By Jennifer Schnellman, PhD, and Lucy Berrington, MS

Screenshot of a digital magazine pageAs exams approach, students may look for ways to help them stay alert for extra study. Those methods may include prescription stimulants and other medications that they believe could sharpen their thinking or enhance their wakefulness. The March issue of Student Health 101 explores students’ use of substances in five categories (Ask a pharmacologist: Can I take something to boost my brain?):

  • Caffeine, energy drinks, and yerba mate
  • “Wakefulness” medications (e.g., Provigil)
  • Nicotine
  • “Nootropics” or smart drugs (e.g., piracetam)
  • Prescription stimulants (e.g., Ritalin)

Communicating effectively with students about any substance use involves acknowledging their motivations for use, as well as providing evidence-based information about the possible effects. These four messages can help students make informed decisions about using medications that were not prescribed for them or were sold with other intended uses:

1            Choosing to use any substance means accepting some risk

This is true whether the substance is legal or illegal, prescribed or over-the-counter, and socially acceptable or stigmatized. If you self-medicate, you may not be aware of the possible risks of a drug or adequately factor them in.

2            If you choose to use, know exactly what the substance is and whether it can potentially generate the effect you want

Ask yourself three questions:

  • What exactly is this drug or substance? Students’ knowledge of drug names and effects is often vague.
  • What is the active ingredient in this drug or substance? It’s important to read all drug labels carefully, check the active ingredients, and make sure you’re not doubling up.
  • What effect could this drug or substance have on me? This is variable, and determined by your genes, health, other substance use, and additional factors.
3       If you choose to use, learn about dosing

It is not true that if a little bit of a drug is good, more must be better. When there isn’t much wiggle room between a therapeutic and a toxic dose, there’s a high risk of overdosing. For example, 20 micrograms of fentanyl, a potent analgesic, can relieve pain. But as little as 2 milligrams of the same drug (an amount equal to two grains of sugar) can be fatal. The right dose of any substance also depends on your health, age, and genetics. The same dose of the same substance may be ineffective, therapeutic, or toxic to different people.

4            If you choose to use, anticipate any negative effects on your functioning

Using drugs or substances can have affect how you feel and function in the next few days. “Adderall or huge caffeine consumption might help you stay up and get the paper done, but you’ll be depleted the next day,” says Steve Lux, a former senior health educator at Northern Illinois University. You can anticipate those effects and to some extent prepare for them. “If you’re going to burn through the nights during your exams, make sure that for one to weeks beforehand you are getting good sleep and taking care of yourself.” Note: No amount of rest or nutrition can mitigate the side effects of drugs.