By BENJAMIN MARKS
It was the tail-end of the university semester, and architecture student Georgia Balme had bigger workloads and less time to complete them. As her long day of study drew to a close, she still lacked any appetite.
Her heart rate had been high for hours, and as the evening wore on she became increasingly irritable and anxious.
This, she thought, was probably because of the things she had consumed to assist her in studying. She had drunk two coffees and more importantly had taken two different ‘study drugs' – Dexamphetamine and Modafinil.
As she lay in bed still wired and struggling to rest, at the front of her mind was the rapidly approaching time she was supposed to wake-up. She worried how she was she going to function the next day with so little sleep?
For many Australian students, using prescription medications while studying is normal. It’s a phenomenon known as pharmacological cognitive enhancement, or PCE, and it’s been increasing in popularity around the world, partially driven by the increasing availability of the drugs.
Since study drugs are controlled substances, health professionals have voiced concern over their increasing availability and use on campuses.
There are many different types of study drugs. The most common in Australia are all central nervous system stimulants. These prescription-only medications are generally used for treating Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy.
Firstly, there are the stimulants like Dexamphetamine (AKA. ‘Dexies’), Methylphenidate (Ritalin) and Lisdexamfetamine (Vyvanse). They increase the amount of dopamine and noradrenaline in the brain.
Dr Tracey Gaspari, a pharmaceutical research fellow at Monash University, explained that for people with ADHD, this “enables better management of attention and other behavioural symptoms”.
“Ironically, although it’s a stimulant, it helps people with ADHD to focus and maintain a sense of calm,” she said.
The other alternative, Modafinil, is known as a eugeroic stimulant. It’s newer than the others and is usually prescribed in the treatment of narcolepsy - being a “wakefulness-promoting agent”. The jury is still out on exactly how it works.
There’s a possibility that it masks fatigue or that it increases adrenaline levels, leaving users feeling more alert. What we do know is that like the other psychostimulants, it affects the brain’s dopamine levels – crucial in learning, motivation and reward control.
Students use the drugs expecting similar benefits to those with ADHD.
Biomedicine student Ben Spinks said he has used all four of the common study drugs.
“They allow me to study at a more efficient level for a longer amount of time and I can retain information late in the day when usually I’d be exhausted,” he said.
“It’s really good if you have a whole lot of lectures to get through, or a whole lot of rote learning.”
Generally, students seek to improve their concentration, alertness, memory, cognitive performance, grades or mood.
During busy periods at university, Ms Balme said she uses the drugs to help her focus for longer.
“My study can get very monotonous and sometimes I’m sitting on a computer for like eight hours… It helps me get in the zone,” she said.
“Even though I don’t have ADHD, our modern lifestyles are so distracting…between phones and social media it’s hard to focus. They kind of help me forget about whatever else is going on.”
The way the drugs affect mood is also considered to be an important motivation for students taking them – even if they don’t know it.
Students can buy study drugs online, from dealers, or people who suffer from ADHD.
Mr Spinks said, “getting them is very, very easy. Pills usually cost between $1 and $5”.
Little is known about how the drugs affect university students and there are risks involved in using them.
Dr Graham Hocking, a psychiatrist with expertise in ADHD, said students using study drugs is a health concern.
“If a healthy person took them once or twice a week in full control of what they were doing… then it would be low risk… but young people don’t think of the possible side effects of these drugs, or of the interactions with other drugs," he said.
"Taking them without medical supervision is always a risk.”
In the short term, there are a number of possible side effects. Headaches, nausea, anxiety, muscle twitching, problems sleeping, aggression, fever and skin rashes are some examples.
Study drugs also raise the heart rate and blood pressure of users and can be very dangerous for people with heart abnormalities.
Dr Hocking said, “the stimulants can then cause a heart defect and there have been sudden deaths associated with people that have had pre-existing cardiac abnormalities.”
Dr Gaspari added, “a lot of young people don’t know what their blood pressure could be. If you drink a whole lot of coffee at the same time and then add sleeping problems. It puts a lot of strain on the body.”
The amount of the drug ingested also determines the severity of side effects, something that students may not consider.
Mr Spinks said, “there were times when I was doing way over the prescribed dose and times when I did less than that… I often used them while I was already drinking coffee.”
Study drugs can also cause some longer-term side effects, particularly if they are abused.
Dr Hocking said, “if students use the drugs for more than just study they could develop an addiction."
"The other thing that could happen is that people can get sleep deprived which can cause a host of other problems,” he said.
Long-term use can also cause reliance on the drugs.
Ms Balme said the drugs can make her anxious and have a loss of sleep, which creates an unhealthy cycle.
“As painful as it can be though, it’s the price I pay to get the work done sometimes,” she said.
Treatments for ADHD give a “high”, said Dr Gaspari, and this can be addictive. Psychologically, long term use could lead to a “form of depression”.
It’s hard to say exactly how this phenomenon will evolve because there are some conflicting ideas around how effective education on the topic is.
Some evidence suggests students who are aware of the potential harms of the drugs are less likely to use them. But education on the risks and potential side effects are of little concern to most users.
A number of universities in North America have banned the use of study drugs, but until such attitudes are widespread, it’s unlikely things will change dramatically.
It seems that at least for now, the best approach is to make students aware of how they work so they can make informed decisions.