Procrastinating college students facing deadlines for their final term papers often pull an all-nighter or two just to finish on time.  How do they manage to stay alert?

In the old days, a large thermos of black coffee might have done the trick.

No longer.

These days many students have sworn off caffeine.  And besides, all those bathroom breaks make it harder to stay focused

Enter Ritalin – and Adderall.

The two drugs are among the most popular “stimulants” around.  According to a 2017 study, almost a fifth of U.S college students are using Ritalin and Adderall as performance-enhancing “study” drugs.

Where are they getting them?  Mainly from other students with legal prescriptions.  But also online through illicit providers or from campus dealers who specialize in off-the-book stimulants as well a wide array of party drug

Ritalin and Adderall are perfectly legal.  Typically they are prescribed in relatively small doses by a physician to control hyperactivity and lack of concentration in children, usually under parental care.  As those children grow up, they often become dependent on them, even to the point of addiction, studies show.

But in small doses, the health risks are considered fairly small.  The problem?  College students often take far too much of the medication, which can lead to a host of problems, including overdoes, strokes and heart attacks.

Public health officials and school administrators are worried about the trend.  According to campus health statistics, over 4,000 students end up in hospital emergency rooms annually due to stimulant abuse.  Some have become “hooked” on Ritalin or Adderall and vulnerable to abusing other illicit drugs

There are two types of users: those that rely on a stimulant primarily during test time – as a “study” dug — and those that abuse it recreationally.  The test-takers are not chronic users at all, but they may be underestimating the health risk of an excess dosage.

But other students treat the stimulants like a “party” drug.  They may crush the pills and snort them, or they’ll inject them intravenously.  And they routinely – and deliberately — exceed the maximum daily dosage considered “safe.”

Studies show that the effects of Ritalin abuse on the brain and body mirror those of cocaine and heroin.  Hard-core Ritalin abuses sometimes refer to the drug as “kiddie coke.”

Many Ritalin abusers – like meth uses that imbibe their drug to stay awake through double and triple wok shifts – have convinced themselves they’re not “addicts.”

They’re using the drugs to meet their obligations, and the drugs themselves are not actually illegal, they say.

But it’s illegal, of course, to acquire Ritalin or Adderall under false pretenses – or to buy a controlled substance from someone with a prescription.  It’s also illegal – a felony — for them to sell it to you.

But the drug is everywhere on college campuses.  Those with prescriptions often say they have more pills than they really need.  Daily use may cause insomnia, or they worry about building up a resistance to a drug they need to stay calm and focused.

And there’s an incentive to sell their excess supply to make easy cash — a $5 pills might go for $10 or even $25, students say.

Most students, it turns out, are still largely unaware of the abuse potential of the drug – or given its perceived benefits, don’t seem to care all that much.

In a 2008 study of 1,800 college students, 81% said they thought that the drug was only “slightly dangerous” or not dangerous at all.”

Anecdotal accounts of accidental Ritalin overdoses abound.  A student might take 5 times the recommended maximum dosage of 60 mg per day to complete a challenging exam and end up going into convulsions.  They realize they could have died.

But they’re still glad they took the drug, and probably will again.  Why?  Because it helped them get an A.

Efforts to crack down on stimulant abuse have also proven futile.

In 2007, the Food and Drug Administration approved the branded drug Vyvanse, a long-acting stimulant indicated for the treatment of ADHD, on the assumption that had a lower abuse potential than Ritalin.

But documented reports indicate that students are abusing Vyvanse at equally high rates as Adderall, with the same dangerous health effects.

Detecting Ritalin abuse isn’t all that easy.  Not only is the drug legal but those who abuse it don’t reek of marijuana or exhibit tell-tale signs of excessive drinking.

And the hospitalization and arrest rate is still relatively low compared to overdoses or busts for cocaine, for example. Many officials worried about campus dug use are still focused elsewhere.

“People on Adderall don’t pee in the hallways,” says Daniel Swinton, president of the Association for Student Conduct Administration and an assistant dean at Vanderbilt University.

And in the society at large, most of the focus on prescription drug abuse in recent years has been on opioids, especially Oxycontin.  Ritalin abuse rates seem to pale by comparison — but not on college campuses.

Some colleges have instituted policies that define illicit stimulant use as a form of “cheating.” That means students can be expelled from school for using the drug without a prescription.

But that only seems to happen rarely.   Sometimes students are caught drunk or using another illicit drug and their stash of ill-gotten Ritalin or Adderall is also found, school and law enforcement officials say

But the fact is, Ritalin and Adderall are largely a boon to students that genuinely need it.  Without the two drugs, many of those suffering from hyperactivity might never have made it to college, to begin with. This means cracking down on Ritalin abusers runs the risk of stigmatizing all users as prospective criminals.  For schools under pressure to expand and diversify their enrollments, that’s the very last thing they need.