As Aerika Brantley lay in bed, her mind would race, blinking with continuous surges and sparks of residual energy.
Enough hours staring at the ceiling eventually calmed her thoughts to a soft whir and allowed her to sleep, but once morning came around, she'd wake up, take a small white pill and send her mind cyclically sprinting once again.
Brantley started taking Adderall to treat her attention-deficit hyperactivity disorder, but found herself using her pills outside of prescription guidelines to keep up with life. Her medication would get her through early shifts at work and a full load of classes, but wreaked havoc on her sleep schedule, eating habits and general sense of well-being.
"I was basically spreading myself very thin and thought I was capable of doing it," Brantley said. "Even though my body was giving me a red alert."
Brantley is one of many who have fallen into the adverse effects of Adderall. The medication serves as a miracle drug for some, but for others, the threat of abuse looms.
As ADHD becomes more visible on social media, more and more people seek out diagnoses and subsequent prescriptions. But America's past and present infatuation with amphetamines compounded with vested interest from pharmaceutical companies raises alarm for the long-term effects.
The number of Adderall prescriptions sold yearly has proliferated extensively over the past handful of years. Women and individuals under 20 are two leading groups in the current growth of prescriptions.
Alongside this proliferation, a plethora of ADHD Instagram pages produce infographics and memes tackling everything from self-esteem to chores. TikTok help pages are popular, too, with content running the gamut from relatable videos to ADHD interior design.
John Barton, director of ASU's Clinical Psychology Center, often diagnoses and treats children and adults with ADHD.
Barton believes social media to be beneficial as those with the condition are more likely to find the information, treatment and support they need. But he sees trouble arise when trust falling into the internet, especially as certain ADHD symptoms overlap with the bulk of behavioral health disorders and the general anxiety permeating in the U.S. today.
"You see a post on social media that says, 'oh, you know, if you're restless and inattentive and stressed out, you probably have ADHD,'" Barton said. "[You think], 'that's it! That must be it!' When it might not be."
Adderall misuse among college students is fairly prevalent; a 2018 study conducted by the National Institute on Drug Abuse found nearly 15% of male college students included in the study reported misusing Adderall in the past year. Comparatively, the study found 8.8% of female college students interviewed for the study reported the same.
This gender disparity is commonly reflected in surveys related to college Adderall abuse, which in part could be attributed to the variance of ADHD symptoms across gender lines and the explosion of prescriptions written for adult women in the past couple decades.
According to a 2018 CDC report, Adderall prescriptions for women aged 15-to-44 increased by 344% from 2003 to 2015. Prescription stimulants can alleviate an array of ADHD or ADD symptoms, but they are also used habitually as study drugs.
Adderall's reputation as a foolproof study aide is not new by any means, said Benjamin Fong, a faculty fellow in Barrett, The Honors College, who has seen ADHD diagnoses grow steadily over the years. Amphetamines have "been a staple of the American cultural diet since the post-war period," Fong explained, with Benzedrine marketed as the first of its kind in '30s America.
Origins and growth
The American pharmaceutical company Smith, Kline and French first unleashed Benzedrine on the public as a decongestant in the early '30s. The medication came in a small plastic tube inhaler containing a cotton ball soaked in amphetamine oil.
The inhaler, available over the counter, evolved from a sniff to clear sinuses to a quick crack of plastic and ingestion of saturated amphetamine.
As an easily acquired and relatively inexpensive high, recreational use of amphetamines took root and blossomed in subcultures like bebop jazz, beatnik culture and the written reign of the beat poets.
The American Medical Association approved advertising for Benzedrine as a treatment for narcolepsy and minor depression, and later it found its footing as a weight-loss drug.
By 1945, SFK's civilian amphetamine tablet sales had grown to $2 million and showed no signs of slowing, but eventually dipped in the '70s and '80s when other stimulant drugs filled their place and pharmaceutical industry regulation became more commonplace, Fong said.
During the '60s, Americans faced an epidemic of abuse, coming to terms with the size, scope and consequences of prolonged amphetamine use. Amphetamine psychosis became more common, and health organizations recognized the widespread onslaught of dependence and addiction.
Nicolas Rasmussen, author of "On Speed: From Benzedrine to Adderall," the definitive history of amphetamines, notes current amphetamine use quietly matched and surpassed the height of the 1960s amphetamine epidemic about a decade and a half ago.
Considering the context of the first amphetamine epidemic, Rasmussen only sees the same pitfalls ahead.
"It's bound to fall from grace," he said.
He described the U.S. as a sitting duck. Harboring the bulk of the world pharmaceutical market, the absence of a universal public health care system, sky high drug prices and a social ethic prioritizing productivity — the very effects of amphetamines — it comes as no surprise domestic sales make pharmaceutical companies millions.
Fong also points to American cultural and institutional demands when it comes to amphetamines' continuous popularity.
It's not complicated, Fong said; there are few drugs that can mimic amphetamines' ability to lift your mood, keep you awake and help you lose weight as effectively. Although amphetamines can have intense side effects, the societal value of these three effects outweighs the potential danger for many, he said.
Depictions and discoveries
Fong doesn't see the trends ending anytime soon, nor does he see anyone causing an uproar over them. "We're still focused more on opioids and fentanyl, but I don’t really see much about amphetamines," Fong said. "They have serious side effects, especially for prolonged use, but they're extremely effective at meeting the strict cultural imperatives of American society."
As someone who was diagnosed with ADHD, Rowan Alper, a junior studying history and anthropology who uses she/they pronouns, first began exploring the possibility of medication with their psychiatrist. After a few weeks on Adderall, Alper found it to help them, and she’s now been taking it for a couple months.
Alper believes college culture romanticizes and abuses Adderall.
"'Oh I can just pop an Addy and get all my work done' — that's kind of this neurotypical way of looking at Adderall, when in reality it’s something that helps me with my basic daily functions."
It’s not that they wouldn’t be able to function without it, but, for Alper, Adderall helps them with the simple tasks, "like getting from place A to place B and making sure I eat breakfast."
Prior to beginning medication, Alper talked to two friends who were both diagnosed with ADHD. One said Adderall helped him immensely, while the other said the drug did nothing for her symptoms; this made Alper realize for herself, and for many others, trying a new mental health drug is largely a process of trial and error.
Brantley found her way to the same conclusion. After receiving her diagnosis and starting medication, she initially reveled in the sudden increase in confidence, engagement and efficiency.
But error eventually struck. And after enough bodily red flags and some skepticism, she quit cold turkey.
"It was hard," Brantley said. "Everything was mundane."
When Alper was growing up, they knew they were always different, but it wasn't until she found online communities discussing problems she had experienced that she recognized the reality of her situation.
"Social media is a really, really positive outlet for figuring out what exactly is going on," Alper said. "Hearing the experiences of so many diverse people and their experiences with ADHD, because no two experiences are exactly alike, everyone is going to have different symptoms."
De-stigmatization through online communities and discourse has allowed individuals to better understand their psychological needs, Fong said, adding that this de-stigmatization is implicitly coupled with the bottom line for pharmaceutical companies.
"It's good, it can be insulating in all the ways social media is, but the actual de-stigmatization … it’s really important, and it’s one, sort of, virtue to those kinds of spaces."
Self-diagnosing can be extremely helpful to understanding and grappling with mental health, Alper said, especially because of how difficult the medical industrial complex is to navigate as a young adult.
"An immediate pro is that it's much cheaper than going to a doctor and getting a formal diagnosis," she said. "It can be really stressful to go through the testing. The whole process of getting tested for ADHD takes, like, four hours and you have to do all these absurd tests and it's not fun."
One con to self-diagnosis however is its inherent barrier to medication. You're also likely to diagnose yourself incorrectly, Alper noted; they suggested participating in studies that offer informal diagnoses but stressed self-diagnosis is not an inherently "evil concept."
While the internet is becoming an oasis for mental health awareness, pharmaceutical companies are raking in profit from the influx of individuals looking for prescription medications.
What's to gain?
Pharmaceutical companies producing Adderall have a massive stake in normalization via social platforms, Fong said. "That's the inherent difficulty of talking about diagnoses and ADHD, and rising Adderall and Ritalin prescriptions, that the pharmaceutical companies are pushing it as well."
The U.S. is one of two countries in the world where direct-to-consumer drug advertisements are legal. This niche advertising field gives pharma companies a lot of leeway; when drugs are marketed as a product, rather than solely as a medical solution, the end goal can be more about getting as many new patients as possible than about getting patients who need the drug.
"Most countries realize that having extremely powerful corporations advertise very powerful prescription medication on TV is not a good idea," Fong said. "They want to sell a lot of pills. I mean, it's not rocket science."
Akin to Barton's sentiment that overlapping symptoms can cause diagnostic confusions, Fong noted how murky drug advertisements can capitalize on general anxieties and prodromes.
Pharmaceutical companies are engaging in awareness campaigns in extremely vague ways, he said, and they employ "descriptions of problems that almost every human being has" to make their product applicable to a broader population.
"It's definitely a tricky relationship because you never want pharmaceutical companies to have any more money than they already do," Alper said.
"It sucks, but you have to bite the bullet and continue that prescription because your mental health matters more than some corporation getting a billion more dollars. As much as it sucks, you have to put yourself first."
Reach the reporters at kiera10riley@gmail.com and ellefsonsam@gmail.com or follow @kiera_riley and @samtellefson on Twitter.
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Kiera Riley is a managing editor at State Press Magazine. She also interns at the politics desk for the Arizona Republic
Sam Ellefson is the Editor of State Press Magazine, leading a team of writers, editors and designers in creating four print issues each semester. Sam is a senior getting dual degrees in journalism and film studies and is pursuing an accelerated master's in mass communication at ASU.
