Hillsboro physician Jill Russell never imagined a problem would result from mailing a refill of Adderall Jan. 6 to her daughter, Carrie, in South Korea. 
 
 Carrie Russell also expected no trouble when she in turn shipped the medication routinely prescribed by U.S. doctors for attention deficit disorder to Nagoya, Japan, where she planned to teach English. 
 
 But at 11 p.m. on Feb. 20, according to Russell's Portland-area family, five plain-clothed police officers in black suits burst into a Tokyo restaurant where the 26-year-old American was dining with friends. They took her into custody. She was taken 275 miles west to Nagoya, where she was incarcerated in a women's detention center outside the city. 
 
 Russell, a 2012 Western Oregon University graduate, remains in jail on suspicion of smuggling amphetamines into Japan. A U.S. consular official and a Nagoya lawyer, hired by family members, have visited her. They've told the family that Russell has been held in solitary confinement and subjected to numerous interrogations. 
 
 "We're left in a state of disbelief," said John Russell, Carrie's father, who teaches at a Portland elementary school. "We would never imagine something like this assaulting us from a civilized country like Japan." 
 
 As Carrie Russell's family members work frantically for her release, her predicament serves as a warning for Americans traveling abroad. Medication routinely prescribed in the United States can be illegal in other countries, with serious consequences for possession. 
 
 Russell's case also highlights differing U.S. and Japanese systems of criminal justice and drug enforcement, as well as contrasting attitudes toward mental health and treatment. 
 
 In hindsight, warnings against bringing Adderall into Japan show up on the Internet. But they're difficult to find, and veteran international travelers are often unaware of foreign laws that criminalize commonly prescribed U.S. medications 
 
 A traveler who scoured the Internet would find Adderall specifically cited in a parenthetical clause partway through one of several documents linked to an import-restrictions page on the Web site of the Consulate General of Japan in Seattle. 
 
 "Nobody can bring any medicine containing methamphetamine or amphetamine (Adderall and so on) into Japan," the document says. "If you are found with any medicine containing methamphetamine or amphetamine illegally in Japan, you can be arrested as a criminal on the spot, immediately, without a warrant in principle." 
 
 Unwittingly, from all indications, Russell has run afoul of a hidden world of criminal gangs, drug abusers, police and jails seldom encountered even by long-term foreign residents of Japan. 
 
 During World War II, the Japanese government gave amphetamines to soldiers and arms-factory workers. They used the stimulants, known as speed, to remain on duty for long hours. 
 
 After Japan's defeat, looters broke into military depots, stealing and selling large amounts of amphetamines. Japanese used them to suppress hunger during early days of the U.S. Occupation. In the 1950s, Japan outlawed amphetamines. The Yakuza, Japan's main organized-crime syndicate, muscled into the lucrative black market, which it still controls. 
 
 Amphetamines remain the illicit drugs of choice in fast-paced Japan, partly because authorities have managed until recently to keep out many other illegal substances common in the West. White-collar workers use speed to toil long hours. Students take it to pull all-nighters. Truck drivers rely on it to stay awake. 
 
 Illicit Adderall is common as well in the United State, where college students take it to get through exams. But U.S. doctors find the medication effective for treating attention deficit disorder. 
 
 In Japan, arrested amphetamine addicts have often ended up in psychiatric hospitals resembling jails. A 1996 ABC Australia documentary reported that many inmates were heavily sedated and given shock therapy. 
 
 Mental illness is stigmatized more in Japan than in other countries, according to Japanese researchers. While awareness is growing, mental conditions often go undiagnosed. Ritalin, the other main drug used in the West to treat attention deficit disorder, was banned in 2007 by Japanese government officials who cited widespread abuse. 
 
 Japan has some of the world's toughest drug laws. Police announce frequent amphetamine busts. Therefore the idea that Adderall might have some legitimate medical use elsewhere strikes Japanese officers as far-fetched. 
 
 Most amphetamines are smuggled into Japan, which is why Customs inspectors search for them, especially in shipments from the Korean peninsula. It didn't help Russell that her 180 generic 20-milligram pills were repackaged - apparently in an old Tylenol bottle, instead of the original prescription container -- increasing officials' suspicions. 
 
 Jill Russell said she originally sent the three-month supply of pills that way to her daughter for two reasons. 
 
 First, as a physician who often prescribes Adderall, she routinely advises patients to consider keeping pills in unmarked containers because prescription bottles attract burglars, due to the substance's high street value. She advises against carrying the medication in a car or purse, and to consider keeping it in a locked safe. 
 
 Second, knowing of the stigma in Japan concerning mental disorders, she didn't want Carrie Russell's reputation to suffer in case someone opening her household shipments noticed the medication. 
 
 "My repackaging was not an attempt to break or circumvent the law," Jill Russell wrote in a sworn affidavit sent Feb. 25 to Japanese police. "It was intended to preserve Carrie's privacy and dignity around a sensitive issue regarding medication to treat a disorder which falls under the area of mental health." 
 
 In a second affidavit sent Feb. 26, Jill Russell added: "At the time this medication was shipped, I did not know that later Carrie would be fortunate enough to be hired to teach in Japan, thus resulting in her move to Japan and the need to ship her belongings to Japan." 
 
 So far, the affidavits haven't swayed the police or prosecutor on the case. Neither have Jill Russell's answers to police officers during three phone calls from Japan, each lasting more than an hour. Officers also questioned Carrie's physician, Michelle Mears, by phone. 
 
 Officers said that under Japanese law, Carrie Russell can be jailed for as many as 23 days before being charged. If found guilty of smuggling amphetamines, she could be sentenced to years in prison. 
 
 Family members have worked on the case since Feb. 21, when Russell's father received word of Carrie's arrest from one of her friends. Russell's stepfather, Portland lawyer Loren Podwill, immediately contacted the U.S. Embassy in Tokyo to find out where she was. 
 
 It took U.S. diplomats 24 hours to locate her. The National Police Agency hadn't notified the embassy of her arrest, a step normally taken when Japanese police apprehend an American. 
 
 Family members worry that Carrie Russell might buckle under the relentless interrogations - at which she has no lawyer present - and confess to a crime she didn't commit. 
 
 Interventions by congressional staff members including those of Oregon's Democratic U.S. senators, Ron Wyden and Jeff Merkley, and U.S. Rep. Suzanne Bonamici, D-Ore., have also failed so far to secure Russell's release. But the staff members continued working angles in Tokyo and Washington, D.C., over the weekend at all hours in hopes of a diplomatic solution. 
 
 On Thursday, Podwill wrote a heartfelt letter to the prosecutor in Nagoya. He described the background and character of the girl whom Jill and John Russell adopted at infancy from a Guatemalan birth mother. 
 
 Podwill described Carrie Russell's success in life through hard work and dedication despite the challenges she has faced since 7, when diagnosed with attention deficit disorder. 
 
 He noted his stepdaughter's volunteer work at a school for the deaf. He cited her work during three college summers in Japan and Germany, teaching children of military personnel. Russell had taught English in South Korea for the last two years. 
 
 "Like her dad," Podwill wrote, "she has a passion for working with children and teaching, which is what brought her to South Korea two years ago and to her new job in Japan, which she is supposed to start in a few weeks." 
 
 Podwill wrote in terms that a Japanese might understand. He asked the prosecutor to accept the family's sincerest apologies. He said that no one intended to ignore or break Japanese law. 
 
 "That's not who we are," Podwill wrote. "That's not who Carrie is. She made a mistake. Jill made a mistake." 
 
 "Carrie has been humiliated and punished enough for that mistake, which she will never make again." 
 
 rread@oregonian.com 
 
 503-294-5135 @ReadOregonian ||||| Your Health 
 
 Neurologists Warn Against ADHD Drugs To Help Kids Study 
 
 itoggle caption Jb Reed/Bloomberg via Getty Images 
 
 Adderall and other ADHD medications are among the most prescribed drugs in America. 
 
 Quite a few of those pills don't end up being used to treat ADHD, though. They're used as "smart drugs" or "study drugs" by students who find the pills give them a mental edge. 
 
 The American Academy of Neurology now says: Stop that. 
 
 The brain docs are directing that advice first and foremost to their fellow physicians, the ones who have been writing all those scrips for people who don't have ADHD, or who perhaps don't think about all the pills their patients sell on the student black market. 
 
 "We don't believe that doctors are supposed to be drug dispensers for healthy people," says William Graf, a professor of pediatrics and neurology at the Yale School of Medicine. "This is an ethics issue." 
 
 But the message is also being sent to teenagers and their parents, some of whom who might think that giving their child a little leg up for a big test isn't such a bad thing. The buzz term for that? "Pediatric neuroenhancement." 
 
 Prescribing ADHD drugs to children who don't have the disorder is "not justifiable," according to the American Academy of Neurology's new position paper. That's because children's brains are still developing, the paper says, and they don't have the ability to weigh the risks and benefits of medication. 
 
 Prescribing study drugs is "inadvisable" in teenagers, the Academy said, a word chosen to reflect both teenagers' growing autonomy, and the fact that the Academy can't tell doctors what drugs they can and can't prescribe. 
 
 The number of children diagnosed with ADHD rose 24 percent from 2001 to 2011, according to a study published earlier this year. Over the same time, the number of prescriptions for Adderall and other ADHD drugs has soared exponentially. 
 
 More pills in circulation means more pills that can be bought, borrowed, or snitched. Various surveys report that 8 to 35 percent of college students say they have used stimulant pills to improve school performance. 
 
 The neurologists are not saying that stimulant drugs shouldn't be used to treat ADHD, which is characterized by problems with attention and hyperactivity. "We're not touching that here," Graf told Shots. 
 
 What they are saying is that doctors have a moral obligation to protect the best interests of the child — who doesn't yet have legal control over health care decisions — and to prevent the misuse of medication. 
 
 Amphetamines like Adderall and Vyvanse can be addictive, which is why they're classified as Schedule II controlled substances, along with Oxycontin and morphine. Side effects can be as simple as insomnia, or as serious as sudden high blood pressure, irregular heartbeat, and seizures. 
 
 Other popular ADHD drugs like Concerta and Ritalin are methlphenidates, and are considered less risky. But they can cause a wide range of side effects including insomnia, aggression, mood and behavior changes, twitching, and shaking. 
 
 About 15 percent of 12th graders say they misuse prescription drugs, according to the 2012 Monitoring the Future survey, and about 6 percent say they've misused Ritalin or Adderall. Adderall is the only drug class that showed increased use in 2012, the federal survey reported. 
 
 "As a society we have a pill for everything," Graf says. "It's one thing if you're taking something from the Vitamin Shoppe. It's another thing if you're talking about amphetamines." 
 
 Doctors should talk with patients and parents about why they feel the need for academic performance enhancing drugs, Graf says. Then they should point out that there are other ways to deal with competition and anxiety. 
 
 "We have to get back to the basics," Graf says. "Sleep, exercise, and social interaction."
– Carrie Russell apparently thought little of shipping her Adderall to Japan before moving there to teach English. But Japanese police saw it differently, arresting the 26-year-old American last month for allegedly smuggling illegal amphetamines into Japan, the Oregonian reports. "We're left in a state of disbelief," says her dad, a Portland teacher. "We would never imagine something like this assaulting us from a civilized country like Japan." But Adderall is strictly illegal there, and police can hold Russell for up to 23 days without charging her. Meanwhile, her family, US politicians, and even her doctor are trying to get her out of a possible years-long prison sentence—for carrying a drug that's one of America's most widely prescribed, NPR reports. Trouble is, Japan's drug laws are among the world's toughest. The country routinely announces busts of amphetamines, which Yakuza crime syndicates smuggle into Japan for those who pull long hours, like white-collar workers, students, and truck drivers. Another problem: Russell's mom sent her the prescription in an old Tylenol bottle, which created the appearance of smuggling. She says she did it to ward off thieves and avoid identifying Russell's illness—attention deficit disorder—in a country where mental illness is stigmatized. But warnings against taking Adderall to Japan do exist online, and so far Japanese authorities haven't budged. "She made a mistake," her stepfather wrote Japanese prosecutors. "Carrie has been humiliated and punished enough for that mistake, which she will never make again." (A tourist was once jailed in Dubai after reporting a rape.)