An earlier version of this story and of the accompanying graphic were originally published in Inklings News, the student newspaper of Staples High School in Westport, CT.
Jane was studying for an upcoming test in the library at Staples High School when a classmate approached her with a simple “fix” to her stress: Adderall. The student said that if Jane wanted pills to help her focus, they could easily sell her some of their own prescription. She declined. (Jane’s first name has been changed and last name is being withheld at her request.)
“I was really taken aback,” she said. “I didn’t know that there was a culture of that here.”
The use of unprescribed stimulants like Adderall among teens appears to be on the rise, at least in some parts of the country. While nationally, the percent of adolescents between ages 12 and 17 misusing those drugs is just .9%, according to a 2022 government survey, that figure masks a lot of variation. A study published in the journal JAMA Network Open found that up to one in four middle and high school students in some locations report misusing prescription stimulants. This may be linked to schools where performance expectations are high or to an increase in prescriptions: From 2022 to 2024, Adderall (dextroamphetamine) prescribed in Connecticut, for instance, rose by 11.4%, according to state data. Off-book use carries risks, as students at Staples High have experienced, and as experts attest.
Stimulant medications are used to control impulse and energy levels by altering how the brain uses two key chemical messengers, dopamine and norepinephrine. These neurotransmitters play major roles in motivation, attention, mood, and the body’s stress response. A person with ADHD has a brain that struggles to regulate its own attention and arousal, so medication helps to improve clarity and focus.
Millions of Americans are prescribed and benefit from taking Adderall or other similar drugs, doctors say. According to the CDC, approximately 6% of adults in the U.S. had an ADHD diagnosis in 2023, about one-third of whom reported taking prescription stimulant medication. Roughly 5% of children are currently prescribed medication for ADHD. According to a study conducted by researchers at Washington University in St. Louis, compared with children with ADHD who did not take a stimulant, children with ADHD who took a stimulant medication had better grades in school (as reported by their parents) and performed better on cognitive tests administered during the study.
But when people without ADHD take the medication, short-term boosts in focus come at a cost — the drug has side effects, without providing the therapeutic benefit.
Emma, a senior at Staples High whose name has been withheld since off-book possession is a felony and against school rules, admitted to occasionally taking unprescribed Adderall, provided by a friend, in order to prioritize schoolwork. She said Adderall helps her focus and complete her work, but she ultimately decided to limit her use due to unwanted side effects. “Since I took it in the afternoon [4 p.m.], I couldn’t fall asleep until almost 4 a.m.,” *she said.
Continuous abuse is also a risk of taking Adderall without a prescription, which is classified as a Schedule II controlled substance. Students who misuse stimulants have a 5% chance of getting addicted, according to Dr. Randi Cohen, a Westport psychiatrist.
James, another anonymous senior at Staples High who has taken unprescribed Adderall on multiple occasions for schoolwork, described experiencing dependency. “I only really take it when it’s really needed and even then I’ve been trying to stop,” he said. “I got kind of reliant last year at one point, to the point where I couldn’t focus without it.”
Experts warn that when someone abusing the medication suddenly stops, dopamine levels crash, and the brain struggles to adjust, losing motivation, energy and focus.
Taking unprescribed Adderall can also have other serious consequences. In rare instances, it can cause psychosis, which might be tied to dosage, an outcome Cohen has seen several times and says “is often irreversible.” According to research from Johns Hopkins University, between 2006 and 2011, ER visits associated with non-prescription Adderall use rose by more than 150%.
Part of the problem with students taking Adderall unprescribed, Cohen said, is they risk taking a higher dosage than they can handle, which can intensify side effects. Correct dosages depend on factors such as age, medical history, the severity of ADHD symptoms, comorbidities, height and weight. When James was taking 20mg of Adderall, a dose he said was too high for him, he experienced high stress, “and was sweating a lot and felt like I had a really high heart rate,” he wrote in a text message.
There are also risks for teens who mix Adderall with alcohol, which is often done for social reasons. According to Cohen, stimulant drugs make it harder for the body to regulate alcohol, which makes it hard to know when you have had too much to drink.
“My friends have taken [my prescribed Adderall] before going out,” said Ally, an anonymous senior at Staples. “If you mix it with alcohol, it will make you feel not as intoxicated. But it’s also bad because you think you’re fine, and then you get really sick.”
Additionally, mixing alcohol and stimulants increases impulsive behavior, which could lead to reckless decisions, said Cohen.
As is true at all schools nationwide, students’ use of unprescribed stimulants is not tolerated by Staples High school. At Staples, the use of stimulants can result in a five-day in-school suspension or a 10-day out-of-school suspension; selling or distributing stimulants can lead to a five-day out-of-school suspension, expulsion or possible police referral. In other states, the policy is similar: The California Education Code 48900 EC permits public school students to be suspended or recommended for expulsion if they possess drugs.
“I definitely would warn students to be aware of [stimulant dangers],” Cohen said. “And also families to be aware of their stimulants being where kids can get to them or people having their stimulants where their friends might unscrupulously get to them.”
