Ohio University sophomore Nick Ernst’s gaze drifted toward the window in the middle of his explanation about his ADHD. The direction of his part in the conversation went from talking about the perceptions of people with ADHD to what a nice day it was outside.

The conversation turned to his girlfriend and how their relationship is a combination of OCD and ADHD. While his girlfriend likes things done in a specific way, he finds focusing on those things more difficult. It isn’t out of the ordinary for him to say something out of the blue, catching his girlfriend or someone else who he is talking to off-guard. Sometimes he finds that it gives the impression that he wasn’t listening.

“No, I am, I’m trying to but this is just the way I am,” Ernst explained. “It’s the way I’ve been since I was a kid.  It’s not that I’m trying to offend anyone, it’s just that ... it’s what happens.”

Two Ohio University students with ADHD like Ernst, freshmen James Burns and senior Hannah both developed different ways to work around the disorder for social and academic situations. Hannah went up until her senior year without taking medication for it. Studying in college without an official diagnosis or prescription not only filled her time with stress and a lack of motivation, but she didn’t trust that she would fully retain the information. Hannah now takes a prescription of amphetamine salts. Her study time has gone from mostly study breaks to a seamless session. However, the stimulants also interfere with her appetite and sleep schedule.

“I never get hungry, so my brain is never like, ‘Hey, take a study break and make food,’ until it’s 9 o’clock, and I realize I haven’t eaten anything all day.”

The saving grace for a reminder to eat is a well-timed glance at a clock, or her friends inviting her to have lunch or dinner with them. Hannah has also found that taking melatonin counteracts the medication for the nights when the amphetamine won’t let her sleep.

Ernst chose to stop taking medication for the disorder in his senior year of high school, so he had to find a way to study productively despite his ADHD. His approach to school work is more or less the approach of ripping off a bandage, wanting to get everything done quickly. However, he describes the frustration of just trying to get started on his work without the help of medication.

“It’s the same thing when you walk into the room and you had this objective or something you need to get in the room, and then you get to the room and you’re like, ‘Oh, wait … why am I here?’ And then you leave and then come back —  it’s a never ending cycle. I guess that’s the best way to sum it up.”

Burns combats his ADHD with music to help him study, listening to mostly white noise and instrumental music. If the music is akin to armor to protect him from distraction, his weapon of choice is coffee.

“Fun fact: coffee works like ADHD meds. So if I really need meds, all I have to do is drink some coffee and that’ll keep me pretty good for about … three hours,” Burns said.

Contrary to what someone may think of a person with ADHD, the disorder has contributed to both of them falling asleep in classes rather than portraying a stereotypical image of a student with ADHD fidgeting in the classroom. The classes aren’t dull morning classes as might be imagined, and it isn’t out of disinterest or laziness.

“For some people, they’ll fall asleep because they don’t care. Even when I care, there’ll be times when I fall asleep in class just because I can’t pay enough attention,” Burns said.

The Decision

Ernst and Burns both stopped taking medication for their ADHD before college. However, both said they have no regrets in dealing with their ADHD without medication.

“The transition (of the medication wearing off) was like waking up. When I was on them it was like a computer,” Burns said, recalling the bus rides home during elementary school. “The meds for me didn’t really change my personality. They just pushed under the parts that were caused by ADHD.”

Burns was on prescribed medication for his ADHD for about five years, switching from Adderall to Vyvance right before seventh grade. He stopped taking the medication before eighth grade.

“I didn’t feel like myself when I was on the medication,” Burns said when recounting being on the Adderall prescribed to him while he was in elementary school. “I felt like a robot, and those are the words I used to describe it at the time. I felt like an emotionless being only here to do work and I didn’t really have any drive to do anything.  It was kind of like forced depression without the sadness.”

Ernst took prescribed Focalin throughout high school until his senior year. The medication shifted his attentions from socializing and finding ways to make people laugh to focusing primarily on school work.

“I didn’t have an urge to go out and be social. I didn’t have an urge to, you know, be a regular human being. I felt like a drone almost. I was just monotonously going through everything that I had to go through … It’s not that there wasn’t time for me to do social things, it’s just the medication was like ‘social things don’t matter.’ It was almost like there was another voice in my head telling me what to do and I did not like that.”

However, come the second half of Ernst’s senior year, he decided to stop taking the medication so he wouldn’t need it in college. Ernst went “cold turkey” and a mild withdrawal followed. He recalled that it wasn’t a serious withdrawal, but he missed a few homework assignments as he adjusted to the more distracting world around him.

“I told myself, ‘Look, fix this now, or you’re going to have to deal with it in college where grades actually matter.’”

Both he and Burns suggested to not take medication unless ADHD was severe.

“Taking meds depends on your condition for ADHD,” Burns said. “If it debilitates you to the point that you can’t function then go for it, but if you just have it like I do, which really isn’t to an extreme, it’s a mild form of ADHD, I would not suggest taking meds. You function better on a work level, but on an emotional level there’s basically nothing.”

Burns later summed up his own emotional level of when he was on the medication in three words:

“I felt caged.”

Campus Care

Forty-five Ohio University students signed up with Campus Care in 2015 to receive ADHD prescription medication through them. Those students signed a controlled substance agreement with Campus Care, and ten more had already signed in 2016 by the end of February.

Within the agreement is consent to random drug screenings, the agreement to bring in their prescription bottles for pill counts and the acknowledgement that if any students are found sharing or selling their pills, Campus Care will stop providing them with the controlled substance.

Pill usage graph

Graphic by Brady Menegay

That specific agreement, of course, only applies if the person receiving the medication gets it from Campus Care. Students like Hannah get their prescriptions from other providers.

Drug screening is common in medical practices that prescribe controlled substances, Dr. Jane Balbo, who works for Ohio University’s Campus Care, said. The university uses the screening and pill counts to try and discourage the students prescribed these prescriptions by Campus Care from abusing, selling and sharing the medication they receive.  

About ten percent of college students nationwide have taken ADHD medication without a prescription, 1.6 percent of which are Ritalin and 9.6 percent are Adderall, according to Monitoring the Future, which is a research institute focused on college students and young adults. 

“This (drug screening) is common practice in medical practices that prescribe any ‘controlled substances’ such as pain medication or benzodiazepines,” Balbo said in an email. “Many illegal drugs work at cross-purposes to the stimulants, so if I am prescribing a stimulant for a patient, if he or she is using marijuana it is having the opposite effect. Also it is illegal, and medical providers are generally to avoid prescribing controlled substances to people using illegal drugs. Finally, the use of illegal drugs or non-prescribed drugs recreationally demonstrates a likely pattern of drug abuse, not appropriate use of the medication I am prescribing.”

The Medication

Hannah sells concentration in the form of pills. Her medication of amphetamine salts — what Adderall is composed of — goes for $2 to $3 dollars. It’s cheaper than some of the other pills on campus that go for around $5 because her prescription isn’t brand name, she said.

Of the 60 pills she gets each month, two for each day, Hannah said she she sells around ten to 15 each month.

“During finals, all of my friends are looking for some,” she said. Her friends mostly come to ask for the pills when there are big tests or projects around the corner.

Selling and sharing Adderall and other stimulants isn’t a foreign concept on a college campus. The reasons for taking it vary from studying to recreational purposes.

“Most, but not all, drugs used to treat ADHD are structurally similar, similar chemical structure, to many common street drugs including meth (methamphetamine) and ecstasy,” according to Professor Stephen Bergmeier, who has researched medicinal chemistry, in an email.

Split into the binary genders, the annual prevalence of female, full-time college students taking Adderall is 8.6 percent compared to the annual prevalence of 6 percent of women out of college who use it. For men, it’s 11.1 percent for those in college and 8.8 percent for those out of college, all according to Monitoring the Future.

One purpose of recreational use of amphetamine is to take away the drowsiness from alcohol while drinking, Jason Smith, who has used Adderall six or seven times in his college career, said. A few times, he crushed the pills to snort the powder, but he said found it to be “ineffective.”

His first time was in freshman year for academic purposes. Smith had to work on a large project all in one night. The Adderall helped him to “sit down and work without thinking about anything else.”  

Patrick Taylor started taking unprescribed Adderall a few months ago for studying purposes.  

“Everybody says it’s like a euphoric sensation somewhat,” Taylor recounted, though he somewhat agreed with what he had heard before about the drug. “It also depends on the kind you take because some have more side effects than others.”

Both of the students said that finding someone to sell them the Adderall was easy and the drug cost at most $5 per pill for them.

“I remember the events, and I remember pictures. I guess if you took a camera from my point-of-view and took pictures that’s kinda all I have. There’s no context.”James Burns, freshman with ADHD

Sophomore Nick Ernst hasn’t taken any medication for his ADHD since his senior year in high school, though this year he had a friend  bring up Ernst’s ability to get a hold of Adderall to share. Ernst took it as a joke and let it pass.

“But at the end of the day, if I really wanted to do it, I don’t think they would really complain about it,” Ernst said, though also added that he wouldn’t do it.

In Ohio, the laws for the possession of a controlled substance is at the least a fifth degree felony, which entails a fine of up to $2,500, between six to 12 months in jail or both. As for the seller, they can be charged with at the very least a felony of the fourth degree, which would mean a fine of up to $5,000, at least six months in jail and up to 18 months in prison or both.

However, Adderall can also negatively impact studying because of state-dependent learning. When the brain is in a certain condition, like on Adderall, the information learned during that time is easier to recall when on Adderall again rather than without the drug. For example, if someone used Adderall for the purpose of studying, then that information would be easier recalled on a test while using Adderall than taking a test without the drug, which is what happened to graduate Sarah Jones.

“The state-dependent learning, I didn’t realize how much it had actually affected me,” she said. “I didn’t really know that it was a thing until I started attending the Collegiate Recovery Community where I learned about what happens from amphetamines. I felt like I had to relearn everything.”

With state-dependent learning in mind, it’s important to note that children who are diagnosed with ADHD take stimulants such as Adderall before heading off to school in hopes of aiding their focus.

“I don’t have a ton of memories from elementary school, and I partially blame the meds for that,” said Burns, who was diagnosed with ADHD and then prescribed Adderall in third grade. “ I have a lot of friends who will recall back to elementary school, middle school with a lot of fondness and I’ll be over here like I remember nothing.”

Instead, Burns only has snapshots of his childhood memories.

“I remember the events, and I remember pictures. I guess if you took a camera from my point-of-view and took pictures that’s kinda all I have. There’s no context.”