It was finals week at the University of Minnesota and, like many of his classmates, Christopher Meyer was drowning in term papers, exams and projects.

Then, he said, a friend opened his mind and medicine cabinet to the little orange secret that is fueling all-nighters and study sessions for an increasing number of college students: the prescription stimulant Adderall.

Students like Meyer say legal and illegal use of prescription stimulants has become common at the U, and now some Twin Cities doctors are growing alarmed that young adults are faking symptoms to get prescriptions.

A new study at Hennepin County Medical Center found that one in four adult ADHD patients fakes or exaggerates symptoms to get prescription drugs, and its author says unwarranted use of Adderall is contributing to a shortage affecting Minnesota patients who genuinely need the medication to treat serious illnesses such as narcolepsy and attention deficit hyperactivity disorder (ADHD).

Dr. Paul Marshall, a neuropsychologist at HCMC, was so troubled by the trend that he developed a tougher screening test for symptoms and says it should be administered to all ADHD patients. Dr. Gary Christenson, a psychiatrist who has watched student use at the U's Boynton Health Services, agrees.

"Clinicians need to be more discriminating," he said.

When Meyer got his first taste of Adderall last spring during final exams, he said it was going for as much as $20 per pill on campus. But he struggled to get a consistent and affordable supply from the "friendly campus drug dealer," so he went to a doctor and got a prescription.

Meyer, who has Asperger syndrome, said he has a legitimate claim to use the drug, and says it has improved his quality of life and academic performance. In a recent op-ed in the Minnesota Daily, he argued that stimulants such as Adderall and Ritalin can improve student performance -- a good thing.

Audience favorite

Steven George, a recent U graduate, says Meyer's experience is common. He and a friend wrote, produced and directed a short film called "How I Learned to Stop Worrying and Start Loving Adderall," which turned into a hit at last year's U of M Film Festival and took several awards, including Audience Favorite.

"We knew it was popular on campus," the 23-year-old freelance filmmaker said. "Lots of people use [Adderall] during finals to stay up later."

Christenson estimates Boynton Health Services sees one new patient a week asking to be diagnosed with ADHD. According to a 2010 Boynton survey, one-quarter of Minnesota college students who report ADHD symptoms were diagnosed within a year of the survey -- which means they waited until college to be diagnosed with a disorder typically detected during childhood.

"From what I can tell, it doesn't seem too difficult to get a prescription," George said.

That's the problem, according to Marshall, who conducted the study of exaggerated symptoms. He said the diagnosis of adult ADHD relies on self-reporting of symptoms, and that less than 30 percent of doctors nationally use validity tests to screen for dishonesty or exaggeration.

Marshall says more doctors should use rigorous validity tests to minimize health care costs and get medications and care to patients who truly depend on Adderall and Ritalin. The share of U.S. adults who actually have ADHD is less than 5 percent, according to the National Institute of Mental Health.

Controlled drugs

In his Minnesota Daily column, Meyer argued that students should have free access to stimulants such as Adderall and Ritalin because they help them focus and produce work that would benefit society.

But when Dr. Christenson of Boynton Health Services read the column, he was disturbed. Adderall and Ritalin are both listed as Schedule II controlled substances because of their "high potential for abuse," according to the U.S. Drug Enforcement Administration -- the same category as cocaine and oxycodone.

Christenson said the medications are intended to level the playing field so that patients with ADHD or narcolepsy can function at a normal level. "There's a societal pressure to move everything to the next level," he said. "It's a big disadvantage to those who actually need these drugs to step into the normal level of competition."

Meyer still takes Adderall three times a day. He said he is more productive than ever, but admits the drug isn't for everyone and doesn't guarantee improved performance in school or work.

"It's a medicine with high highs and low lows," the aspiring political writer said. "You have to have the right mind-frame before taking it or it could only exaggerate your problems."

He has yet to have trouble filling his prescriptions.

Amanda Bankston is a University of Minnesota student on assignment for the Star Tribune.