Adderall is a wonder drug, helping millions of Americans with ADHD, but its widespread use on campus—and by college athletes—left some oblivious to its dangers. Performance enhancer or not, its addictive potential is now well known at one fabled tennis program
IT WAS FITTING that the 2017 NCAA tennis championships were held at the University of Georgia's Dan Magill Tennis Complex. College football has the Big House and Bryant-Denny Stadium, and college basketball has Allen Fieldhouse and Cameron Indoor Stadium, and college tennis has Dan Magill. Both grand and intimate, the venue sits tucked in the center of the UGA sports facilities. A clubhouse resembling a stately Southern mansion is ringed by a dozen courts. Thanks to a donation from Kenny Rogers, the College Tennis Hall of Fame also resides on the grounds.
The facility is home to a college sports dynasty. Georgia men's tennis teams have won six NCAA titles and 41 SEC championships since 1971. Dan Magill, the venue's eponym, played for the Bulldogs in the early 1940s and coached the program for 34 years, retiring in '88—the John Wooden of college tennis. John Isner, the most accomplished American currently on the ATP Tour, played at UGA from 2003 to '06.
But on May 7, two weeks before the NCAA tournament began, campus police announced that the famed complex may also have been the scene of a crime. They were launching an investigation into "possible theft and mishandling of prescription medication involving a number of individuals within the tennis program."
Manuel Diaz, UGA's coach since 1989, was listed as the reporting party on the initial incident report. The same day police launched the investigation, UGA announced that Bo Hodge, 35, the team's associate head coach, was suspended immediately and indefinitely because of a "personal matter."
UGA was eliminated in the semifinals—Virginia won the men's title, and Florida won the women's. But in the everyone-knows-everyone ecosystem of college tennis, the talk that week was less about match results than rumors of a drug scandal within the vaunted UGA program. In the following weeks UGA posted a job listing for an assistant position. As one message board poster put it, "What the hell is going on with Georgia?"
The answer is a story with elements reminiscent of the classics: the frayed fabric of a community, mentor pitted against protégé, a father forced to implicate his own son. But it is also distinctly contemporary, flush with text messages, social media and a voguish drug, Adderall, that has slipped into the bloodstream of college students everywhere.
WHEN JAMES BOUKEDES (BO) HODGE postponed a pro tennis career to play in college instead, the decision to attend Georgia was really no decision at all. Mark Hodge, Bo's father, had been a tight end in Athens just before Herschel Walker arrived and was captain of the 1978 team. After marrying Suzette Boukedes, Mark settled in Athens and became a prominent lawyer. The Hodges' athletic son was a sports omnivore, but he gravitated toward tennis.
By the time Bo was a sophomore at Athens Academy, he was the best player on the team that won the Georgia state championship. His college recruitment consisted of little more than a phone call.
It wasn't just that he grew up a local Athens kid. When Mark Hodge played football for Georgia, he'd struck up a friendship with Manny Diaz, a star on the UGA tennis team. After graduation Diaz stayed in Athens to become an assistant to Magill, and when Magill retired, Diaz was named his successor. The Hodge and Diaz families would vacation together; Bo's sister, Jennifer, sometimes drove Diaz's sons to junior tournaments. In Georgia tennis circles Bo Hodge and Manny Diaz were referred to, respectively, as each other's "second son" and "second father."
In 2001, Georgia won the NCAA title and Bo, then a freshman, was named All-America for the first of four times. As a senior he played doubles in the main draw of the U.S. Open, partnering with Mardy Fish. After four years at UGA, as one of the most decorated players in program history, he turned pro. He reached a career-high ranking of No. 497, but he wearied of trolling for ranking points and gas money. In his final pro match, in 2005, he lost at a Challenger event in Waco, Texas, and left town with $176 in prize money. He spent the next two years as a hitting partner for Venus and Serena Williams.
By spring 2008, Bo was back in Athens, finishing up his degree in communications. The week before the NCAA tournament that May, Diaz asked if Hodge would help with some coaching. Georgia won another NCAA title. Suddenly Hodge was a hot assistant coaching prospect, and, after stints at Alabama and Oklahoma, he returned to Athens. In 2015, Diaz offered him the job of associate head coach. The title suggested Hodge was positioned to succeed Diaz. "I am so excited to be here," Hodge said at the time, "and I don't ever want to leave."
It was around then that Bo Hodge received a prescription for Adderall from a local physician. He says that he had been having trouble focusing, was diagnosed with attention deficit disorder and began taking one pill in the morning and another after lunch.
Hodge now had something in common with millions of other Americans—and with a number of the UGA players he coached. Adderall is a banned substance under the NCAA's drug policy. Its use is permitted, however, when the athlete has a valid prescription. And its use was so commonplace among UGA players that Hodge kept allotments in his desk drawer for some of the players with prescriptions to take on an honor system.
"A lot of the time the players would forget to take their medication," says Hodge. "They agreed, and Coach Diaz agreed, that they could leave [their pills] in my desk and if they forgot to take one, they could go to my office and get it. It wasn't like I was hiding something. If I wasn't there, the players would come up sometimes and take 'em. We didn't see a problem with it. We know now we should not have been doing that." (Diaz confirms this arrangement.)
In 2015, with a newborn daughter and a new full-time job, Hodge says, "I started taking more than what was prescribed and more than I should have. I kind of self-medicated." Hodge would find himself out of pills before his prescription lapsed.
That spring, multiple players approached Manny Diaz expressing concerns about their Adderall. One player reported that his supply of pills had, unaccountably, dwindled. Another player told Diaz that Hodge had repeatedly asked to borrow or buy a few pills.
In another era a matter like this might have been handled within the team, but Diaz complied with NCAA rules and forwarded this information to his direct superior, athletic director Greg McGarity, another former UGA tennis player. McGarity was duty-bound to forward the information to university attorneys. They, in turn, were duty-bound to alert campus police.
On July 10 the local DA's office issued an arrest warrant for Hodge, charging him with a felony for purchasing a controlled substance and a misdemeanor for theft. Hodge was booked into Athens--Clarke County jail at 10:50 a.m. on July 11 and was released that afternoon after posting bail.
That same day, the DA's office charged a UGA tennis player, a redshirt freshman, with a felony count of selling a controlled substance. It was Alex Diaz, the coach's 19-year-old son.
ADDERALL CAME to market under its current name in 1996. It was promoted as a drug prescribed to treat attention deficit hyperactivity disorder (ADHD), a neurobehavioral condition seen mostly in children, marked by inattention and impulsivity. Adderall made a smashing debut. At roughly $5 per pill, it came relatively cheap and the side effects were minimal.
The rise in Adderall use coincided with a rise in diagnoses of ADHD. Doctors and researchers debate which came first. Did the effective treatment trigger a surge in diagnoses? Or did the surge in diagnoses motivate drug firms to develop an effective antidote? Regardless, according to the Centers for Disease Control and Prevention, in the 1990s between 3% and 5% of school-age children in America were believed to have ADHD; the most recent statistics put the diagnosis rate at nearly 11% among children 5--17. By 2006, more than six million annual prescriptions of Adderall were being written. By 2012, annual sales exceeded $2 billion.
Adderall increases attentiveness and decreases distraction. And when it works as intended, the effects are remarkable. The testimonials invariably reference increased "alertness" and "focus." The drug has become especially popular on college campuses, where millions of students carry a prescription. Some students take advantage of a notoriously loose diagnostic process. Entire websites are devoted to tips for persuading doctors to issue a prescription for what's called the "get ahead drug."
In most cases though, college students take Adderall with no prescription at all. A 2015 study by the National Institute on Drug Abuse reported that 7.5% of 12th-graders had taken Adderall without a prescription. A '16 study in The Journal of Clinical Psychiatry found that the nonmedical use of Adderall by adults had gone up 67.1% between '06 and '11. "Most schools recognize that there is an issue," says Alan Schwarz, author of the book ADHD Nation. "But unlike recreational drugs on campus, there are students using Adderall legitimately and with prescriptions, and they shouldn't be made to feel stigmatized."
While it's a federal crime to possess Adderall without a prescription, that threat has not had much of a chilling effect on its use on campus. As Roger Cohen wrote in The New York Times, "Adderall has become to college what steroids are to baseball: an illicit performance enhancer for a fiercely competitive environment."
Cohen's analogy is more apt than he might have realized. Adderall has found particular favor within the competitive environment of sports. The same way it can imbue students with alertness for finals or the freedom from distraction to power through Wuthering Heights, so too can Adderall help athletes compete and practice with unblinking focus and improved reaction times.
Mark Kovacs, a performance physiologist who's worked with major sports leagues and more than 20 Division I athletic departments, has seen Adderall become increasingly common in locker rooms. "Any athlete that can benefit from greater alertness, motivation and concentration," says Kovacs, "could potentially benefit from Adderall."
While Adderall is on the banned list for most sports, it is permitted if the athlete is granted a Therapeutic Use Exemption (TUE). A 2013 report revealed that 119 MLB players—nearly 10% of the league—had TUEs allowing for an Adderall prescription. This is strikingly higher than the rate of ADHD in the general adult population, which is about 4.4%.
That same year, Seahawks cornerback Richard Sherman tested positive for Adderall. Though his suspension was overturned on appeal (Sherman contended the sample was tainted), he told reporters, "About half the league takes [Adderall], and the league has to allow it." (Sherman later claimed he had been misquoted.)
To be clear: Just as many students use Adderall for treatment, not all athletes using the drug are doing so to enhance performance. When, for instance, the hacked medical records of gymnast Simone Biles were leaked after the 2016 Olympics, revealing her use of a stimulant, she was quick to explain, "I have ADHD and I have taken medicine for it since I was a kid. I believe in clean sport, have always followed the rules." When Orioles slugger Chris Davis tested positive for Adderall in 2015, he explained that he had ADHD but had neglected to renew his TUE.
College athletes listing specific drugs on a TUE are exempt from sanctions for testing positive for those drugs. "The NCAA has failed miserably at controlling [TUEs]," says Travis Tygart, CEO of the U.S. Anti-Doping Agency (USADA). "It's become the crutch for victory in sports where it's not effectively regulated. Knowing the policy and knowing the pressure on athletes to win, [usage] makes all the sense in the world."
Quantifying Adderall use among college athletes is difficult because studies often rely on self-reporting. A 2014 NCAA report on drug use among college athletes found that participants in wrestling (12.6%), lacrosse (11.9%) and hockey (7.3%) had the highest prevalence of using amphetamines." But many in the college sports world raise a skeptical eye at those percentages. While stressing that it's based on observation and not data, one former athletic trainer at an SEC school estimates that half of the school's football team used Adderall, some with a prescription, some without. "It's not even taboo," says the former trainer. "It's out in the open."
Athletes playing sports requiring shorter bursts or precise response and reaction time would see the greatest benefits from Adderall. A stimulant, Adderall can also suppress appetite and would therefore be helpful in sports that require weight loss—which might explain the relatively high incidence of amphetamines like Adderall, per the NCAA study, in wrestling. On the other hand, side effects of Adderall can include fever and increased heart rate. One study concluded, "Amphetamines were primarily taken after practice or competition. This may suggest that the amount of physical damage that athletes in high-contact sports endure requires a boost of energy to handle their academic commitments."
ADDERALL CAN also be addictive, although numbers on how often this happens are hard to come by. After exhausting his prescription and blowing through his ration of pills, Hodge leaned on the UGA players. "I don't think it was addiction," Hodge says. "I do think it was an abuse issue."
He sent players text messages asking to borrow some of their Adderall. He would then promise to replenish their supply when he refilled his own prescription. Some students later said they felt pressured to agree. At one point Hodge persuaded Alex Diaz to hand over 20 pills in exchange for transferring $100 to Diaz's Venmo account. It was this transaction—confirmed when investigators combed through text messages—that triggered the criminal charges of "controlled substance sale."
By late June the athletic department announced that Hodge would be replaced by Jamie Hunt, a former UGA player who had been coaching at Vanderbilt. Alex Diaz withdrew from the university for the fall semester.
In August, Hodge and his wife, Tatum, who also works in the UGA athletic department, became parents for the second time. But that was a spasm of happiness amid a bleak few months. Apart from the damage to his reputation, Hodge lost his job and his chance to succeed Diaz in coaching the most prominent program in college tennis. For which he once starred. In his hometown.
On Nov. 9, Hodge, a first-time offender, agreed to three years of probation and six weeks of outpatient therapy in exchange for pleading guilty to possessing Adderall that was not his. The theft charge was dropped. "That was the one that hurt," he says. "I have no problem telling people I took too much Adderall and I'm glad that I've gotten some help. But I never stole anything." He's hoping to get back on the tennis coaching ladder elsewhere.
As he awaits his fate, Alex Diaz is playing low-level futures tournaments. He plans to return to school and the UGA program this spring.
And at age 64, Manny Diaz, the venerable head coach, has taken an unexpected detour on his way to the Hall of Fame. Worse, he says, he "has been through a hell of a time with this as a parent." When his players first requested a Friday night meeting to speak to him without Hodge present, Diaz was annoyed. Why? This late in the season? "I thought to myself, This'd better be good."
When he learned of his players' concerns, he says that he admired their conviction and understood the severity of the situation. "I slept on it—or didn't sleep at all, actually—but I knew what I had to do," he says.
Months later his voice fills with emotion when he replays his decision and its consequences. But he harbors no regrets. "If I had tried to solve this on my own, I would have been seen as someone trying to cover something up," he says. "I've always done things by the book, and I felt like while I hated to do it, I had to do the right thing. And I believe I did. So much so that I basically had [to incriminate] my son, even though I felt he was pressured by a superior.... It's an unfortunate situation all around."
When it is suggested to Manny that the system has been awfully harsh on his son, a teenager who was pressured by not only an authority figure but also someone he had idolized, he sighs. But he doesn't want to denounce local law enforcement, much less the athletic department that has employed him for the last 35 years. "I'm wearing a lot of hats in this situation," he says, "so that makes it even tougher."
He's also processing a kaleidoscope of feelings about Hodge, with whom he hasn't spoken since the investigation started. There's anger and frustration about broken trust and the erosion of the prestige of his beloved program. There's love and sympathy toward a family friend, former player and handpicked successor who fell into the abyss of substance abuse.
He is similarly ambivalent toward the drug itself. If it were an unambiguous and banned PED, that would be an easy case. (Diaz is adamant that his players were not using Adderall as a performance enhancer.) But this is a prescribed medication that, Diaz rightly notes, he couldn't ban from his team's locker room if he wanted to. Beyond that, he has seen the way Adderall had helped his players, including his son, who struggled to absorb information as a kid and couldn't focus long enough to keep score in his junior matches. Later, once he had an Adderall prescription, he began to thrive.
Yet he recognizes that Adderall is a controlled substance for a reason. "This is a serious [stimulant] that needs to be monitored. Coaches should never have access to these medications," Manny Diaz says, referring to Hodge's supervisory role with his players' Adderall. "We never did that before. We never will again."
Like most coaches, Diaz stresses preparation. Part of what's so agonizing to him about the entire saga is that he was caught flat-footed. When he takes inventory of the past few months, he sounds not unlike an athlete describing a sandbagging opponent who seemed so innocuous and unthreatening. Until he wasn't. Says Diaz, "I didn't see it coming."
"I STARTED TAKING MORE THAN WHAT WAS PRESCRIBED AND MORE THAN I SHOULD HAVE," SAYS HODGE.
"IT'S BECOME THE CRUTCH FOR VICTORY IN SPORTS WHERE IT'S NOT EFFECTIVELY REGULATED," SAYS TYGART.