Caveat Emptor, Venditor, et Praescribor: Legal Liability Associated with Methyplenidate Hydrochloride (MPH) Use by Postsecondary Students

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INTRODUCTION

For years, students have endured the physical and mental stress that comes as a result of the demands of postsecondary education. All-night cramming for exams and marathon paper writing sessions are considered, by many, to be a rite of passage, endured by generations of students. For many years, students have also turned to stimulants (from coffee to energy drinks and caffeine pills) to extend their physical and cognitive limits in order to better cope with the demands of school and life. In this sense, the use of stimulants as study-aids is not a new phenomenon nor has it been the subject of much concern or discussion. But within the past few years, the use of a prescription drug (specifically, methylphenidate hydrochloride, MPH, often known as Ritalin) by postsecondary students for cognitive enhancement purposes has emerged as a phenomenon and has become the subject of considerable attention in the bioethics literature as well as the popular press. (1)

MPH is known for its cognitive effects, specifically, its ability to reduce restlessness and improve concentration, for individuals with Attention Deficit

Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). (2) Some students have noted this and begun using MPH in an effort to study with increased focus, for long periods of time without tiring, while also being able to retain the information they are learning. (3) David Green, a student at Harvard University, told the Washington Post: "In all honesty, I haven't written a paper without Ritalin since my junior year in high school." (4) A straight-A student at Queen's University reported that when she takes MPH "the material becomes so interesting, you don't want to move, go to the bathroom, eat, or do anything. And you remember all of it." (5)

Although MPH is legally available by prescription only, there appears to be a significant amount of use without a prescription or usage that is deemed to be outside of the prescribed usage directives of a physician. The vast majority of studies have been conducted within US universities (6), although at least one study has been conducted at McGill University in Canada. (7) In one of the more comprehensive studies of illicit MPH use, White et al. reported on the results of a sample of 1,025 returned surveys from students at the University of New Hampshire. (8) In the survey they round that 16.2% of the population reported using stimulants "in ways not prescribed by a physician." Of this 16.2%, 96% specified that MPH was their stimulant of choice, with 2% choosing the mixed amphetamine salt compound (better known by the trade name Adderall). The study round that 15.5% of the users reported that they were using two or three times a week, 33.9% one or two times per month, and 50.6% two or three times a year. (9) Similar questionnaire-based studies have provided estimates for lifetime usage (variously described as use without a prescription and/or use that is not in accordance with medical guidance) of between 8.1-35.5%. (10) These statistics on this new version of an old phenomenon are troubling for a variety of reasons, including the potential health risks associated with the use of illicit stimulants as a study-aid and the legal liabilities that the various players involved in such use may face.

Students who use MPH illicitly are risking their health. Furthermore, when students take, buy, sell, or give away MPH they are exposing themselves to the risk of significant legal repercussions. Many students are unaware of the severity of consequences they could face with respect to both criminal and civil liability and how these consequences could affect their future. Thus, one purpose of this paper is to outline the potential risks for postsecondary students associated with the use of MPH for cognitive enhancement--both physical and legal risks. We describe the evidence with respect to the cognitive benefits and physical risks of illicit MPH use for cognitive enhancement purposes and explain the potential legal repercussions associated with this use. …