Law Student Use of Adderall and/or Ritalin:
Here's a poll for current or very recent law students: In your experience, how common is use of the prescription drugs Adderall and/or Ritalin among law students who do not have a prescription to try to boost performance either for studying or for exams? Please pick the answer that you think best describes use of these drugs at your law school:
Among those groups it was most likely above 50%, in law school it's quite a bit lower than that.
Student scandals for us usually involve back signing the roll sheet (yes, we actually have mandatory attendance--and they wonder why we always surf the net in class)
For example, I am willing to bet that more than half of the top 25% in my class (by GPA rank) took them. In the bottom half of the class, far fewer took them (if any). This is not to say Adderral is causally related to higher GPAs. The people pushing to be in the top 10% were more likely to take the Adderral just because of their personality. These people were willing to work tremendous hours for a shot at moving up a few spots in the class ranks. They were also willing to accept any perceived risk associated with the "doping."
But be careful - estimating the extent of study-aid prescription drug use among students is more difficult than estimating the extent of recreational drug use or tobacco use on campus: recreational drug use and cigarette smoking are social activities, so students are more likely to see their friends engaging, or be invited to join. Study-aid prescription drug use, however, is generally done alone (even if the studying is done in a group), so you only hear about it when people discuss it with you.
And kudos, Prof. Kerr, on bringing up this issue for discussion. If it's not too personal, might I ask what caused you to post about this?
But I really have no idea, and I don't think I'd be surprised to learn the truth, one way or the other.
~ MD/PhD/JD('88)
I can see using it to go with less sleep in an emergency, but while the extra wakefullness could certainly be helpful I would guess that the (minor but existant) problems that occur when starting it up after not using it for a while would be more harm than help.
Typically, instead of taking them on a regular, supervised regimen, the addicts-to-be start taking them as you or I would take a cup of coffee: "Gee, I'm feeling tired and run down. Down the hatch!" They're literally addicted before they know it.
If you're doing this, please please please be careful.
- Alaska Jack
Relatedly, there was one guy who missed huge chunks of class every year, reportedly due to multiple stints in rehab for heroin. I'm pretty sure that's NOT a study aid...
The GW Law faculty had a presentation today about law student mental health, and one issue raised was the use of these drugs by today's law students. I hadn't thought about the issue before, so I wanted to get a sense of how widespread it is. (And I also figured that many others were probably as clueless about the issue as I was, so the results could be eye-opening either way.)
Adderall wasn't around when I was in law school -- it came on to the market in 1996, and I graduated in 1997 -- so I've never really thought about the issue before.
I did see some very odd behavior, though. At the time I put it down to caffeine and stress, and in certain cases I wondered about cocaine. But there may be another explanation.
I mean the reality is that if you're trying to outline a 1000 page casebook over a period with no classes in anticipation of an exam, people see an endurance advantage to coming in and taking it and sitting there, focused, for 12-13 hours straight every day. I can admit that the biggest enemy of the modern law student is distraction (thanks VC!), so it is theoretically a big advantage.
So I'm just saying that, like most other drug use, even where not entirely common there's a few outliers who become heavily dependent on it.
And I know of no one else at my school who uses drugs, with prescription or not, though I'm sure they're out there. Part of it is that I'm still embarrassed about being on adderall, and would never admit it to anyone -- I guess I feel that there's a stigma attached to the use of it, or that people who use Ritalin and adderall only do so because they're not able to cut it on their own. Assuming others feel the same way, a survey of what law students know about the use of drugs among their classmates won't be too accurate, since it's something that would generally be kept quiet.
When partners angrily ask me why I am not billing 250+ hours every month like associate so-and-so, I am always tempted to respond: "Because I am not on drugs."
And yes, it is very similar to meth. Indeed, some people take Desoxyn instead of Adderall -- and Desoxyn is meth. The difference, as I understand it, is the addition of an extra methyl group, which makes it more fat soluble, which makes it absorb into brain tissue quicker.
From what I've heard from people who tried both, they are almost exactly the same, except you can get the same effect with a lower dose of Desoxyn, by a ratio of about 2:1.
It has serious side effects and serious risks. On the other hand, lots and lots of people (both prescribed and not) use these drugs without very serious adverse consequences. Which, to my mind, somewhat undermines the overheated claims about meth that you occasionally hear in the media.
Also note that meth and substitutes have been widely used in other arenas (major league baseball, the Air Force, etc.) for decades. And all of those people did not turn into zombies with no teeth.
Getting an Rx for ADD meds through student health (here) is nearly impossible, requiring numerous interviews with skeptical counselors and testing over the course of weeks. I did it, but others found that going to private practitioners costs a bit more but they could get the Rx in a matter of days. Abuse by undergrads is very high, thus the skepticism. I think for JD and MD (and other professional) students the risks of illicit use is high enough to dissuade abuse in all but the most competitive. Undergrads and other graduate students don't have the bar/boards/licensing issue to temper their abuse.
Increased from what? How could you possibly know what they would have gotten without it?
However, I do study at the main campus library (the law school can be too much). I have seen undergraduates openly exchange these pills on multiple occasions. After working over the weekend on a paper at the library, an undergrad who had observed me asked if he could score some from me. Apparently, I needed a haircut and a shave.
I finally went to a private practitioner. She's an internist and she has been a complete joy to work with.
I would never let any of my friends know I am on it because a) it's law school and you aren't supposed to ever admit to any weakness and b) I wouldn't want people finding out and asking me for mine.
I take 20 mg every morning for most of the year but I definitely increase my dosage during finals.
I'll bite: what percentage of students use these drugs? (As opposed to abuse.) How's one to tell the difference?
Unless you are against coffee, you have to be against Adderall too. And don't give me the "well it's illegal" argument. Sure, but that's not relevant to why it's a problem. "It's bad because it's illegal and it's illegal because it's bad" is the most circular of logic.
"Unfair advantage" is the best answer as to why it's improper, but the unfairness of it stems only from the fact that it's illegal to use without a prescription, so buying some for the bar exam is thus unlawful. It's hard to disagree with the issue when it's phrased as "people who break the law and get away with it should not be rewarded." But if it were readily available over the counter, just like coffee, the unfair advantage argument would go out the window. Moreover, the very purpose of breaking the law is to acquire something otherwise unavailable (whether it's money, a high exam score, or the death of your ex-wife). With risk comes reward, they go hand in hand.
Finally, if a lawyer knows he can perform better for his clients while taking a drug, I think he has a fiduciary duty to take it so long as it will cause no physical harm. Of course there can't be a fiduciary duty to break the law. But that's why drug prohibition is so dumb. Prohibiting drugs that hinder, obstruct, interfece with, or otherwise reduce mental functioning and performance is at least understandable and somewhat rational. However, prohibiting drugs that cause us to perform better, whether it be mentally or physically, is simply asinine and irrational.
This is pretty funny. I can imagine the malpractice suit now against the lawyer who refused to take performance enhancing drugs.
I don't think I want to live in BruceM's world. =)
If that is the only benefit, how is it better/worse than the marketed Redbulls, 5-hr energy drinks, Monster and/or Rockstar?
Personally, I always preferred copious amounts of sleep to medication. ;)
I'm a double-majoring, double-minoring pre-law undergrad at a major university (with a 30 hr/week job!) who typically gets by on Red Bull and Folgers Gourmet Supreme, but around exam season I have a box of cheap, quasi-illicitly obtained modafinil that I break out. While on the stuff, I can do 72-hr sleepless marathons or two weeks solid of 3 hours a night (or, as was the unfortunate case last semester, both), and get pretty much entirely back to normal after a good night's sleep - none of the zombification that typifies my friends coming off a three-day Adderall binge. I've never actually used Adderall myself, so I have no point of reference to make a comparison.
I wouldn't say that Adderall use at my school is "rampant," but "prevalent" would probably be an accurate assessment - almost all of my friends have tried it once or twice at moments of peak stress, and a few of my friends use it on a regular basis. I think the only reason Adderall remains more popular than modafinil is because it is easier to obtain - few people have even heard of modafinil and name-brand Provigil is prohibitively expensive. I've shared mine on occasion, and most have preferred it to Adderall - however I have no intention of becoming a dealer. Slippery slopes and whatnot.
As for why it would be theoretically bad: I suppose it's the difference between eating a diet designed to help your muscles recover more quickly from a workout, and taking steroids to bulk up on strength. We do prefer that which is found in its (roughly) natural form to synthetic chemicals designed for the sole purpose of enhancing performance.
I didn’t conduct any formal surveys, and I obviously can't speak for all law schools, but my suspicion is that – at least in the higher-tier schools – this is a much, much bigger problem than most suspect. Normative questions aside, I’d be willing to bet that not using these drugs was the exception, not the rule.
In the dark ages when I was in school (1980's) I knew a couple of guys who took some new smart drug nose drops (or spray) around finals, but I don't remember the name.
On one hand there was definitely an improvement in concentration, but it had several side effects that worried me (especially heart palpitations). I think it may have helped me study for that month, but it was not anything spectacular. That semester (1st semester of 2L year) I had a B average. The next semester I did not take any Ritalin, studied as hard as I've ever studied in my life, and received all A's. This convinced me that I didn't really need it.
I do believe that some people with severe ADD, like my family member, do need it. But I also believe that it can be an unhealthy crutch, and that it is better not to use if if you don't have to.
Let's put it this way. Two equally qualified lawyers are in litigation and one of them took 10 to 20mg of adderall that morning. I will put my money on that lawyer to do a significantly better job during trial.
Free Trader: yeah it would be a wacky malpractice suit, no doubt. I don't think it would be too common because the client would somehow have to prove that that particular lawyer not only would have performed better, but knew he would (and knew that the drug wouldn't cause him any physical harm, i.e. not allergic to it). I wouldn't expect it to be a common suit, let alone one that's every very viable.
I even gave up coffee during law school because it gave me the jitters, which introduced mistakes. Stimulants were the last think I needed.
What I couldn't do was get rid of the PEOPLE who gave me the jitters, some of whom I now suspect of using stimulants to get by. So thanks, folks. (Mutters nasty remarks under breath...)
However, during the "pressure times" in law school I do develop an unhealthy addiction to Caffeine. In the 2 weeks leading up to finals and during finals I'm drinking several energy drinks as well as a larger number of cans of coke every day to keep focused.
Then after finals are over I go through caffeine withdrawals and generally swear off energy drinks for a while, but generally end up going back to them when I need to get a lot of stuff done.
My 16 year old son takes Adderall and it is highly beneficial for him, but I wouldn't call it "performance enhancing" by any stretch.
While I'm still at the undergrad level right now, I suspect that it isn't so "widespread" as it is highly popular in isolated circles. If you interact with a group of people that use it, it will likely seem more pervasive than it really is. One person with no real ADD problems could easily get enough Ritalin for 5+ people to abuse it - a 5mg pill, the smallest available, is enough for someone without ADD to experience a significant boost in alertness and focus for 4-6 hours. By the time I was 16, I was taking a total of 50mg of Ritalin a day.
Hmmm. Perhaps FL Law meant Adderall can only be prescribed by an MD with a specialty in psychiatry?
In any case, I'm surprised by the claim [that in FL only psychiatrists can prescribe Adderall]. I would have assumed that doctors have considerable discretion in prescribing meds (e.g., for on and off-label uses), as long as the script is medically indicated and can be justified.
/On anti-depressants, so the synergistic effects precluded me from ever taking them.
//I can't say that I would categorically refuse, sadly.
For the record, I graduated in 2001 and didn't use these and never even heard of anyone who did. But I am a smoker and hung out with the other smokers, so we had our own drug of choice (nicotine) without resorting to pills.
Well, tsdj, that could be b/c the drug form obtained by prescription have been manufactured according to very specific and controlled specifications, and NOT cooked up in somebody's basement with haphazard, make-do ingredients. I can very easily make acetyl-salicylic acid (aspirin) in the average general chemistry lab, but that doesn't make it pharmaceutical grade. Same concept for meth.
Also, just b/c a drug is the same type, doesn't mean it behaves exactly the same. Morphine and codeine are in the same family as cocaine, but don't have all the same fall out.
Most people who've taken both ritalin and adderall will say that adderall is many times more effective than adderall, which only acts on 2 of the 3 neurotransmitters adderall acts on (and adderall acts on them much stronger).
The difference between recreational use and medicinal use is either a legal triviality (a prescription, which is just something you've got to either have the money and insurance for, or just bother asking for --- they hand these out like candy), or the dose. Take a little bit, and it's a study aid, take more, and it's a party.
I also recommend dexedrine over adderall: adderall makes me jittery, but dexies don't.
Anyway, I am sure the average scores of the people taking adderall are better than the average scores of people not taking it. That's all that should matter.
However, at my medical school, I guess from personal experience (discussions with classmates about their stimulant use) that illicit or generally off-label stimulant use as study aids runs about 8% of my class. That is comparable to the average found in studies of off-label stimulant use among undergraduate students.
I would guess that the incidence of stimulant use increases as stress increases and sleep decreases -- we hear it used a lot by students and residents on surgery rotations -- and it would follow that if medical and law school are more stressful than undergrad, the incidence of stimulant use should be higher.
My classmates and I have talked with our county and state medical societies about doing research into the prevalence among medical students and physicians because it brings up a couple issues we find disturbing:
1. medical students are often graded against one another. access to a costly prescription drug provides an illegal and (even if legal) unfair advantage to a small portion of the class.
2. most people who use stimulants for study-aids get them from friends with prescriptions, however faking symptoms of ADHD is not uncommon, and physicians aren't catching the fakes.
3. in addition to faking, many physicians willingly prescribe the medications knowing it will be used as a study aid. This type of prescribing practice undermines physician legitimacy.
4. many studies have shown that physicians with addictions often have them in medical school, and they often involve medicine (although alcohol abuse is still #1).
I suspect that law students use stimulants as much as medical students (but perhaps are less trusting of their peers and so are not as open in their use). Even if they don't, I see some crossroads between stimulant use as a study aid and the legal profession, such as prosecuting physicians for fraudulent prescribing.
1. If non-disabled bar exam takers are substance-abusing psych drugs like this to gain a performance-enhancing endge over disabled persons with autism who do not take such drgus, isn't this a violation of Title II of the Americans With Disabilities Act that should enjoing the use of the present standardized A-B-C-D bar examination process?
and
2. Why shouldn't bar examiners be subjecting every bar examinee to a mandatory drug test at the ingate to the bar examination on bar examination testing days, and, if a bar applicant is found to be substance-abusing such performance-enhancing psych drugs, why shouldn't they be subject to a mandatory substance-abuse conditional bar examination like all the alcoholics?
I'm all for it.
And. I'll bet if bar examiners and bar associations actually did studies on the correlation of these bar examinee substance-abusers of performance enhancing psych drugs to those attorneys who have substance abuse problems that get them into client trust fund or other discrinolinary trouble, they would be one and the same.
"drgus" = drugs
"enjoing" = enjoin
"discrinolinary" = disciplinary
"I'm a 3L at a top 6 law school, and I've had a prescription for Ritalin since I was in middle school. No question that I lean on it much more than I should come exam time (they do help to pull the all-nighters), but my conscience is clean: I've never sold them and I've never even given them away"
Personally, I haven't used any of the other stimulant drugs prescribed for ADD while I have been in law school. However, law students definitely abuse them - in fact, I have been offered Adderall out of the blue by classmates in class after randomly declaring that I was tired and have declined their offers. I don't think very many students use it at my school, but a number of my friends from undergrad (now all at top 5 or top 10 law schools) have openly admitted - even boasted - about using Adderall to be able to focus during finals, and pretty much all of them used it before taking the LSAT. In fact, 2 days before I was scheduled to take the LSAT, one of my friends who was admitted to Harvard Law School nonchalently told me to "just take Ritalin before the test, that's what I did and got a 174."
I guess the point of this post is that abuse of these drugs definitely does happen by students wanting to gain an edge, and especially in law school, where you are graded on such a harsh curve against your fellow peers, I think it's horrible to do that for a number of reasons:
First, it is illegal to possess these drugs without a prescription, and law students who are getting geared up to be lawyers have no business breaking the law in this manner. What sort of precedent are they establishing re: their abilities to NOT break the law in practice??
Second, these drugs DO improve performance, often (but not always) unfairly. Admittedly, there are legitimate users: for example, I had a boyfriend who had ADD and was on Ritalin and when he didn't take it it was virtually impossible for him to focus for more than 5 minutes at a time, so I understand the legitimate need that some students have for these drugs. However, it is an illegal and unfair practice for students who don't need the drugs to take them simply to gain an edge over fellow students. Seriously, practicing members of the legal profession already have insanely high substance abuse rates, and this just perpetuates the trend.
Finally, I don't think that drug testing before things like the bar exam (and even the LSAT given the number of my friends who took ADD meds before taking that test) would be such a crazy idea - I forget who brought up such a proposition above. The bottom line is that we don't want cocaine abuse or other drug abuse to be prevalent among lawyers, and when people are already using drugs to gain an edge in getting good grades in law school or admission to the bar, that is not a good sign. Studying while amped up on speed for 12-13 hours in a row during the week before your finals does not = a good lawyer. Lawyers should like what they are reading enough to be able to just suck it up and read it.
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