The Ranger Online

Issue date: 5/18/06 Section: Urban Journalism Workshop

Media Credit: Jeanette Scarsdale Dr. John C. Burnside, a pediatric and adolescent psychiatrist at the ADHD Clinic of San Antonio, has been counseling teenagers for 21 years.

Finding a student who has illegally used Adderall, a drug for attention deficit hyperactivity disorder, is as easy as making two telephone calls.

Late-night cram sessions, efficiency at work, creating Shakespearean poetry and reading for hours at a time are all reasons high school and college students have taken Adderall without a prescription.

When Angie Drymala was 16 years old, she began using Adderall to enhance her creativity.

"It's like you're forcing yourself to be creative," Drymala said. "(It's the) process of tapping into that artistic side of yourself. (I was) tapping into an aspect of myself that I couldn't reach normally."

Obtaining the medication from her brother, who was prescribed the drug, Drymala would sometimes crush Adderall and smoke it with marijuana.

Now at age 25, Drymala works for the Palmer Drug Abuse Program, the same program that helped her kick her drug addiction.

The misuse of Adderall and other amphetamines is decreasing, according to the National Institute on Drug Abuse's Monitoring the Future survey, but according to Drymala, the availability of prescription drugs to those not diagnosed with a medical condition is "insane."

According to Monitoring the Future, 35.6 percent of 10th-grade and 51.2 percent of 12th-grade students said amphetamines were easily available to them.

Whether paying for the pills or simply being given them, these so-called study drugs are easily accessible to students.

"I tried to buy it off her, but she would just give it away to me like candy," 17-year-old Renee said of a friend.

Renee, who did not want her full name used, said she used Adderall when she was 15 without a prescription to help her stay awake and concentrate during school.

Adderall helped Renee's grades rise in school, but she constantly had to take more of the drug to gain the same effects.

While taking Adderall, Renee noticed dark circles forming under her eyes. She couldn't sleep, and she lost 10 pounds in one month because she lost her appetite.

Through the course of six months, Renee progressed to taking 110 mg of Adderall a day before she decided to quit taking the drug.

An obese adult diagnosed with ADHD should not take more than 50 to 60 mg of amphetamine a day, said Dr. Steven R. Pliszka, professor and vice chair of the department of psychiatry at the University of Texas Health Science Center.

Adderall is an amphetamine classified as a C2 substance by the Food and Drug Administration. C2 substances are the most closely controlled products next to C1, which includes cocaine.

When taken as prescribed, Adderall increases dopamine and norepinephrine levels, increasing brain activity.

This stimulates the frontal lobes, which control everyday functions such as time management, persistence and problem solving, the functions not displayed in ADHD patients.


Adderall can cause headaches, stomach aches, weight loss, lack of sleep or twitching of the face if more than the prescribed amount is taken.

Students normally obtain Adderall through people who have been diagnosed with ADHD, a method called diverting.

"To dispense a controlled substance without a prescription is a felony," Burnside said, later adding that distributing Adderall without a prescription could be a more serious felony than distributing marijuana.

To help him concentrate at his job as a directory assistance operator, Jimmy, 20, began taking Adderall given to him by a friend who had a prescription.

Although he took the Adderall only when he thought he needed it, rather than in daily doses, he could still feel the effects.

But Jimmy's concentration was not focused on work as the Adderall made him dwell on trivial annoyances.

"If something small happened I would just keep thinking about it," Jimmy said. "It was just getting on my nerves."

Drymala, the drug counselor, said there is an over prescription of medication for adolescents.

When Drymala went to a doctor to receive treatment for social anxiety, the doctor wanted to prescribe Zoloft and Paxil, the same drugs she had been misusing.

"I'm wondering if there's an alternative solution," Drymala said about the prescription of Adderall.

The process of diagnosing ADHD and prescribing medicine is carefully weighed out, said Dr. John C. Burnside, a pediatric and adolescent psychiatrist at the ADHD Clinic of San Antonio.

The 2 1/2-hour process includes a 1 1/2-hour evaluation with a psychiatrist and an hour filling out forms, Burnside said.

The patient must then have a separate appointment with a psychiatrist before being diagnosed.

Doctors must take Adderall prescriptions seriously, Burnside said.

"If the doctor doesn't take it seriously, the patients won't take it seriously," he said.

The three evaluations Burnside uses before prescribing ADHD medication are careful history taking, a series of checklists to determine where the patient lies on the ADHD spectrum, and co-morbidity, or checking for any other co-diagnoses.

"You make the decision based on 'If this were my child what would I do'?" Burnside said, adding that diagnosing the condition is difficult because it is a medical problem with no medical tests.

In the end, the parents have the final word.

"Normally, the doctor does not decide if the children are going on medicine," Burnside said. "The parents do."

Pliszka, the psychiatry professor, is leading a study at the Health Science Center to establish medical tests for ADHD.

Their main focus is on functional magnetic resonance imaging, which is a noninvasive measure of blood flow in the brain.

The study found that activity in certain areas of the brain is lower in ADHD patients compared with non-ADHD patients.

Plizska said misuse of Adderall in a person with ADHD would actually cause lethargy. But for a person who does not have ADHD, the drug can create a high for the user.

To prevent patients from diverting their Adderall prescriptions, medical offices monitor refills and the state monitors the number of prescriptions written by physicians.

Burnside said education about Adderall and the legal consequences is the key to preventing misuse.

"I would probably say you look a lot smarter than that," Burnside said he would tell a patient who is illegally distributing his pills. "Most kids don't want to mess with a felony."

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