Coming Into Focus

As final exams loom on the horizon for Marksmen in eighth to 12th grades, the question of how best to prepare is on every student’s mind. But when faced with the challenge, some may be tempted to cut corners

Scanning the back of the room for any remaining faculty announcements, Head of Middle School Warren Foxworth ’66 stands at the front of the stage in Decherd Auditorium, directing yet another Middle School Assembly.

Just a few rows away, Steven* sits in the eighth grade section. He can’t think straight. He’s short of breath, but he can’t convince himself to breathe.

That morning, he had taken his first Vyvanse, one of his sister’s. Just so his doctor could guide him toward the right dose.

He stands up in front of the hundreds of other middle schoolers and walks out. The medicine that was supposed to help him focus only made things worse.

Three years later, he became the dealer.

•••

Steven started selling Adderall his junior year. And every time he sold a pill, he’d remember that same feeling, that feeling of losing control of his body and his mind.

“I’m really cautious when I give it to people because of my first time taking Vyvanse,” Steven said. “I’m super nervous, and any time I gave this to people, I would try to tell them my story of having taken it and having a bad reaction.”

Despite those misgivings, Steven said he felt more comfortable selling stimulants in an environment like the one he sees here, where students are less likely to make dangerously impulsive decisions.

“At. St. Mark’s most people are inquisitive and worried about this kind of stuff, so before they take it, they look up what happens to them,” Steven said. “Because of that, I don’t think it’s as bad of a problem in a community like St. Mark’s.”

But Dr. Harold Urschel ’77, chief medical strategist at Enterhealth, a clinic that deals with all types of addiction, believes the only way to properly mitigate the risk that comes with taking stimulants is to consult with and have them prescribed by a doctor. No amount of student research, he said, can prove equally reliable.

“The misconception is that they are safe because they are prescriptions,” Urschel said. “That and because the FDA approved them and a doctor prescribed them. But they’re not safe. Would you ever take your best friend’s high blood pressure medicine? Would you ever take your best friend’s insulin? No. That’s a big deal. These medicines are only safe when prescribed by a competent physician and used in a way and the dose that they are prescribed. They’re not safe.”

Urschel contends that students often convince themselves that they aren’t in the wrong when, in fact, they are fully aware of what they are doing to their body.

“People justify all the reasons in the world to smoke pot or to drink when they’re not supposed to or use stimulants” Urschel said. “There are all kind of reasons, that’s just them talking to themselves to help themselves come to grips with the fact that they know they are doing something that they know is not the right thing.”

In place of using a stimulant to stay up late to study, Director of Counseling Barbara Van Drie recommends sleep above any drug to improve performance.

“I would almost say study less, sleep more,” Van Drie said. “Sleep would be so much better for you because you would have full access to your long term memory and rely on the fact that you've actually heard it in class at some point, and you could retrieve it. That would give you much better chance of doing well on a test. If you're sleep deprived, it's like you've been drinking. It's like you're going into a test drunk.”

However, for the students who are diagnosed with ADD or ADHD, Urschel emphasizes that proper use of these medication can prove to be largely beneficial.

“The people who are on it, we don’t want to scare you away” Urschel said. “If you really have ADHD, if a doctor has really taken the time to test you, and the only real way to know is called psychological testing where you sit and take a few tests.”

•••

After selling less than 20 doses of the stimulants he had been prescribed, Steven stopped supplying them to others, worried about the ramifications of being responsible for giving possibly unprepared students a medication with side effects that go far beyond what most students suspect at first.

Those side effects are the main reason senior Cole Arnett stopped taking Vyvanse after over a year of taking the prescribed medicine, even though it still helps him control his ADHD when he feels it’s necessary.

“I started taking it junior year [after diagnosis for ADHD] and it, for the most part, was pretty helpful,” Arnett said. “I was focused during the school day. I was getting stuff done. But the drawbacks were enough to this year, with a lower workload senior year, I stopped taking it unless I really need to for certain days.”

Because of the tolerance he slowly developed to the medicine, Arnett and his physician slowly increased his daily dose from 20 milligrams to 70. At that point, the medicine truly began to take a toll on his well being, even though it helped him through the rigorous academics of junior year.

“My dosage was heavy enough to where, last year, I didn’t eat lunch, and I would have small dinners,” Arnett said. “I would skip breakfast. So I lost a bunch of weight last year. Sleep was also tough to get. There were definitely weeks my junior year when I would sleep one or two nights during the week, then the rest of the nights I would just stay awake doing work or other random stuff.”

While those side effects are a key piece of an ADHD-affected student’s experience with stimulants, those are only a small portion of the dangers Urshel sees for non-ADHD-afflicted teens taking those medications, dangers that can lead to addiction in a very short time span.

“If you use somebody else’s ADHD meds, it’s like you’re cheating,” Urschel said. “It’s not you. You change your brain and maybe you can really study and really cram and you do really well on that test. Well, then what’s going to happen next test? You’re going to be tempted to do it again. It’s not like you’re doing the studying beforehand. It gives you less confidence that you can do it on your own, and then you get trapped.”

According to neurohospitalist Dr. Spencer Miller, who owns and operates the Neuro Performance Center neurology clinic in Dallas, there are two sides to the addiction coin.

“In general, mothers and fathers who ask me, ‘do we want to start my kid on this medication?’ are worried that it might make their child an addict,” Miller said. “In reality, if Adderall is prescribed in a proper dose by the physician and used as it’s prescribed based on the response of the patient, then it actually reduces the chance of that person becoming addicted to something else.”

When it comes to students not prescribed these medications, according to Miller, the effects can be detrimental to their mental development.

“On the other side,” Miller said, “if you are misusing it, when you have that withdrawal, your brain will crave other things and can actually make people do things not as bright as they normally would and become addicted to other drugs. It helps if you use it correctly. If you’re misusing it, it can lead into something else such as marijuana, alcohol or heroin abuse.”

While, according to Urschel, the misuse of Adderall or similar stimulants will not cause permanent damage, the short term effects can often lead to other issues with the use of and addiction to related medications.

“When you use substances that you’re not supposed to, you don’t get addicted usually right away,” Urschel said. “What happens is you injure your brain. The more you use the more you injure it. You don’t damage it, but you do injure it. You get hurt like when you break your arm. If you break your arm you put it in a cast and it heals. You take the cast off and your arm’s fine. That’s kind of how your brain is.”

Ultimately, Urschel believes that abusing drugs such as Adderall is a zero-sum game, where there are no real short or long-term benefits to the user.

“Are St. Mark’s and other high schools hard at times? Of course, but it’s less hard if you plan and you focus and you do what you’re supposed to do,” Urschel said. “A lot of times there’s a lot of temptation not to do that. Then with social media it seems like everyone is doing it and it’s really safe. They go online and on the internet and they read more blogs about it and stuff like that. It’s all inaccurate data. These are very powerful medicines that are very helpful when used appropriately and are very destructive when not.”