“He would just procrastinate, wait until the last minute, then take a pill to study for tests,” said Ryan Sykes, a friend. “It got to the point where he looked like he couldn’t do anything if he didn’t have Adderall.”

Various studies have estimated that 8% to 35% of college students take stimulant pills to improve academic performance. Few students realize that giving or accepting even one Adderall pill from a friend with a prescription is a federal crime. Adderall and its stimulant siblings are classified by the Drug Enforcement Administration as Schedule II drugs, in the same category as cocaine, due to their highly addictive properties.

“It’s incredibly nonchalant,” said Chris Hewitt, a friend of Richard’s, of students’ attitudes towards drugs. “It’s, ‘Does anyone have Adderall? I want to study tonight, ”said Hewitt, now an elementary school teacher in Greensboro.

After graduating with honors in 2008 with a biology degree, Richard planned to apply to medical schools and stayed in Greensboro to study for the entrance exams. He remembered how Adderall had helped him concentrate so well as an undergraduate, friends said, and made an appointment at the nearby Triad Psychiatric and Counseling Center.

According to records obtained by Richard’s parents after his death, a Triad nurse practitioner detailed his unremarkable medical and psychiatric history before recording his complaints about “organization, memory, attention to detail.” She called her speech “clear”, her thought process “goal-directed” and her focus “attentive”.

Richard completed an 18-question survey in which he rated various symptoms on a scale of 0 to 3. His total score of 29 led the nurse practitioner to make a diagnosis of “ADHD, inattentive type,” a type of ADHD without hyperactivity. She recommended Vyvanse, 30 milligrams per day, for three weeks.

Telephone and fax requests for comment from Triad officials were not returned.

Some doctors are concerned that ADHD questionnaires, designed to aid and standardize the collection of a patient’s symptoms, will be used as a shortcut to diagnosis. C. Keith Conners, a longtime child psychologist who developed a popular scale similar to the one used with Richard, said in an interview that scales like his “have reinforced this tendency towards quick and dirty practice.”