The New Illicit Drugs: Kids Who Don’t Need Cognitive Enhancers Take Them Anyway
Becca Hartman is sympathetic to the kids who want her Adderall — prescribed for her attention-deficit disorder — to help them study. But she’s becoming less so.
“I’m like, ‘Don’t even go there’” said Hartman, a junior at the University of New England in Maine.
Almost everyone who finds out she has a prescription wants to buy some Adderall from her. The illicit demand, she says, makes it more difficult for people with legitimate prescriptions to get it.
“The whole thing is very frustrating,” she said. “It’s difficult for me to get my prescription filled because of all the people who misuse it.”
That demand for cognitive-enhancing medications — Adderall, Ritalin and other drugs that stimulate the ability to focus attention — partly inspired a controversial December article in the journal Nature. In that article, professors, researchers and others suggested making such medications available to people who merely want to sharpen their brains or improve their performance.
Besides medications for attentional disorders, cognitive-enhancing medications include Provigil (the generic is modafinil), now approved for treatment of narcolepsy, and medications used to enhance memory for patients with Alzheimer’s disease. The Nature article’s authors argue that cognitive-enhancing drugs “should be viewed in the same general category as education, good healthy habits and information technology — ways that our uniquely innovative species tries to improve itself.”
The medications, the authors say, are much like getting adequate sleep, nutrition and exercise, drinking coffee, or hiring a tutor.
A lot of students apparently already see it this way. Almost 7 percent of students in U.S. universities have used prescription stimulants illicitly. On some campuses, up to 25 percent of students have used them in the last year, according to a survey cited in the Nature article.
Dr. Anjan Chatterjee, a neurologist at the University of Pennsylvania who coined the term “cosmetic neurology,” sees the students as a harbinger of an inevitable trend toward the use of such drugs by normal people wanting to be better.
“I do think that in professions that are highly competitive, where people have at least the perception that the slightest advantage might give disproportionate rewards, there are pressures to use this,” Chatterjee said.
One University of Connecticut junior, who asked not to be identified, has experienced this. “I think it’s almost necessary because of the competitive factor,” she said. “If you don’t use it, you are at a huge disadvantage.”
The student said she tried ADD medication for the first time last year, when she realized at the last minute that she had a big exam the next day. “I noticed a huge difference,” she said. “I just had an intensive focus for a very long time, hours and hours more than usual.”
Now she takes Adderall five or six times a semester, purchasing it for $5 or less a pill.
At the College of Charleston, a student who has ADD found he could pull in $200 a day selling his Adderall for about $5 a pill around exam time. But this year he decided not to do it after he ran out of medication, and didn’t have it when he needed it.
Ronald Kessler, a professor at Harvard Medical School and one of the authors of the Nature article, said they are not suggesting making the current medications available now to anyone who wants them.
“We’re not saying open the floodgates right now. We’re saying start thinking right now,” he said, and start doing the research.
“We need better information,” he said about what works and what doesn’t. This would entail research for new medications with fewer side effects and a rational, rather than moralistic, approach.
Movie stars, he noted, enhance their looks with plastic surgery. If a pill helps a medical student learn more information, remember it longer and understand it better, Kessler said, “I want my doctor to have that pill.
“Just speaking as a selfish individual patient, if it makes my doctor sharper and he detects my cancer on some subtle test, I wouldn’t have it otherwise. I want him to wear eyeglasses that make his vision better.”
Audrey Chapman, a medical ethicist at the University of Connecticut School of Medicine, “would not like a doctor who was hyped up on drugs to examine me.”
Chapman says there “are serious questions about whether we want to manipulate human beings to try to enhance them.”
Dr. Edward Volpintesta, a general practitioner in Bethel, opposes the use of such medications by people without the disorders. “We have become such a performance-oriented society, whether you’re talking steroids, Viagra, or Adderall for taking an exam,” he said. “It really is a form of sickness.”
Also of great concern to experts are the side effects of some cognitive-enhancing medications. With Adderall and Ritalin, the risks include addiction, a racing heart, increased anxiety and insomnia.
Chapman said she is also concerned about the societal inequities if well-to-do people buy cognitive enhancers while others can’t afford them.
“We are not advocating handing these pills out like candy,” Kessler wrote in an e-mail. “We’re advocating recognizing the reality of what is already happening … and being thoughtful in addressing this reality.”
At UConn, the young woman who takes Adderall during exam time has noticed that students who are involved in a lot of campus activities — sports, leadership, fraternities — are more likely to use the drugs. “Because there are only so many hours in a day,” she said. “I wish I had known about it with the SATs. I was falling asleep at the end of it.”
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