If she wanted to, Susan Cavicchioli could turn her ADHD diagnosis into a profitable business.

Instead of taking Adderall every morning, she could sell the in-demand psychostimulant to students who stay up late to study, who want to lose weight or who are simply looking for a mood-booster.

So, in other words, basically all students.

"Tons of times, people ask me (for it), but for me, it's too difficult," Cavicchioli, a hospitality business freshman, said. "It's not worth giving away because I'm missing out on opportunities to get stuff done. I've given two away before, but I didn't charge anyone for them. They were close friends, and they had big exams, so they had to pull all-nighters."

Cavicchioli was diagnosed with attention deficit hyperactivity disorder, or ADHD, during her sophomore year of high school, though she noticed symptoms since she was about 3 years old. Taking medication helps her accomplish homework and other tasks, she said.

But for those who don't have ADHD, psychostimulants have a much different effect. They act as coffee to the extreme, providing extra energy and suppressing appetites.

"In a horribly funny way, there's not a tremendous difference between Adderall, Ritalin and caffeine," psychology Professor Gary Stollak said. "They all have, depending on dosage level, similar effects on attention span. And Adderall is actually cheaper than Starbucks, depending on who you know to get Adderall or Ritalin, than to pay for eight cups of coffee per day."

Business freshman Britney Krupa has been offered psychostimulants to help her study. While she declines, her friends have used them often.

"A lot of my friends get it from so many different people because it seems like everyone has ADHD," she said. "They talk to their friends about it and say, 'Try this, it keeps you awake.' I think that's how it gets around."

Aside from increased awareness of the disorder and environmental factors, people seeking psychostimulant prescriptions could be one reason why cases of ADHD have increased, said Kelli Cotter, the pharmacy clinical coordinator at Ingham Regional Medical Center.

"If a physician says there's no clinical problem, the parent can disagree with the physician and find another physician who will agree," Stollak said. "The problem for diagnosis is very complicated. It's not like, 'Here it is on the MRI or in the blood.' So that's very, very subjective. You would hope if you brought in your car with a broken whatever, three or four mechanics would give you the same diagnosis. But they might not."

Dr. Sarabjit Tokhie, a psychiatrist at Sparrow Health System, diagnoses ADHD by using Conners' Rating Scales, which examine factors such as defiance, cognitive impairment and inattentiveness. Tokhie also considers a patient's history and gathers information from schoolteachers before writing a prescription.

"There are people who are going to abuse the system," he said. "It depends on the ability of the clinical psychiatrist to separate that out. There are a lot of people who come, and I don't prescribe them anything. Just because someone walks into my office doesn't mean they get what they want."

Education junior Chris Staubach was introduced to Adderall during spring finals his freshman year. He said they help him stay awake to study, but added that students can't expect the drug to provide complete academic success.

"It's not like you can rely on it to make good grades," he said. "It's the person who's going to get the good grades. I think (psychostimulants) are out in the open around finals time, but other than that, not really at all. It's not accepted, but that's not going to stop people from doing it."

If those looking for psychostimulants can't get prescriptions through a doctor, some go to places outside the United States, such as Mexico, where psychostimulants can be purchased without a prescription. Students sell them on campus, too.

"I know a lot of people who have (psychostimulants) and use it as an opportunity to sell the drugs," Cavicchioli said. "They have the prescription for it, choose not to take it themselves and sell it off to people. Generally speaking, 10-milligram ones can go up to $5 apiece. At the same time, I've heard of people who sell it for $30."

While some effects of psychostimulants may be alluring to students, they don't come without dangerous side effects — even for those who take the medication as prescribed.

When Cavicchioli began taking Concerta in high school, she experienced heart palpitations. Krupa's friend took a time-release pill and couldn't sleep for 48 hours.

Other side effects include increased blood pressure, hallucinations, fainting, dizziness, insomnia and though it's highly uncommon, death can result in those with heart defects.

For some, the appetite-suppressing effect of psychostimulants is enticing. Tokhie said the drugs were marketed between the 1960s and '70s as weight-loss medications, but later were withdrawn from the market to become strictly a controlled substance.

"When my friends take it, they say, 'I'm not hungry as much,' and they make comments like, 'Yeah, I'll lose weight,'" Krupa said.

Scott Schadel, clinical director of the Greater Macomb chapter of Project Vox, which is an alcohol and drug addiction center, said he has worked with adolescents who have used psychostimulants to lose weight.

"Especially with teenagers, if they believe they'll get a certain reaction from a drug, they're going to try it," he said. "Body image is a huge issue for teenagers overall. The more teenagers are exposed to certain body types, everybody's influenced by it."

Though Schadel said psychostimulants don't have physical withdrawal symptoms, they still are addictive. When abusers stop taking the drugs, they'll become lethargic and experience mild depression.

"The more you take, the more you need to get the same effect," he said. "First, you stay with that half pill, then you go to a full pill, then two, then four. That's a lot of chemicals to put in the body — it puts a strain on the body to go through."

The first step in overcoming an addiction, Schadel said, is to find out why the drug is being used in the first place and work out those issues. With psychostimulants, the cause could be social insecurities, depression and lethargy.

But for those who actually have ADHD, like Cavicchioli, Adderall is a healthy cure for an inability to focus on schoolwork.

"I can accomplish daily tasks without taking forever," she said. "It would take an hour to read five pages. I would skim over it and wouldn't take in anything that I read. I can finally focus and get things done."

Elizabeth Swanson is the State News lifestyles reporter. She can be reached at swans130@msu.edu.