Case in point: S., who asked to be referred to by the initial of her nickname, was heading home on the subway the other day, midway through her second week of classes at an Upper East Side private school. Across from her, a guy in his twenties was fiddling with a Game Boy, which made her realize how long it had been since she’d done something stupid and childish like played Nintendo. Though she had only just turned 16, she felt old and weirdly nostalgic, which led to her starting to stress about school. It was now junior year—the one everyone tells you means everything—and she still hadn’t made it through her summer reading, The Mill on the Floss, George Eliot’s 560-page novel known for its mastery of nineteenth-century British dialects. Another year of questions, quizzes, worksheets, papers—and already her brain felt like it was overheating. “That’s when I was like, Okay, I need some Adderall,” she told me.
Similar to Ritalin, Adderall is prescribed to treat attention-deficit disorder, and it can be thought of as a parent’s best dream and worst nightmare synthesized into tiny orange and blue pills. “It makes you a little euphoric,” explains Dr. Turecki, “and it truly will help you concentrate on a paper or pull an all-nighter if you have to, which lends it to dependency issues.” It also zaps your appetite, making it especially popular among image-conscious teenage girls. S. first tried Adderall her freshman year—when she was 14—grinding up and snorting a pill “just because,” and found herself using it more last year, both for school and because it was similar to cocaine, a drug introduced to her through a friend’s older sibling. “You swallow Adderall to study, and snort it for fun,” S. explained during one of many long chats we had over the past month. “Whenever I couldn’t get a dealer I snorted Adderall instead. A lot of people use it when they’re trying to quit coke, because Adderall gives you the same rush—well, not the same, but close. The comedown isn’t as intense, either.” (As it happens, the NIDA is sponsoring studies on whether drugs like Adderall could be effective in curbing cocaine addiction.)
S. is a pixie of a girl, so thin and tiny it makes her self-conscious, namely because teachers often ask if she has an eating disorder. (“I don’t! I’m just like this—I want to be fatter!”) Her black hair is always meticulously straightened, her lips coated in gloss, her wardrobe a mix of hipster and prep. A vegetarian who makes a single exception for Gray’s Papaya, she wavers between Jaded New Yorker (bemoaning the meatpacking-district club scene and how “fake” all her private-school friends are) and Archetypical Teen (playing laser tag in Times Square; deconstructing The Family Guy). She can be charming, brash, introspective, shy, mean, sarcastic, and heartbreakingly kind within a single conversation. When I asked where she gets Xanax, which she’s taken “here and there” since she was 14, she looked at me like I was lobotomized and said, “Xanax you steal from your parents. All my friends’ parents are strange and depressed, these housewives who don’t have anything to do with their lives, the classic depressed mothers who have so many pills. I know it’s a stereotype, but it’s true. I feel sorry for them.”
Though she’s also tried codeine, Focalin, and Ambien—as well as the antidepressant Celexa accidentally when a friend thought it was Concerta, another pill S. has sampled—she likes Adderall the most. Last year, she took two 25-milligram pills (twice the standard prescribed dosage) an average of three times a week because “you study literally until your brain can’t absorb anymore.” Not that it doesn’t have unpleasant side effects: Adderall made sleep nearly impossible, which tweaked her moods—and upped the appeal of Xanax. “You’re really happy, and then you get depressed and start thinking about things you don’t want to think about,” she said. “One of my friends snorted Adderall right before an exam, and during the test he started breaking down crying.”
“We got back to my house by 1 A.M. and had the coke jitters, so we snorted a milligram each of Xanax and passed out. You know, it’s good for anxiety but it really works to counteract cocaine.”
She decided to make a brief stop before going home, heading to Union Square—she knew that the skater kids dealt Adderall. Walking into the park, she thought about her mother, who a few days before had delivered a familiar lecture—big year . . . need good grades . . . better than normal . . . if you really want Cornell . . . your future—which had been gnawing at S. ever since. A few minutes later, she was approaching a scrawny, pimply kid wearing baggy black pants, his hat turned sideways.
“What’s up?” S. said.
“You got any Adderall?”
It was her use of Adderall, in conjunction with cocaine, that resulted in S.’s expulsion from the all-girls private school she attended last year—despite the fact that her grades had gone from B’s to A’s. She found herself in rehab, which she accepted at first, agreeing that cocaine—and only cocaine—had become a problem. Tessa Kleeman of the Freedom Institute says that she’s seen a dramatic increase in cocaine use among private-school kids over the past year—perhaps partly owing to the fact that kids grow more accustomed to the idea of inhaling a powder first through prescription drugs. “Oh, that’s definitely true,” S. said when I asked about this.
Her rehab experience quickly soured once therapy was introduced. “My mom thought I was really fucked up, so she made me see a therapist,” S. said. “And I hate therapists. They’re sneaky, nosy, and manipulative. I’ve just never really believed in psychiatry.” This is a common outlook among people her age: A recent government-funded study led by Dr. John S. March, a professor of psychiatry at Duke, found that taking Prozac was more effective for teens than traditional therapy—findings that wouldn’t surprise S., considering that after “only my third session” her therapist suggested that she go on Prozac, Zoloft, or “some other ones that I hadn’t heard of.” She refused. It wasn’t that she didn’t think she was depressed—losing her parents’ trust tortured her, and earlier in the year a close friend she had briefly dated had committed suicide. He was a freshman in college, and used to confide in S. about how he was depressed, mainly because he wasn’t doing well in school. “Of course, I didn’t really think about it, because a lot of people are depressed, and everyone always says they don’t want to live anymore,” she said. He called her the night he died—she didn’t feel like talking to him and didn’t answer her phone—leaving her with what she knew was the irrational feeling that “I could’ve somehow prevented it.” At his funeral, she had an anxiety attack: crying, loss of breath, her knees so weak she collapsed. A friend gave her some pills—“I don’t even know what they were; Xanax, I think”—which helped her relax. Yet when, just a few weeks later, the therapist suggested she go on antidepressants, she felt as if people were trying to control her moods. She’d taken prescription drugs for years, she knew what they were all about, and didn’t need a doctor—or, for that matter, any adult—trying to convince her otherwise.