Bronkaid: Adderall’s Less Popular Sister

It’s past midnight and Samantha has a presentation due at nine am.  She hasn’t started.  And it’s her senior thesis, which represents four years of lab work.  Her usual weapons of choice - coffee, Red Bull, and Five Hour Energy - seem to be failing.  Then she remembers the small white pill tucked inside her purse pocket.
 
Sam has always steered cleared of Adderall and Concerta, drugs prescribed for ADHD that are abused on many college campuses for the long-lasting energy they deliver.  Not that she is morally opposed, but Sam is too nervous to take a substance not prescribed to her, always fretting over the potential side-effects.  Then her lab partner told her about Bronkaid – a drug that is supposed to deliver the energy rush similar to Adderall but is available without a prescription.  All you have to do is walk into CVS and ask the pharmacist for the pill.

 

Sam asked her lab partner for a pill, thinking that if it’s available over the counter, what’s the worst that can happen?  She wrapped the 25-milligram tablet in a wad of tissue and threw it deep into her purse, waiting for the perfect moment to use it.  She didn’t want to waste it reading Pride & Prejudice.  Her Modern History midterm didn’t seem like the right occasion nor did her essay on Sophocles.  Eventually, Sam completely forgot about it.
 
That is, until this moment of desperation.  She tore through the bowels of her Longchamp until she discovered a crusty wad of tissue that encased a gleaming white tablet of Bronkaid.  Sam popped the pill into her month and washed it down with some stale coffee and prayed that she could get through the night.  “It’s a definite buzz,” said Sam.  “I had so much energy and was so focused.  I sailed through my lab reports and came up with this great presentation.  I almost felt smarter.”

Like Sam, hundreds of college students have used Bronkaid in their moments of desperation.  The pill, which is used to treat asthma, has made its way onto college campuses as a wonder pill - a pill that can sharpen focus, deliver energy, and even suppress appetite.  But what does asthma have to do with all of this?  The 25 mg of Ephedra is the answer.

 

“Ephedra works to activate the adrenergic nervous system, the body’s defense mechanism that produces the ‘fight or flight’ response to danger,” says Kimberly Bernosky of the Physiology and Pharmacology Department at Wake Forest University School of Medicine.  “The adrenergic nervous system increases blood flow to the brain and muscles and more air flow to get oxygen to the muscles.  This relaxes the lung passages to allow more air flow, and leads to immediate relief from asthma.”

Ephedra doesn’t stop there.  It’s “a stimulant, both on the cardiovascular system and on the brain,” says Bernosky.  “In the body, it acts as a stimulant by increasing blood pressure, heart rate, the force at which the heart contracts, and the output of blood from the heart.”
 
“In the brain, Ephedra causes the release of adrenaline and dopamine (feel-good neuro-transmitters).  This means that these neurotransmitters can stimulate their target neurons and keep them active for longer periods of time,” says Bernosky.  Practically, this means that you can stay awake longer with a “feel-good” buzz – neurotransmitters beat out Red Bull any day.  Bernosky also adds that “like other stimulants, it leads to appetite reduction.”
 
Energy.  Focus.  Appetite Suppression.  Bronkaid is the new Adderall.  Even Bernosky agrees:  “Adderall and Ephedra are chemically very similar.  Adderall works similarly in the brain as a stimulant, by causing the release of dopamine and norepinephrine neurotransmitters.”  Students no longer have to seek out a friend for a $10 “addy” or beg their ADHD-diagnosed roommate for a pill.  Bronkaid is right behind the pharmacy counter for just $12.79. 

 

The pill is easily accessible and just as easily abused.  Bronkaid remains in the system for about four hours (as opposed to eight for Adderall), meaning that students are likely to take more than the recommended one pill dose.  Some confessed to taking two at a time and even exceeding the six-pill maximum over 24 hours.  “It’s a pussy version of Adderall if you just take one pill,” says Christina, a senior at Boston College.  “But when you take two – it’s much better.  I bite it in half or crush it, too.  That quickens the release.”
 
Students should be wary.  The stimulant effects of Ephedra carry dangerous side effects:  rapid heart beat, dizziness, headache, loss of appetite, nausea, stomach upset, trouble sleeping and nervousness.  This is in one dose – not two.  “My heart was beating like crazy,” said Katelyn, a senior at BC.  “And I felt lightheaded.  It was kind of scary, but I think I was too focused on work to really think about it.”  Katelyn might have admitted that these side effects were frightening, but she also confessed that she would take it again:  “It just helped me get stuff done.”
 
“I almost liked how I felt.  It was a high,” said an anonymous BC senior.  “Yeah, my heart was racing and I think I was sweating a little bit, but I was so buzzed that I didn’t care.  I want to take it again.”
 
Even if Bronkaid doesn’t require a prescription, it’s behind the pharmacy counter for a reason.  Ephedra, the active ingredient in Bronkaid, was once a popular substance in diet pills, but was banned by the FDA in 2004 for “unreasonable risks to health.”  After a government-ordered study into the effects of low to high dose Ephedra, 19,000 adverse events were reported, leading to the conclusion that no dose of Ephedra was safe for sale.
 
“The drug can be toxic at doses only 2-3 times above the therapeutic range used to treat asthma,” said Bernosky.  So although “doubling-up” may not seem like a big deal, it is.

 

So is mixing the Bronkaid with alcohol.  It may be tempting to take the pill to party through the night, but mixing any stimulant with alcohol (a depressant) can lead to adverse side effects.  “When alcohol is mixed with potent caffeine drinks (like the recently banned 4Loko), the dangers of over-intoxication emerge,” said Bernosky.  “People report that when they take the alcohol with a stimulant, they do not feel sedated or drunk.  So, they go on to drink alcohol in toxic amounts, leading to a greater likelihood of alcohol poisoning.”
 
Although Bronkaid may be ready for the purchase, that doesn’t make it safe.  “I would never buy something that isn’t prescribed to me,” says Lauren Smith, a senior at BC.  “That’s just dangerous.  And dumb.”
 
 
Sources:
 
Food & Drug Administration (FDA)
Kimberly Bernosky working with Allyn Howlett, PhD, in the Physiology and Pharmacology Department at Wake Forest University School of Medicine