Ethical or not?

Gannett News Service asks, "Is popping a pill the same as cheating?"  (Norwich Bulletin 11/24/05, page A12) Colleges provide clear guidelines on  traditional forms of academic dishonesty (cheating) in their college catalogs or student handbooks, but "most handbooks don't mention the ethics of using drugs such as Adderall to boost performance" (Gannett)

College Catalog Student Handbook

At the crux of the issue is "What constitutes cheating?"

Students use coffee, lattés,  high-caffeine drinks, and Red Bull to be able to stay awake to study.

But now an increasing amount of students are using  prescription stimulants to give themselves an advantage.

Other students are resorting to ADHD drugs, like Adderall to help increase their exam grades.  These drugs offer the advantage of helping students focus and concentrate.

Many students claim, ""I'm studying. I'm learning.  I'm not creating a cheat sheet.  Every needs to do           what he can to improve his grade. There's pressure & stress. We're all exhausted from all our extra-curricular responsibilities.

On the other hand other points of view are offered:  "John Lachs, centennial professor of philosophy at Vanderbilt, says that it's unethical for a student to put himself at an advantage at the expense of other students, but the widespread availability of ADHD drugs means a student is not getting an unfair advantage." (Gannett)

So where do students get the prescription medication?
Some from their doctors;
Some from their classmates who have exaggerated their need for medication to their doctor & they sell the prescriptions.
Some from parents: "Some parents go so far as to obtain the pills for their kids. 'It's that whole super-achiever thing,' Williams says. 'You always have to be fighting for an A." (from "College Exam Cram: Students are turning to new breed of drugs" by Sameh Fahmy of Gannet News Service, Norwich Bulletin, 11/24/05 , page A12

What percentage of students take prescription medication to increase their college test scores?
"From a pool of 11,000 students, " nearly 7 percent of students surveyed had taken a stimulant without a prescription" (Fahmy).

What re the side effects of ADHD medication?
stomachache,
loss of appetite
difficulty sleeping
unknown long-term effects (addiction...)

What percentage of teen abuse prescription drugs?
"According  to a 2004 national study by the Partnership for a Drug-Free America, one in five teens has abused a prescription painkiller to get a high. In fact, the study found, they are more likely to use prescription nmeds to get a high than snort cocaine, drop acid or take Ecstasy.. 'Ease of access is the number one reason kids are abusing prescription drugs...They don't have to go to a scary street dealer because the drugs are right there in Mom's or Grandma's medicine cabinet.'"  (Prescription  for Danger by Melba Newsome, Family Circle Magazine 11/29/05, page 24)

Case Study:

Nancy is studying for tomorrow's nursing boards.  She has been a, hard-working, and high-achieving student in her college classes.
Nancy is now nervous and scared of the board competition.  She needs to pass the boards ASAP, as she is a single mom and beginning to fall behind on bills.

Nancy's hospital supervisor promised her a position upgrade if she passes the boards.

Nancy is considering taking Adderall to help her concentrate and focus. She has used it three times previous to this for cumulative exams, and she scored an A each time she took the prescription medication.  

Should  Nancy take Adderall for the boards too?

Would it place her at an unfair advantage?
(Is being rich - with  spare time, the latest in computers and a private tutor and editor an unfair advantage?)
What are the ethical considerations?