Most everyone is familiar with the term “doping” after American road racing cyclist, Lance Armstrong, was stripped of all his titles in 2012 because he used performance enhancing drugs to win races. In the aftermath, he lamented he felt he had no choice because, according to him, competitors were doping too and he had to do it to “level the playing field.”

Just as in professional sports, the pressure to compete in law school is extreme. Unfortunately, over the last two decades, more and more law students have adopted a “doping to win” strategy that involves illicitly abusing the prescription drug Adderall that is normally used to treat attention-deficit/hyperactivity disorder (ADHD).

‘Dirty Little Secret’

The drug abuse starts as a so-called “study aid” in law school. Some students will continue to illicitly use Adderall and other drugs as lawyers. In the fullness of time, some will develop severe substance use disorders (addiction). And a few will not survive it.

Adderall is an amphetamine stimulant drug, used to treat hyperactivity and lack of focus fueled by abnormally low levels of dopamine associated with ADHD. It increases dopamine to normal levels. This “slows down” an ADHD patient’s mind and reduces hyperactivity.

As for everyone else, however, with normal levels of dopamine to begin with, using any amphetamine (Adderall or its illegal first cousins cocaine and methamphetamine) increases dopamine to above normal levels. This results in a burst of euphoria followed by being “wired” for hours.

In 2016, Leigh Jones published an article at Law.com entitled “Adderall in Law Schools: A Dirty Little Secret” that reveals “in the cutthroat environment of law schools, where a handful of exams can determine their fate, students are misusing Adderall in hopes of gaining a competitive edge, especially when they think other students are taking it, too.”¹

In 2019, Casey Sullivan published an article at FindLaw.com entitled “Don’t Take Adderall to Help You Study for Law School Finals” and he writes, “plenty of students use Adderall, more or less openly, in order to obtain a prescription-fueled edge over their classmates. These gunners either pop pills that they’ve obtained through a dubious prescription or which they buy on the study drug black market.”²

With the pressure of law school study and grinding huge volumes of information, it is no surprise that “doping” with Adderall has gained popularity among some students.

A Growing Problem

Amphetamine abuse is also not limited to law schools or even college students. In fact, amphetamine abuse is growing on a much broader scale. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the misuse of prescriptions among youth and young adults aged 12 to 25 is a now major public health issue in the United States.

The prevalence of prescription drug misuse is now highest among young adults between the ages of 18 and 25 and the rates of prescription stimulant misuse are higher than the rates of misuse for other categories of prescription medications.³ Thus, amphetamine abuse is now the top problem.

Also, per SAMSHA, very young people who begin to abuse amphetamine medications tend to also use other substances. By age 18, almost all amphetamine abusers have used at least one other substance. Two-thirds of high school seniors who misuse prescription amphetamines did so simultaneously with the use of other substances like alcohol or marijuana. College students who misuse prescription amphetamines are over six times more likely to be heavy drinkers.

It appears that illicit amphetamine use is often embedded in much broader addictive behavior that includes the use of several different substances (polydrug use).

As to Adderall prescribed to patients, in the last two decades it has become spectacularly popular in the U.S. and elsewhere. One study in the United Kingdom cites an 800% increase in amphetamine prescriptions between 1995 and 2015.⁴

Abusing a Schedule II Drug

But not all Adderall prescriptions are legitimate. It is easy to feign ADHD symptoms and dupe doctors into prescribing it. Google “how can I get an Adderall prescription” and a plethora of links prepare you to fake ADHD symptoms either online or at a doctor’s office and obtain an Adderall prescription to abuse and divert among classmates as you wish.

New studies are exposing just how difficult it is for doctors to detect ADHD malingering by college students. Measures commonly used in current ADHD diagnostics do not adequately detect malingering, and there is likely a high rate of false positives in ADHD diagnoses.⁵   

But what if you don’t feel comfortable participating in Adderall fraud at a doctor’s office? No problem, just ask around campus and see if one of your classmates has some so-called “Study Buddy” or “A-Bomb” pills to lend or sell. There is a lucrative black-market to sell Adderall to students who have been convinced that they can’t compete without it.

At this point, some law students surely sneer: “What’s the big deal if a classmate gives or sells me a couple of little pills to use once in a while to help me study? Adderall is an FDA approved prescription medication so it must be safe. Besides, everyone is doing it.”

The truth is that grave danger is involved. Adderall is a Schedule II Drug (the same classification as cocaine, methamphetamines, heroin, opioid pain medication, etc). All these drugs have a high potential for abuse, can be dangerous, and can cause severe psychological or physical dependence (addiction). It is also a felony to possess Adderall without a prescription.

It is a fact that no one knows what will happen to them physically, mentally, legally or ethically after crossing a threshold into the illegal use of prescription drugs.

Is It Really Worth It?

The improper use of stimulant medications like Adderall can cause “stimulant psychosis” that is a very serious condition involving hallucinations, delusions, paranoia, agitation and aggression. In some cases, the damage is permanent and the psychotic person never makes a full recovery.

In the worst cases, Adderall abuse results in death. In 2010, Kyle Craig, a student at Vanderbilt University, was suffering from increasing deterioration of his mental health due to Adderall abuse. At 21 years old he stepped in front of a passenger train and ended his life.⁶

In 2011, Richard Fee died at 24 years old. Psychotic from Adderall abuse in attempts to make the grades to enter medical school, he hung himself in his closet. The New York Times (NYT) article “Drowned in a Stream of Prescriptions” is a horrifying window into how easy it is to get Adderall and how terribly dangerous it can be when misused.⁷

According to the article, Richard was “an intelligent and articulate young man lying to doctor after doctor, [with] physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of [Richard’s] growing addiction and psychiatric breakdown.”

Now, more than a decade later, the stakes just got even higher. Yet another NYT article in 2022 states: “Officials Warn of Fake Adderall Pills After Two College Students Die” and that “there are fake [Adderall] pills circulating that could be laced with Fentanyl.⁸

There have never been so many readily available medications and illicit drugs and with Fentanyl out there, just one little counterfeit Adderall pill can kill.

Finally, as to doping with Adderall, here is the cruelest cut of all: studies now expose that Adderall is not a “smart drug” at all. It turns out that students only think they are performing better on tests when they actually are not.⁹ That means there is no gain despite all that risk.

TLAP’s Role

So what is the clinical path at TLAP to address a problem with Adderall and/or ADHD? The first step is to facilitate a TLAP-approved ADHD assessment that actually includes comprehensive and reliable testing that can’t be manipulated by the patient. This will reliably determine whether or not a person actually has ADHD. If they do, TLAP helps facilitate clinically addressing the ADHD to properly support the individual’s mental health and fitness-to-practice law.

If the person does not have ADHD, they may be abusing or addicted to Adderall. A TLAP-approved provider can meet their individual needs by helping to extricate the person from the grip of Adderall addiction. The mission at that point is to restore the person’s health and ability to navigate life with proper medical care as needed. |||

If you or someone you know needs help, make a confidential call to TLAP at (615) 741-3238 or visit www.TLAP.org for more information.

BUDDY STOCKWELL was appointed by the Tennessee Supreme Court in July 2020 as executive director of the Tennessee Lawyers Assistance Program (TLAP). He comes from south Louisiana where he has been a volunteer and program monitor for the state’s Committee on Alcohol and Drug Abuse and the executive director of Louisiana’s comprehensive Judges and Lawyers Assistance Program (JLAP) peer professionals’ program. He is a certified clinical interventionist through “Love First” training at the Betty Ford Center and has personally been in recovery from alcoholism for over 38 years. Stockwell earned his law degree from LSU Law School in 1993. He practiced in both large and small firm settings, including a solo practice in Baton Rouge where he focused heavily on domestic litigation. Read more about him at tba.org/Stockwell.

NOTES
1. “Adderall in Law Schools: A Dirty Little Secret,” www.law.com/2016/11/03/adderall-in-law-schools-a-dirty-little-secret/
2. “Don't Take Adderall to Help You Study for Law School Finals,” www.findlaw.com/legalblogs/greedy-associates/dont-take-adderall-to-help-you-study-for-law-school-finals/.
3. pep21-06-01-003.pdf (samhsa.gov).
4. Renoux, C., Shin, J. Y., Dell’Aniello, S., Fergusson, E., & Suissa, S. (2016). “Prescribing trends of attention-deficit hyperactivity disorder (ADHD) medications in UK primary care, 1995–2015.” British Journal of Clinical Pharmacology, 82(3), 858-868.
5. Musso, M. W., & Gouvier, W. D. (2014). “Why is this so hard?” A review of detection of malingered ADHD in college students. Journal of Attention Disorders, 18(3), 186-201.
6.ABC News Online, see: http://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619
7. The New York Times; “Drowned in a Stream of Prescriptions,” www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html.
8. The New York Times; “Officials Warn of Fake Adderall Pills After Two College Students Die,” www.nytimes.com/2022/05/07/us/adderall-fentanyl-osu-deaths.html.
9. The Daily Beast; “Busting The Adderall Myth.” see: www.thedailybeast.com/articles/2010/12/21/adderall-concentration-benefits-in-doubt-new-study.html.