VUcept

Who’s Your Addy: Prescription Stimulant Misuse

Goal

Vanderbilt University, like many other campuses nationwide, has experienced considerable growth in misuse of prescription stimulants. Several national studies have found that approximately one-third of college students misuse, and a recent survey of Vanderbilt students confirmed this. Why is this rate so high? This module will attempt to tackle the misperceptions about the dangers of this misuse and the high levels of availability on campus, as well as alternative strategies for stress relief.

Establish the legal medical use of these stimulants, so as not to ostracize those who legally take the drugs. Make sure all students are aware that the module will refer only to the misuse of prescription stimulants.

[Inclusion of a module on misuse of prescription drugs was recommended by a group of students enrolled in a course on Health Promotion in spring 2014. This module is an adaption of their draft.]

Preparation

Have access to a computer and projector to display YouTube video clip.

Part 1: Media Representation (15 Minutes)

Prescription stimulants (specifically Adderall) have seen rising popularity, as demonstrated by their presence in popular TV shows (such as Pretty Little Liars) and Youtube videos.

To open up the discussion, you may want to show Jimmy Tatro’s popular Youtube video, “Final’s Week” (https://www.youtube.com/watch?v=C2QL8hwMvCo, 5:24 min.) which displays Adderall misuse in a comical way.

Possible discussion questions:

  • What does the film highlight about the effects of Adderall? What does it say about group pressures?
  • They take Adderall, presumably to study for their exam, but what do they do instead? How do they feel in the morning?
  • What symptoms do they show after taking Adderall?

 

Part 2: Discussion of Risks of Misuse of Adderall or Other Stimulants Without a Prescription (10 Minutes)

  • For what purposes do students misuse Adderall?
  • Do you know what risks are involved when taking Adderall or other stimulants without a prescription?
  • Do you know its effects when used with alcohol?

Incorporate answers from the Background information below.

Part 3: Small Group Discussion of Scenarios  (10 Minutes)

Ask for students to get into 6 small groups and give each group one of the prompts (2 groups will have the same prompts) to discuss for 5 minutes.

~Your roommate is misusing to pull an all-nighter and study for a test. What would you do?

~Your friend is about to snort Adderall before going out and drinking. What would you do?

~You have a legal prescription for Adderall or Ritalin, but you don’t use all of it. A friend knows you have several leftover pills and asks if he can use them to study. What would you do?

Ask groups to share their responses.

Part 4: Stress Relief (10 Minutes)

Ask students to come up with ideas to relieve stress.

They may include:

  • Planning ahead to create a study schedule
  • Keeping a to-do list
  • Being conscious of time spent socializing (in person or virtually)
  • Prioritizing your responsibilities and, if necessary, skipping extra-curricular activities during times of high academic demands
  • Getting enough sleep
  • Learning effective study skills
  • Eating well
  • Taking time, even if briefly, to do things that relax you (e.g. workout, being creative)
  • Planning to use the Writing Studio or Tutoring Services
  • Talking to your professor about your questions

The Vanderbilt Psychological & Counseling Center and the Vanderbilt Health & Wellness Center are both excellent sources for students to discuss their feelings of stress with regards to their academic burden and to find strategies to relieve this stress in a healthy way.


Who’s Your Addy? – Background Information

You may want to review the 60-minute video before the session: “Popping Pills a Popular Way to Boost Brain Power.” This video includes a focus group with college students, facts about the drug and its misuse, and advice from experts.

What are stimulants prescribed for?

  • Attention Deficit/Hyperactivity Disorder (ADHD)
    • 7%-11% of children and adolescents are diagnosed with the disorder & two-thirds of them are prescribed stimulants
  • Narcolepsy
  • Obesity

 

How do stimulants work?

  • increase dopamine levels in the brain
    • neurotransmitter associated with pleasure, movement, and attention
    • creates a therapeutic effect with an increase in one’s ability to focus
  • prescribed in low dosages to increase dopamine in a manner similar to the natural release in the brain

Increasing Availability of Stimulants

  • ADHD diagnosis grew 17% between 2010 and 2011 and continues to rise
  • 19-25 year olds increased medicine use by 2% from 2010-2011
  • 2.7 million youth are prescribed the drug each year
  • 5.3% of college students prescribed stimulants

 

 

Public Perception

  • Little Risk
    • 40% of young adults believe that it is safer to abuse prescription stimulants than illicit ones
    • 30% of young adults believe that prescription stimulants are not addictive
  • High Reward
    • “Smart pill” that boosts GPA and academic performance
    • 65.2% use to improve alertness and concentration

Health Risks of Stimulant Abuse

  • Paranoia
  • Increased body temperature
  • Abnormal heartbeat
  • Hostility
  • Psychosis
  • Anxiety
  • …and even a drop in academic performance

 

Addiction and Withdrawal

  • High risk of addiction
    • Quick rise in dopamine can create sense of euphoria
    • Body becomes reliant on medication to produce dopamine
  • Withdrawal symptoms
    • fatigue, depression, disrupted sleep

Stimulants and Alcohol Use

  • Masks the depressant action of alcohol
    • Increases risk of alcohol overdose
  • May compound the stimulant health risks
    • higher risk of:
      • paranoia
      • hostility
      • anxiety

Prescription Stimulant Abuse at Vanderbilt

Anonymous Survey conducted on March 13-14, 2013

-242 students

-59% female

-88% greek life

-equal representation of all four classes

Survey Data: Prevalence on Campus

– 36% of students admitted to using prescription stimulants without a prescription

– 31% admitted to using prescription stimulants to help them focus on studying

-19% used prescription stimulants to pull an “all nighter”

-17% used prescription stimulants for recreational (for fun) use

-3% used prescription stimulants to lose weight or for athletic purposes

 

Survey Data: Supply

-How easy is it to obtain Adderall, Ritalin, Vyvanse, etc. from students on campus?

-0%: very difficult

-35.56%: somewhat easy

-35.15%: very easy

-8.37%: somewhat difficult

-20.92%: I’m not sure

 

Legal Consequences: Vanderbilt

The following are excerpts from the Vanderbilt Student Handbook at http://www.vanderbilt.edu/student_handbook/alcoholic-beverage-and-controlled-substances-policies/

Distribution or facilitation of distribution of illegal drugs (including unlawful distribution of prescription medication) may result in suspension or expulsion for a first offense; unlawful distribution includes incidents in which no money is exchanged. In addition, the possession of controlled substances or alcohol in such quantities as to create a presumption of possession with the intent to distribute on or off campus is a serious violation that may result in immediate suspension or expulsion. Evidence that a student has distributed drugs is grounds for interim suspension from the University and/or expulsion from University housing pending the findings of accountability proceedings. Students found to have distributed drugs to others may also be held responsible for personal injuries or property damages resulting from misconduct committed by the students under the influence of the distributed substances.

The presumptive sanction for a third violation of alcohol or controlled substances policies is suspension.

Violations involving behavior that injures persons, that damages property, or that injures or damages the community at-large, will increase the presumptive strength of the sanction given.

In addition, sanctions will be imposed for misconduct that results from the use of alcoholic beverages or other drugs. Students will also be held responsible for any damages that result from their misconduct. These sanctions will be imposed consistent with standards and procedures found in Chapter 3, “Student Accountability.”

Prescription Drugs:

Many medications and prescribed drugs have the potential for abuse. Those listed below are some of the most abused, addictive and dangerous.

  • Adderall, Concerta, Ritalin, etc. are stimulants and controlled by the Drug Enforcement Agency (DEA). These drugs are often prescribed for students who have been diagnosed with Attention Deficit Disorder (ADD) or ADHD. They are, however, used by some individuals who have do not have ADHD to increase alertness or recreationally for a “high.” Studies do not show improved academic performance when these stimulants are taken by students without ADHD. The risk from misuse of these drugs ranges from lack of sleep and weight loss to the more severe risk of psychosis with severely disorganized thinking. Individuals who develop psychosis have very poor insight and judgment and so continue to use the drugs in excess. For individuals abusing these stimulants, abrupt withdrawal may lead to significant mood changes including severe depression with a risk of self harm.
  • Codeine, Hydrocodone (Lortab and Vicodin), and Oxycodone (Percocet and OxyContin) are medications that are prescribed for severe pain. All these drugs can be addictive and may be abused for feeling anxious, sedation, falling asleep or to get a “buzz” or “high.” Addiction to pain medications is common and withdrawal can be very difficult to manage.
  • Xanax, Valium, and other benzodiazepine drugs are prescribed for acute anxiety and panic attacks. Use of all benzodiazepine compounds can lead to psychological and physiological dependence.  Symptoms associated with withdrawal from these drugs can be severe and include seizures. Barbiturates are also sedative medications that can be addictive. Barbiturates are no longer commonly prescribed, but are potentially addictive. As with all sedatives, withdrawal symptoms can be dangerous and severe. Combination of these drugs with other central nervous system depressants can be dangerous.

Warning Signs of Possible Substance Abuse

  • Withdrawal from social situations
  • Increased boredom or drowsiness
  • Change in personal appearance (increasingly unkempt or sloppy)
  • Change in friends
  • Easily discouraged; defeatist attitude
  • Low frustration tolerance (outbursts)
  • Violent behavior and vandalism
  • Terse replies to questions or conversation
  • Sad or forlorn expression
  • Lying
  • Poor classroom attendance
  • Dropping grades or poor work
  • Apathy or loss of interest
  • Change in sleep pattern ranging from excessive sleep to inability to sleep
  • Frequent excuses for absences from planned activities

When such signs appear in friends,

DO

  • Express your concern and caring
  • Be ready to listen
  • Communicate your desire to help
  • Make concrete suggestions as to where the student can find help or how he or she might cope with a given problem
  • Try to get the student to seek professional help
  • Ask for assistance from campus resources
  • Be persistent
  • Understand the definition of friendship to include making difficult decisions that may anger your friends

DON’T

  • Take the situation lightly or as a joke
  • Be offended if the student tries to “put you off”
  • Take “I don’t have a problem” as an answer
  • Try to handle the student alone-ask for assistance
  • Lecture about right and wrong
  • Promote guilt feelings about grades or anything else
  • Gossip: speak of it only to those who can help
  • Excuse behavior because “everybody does it”

References

  • “Data & Statistics.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 13 Nov. 2013. Web. 15 Mar. 2014. <http://www.cdc.gov/ncbddd/adhd/data.html>.
  • “DrugFacts: Stimulant ADHD Medications – Methylphenidate and Amphetamines.” National Institute on Drug Abuse (NIDA). N.p., n.d. Web. 17 Mar. 2014. http://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines
  • “Nonmedical Use of Prescription Stimulants.” Medicine Abuse Project. N.p., n.d. Web. 12 Mar. 2014. http://medicineabuseproject.org/assets/documents/NPSFactSheet.pdf?utm_source=Red+Alert-Prescription+Drugs&utm_campaign=Teens+Under+Stress&utm_medium=email
  • “Partnership Attitude Tracking Study.” The Partnership at Drugfreeorg. N.p., n.d. Web. 9 Mar. 2014. <http://www.drugfree.org/newsroom/research-publications>.
  • “Prescription Stimulants.” NIDA for Teens. N.p., n.d. Web. 17 Mar. 2014. <http://teens.drugabuse.gov/drug-facts/prescription-stimulants>.
  • “State-Based and Demographic Variation in Parent-Reported Medication Rates for Attention-Deficit/Hyperactivity Disorder, 2007–2008.” Preventing Chronic Disease. Centers for Disease Control and Prevention, 14 Feb. 2013. Web. 19 Mar. 2014. http://www.cdc.gov/pcd/issues/2013/12_0073.htm.
  • “The Use of Medicines in the United States: Review of 2011.” IMS Institute for Healthcare Informatics. N.p., n.d. Web. 18 Mar. 2014. <http://www.imshealth.com/ims/Global/Content/Insights/IMS%20Institute%20for%20Healthcare%20Informatics/IHII_ Medicines_in_U.S_Report_2011.pdf>.