Fading fast at 11 p.m., Elizabeth texted her dealer and waited just 30 minutes for him to reach her third-floor New York apartment. She handed him a wad of twenties and fifties, received a tattered envelope of pills, and returned to her computer.
Her PowerPoint needed another four hours. Investors in her health-technology start-up wanted re-crunched numbers, a presentation begged for bullet points and emails from global developers would keep arriving well past midnight.
She gulped down one pill — pale orange, like baby aspirin — and then, reconsidering, took one of the pinks, too.
“O.K., now I can work,” Elizabeth exhaled. Several minutes later, she felt her brain snap to attention. She pushed her glasses up her nose and churned until 7 a.m. Only then did she sleep for 90 minutes, before arriving at her office at 9.
The pills were versions of the drug Adderall, an amphetamine-based stimulant prescribed for attention deficit hyperactivity disorder that many college students have long used illicitly while studying. Now, experts say, stimulant abuse is graduating into the work force.
Reliable data to quantify how many American workers misuse stimulants does not exist, several experts said.
But in interviews, dozens of people in a wide spectrum of professions said they and co-workers misused stimulants like Adderall, Vyvanse and Concerta to improve work performance. Most spoke on the condition of anonymity for fear of losing their jobs or access to the medication.
Doctors and medical ethicists expressed concern for misusers’ health, as stimulants can cause anxiety, addiction and hallucinations when taken in high doses. But they also worried about added pressure in the workplace — where the use by some pressures more to join the trend.
“You’d see addiction in students, but it was pretty rare to see it in an adult,” said Dr. Kimberly Dennis, the medical director of Timberline Knolls, a substance-abuse treatment facility for women outside Chicago.
“We are definitely seeing more than one year ago, more than two years ago, especially in the age range of 25 to 45,” she said.
Elizabeth, a Long Island native in her late 20s, said that to not take Adderall while competitors did would be like playing tennis with a wood racket.
“It is necessary — necessary for survival of the best and the smartest and highest-achieving people,” Elizabeth said. She spoke on the condition that she be identified only by her middle name.
Most users who were interviewed said they got pills by feigning symptoms of A.D.H.D., a disorder marked by severe impulsivity and inattention, to physicians who casually write prescriptions without proper evaluations. Others got them from friends or dealers.
Obtaining or distributing stimulants without a prescription is a federal crime, but the starkest risks of abuse appear to be overdose and addiction.
A 2013 report by the federal Substance Abuse and Mental Health Services Administration found that emergency room visits related to nonmedical use of prescription stimulants among adults 18 to 34 tripled from 2005 to 2011, to almost 23,000.