Wednesday, April 20, 2011

4-20 Special: Why ADHD meds are better than weed ... to deal

The following is an excerpt from my "Discussion/Conclusion" chapter.  It being April 20th today, a doobieous day for so many college students, I thought it appropriate to post some of my findings related to cannabis use.  This piece discusses the financial incentives for a prospective dealer of ADHD medications (controversial!), and concludes that if you're a weed dealer on a college campus, you're in the wrong game (even more controversial!).  Enjoy.

There are several advantages to quasi-licit use achieved through doctor shopping. First of all, it’s legal. Second, it’s safe; you know what you’re getting. The “safety” of dealing stimulant medications is not a concern to begin with, but several illicit users had concerns about what they were taking. This is not to say that illicit drug diversion can’t be dangerous or “sketchy.” As seen with “operation sudden dawn” and “operation Ivy league” with the experiences of several participants, dealers of illicit medications may be the same dealers who peddle more dangerous street drugs. Sometimes interactions can be unsafe, or the products can be of questionable. Getting it from a doctor is cheaper, more convenient, and certainly safer.

Another advantage is simply having a consistent, reliable, and price-controlled source. Especially with health insurance, nootropic medications obtained directly through pharmacies are much cheaper than typical WCU illicit market prices. Looking closely at the specific price differences, it’s easy to see why savvy or entrepreneurial students would consider feigning ADHD symptoms for profit, rather than (or in addition to) primarily for their own personal use.

For example, student patients with the WCU student health insurance plan can fill a prescription for 30 20mg pills of generic methylphenidate or dextroamphetamine for $15; $30 if they choose the drugs by their respective name brands, Ritalin and Adderall (citation omitted). Considering that illicit users seldom discern what they take, let’s assume that the profit-motivated hypothetical dealer opts for generics: $15 for 30 pills. Students quoted many prices for a single Adderall or Ritalin pill, depending in part on potency (mg) and release formulation. Just to control for this hypothetical example though, an oft-quoted average price was $5 (even though Mike reported selling Adderall at peak times for as much as $30 for a single pill). A student could therefore resell his/her $15 prescription for $150—a ten-fold markup. A patient could refill this prescription monthly, bi-weekly, or even more frequently, depending on the patient and prescribing physician. If you factor in higher prices for higher dosages or extended-release formulations, or varying market dynamics (read: finals), diverting ADHD medications in college can be extremely lucrative.

This study echoes earlier research callings to urge student health centers to exercise extreme caution, both when diagnosing ADHD, and when prescribing treatment medications (Harrison & Rosenblum, 2010). With on-campus pharmacies at many large universities offering even better price discounts, dealing could hardly be more convenient or profitable.

Being college students, cost is a huge barrier for many. A lot of participants found the prices of Adderall prohibitive; for many it was the same with weed. Unlike stimulant medications however, most insurers do not cover medical cannabis, and the illicit market value of marijuana is nearly identical to its store price (at least it’s nothing close to the approximately 1000% markup hypothetically outlined). This offers relatively little financial incentive for prospective dealers to consider diverting medical marijuana over ADHD medications, and considering that medications are small, concealable, logistically easier to divert, with very little perceived concern among dealers getting caught. All of this amounts to arguable advantage for licit users, who include doctor-shoppers-turned-dealers of ADHD medications.