People are well used to seeing performance enhancing drugs in the world of sport, but now chemical enhancement is spreading to the world of academia as students go to extreme lengths to get the right grades.
EPO. Nandrolone. THG. Ephedrine. Anybody who follows sport will have heard of these performance enhancing drugs, usually accompanied by the word "cheat".
Now students are taking the same route, using illicit drugs to gain an advantage over their peers in the exams that will shape their lives.
Students have long used plentiful cups of coffee, as well as caffeine in pill form, to stay up revising late into the night. But now some are going a step further and taking "study drugs".
At the top of the list of study drugs are Ritalin, a drug prescribed to children who suffer from Attention Deficit Hyperactive Disorder (ADHD), and Modafinil, a narcolepsy drug. If not prescribed, Ritalin is a class B drug in the UK, meaning possession can lead to a five-year prison sentence and dealing could put you behind bars for 14 years. Modafinil is also not available over the counter.
So why are students taking them? Modafinil and Ritalin are drugs that stimulate the brain. They make people feel more awake and alert, and help control the behaviour and concentration of children with ADHD.
"It helps me stay awake and stimulates my mind," says Linda - not her real name - who graduated from Manchester University in June.
The 22-year-old psychology graduate took Modafinil with a group of friends several times while working on her dissertation. She used the drug to help her "pull all-nighters" and said that it allowed her to focus on her work for hours at a time.
"It's a stimulant, similar to caffeine or Red Bull although I didn't get distracted and feel jumpy like you sometimes do on caffeine. You don't feel wired but I did lose my appetite... I found it dificult to eat afterwards.
"It's easy to buy and very cheap," says Linda, who bought the drug online, for, she claims, 40p per tablet.
A recent study published in the Pharmacotherapy journal shows that Linda is not alone. At the US university surveyed, 18% of 1,253 first year students had used non-prescribed stimulants, primarily to help with their studies. Other studies have found similar results.
After a few clicks the drugs can easily be found for sale on the internet at affordable prices. This is the source of the pills used by many UK students, although some say they buy their tablets from friends who are prescribed them.
Carson, an 18-year-old high school student, takes Ritalin and Adderall, another drug with similar effects, two or three times a week to help him study and socialise. Studying in Utah, US, he buys the pills for $4 (£2.50) each from a friend at college.
"When I take Ritalin, I can stay awake in class, concentrate on the subject matter, and even take notes during class. I have more energy, I am more outgoing, and more sociable," says Carson.
Carson began taking Ritalin - one every other school day - after a run of poor exam marks, and says that his grades improved dramatically as a result.
"By the end of the school year I was passing every class I was taking."
But Carson's reliance on performance-enhancing drugs has spilled over from his study life to his social life.
"I now take it recreationally, to help myself be more outgoing and socially at school. This morning I took two Adderall capsules. Subsequently, I talked with more people than I would have otherwise and I spent about five hours studying mathematics, which is completely out of my nature."
While the drugs are considered simply as another study aid to those who use them, there are hidden and potentially very dangerous health hazards, according to Dr Ros Maycock, a general practitioner in Poole.
Brand name for methylphenidate
First used to treat ADHD in 1960s
Possible side effects include loss of appetite, nausea, headaches, blurred vision
"[These drugs] put a rush of adrenalin into the blood. Your pulse rate and blood pressure increase and your pupils dilate," she says.
"There can be potentially very dangerous physical side effects if you have an underlying cardiac disorder. The effects could lead to a heart attack or similar."
When the drugs are prescribed, a doctor usually carries out checks on a patient's blood pressure and susceptibility to side effects and a careful risk verses benefit calculation is made, says Dr Maycock. But for the students, none of these checks are performed and the taker may not know that they are at risk.
Long term effects
"If you had a hidden aneurysm in your brain, it could blow it apart. People never think that they are the ones at risk."
In the short term, Ritalin users can suffer from an array of side effects - anxiety, insomnia, loss of appetite, irritability and headaches and all common. The long-term effects of the drug are largely unknown.
But potential health risks aside, some will feel the use of illegal stimulants gives an unfair advantage in exams and essays.
While caffeinated drinks and other legal stimulants are available to everybody, amphetamines such as Ritalin are not, says Hazel Biggs, professor of medical law at Lancaster University.
"If people need the drug, it levels the playing field, but if they do not, it may give people an unfair advantage," she says.
There is very little that universities can do to police the use of these substances, short of performing a drugs test on every student entering the exam hall. Manchester University, where Linda studies, has no policy about the use of such drugs.
But did Linda, who got a first for her dissertation, not feel she had been dishonest? No. "I didn't feel like I was cheating. If it was that good, everyone would be doing it," she says.
While the practice was not condemned by her university friends, she concedes that her parents probably wouldn't approve.
And of course, whatever the rights and wrongs of Ritalin as a "study drug", students are still going to have to do the work and perform in the exams.
A good night's sleep might not be a bad idea.
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