By: Carey Dunne
Quartz
October 19, 2016

In 2010, when Raphael was a first-semester college freshman struggling to get through finals, he did what it seemed like all his friends were doing: he got an Adderall from a fellow student and holed up in the library. It was the first time he’d tried the stimulant—a mixture of amphetamine salts often prescribed for attention deficit hyperactivity disorder (ADHD)—which is often used off-label as a “study drug” by those not diagnosed with the disorder.

“I was a little surprised by how much I loved it,” Raphael, now 25, tells Quartz. “It made me feel like a philosopher king.” Soon, he became part of the estimated 20% of college students who abuse prescription stimulants. But he didn’t anticipate that, six years later, he’d be using Adderall daily while working as a web developer at an e-commerce shop in Los Angeles.

The story of how he procured his first stimulant prescription proves how prevalent an ADHD diagnosis has become. “I don’t really have ADHD. But after freshman year, I found a drug dealer with a PhD,” Raphael says, referring to his psychiatrist. “I said that people thought I had ADHD in high school, and the psychiatrist just said, ‘Okay,’ and took out her little pad. I’ve had a prescription ever since.”

As a millennial, Raphael is part of the first generation of Americans to be routinely prescribed stimulants during childhood and adolescence and who gone on to abuse those stimulants in high school and college. Now, as Alan Schwarz points out in his new book ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic,millennials are graduating into the workplace, and many of them are continuing to use prescription stimulants as job-performance enhancers.

If you used Adderall throughout college, quitting when you start working can be difficult. This isn’t just because ADHD medications like Adderall are highly addictive Schedule II-controlled substances—putting them in the same category as cocaine—but also because many users come to see them as a driving factor in their success. “It stands to reason that if you feel as if you succeeded in college partly because of these drugs, you’re more likely to feel as if you need them to succeed in the workplace,” Schwarz says.

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