Jew World Order

“Isn’t it just like a vitamin?” asked one high school junior from Eastchester, a suburb of New York.

Liz Jorgensen, a licensed addiction specialist who runs Insight Counseling in Ridgefield, Conn., said her small center had treated “at least 50 or 60” high school students from southern Connecticut this school year alone who had abused prescription stimulants for academics. Ms. Jorgensen said some of those teenagers landed in rehab directly from the stimulants or, more often, grew comfortable with prescription drugs in general and began abusing prescription painkillers like OxyContin.

A spokesman for Shire, which manufactures Vyvanse and Adderall’s extended-release capsules, said studies had shown no link between prescribed use of those drugs and later abuse.

Dr. Jeff Jonas, Shire’s senior vice president for research and development, said that the company was greatly concerned about the misuse of its stimulants but that the rate was very small. “I’m not aware of any systematic data that suggests there’s a widespread problem,” he said. “You can always find people who testify that it happens.”

Students who sell prescription stimulants to their classmates focus on their burdens and insecurities. One girl who sells to fellow students at Long Beach High School on Long Island said: “These kids would get in trouble if they don’t do well in school. When people take tests, it’s immediately, ‘Who am I getting Adderall from?’ They’re always looking for it.”

Every school identified in this article was contacted regarding statements by its students and stimulant abuse in general. Those that responded generally said that they were concerned about some teenagers turning to these drugs, but that their numbers were far smaller than the students said.

David Weiss, superintendent of Long Beach Public Schools, said the survey his district used to gauge student drug use asked about only prescription medications in general, not stimulants specifically.

“It has not been a surface issue for us — we’re much more conscious of alcohol or other drug use,” Mr. Weiss said in a telephone interview. “We haven’t had word that it’s a widespread issue.”

Douglas Young, a spokesman for the Lower Merion School District outside Philadelphia, said prescription stimulant abuse was covered in various student-wellness initiatives as well as in the 10th-grade health curriculum. Mr. Young expressed frustration that many parents seemed oblivious to the problem.

“It’s time for a serious wake-up call,” Mr. Young said. “Straight A’s and high SAT scores look great on paper, but they aren’t reflective measures of a student’s health and well-being. We need to better understand the pressures and temptations, and ultimately we need to embrace new definitions of student success. For many families and communities, that’s simply not happening.”

Fooling the doctors

During an interview in March, the dealer at Lower Merion High reached into his pocket and pulled out the container for his daily stash of the prescription stimulants Concerta and Focalin: a hollowed-out bullet. Unlike his other products — marijuana and heroin, which come from higher-level dealers — his amphetamines came from a more trusted, and trusting, source, he said.

“I lie to my psychiatrist — I expressed feelings I didn’t really have, knowing the consequences of it,” he said, standing in a park a few miles from the high school. “I tell the doctor, ‘I find myself very distracted, and I feel this really deep pain inside, like I’m anxious all the time,’ or something like that.”

He coughed out a chuckle and added proudly, “Generally, if you keep playing the angsty-teen role, you’ll get something good.”

Christine, a junior sitting nearby, said she followed the well-known lines to get her drugs directly and legally, a script for scripts. “I’m not able to focus on schoolwork,” she said in a mockingly anxious voice. “I’m constantly looking out the window.” Although she often uses the drugs herself, snorting them for a faster and more intense effect, she said she preferred to save them for when her customers crave them most.

“Right before everybody took the PSATs, a bunch of kids went to the bathroom to snort their Addies,” she said.

This is one of the more vexing problems with stimulants in high schools, experts said — the drugs enter the schools via students who get them legally, if not legitimately.

Older A.D.H.D. drugs required low doses every few hours, and schools, not wanting students to carry the drugs themselves, had the school nurse hold and dispense the pills. Newer long-lasting versions like Adderall XR and Vyvanse allow parents to give children a single dose in the morning, often unaware that the pills can go down a pants pocket as easily as the throat. Some students said they took their pills only during the week and gave their weekend pills to friends.

The mother of one high school freshman in Westchester County said she would open the kitchen cabinet every morning and watch her son take his prescribed dose of Ritalin. She noticed one day that the capsule was strangely airy and held it up to the light. It was empty.

“There were a few times we were short in the month, and I couldn’t understand why,” recalled the woman, whose son was in eighth grade at the time. “It never dawned on me until I found those empty capsules, and then I started discovering the little packets of powder. He was selling it to other kids.”

A number of teenagers interviewed laughed at the ease with which they got some doctors to write prescriptions for A.D.H.D. The disorder’s definition requires inattentiveness, hyperactivity or impulse control to present “clinically significant impairment” in at least two settings (school and home, for example), according to the Centers for Disease Control and Prevention. Crucially, some of this impairment must have been in evidence by age 7; a proper diagnosis for a teenager claiming to have A.D.H.D., several doctors said, requires interviewing parents, teachers and others to confirm that the problems existed long before.

Many youngsters with prescriptions said their doctors merely listened to their stories and took out their prescription pads. Dr. Hilda R. Roque, a primary-care physician in West New York, N.J., said she never prescribed A.D.H.D. medicine but knew many doctors who did. She said many parents could push as hard for prescriptions as their children did, telling her: “My child is not doing well in school. I understand there are meds he can take to make him smarter.”

“To get a prescription for Adderall was the Golden Ticket — it really was,” said William, the recent graduate of Birch Wathen in Manhattan.

A high school senior in Connecticut who has used his friend’s Adderall for school said: “These are academic steroids. But usually, parents don’t get the steroids for you.”

Watch the downside

As with the steroids taken by athletes, the downside of prescription stimulants appears after they provide the desired short-term competitive benefits. This was the case with a recent graduate of McLean High School in Virginia, one of the top public schools in the Washington area.

Late in his sophomore year, the boy wanted some help to raise his B average — far from what top colleges expected, especially from a McLean student. So he told his psychologist what she needed to hear for a diagnosis of A.D.H.D. — even gazing out the window during the appointment for effect — and was soon getting 30 pills of Adderall every month, 10 milligrams each. They worked. He focused late into the night studying, concentrated better during exams and got an A-minus average for his junior year.

“I wanted to do everything I could to get into the quote-unquote right school,” he recalled recently.

As senior year began, when another round of SATs and one last set of good grades could put him over the top, the boy said he still had trouble concentrating. The doctor prescribed 30 milligrams a day. When college applications hit, he bought extra pills for $5 apiece from a girl in French class who had fooled her psychiatrist, too, and began taking several on some days.

The boy said that as his A-minus average continued through senior year, no one suspected that “a kid who went to Bible camp” and had so improved his grades could be abusing drugs. By the time he was accepted and had enrolled at a good but not great college, he was up to 300 milligrams a day — constantly taking more to stave off the inevitable crash.

One night, after he had taken about 400 milligrams, his heart started beating wildly. He began hallucinating and then convulsing. He was rushed to the emergency room and wound up spending seven months at a drug rehabilitation center.

To his surprise, two of 20 fellow patients there had also landed in rehab solely from abusing stimulants in high school.

“No one seems to think that it’s a real thing — adults on the outside looking in,” the boy said. “The other kids in rehab thought we weren’t addicts because Adderall wasn’t a real drug. It’s so underestimated.”

‘No way you’d notice’

The Sklar family lives near the top of a daunting hill in Ardsley, a comfortable suburb north of New York City. Ardsley High School sends dozens of graduates every year to Ivy League-caliber colleges. When students there use Facebook, they all know that its founder, Mark Zuckerberg, once walked the same halls.

At their kitchen table after school last month, Dodi Sklar listened as her ninth-grade son, Jonathan, described how some classmates already abused stimulants — long before SATs and college applications. An accomplished student who said he would never join them, Jonathan described the ease with which he could.

“There’s no way you’d notice — that’s why so many kids are doing it,” he told his mother. “I could say I’m going for a run, call someone I know who does it, get some pills from them, take them, come home and work. Just do it. You’d be just glad that I was studying hard.”

His mother sighed.

“As a parent you worry about driving, you worry about drinking, you worry about all kinds of health and mental issues, social issues,” she said. “Now I have to worry about this, too? Really? This shouldn’t be what they need to do to get where they want to.”

Asked if the improper use of stimulants was cheating, students were split. Some considered that the extra studying hours and the heightened focus during exams amounted to an unfair advantage. Many countered that the drugs “don’t give you the answers” and defended their use as a personal choice for test preparation, akin to tutoring.

One consensus was clear: users were becoming more common, they said, and some students who would rather not take the drugs would be compelled to join them because of the competition over class rank and colleges’ interest.

A current law student in Manhattan, who said he dealt Adderall regularly while at his high school in Sarasota, Fla., said that insecurity was a main part of his sales pitch: that those students “would feel at a huge disadvantage,” he said.

William, the recent Birch Wathen graduate, said prescription stimulants became a point of contention when a girl with otherwise middling grades suddenly improved her SAT score.

“There was an uproar among kids — some people were really proud of her, and some kids were really jealous and mad,” he recalled. “I don’t remember if she had a prescription, but she definitely took more than was prescribed. People would say, ‘You’re so smart,’ and she’d say, ‘It wasn’t all me.'”

One sophomore at Harvard-Westlake School in Studio City, Calif., is unsure what his future holds. Enrolled at one of the top high schools on the West Coast, he said he tried a friend’s Adderall this semester but disliked the sensation of his heart beating rapidly for hours. He vowed never to do it again.

But as he watches upperclassmen regularly abuse stimulants as they compete for top college slots, he is not quite sure.

“Junior and senior year is a whole new ballgame,” the boy said. “I promised myself I wouldn’t take it, but that can easily, easily change. I can be convinced.”

This article, “The Risky Rise of the Good-Grade Pill,” first appeared in The New York Times.

Copyright © 2012 The New York Times