I recently read the article titled “The Extra Edge — More Students are Searching for Adderall.” I was a bit confused by the cavalier attitudes expressed in the article. The article seems to imply that the illicit use of prescription stimulants is safe and poses no risk to students. Methylphenidate (Ritalin®) and amphetamine (ADDERALL® and DEXEDRINE®) are structurally similar to methamphetamine. Cocaine, methylphenidate and amphetamine produce similar effects in the brain.

All of these drugs increase dopamine levels. Dopamine is a chemical in the brain that is thought to be involved in mediating the “euphoric” effects of drugs. Research with laboratory animals and human research participants have shown that amphetamines, cocaine and methylphenidate also produce similar behavioral effects. We have been studying the abuse potential of prescription stimulants for nearly 20 years and consistently found that they produce robust behavioral effects that are qualitatively and quantitatively similar to those observed with illicit stimulants like cocaine and methamphetamine. In one study, for example, the subjective (e.g., ratings of drug liking) and physiological (i.e., increased heart rate and blood pressure) effects of methylphenidate were virtually indistinguishable from those observed with cocaine. In a recent study, the subjective and cardiovascular effects of methylphenidate and amphetamine were virtually indistinguishable from those observed with methamphetamine. The abuse potential and cardiovascular effects of prescription stimulants should not be underestimated.

Moreover, we have shown that prescription stimulants increase smoking, perhaps elevating the risk for nicotine dependence. While most college-age adults will likely discontinue their illicit use of prescription stimulants, they will likely continue to smoke. Given the life-threatening health consequences of prolonged cigarette use, it is important to recognize this side effect of prescription stimulant use.

In summary, the efficacy of prescription stimulants is well recognized for a host of medical conditions. However, these are potent drugs that produce robust behavioral effects that are similar to those observed with highly abused drugs like cocaine and methamphetamine.

Because of risks associated with their unsupervised use, students should be discouraged from using them to simply enhance academic performance. Thank you for allowing me to express my views concerning the inappropriate use of prescription stimulants.

Craig R. Rush, Ph.D.

UK Professor