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Detoxing During College

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Prescription stimulants are drugs that are frequently used to treat certain disorders, such as attention-deficit hyperactivity disorder (ADHD) and narcolepsy. They are beneficial when taken therapeutically, increasing energy, alertness, and attention. The effects of these drugs are mediated in large part by their impact on two important neurotransmitter systems: dopamine, which is responsible for feelings of pleasure and reward, and norepinephrine, which helps to regulate several involuntary processes, including blood pressure, breathing rate, and heart rate.1

Some examples of common prescription stimulants include brand name drugs like Ritalin and Concerta (methylphenidate), as well as Adderall (dextroamphetamine/amphetamine combination drug).1 They are classified as Schedule II controlled substances, which means they have an accepted medical use but also a high potential for abuse.2

College students often abuse prescription stimulants in order to stay awake for long periods of time, especially when they need to study or cram before exams, which is why they tend to refer to these drugs as “study drugs”. College students may also combine stimulants with alcohol to enhance intoxication. Nonmedical users of these drugs are more likely to report polysubstance abuse, including abuse of alcohol, marijuana, ecstasy, and cocaine.3

How Many Students Report Nonmedical Use?

College student using study drugs to stay awake
Prescription stimulant abuse is a serious problem on college campuses across the U.S. One report indicates that around 33% of undergraduate college students have abused a prescription stimulant in the past year to help enhance academic performance.4

Study drug abuse has grown significantly in recent years, with rates of use in college students increasing from 5.7% in 2008 to 9.8% in 2016. Adderall appears to be the prescription stimulant drug of choice for many college students; in 2016, Adderall was used by about 4 times as many college students (9.9%) as was Ritalin (2.4%).5

Who is More Likely to Abuse Prescription Stimulants?

Although it may be a popular belief amongst college students that the best students use study drugs, recent research shows that it is students who are struggling academically who most often seek out prescription stimulants. Non-medical stimulant users actually tend to have lower GPAs than non-users.6

Certain student populations may be more likely to engage in prescription stimulant abuse, including:6

  • Those who are heavy/binge drinkers or users of illegal drugs, such as ecstasy, cocaine, or hallucinogens; nonmedical stimulant use is generally part of a larger problem of substance abuse.
  • Those who are dependent on marijuana or alcohol.
  • Those who skip class more frequently.
  • Those who spend less time studying.

Overall, most college students who engage in study aid abuse appear to do so as a way to compensate for poor study habits, excessive absences, a lack of diligence in the classroom, and/or excessive partying.6

Common Misconceptions

There are a number of common misconceptions and myths about nonmedical use of prescription stimulants. In fact, one journal article quotes a distinguished physician as saying [with regards to prescription stimulant misuse], “It doesn’t seem to be causing too much trouble since most [students] use the drugs not to get high but to function better. When exams are over, they go back to normal and stop abusing the drugs.”6 This type of commonly-held attitude trivializes—and could actually perpetuate—the problem. Yet due to the pressure to achieve and perform, prescription stimulant abuse is, unfortunately, normalized throughout college campuses across the U.S.

Many college students think that they are using a study drug or performance enhancer that will possibly make them smarter, improve their memory, or improve their grades. They falsely believe that it’s okay to use the drug because they are using it to study. Yet they do so often without knowledge of the detrimental consequences of these drugs. And some college students use these drugs to get high, not to help them study. Stimulants are not benign substances, regardless of how or why the substance is abused.

Of course, prescription stimulants can be beneficial for people with a diagnosed medical problem—these drugs may help those with ADHD improve their academic performance by helping them pay attention and stay alert and those with narcolepsy to remain awake during the day. But for those without ADHD or narcolepsy and who are not taking the substance under medical supervision, stimulants can be very dangerous. What college students may also not realize is that it is illegal to use, give, or sell drugs that are prescribed to someone else.6

Signs & Effects of Use

Female student using study drugs
The nonmedical use of prescription stimulants is hazardous and can even be deadly. Abusing study drugs can result in a number of detrimental effects to your physical and psychological health and overall well-being. While you can’t always tell if someone you care about is abusing study drugs, certain signs could be an indication, such as:1,7

  • Giving up previously-enjoyed activities.
  • Displaying secretive behavior.
  • Failing to meet school, work, or interpersonal obligations.
  • Worsening of mental or physical problems.
  • Exhibiting aggressive, erratic, or violent behavior.
  • Experiencing anxiety or paranoia.
  • Exhibiting inexplicable euphoria.
  • Rambling speech.
  • Feeling depressed.

In addition, many dangers are associated with study drug abuse, including:1

  • Dangerously high body temperature.
  • Irregular heartbeat.
  • Heart attack.
  • Seizures.
  • Psychosis.
  • Coma.
  • Death.

Chronic abuse of study drugs can cause dependence, which means that you need the drug to feel normal and to be able to function optimally. In addition to the development of physiological dependence, consistent misuse of these drugs may lead to addiction, which is a chronic condition characterized by intense cravings and compulsive drug-seeking behavior, despite knowing the negative consequences of drug use. People who are addicted to or dependent on study drugs are likely to experience withdrawal symptoms when they suddenly stop using.

Some of common prescription stimulant withdrawal symptoms include:1,7,9

  • Fatigue.
  • Dysphoric mood (you feel generally unhappy and dissatisfied).
  • Depression.
  • Irritability.
  • Increased appetite.
  • Vivid and unpleasant dreams.
  • Insomnia or hypersomnia (sleeping too much).
  • Psychomotor retardation (slowed thoughts and movements) or agitation (unintentional, purposeless movements).

Detox and withdrawal from study drugs is not usually fatal, but sometimes, people can develop severe depression that could lead to suicidal ideation or attempts to cause self-harm.7

Abusing study drugs isn’t worth the risk you take with your physical and mental health. If you are struggling with compulsive use of stimulant drugs, quitting with the help of a formal detox program is an advisable way to ensure your well-being and best chances for a happy and healthy future.

Detoxing During School

If you’re in college and you are abusing prescription stimulants, you might be hesitant to seek formal treatment. You may be concerned that treatment could interfere with your education or academic program. If this is the case, the first thing you may want to consider is seeking out on-campus counseling services. In many cases, college counseling services are offered for free to students who are enrolled at the school. A qualified counselor can provide an assessment of your mental health and prescription stimulant addiction to provide a recommendation about the type of treatment that would be best for your individual needs.

People who have mild addictions or who haven’t been abusing prescription stimulants for a long time may benefit from meeting regularly with a mental health counselor on campus. This can provide you with the opportunity to learn healthy coping skills for when you feel cravings or when you encounter triggers to use. You may be able to schedule daily meetings for a specific period of time to help you become clean and sober. After you achieve and maintain abstinence for some time, you can likely reduce the number of sessions to a few times or once a week, depending on your counselor’s recommendation and how things are going for you at that point.

Another option could be that your counselor refers you to an outpatient detox program that takes place in a clinic, which allows you to continue attending classes while benefiting from professional treatment. In this case, you attend meetings that accommodate your class schedule, and then you return to your dorm (or apartment or home) to sleep. This can be a beneficial option (as with the campus counselor option) for people with mild addictions and for those who have strong social supports to help them (which isn’t always easy for college students to find). It’s also often helpful to participate in an on-campus recovery support group while attending detox or participating in sessions with a counselor. Additionally, you may also wish to consider living in substance-free housing if offered by your school.8

However, people who have more severe addictions, who have a co-occurring psychological or physical condition, who are addicted to more than one substance, or who have had a series of troublesome withdrawals or unsuccessful attempts to quit in the past may benefit most from inpatient detox. This is especially advisable if you are at risk of severe depression or suicidal behavior. Your counselor can refer you to local inpatient detox programs or substance abuse treatment programs that offer detox services.9

Male student distracted in class, concept of adhd
An inpatient detox program is not a complete course of substance abuse treatment but rather a set of interventions designed to help you stay as comfortable and safe as possible during the acute withdrawal phase. Inpatient detox centers offer 24/7 medical care and attention and can address any co-occurring medical or psychiatric needs you may have during withdrawal. When physical dependence is significantly severe, acute stimulant withdrawal can start within hours of your last dose and typically lasts 3-5 days.9 This timeline will differ depending on a number of factors, though, such as:

  • Your individual physiology.
  • Your average dose taken.
  • Your length of stimulant abuse.
  • Your co-occurring disorders.
  • Your method of administration (orally, intranasally, intravenously, etc.).
  • Whether the stimulant was long-acting or short-acting.

Because of this variation, you may remain in a detox center for as long as necessary to manage your study drug withdrawal symptoms.10

You might be worried that inpatient detox will cause you to miss class or get even further behind in your studies, situations which potentially trigger you to start using again. In order to avoid negative consequences to your grades and academic performance, you may want to consider talking to your professors about getting an extension on assignments (or you can ask your counselor to talk to your professors, if you’d prefer). In all likelihood, your professors will understand that your health is paramount and they will want to help you meet your needs. However, if you prefer not to disclose personal information to your professors, you might consider attending detox during a semester break or during your summer vacation.

Maintaining Sobriety

It’s important to receive ongoing support to maintain abstinence. Many college campuses offer recovery groups for college students. Attending these meetings regularly with other sober students can help cement your sobriety and help you avoid relapse. It can also be a way for you to find new friends who don’t abuse drugs or alcohol. If your campus doesn’t offer a recovery group, you may wish to consider starting one or participating in free off-campus support groups, which might include:

  • Narcotics Anonymous (NA): This is a 12-step group based on the original 12 steps of recovery originally formulated by Alcoholics Anonymous (AA). You submit to a higher power, work with a sponsor, and benefit from group support.
  • SMART Recovery: This is a secular support group that relies on self-empowerment and taking responsibility. It is not a 12-step group. They also offer online meetings if you are not able to attend in person.
  • Secular Organizations for Sobriety (SOS): This is another type of secular support group that is not spiritual or religious in nature. SOS offers online support groups if you cannot attend in person.

It may seem like a challenging endeavor to get sober during college, but it is possible. It’s never too late to seek counseling and professional detox treatment.

Sources

  1. National Institute on Drug Abuse. (2018). Prescription Stimulants.
  2. Lakhan, S. E., & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661–677.
  3. Sussman, S., Pentz, M. A., Spruijt-Metz, D., & Miller, T. (2006). Misuse of “study drugs:” prevalence, consequences, and implications for policySubstance Abuse Treatment, Prevention, and Policy1, 15.
  4. University of Maryland School of Pharmacy. (2016). Determinants of College Students’ Nonmedical Use of Prescription Stimulants and Recommendations for Campus Education.
  5. Schulenberg, J. E., Johnston, L. D., O’Malley, P. M., Bachman, J. G., Miech, R. A., & Patrick, M. E. (2017). Monitoring the Future national survey results on drug use, 1975-2016: Volume II, college students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of Michigan.
  6. Arria, A. M., & DuPont, R. L. (2010). Nonmedical Prescription Stimulant Use among College Students: Why We Need To Do Something and What We Need To Do. Journal of Addictive Diseases, 29(4), 417–426.
  7. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  8. Perron, B. E., Grahovac, I. D., Uppal, J. S., Granillo, M. T., Shutter, J., & Porter, C. A. (2011). Supporting Students in Recovery on College Campuses: Opportunities for Student Affairs ProfessionalsJournal of Student Affairs Research and Practice48(1), 47–64.
  9. World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. Geneva, Switzerland: World Health Organization.
  10. Center for Substance Abuse Treatment. (1999). Treatment for Stimulant Use Disorders.(Treatment Improvement Protocol (TIP) Series, No. 33.) Chapter 5—Medical Aspects of Stimulant Use Disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration.

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