"BILL" turned a corner when he started taking Ritalin three years ago. He had dropped out of high school, had a narrow brush with the law, and was facing an uncertain future.
A mate who had been diagnosed with attention deficit hyperactivity disorder gave him some Ritalin to try.
He liked it. He felt steadier, more focused. When he returned to school after a break of several months, he got a script, sailed through final exams and amazed his parents by getting into the university course of his choice, where he is now doing well.
Bill's was a success story.
But some of the other students at his Sydney school were not using their prescribed drugs the way their doctors intended. Instead they found a ready market among classmates, who were prepared to pay $1 or $2 a pill, sometimes up to $5 a tablet, depending on the strength of the dose, the Herald has been told.
Another former student recalls seeing a group of his classmates at one New Year's Eve party crushing Ritalin tablets to ''snort'' for a buzz.
Little wonder this widely prescribed drug has won the nickname ''kiddie cocaine''.
On university campuses, the trade seems even more widespread.
Hard data in Australia is almost non-existent. But anecdotally, increasing numbers of university and college students are acquiring ADHD drugs under the table to give themselves a brain boost.
''Karl' is studying psychology at a Sydney university. He said that among his circle, the use of ADHD drugs for non-prescribed purposes was ''very prevalent''.
And it was not just ADHD drugs they were using to get them past a deadline, through an exam, or to compensate for a weekend of hard partying.
They were also buying other cognitive enhancers over the net: drugs such as the sleep-inhibitor modafinil (sold as Provigil in the US) and selegiline, which is most often prescribed for sufferers of Parkinson's disease. Ian Hickie of the Sydney University Brain and Mind Research Institute says: ''We are unsure about the extent to which [so-called 'smart drugs'] are being used covertly in the Australian higher education environment. There has been no open dialogue about it here, as there has in the US, so there has been no systematic investigation.
''But we would be naive to think it wasn't happening.''
In schools there is even more ignorance about what is happening. The NSW Teachers Federation said the issue was not even on its radar, though schools had procedures for dealing with illegal drugs.
Ritalin is one of the two pharmaceutical stimulants most commonly prescribed for ADHD in this country, the other being dexamphetamine (known in the US as Adderall). More than 600,000 scripts a year are being doled out for these medications in Australia.
Until recently ADHD was seen as a childhood disorder but there is a growing trend for it to be diagnosed in adults as well.
There is also a substantial group who started on the drug in primary school, staying on it through adolescence and into young adulthood.
The more widely available the drugs have become, the greater the risk that they will be diverted to non-prescription or ''off-label'' use.
Iain McGregor, the professor of psychopharmacology at Sydney University, says: '' If you are a normal person using it, there is no doubt that there is short-term cognitive enhancement to be had.''
But because of the close pharmacological relationship of Ritalin and dexamphetamine to illegal stimulants, such as ice, methamphetamine (speed) and cocaine, there is also potential for addiction and abuse.
Ritalin is ''uncannily like cocaine in terms of what it does in the brain'', Professor McGregor said.
Overseas there has been an increasingly heated debate about the ethics of healthy tertiary students using prescription drugs such as Ritalin or Adderall to do better at their studies.
A Cambridge University neuropsychologist, Barbara Sahakian, has even raised the prospect of universities applying ''dope tests'' for those sitting exams.
Others argue that popping a pill to sharpen the brain should be seen as no different to other things people do to give themselves a cognitive leg-up.
A Stanford Law professor and neuroethicist, Henry Greely, took this line in Nature magazine just over a year ago, arguing that drugs such as Ritalin and Adderall ''should be viewed in the same general category as education, good health habits, and information technology - ways that our uniquely innovative species tries to improve itself''.
Professors McGregor and Hickie are having none of it.
Both point out that there is very little research on the long-term effects of pharmaceutical stimulants, particularly in people with normal brain function.
Professor McGregor says the National Drug and Alcohol Research Centre should be looking at the prevalence of non-prescription use of ADHD drugs.
''If you are chopping up Ritalin tablets or dissolving them and injecting them or snorting them, you are more or less taking the same risk as someone doing cocaine or amphetamines intravenously or intra-nasally.''
There are other risks when these drugs are diverted from their intended use, such as using them to prolong drinking binges.
Professor Hickie wants universities to move towards an agreed ''industry position'' or code of conduct on the use of so-called smart drugs, for health and equity reasons. Do they give some students an unfair advantage?
But some see the wider advent of these types of drugs as inevitable. As Professor Sahakian told The New Yorker recently, ''We are a society that so wants a quick fix''.
February 27, 2010
Sydney Morning Herald
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Ritalin is students' new drug of choice for parties and studying