Dear Dr. Jeff: Is there anything wrong with occasionally sharing a friend's Adderall? ?T.F.

Dear T.F.: Actually... There are some pretty compelling medical and legal reasons not to share Adderall.

Let's first get right to the legal bottom line. Adderall is a Schedule II Controlled Substance, and by federal and state law, it is only available by special, restricted prescription for supervised treatment of specified medical conditions. Taking someone else's Adderall is illegal. Giving someone some of your own Adderall is illegal. Selling a friend some of your Adderall is illegal. In fact, selling Adderall is dealing, and constitutes an unambiguous violation of state and federal drug trafficking laws as well as College policy.

That being said, on college campuses nationwide, stimulant medications like Adderall and Ritalin are frequently traded among friends as "study aids." At Bowdoin, nearly one in 5 students surveyed has reported doing so during the previous year. More informal surveys suggest even higher rates of sharing. Is this safe?

Regular doses of stimulant medications may not be particularly benign. Common side effects include loss of appetite and weight loss, inability to fall or stay asleep, abnormal heartbeats, abdominal pain, and abnormal muscle movements and twitching. Possible side effects include elevated blood pressure, chest pain, shortness of breath, dizziness, skin rashes, anxiety, psychosis, and manic and schizophrenic breaks. While all of these side effects are likely dose-related, and reversible after stopping the medication, they are not always or universally so. And these possible side effects are not uncommon. A recent study found that nearly one in 10 children placed on stimulant drugs for ADHD develop psychotic symptoms, fortunately reversible as soon as the medications are withdrawn.

Stimulants cannot be taken safely if you have an underlying seizure disorder, cardiac condition, glaucoma, pregnancy, or narrowing of your esophagus, stomach or intestines. They can have very dangerous interactions with other drugs.

The cardiac risks of stimulants, in particular, have recently gotten a lot of press. The Food and Drug Administration recently imposed new "black box warnings" for Ritalin and related medications, specifying that they may lead to increased risk of sudden cardiac death. Adderall and Adderall XR have carried this exact same warning since 2004.

I am not trying to "scare" you away from Adderall or other stimulants. I'm just trying to point out that there are very real risks to taking these medications, and that these risks need to be thoughtfully considered in the context of your medical history and an understanding of your physical and mental status and needs. Treatment with Adderall, like treatment with any prescription medication, involves more than just prescribing or dispensing. It also includes monitoring for side effects, and continually evaluating the risk-benefit ratio of treatment.

One final point, T.F. If you are struggling to keep up with your academic work load, you'd be well advised to talk it over with your advisor and/or dean. Staying up late on Adderall to study or to write a paper is not the answer. There are many other ways to better and more safely manage your time and your workload.

And if you are having trouble concentrating, remember that the likely causes are inadequate sleep, diet or exercise, recreational drug or alcohol use, stress, depression, or anxiety. You may want to come into the Health Center or the Counseling Center to look into those possibilities.

Be well!

Jeff Benson, M.D.
Dudley Coe Health Center