“Adderall is Definitely Not a Drug”: Justifications for the Illegal Use of ADHD Stimulants

Abstract

In-depth interviews were conducted in 2007 with 175 undergraduate students (94 males, 81 females, 13 non-Caucasian) at a large, public southeastern research university located in an urban area in the United States. Our primary goal was to identify how these students conceive of Attention Deficit Hyperactivity Disorder (ADHD) stimulants and their illegal use. We discovered that these students frame stimulant use as both physically harmless and morally acceptable. Specifically, these students justify their drug use through the use of four recurring prostimulant arguments: 1) comparison-and-contrast, 2) all-things-in-moderation, 3) self-medicating, and 4) minimization arguments. We discuss limitations to the study and conclude by suggesting five strategies for prevention researchers that would directly target these four arguments.

RÉSUMÉ

“Definitivamente Adderall no es droga”: Explicaciones para el uso ilegal de los estimulantes TDAH

Se realizaron unas entrevistas extensivas en 2007 con 175 estudiantes de pre-grado de una universidad grande, pública y dedicada a la investigación, ubicada en una zona urbana en el suroeste de los EEUU. Nuestro objetivo primario fue de identificar cómo estos estudiantes perciben los estimulantes TDAH y su uso ilegal. Descubrimos que estos estudiantes se consideran los estimulantes ambos físicamente inocuos y moralmente aceptables. Específicamente, estos estudiantes justifican su uso de drogas por cuatro argumentos pro-estimulantes que se repiten: 1) la comparación y el contraste, 2) el todo-con-moderación 3) el auto-medicamento, y 4) la minimización. Exploramos las limitaciones del estudio y concluimos por sugerir para los investigadores de prevención el uso de cinco estrategias que enfrentan estos cuatro argumentos.

RESUMEN

“Adderall n'est définitivement pas une drogue”: Les justifications pour la consommation illégale des stimulants ADHD

En 2007 on a effectué des interviews détailées avec 175 étudiants préparant une licence auprès d'une grande université de recherches située dans un périmètre urbain au sud-est des Etats-Unis. Notre objectif principal était d'identifier comment ces étudiants concoivent des stimulants du syndrome d'hyperactivité et de manque d'attention (ADHD) et leur consommation illégale. Nous avons découvert que ces étudiants définissent la consommation des stimulants non seulement physiquement inoffensive mais encore acceptable moralement. Ces étudiants justifient leur consommation de drogues parmi quatre argumentations pro-stimulants répétitives: 1) comparaison-et-contraste, 2) toutes-choses-en-modération, 3) automédication, et 4) argumentations minimisantes. Nous discutons des limitations de l'enquête et nous concluons en suggérant aux chercheurs cinq stratégies en prévention qui visent ces quatre argumentations directement.

Keywords :

• ADHD
• Adderall
• drug abuse
• college students

Notes

¹The rise in the diagnosis and treatment of American children with ADHD has been well documented since the mid-1990s (McCabe et al., 2004; Olfson et al., 2002; Robinson et al., 1999; Rushton and Whitmire, 2001; Safer et al., 1996). According to the Centers for Disease Control (2005), there are over 4.4 million children between the ages of 4 and 17, or a national prevalence rate of 7.8%%, that have been diagnosed with ADHD. Of these, 2.5 million children have been prescribed stimulants to treat the disorder.

²Other often-discussed Schedule II drugs include cocaine (used as a topical anesthetic), Morphine, Phencyclidine (PCP), short-acting barbiturates, injectable methamphetamine, and most pure opioid agonists such as opium and OxyContin, (USDOJ DEA)

³Exploring the issues of ethnicity and motivation, Teter, McCabe, LaGrange, Cranford, and Boyd (2006) asserted that Caucasians and Hispanics were more likely to illegally use prescription stimulants than African Americans and Asians. They also found that the majority of students who used illegal prescription stimulants, regardless of ethnicity, did so to enhance their academic performances. Sixty-five percent reported using to aid concentration, 59.8%% to “help study,” and 47.5%% to “increase alertness” (p. 1501). Other motives not associated with academic performance included getting high (31.0%%) and experimentation (29.9%%),” (p. 1501).

⁴Of these 574 illegal users, 49%% (n == 260) were males, 51%% (n == 273) were females. Forty-one participants did not report a sex. Whites comprised 94%% (n == 536) of illegal users; the remaining 6%% of the participants consisted of 14 African Americans, 4 Asian/Pacific Islanders, 5 Hispanic/Latinos, and 10 other or mixed raced. Five participants reported no ethnic affiliation. Of the illegal users, 22%% (n == 112) were freshman, 25%% (n == 123) were sophomores, 28%% (n == 140), and 25%% (n == 128) were seniors. Seventy-one of our reported users did not report a class rank. Finally, 27%% (n == 155) of these illegal users were in fraternities, while 31%% (n == 178) were members of a sorority.

⁵Finding interviewees to discuss their illegal stimulant use was far easier than we had anticipated. In fact, only 2 students declined our request to be interviewed. The 175 students that volunteered their time and insight were forthcoming and seemed to enjoy the interviews. The quality and quantity of these interviews underscores the general lack of stigma attached to the use of ADHD medications by the subjects in our study.

⁶DeSantis (2002) and DeSantis and Morgan (2003) examined the types of prosmoking arguments used by cigar smokers to justify cigar use. Both works argued that by using such arguments, smokers are able to reduce the cognitive dissonance and anxiety usually associated with tobacco use. These basic justifications were used in this current study as an initial template for understanding similar arguments produced by illegal stimulant users.

⁷Our suggestions come from an “abstinence” orientation. There are, however, other perspectives that could be considered. The newer “harm-reduction” model would advocate strategies such as reducing the frequency of use or targeting only “social motivations” for illegal ADHD stimulant use. Since most users in our study, however, primarily use Adderall during “rare” academically stressful situations, this approach is less appropriate. There is also the “quality-of-life” model that considers both the physical and the psychological well-being of the user. It is compellingly argued from both a psychological and physiological perspective, however, that unprescribed amphetamine use is not beneficial to a user's psychological state or his/her physical well-being.

⁸According to Bormann (1983), the “chaining out process” occurs when a group of people, who share a similar experience and who have regular discursive interactions with each other, socially construct a collective reality. In this process, a group member is simultaneously persuaded and persuader, sender and receiver. Most of the time, members remain unaware that they are cooperating in the creation of this collective message.