part of the brain, so for someone with ADHD, the increased availability of dopamine provides more “motivation” for the tasks that are difficult to concentrate on, increasing focus and providing an internal “reward” for that task. For people with ADHD, use of these drugs helps regulate their brain chemistry to minimize the differences between their brain functioning and that of someone without ADHD. For someone who doesn’t have ADHD, the increase in available dopamine may lead to a sense of euphoria (which may explain why some folks take these drugs to party). However, those feelings may also be associated with increased heart rate and blood pressure, mood swings, hallucinations, and in some cases, such use may be fatal. These drugs can also interact with other medications in a variety of ways (dependent on the medication), and the potential for overdose is a concern.
On the other hand, Provigil (also called modafinil) isn’t an amphetamine — it’s in a different class of medications called wakefulness promoting agents. It’s used to treat sleep disorders and can be habit-forming. Modafinil's more common side effects may include headaches, nausea, and insomnia, and it can decrease the effectiveness of some types of hormonal birth control. It also has some serious and uncommon side effects including allergic reactions, extremely low or high blood pressure, and breathing problems. Finally, it's not recommended for folks who have heart problems, high blood pressure, and a history of mental illness, kidney disease, or liver disease.
Awake, you mention the idea that “study drugs” are common in “top-notch” schools, and it’s true that some students may obtain these drugs (often from friends or classmates who have a legitimate prescription) to help them cram for exams or pull all-nighters to study. So, can these drugs help you academically? When combined with behavioral therapy, stimulant drugs such as amphetamine-dextroamphetamine have been shown to improve academic performance for those with ADHD, but there's solid research demonstrating that using these drugs doesn’t really help individuals who aren't diagnosed with ADHD. These substances may make it easier to study for longer, but they don't really improve learning — particularly the complex memory and learning processes that are most commonly assessed in higher-level education. In some research studies, students without ADHD who used these drugs didn't see any improvement in grades and grade point average. For others, studies show that the placebo effect skews students’ perception of their own performance. For example, study participants who received the placebo instead of the stimulant believed they performed better on tests, even though their results indicated they hadn’t. Lastly, long-term effects are another key consideration — several studies have shown that misuse of prescription stimulant drugs is associated with lower educational attainment overall. So, while you may be able to study for longer after taking one of these drugs, it likely won’t have a significant impact on your long-term academic performance if you don’t have ADHD.
In light of these findings, it may be helpful to keep in mind all the non-medication resources available to help handle the flood of commitments that accompany student life. One of the keys to effective time management is prioritizing and assessing the quality of your responsibilities, commitments, and activities — which may include saying no. Despite the high-achieving culture at many universities, it's possible to make choices to drop some of your commitments to get enough sleep and better manage various responsibilities. Managing stress in effective and healthy ways (getting enough quality sleep, eating balanced meals, and being physically active, for example) may prevent stress from negatively affecting your brain processes, including forming and retrieving memories.
If you’re still feeling overwhelmed, you might consider reaching out to friends, family, academic advisors, health promotion professionals, and mental health professionals for help with stress management techniques and balancing your schedule. For more information on time management and stress relief tips, take a look at the related questions and Stress & Anxiety in the Go Ask Alice! archives.
Originally published Sep 19, 2003
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