Adderall and the need for speed

It’s 2:50 a.m. on a school night, and I am faced with the decision to sleep, polish this column or finish the homework for a class that starts in five hours. The first option is a fast track to failure, in spite of a consistent, weeklong effort to avoid this conundrum. If only there were a superhuman wonder drug whose off-label use could deliver me from that enemy “sleep” and its plot to destroy my chance at multidimensional success.
Adderall® is a stimulant used to treat Attention Deficit Hyperactivity Disorder (ADHD). It is a mixture of amphetamine salts, which stimulate the production of dopamine and norepinephrine in the brain. Laymen read: happiness plus stress equals euphoric productivity (or teeth-grinding nausea, depending on your body chemistry). The most common effects of Adderall are appetite suppression and an increase in focus, motivation and reading retention. It is just one in a family of neuroenhancing drugs, including Ritalin and Provigil.
For a person with ADHD, stimulants have a calming effect, narrowing focus and reducing impulsivity. But for “healthy” individuals, drugs like Adderall are subtle yet powerful in their ability to enhance cognitive function, transforming dense texts into whimsical roller coaster rides.
Adderall is classified as a Schedule II controlled substance because of its high propensity for abuse. Amphetamines are extremely addictive, and it is possible to overdose on them. They act as ticking time bombs in those with underlying heart conditions, eating disorders or neural imbalances. That being said, cognitive enhancing drugs are widely seen as fairly harmless in healthy adults who consult with a doctor and exercise caution. But such viewpoints exist in the absence of adequate studies on long-term use.
The fine print in manufacturer’s literature on Adderall clearly states that controlled trials on adults lasting longer than four weeks have not been conducted. Given the lucrative nature of these drugs, such expensive and potentially unfavorable trials are difficult to get off the ground. All doctors who prescribe Adderall and patients who take it are choosing to gamble with how they experience reality, perhaps permanently. However, at some universities, as many as 25 percent of students are willing to take that risk if it means a better GPA.
The University of Minnesota’s numbers have not been tallied, but I flagged down 100 students on campus to poll — unscientifically, of course — about their experience with Adderall. Thirty-seven had taken the drug, only six of whom had prescriptions. These six shed light on the dichotomy of cognitive enhancing drugs and the loss of pride in personal performance. Many had been taking Adderall or Ritalin for several years. “I wish I didn’t need foreign substances to do well in school,” said a male with ADHD. “But I can’t escape the fact that my body needs it now.” Being a slave to drugs is never fun, regardless of whether they’re what the doctor ordered.
The underlying theme reflected in these numbers is the intensity of the modern-day rat race, specifically within an academic institution. A common misconception about Adderall is that its off-label users are procrastinators or drug abusers. In some instances, this is true. But for most, it is used to maximize time and output in a high-risk, high-reward situation. Adderall works, which is the problem. Or rather, the reality.
A fascinating article about the phenomenon of “cosmetic neurology” in The New Yorker profiled a Harvard University student named Alex who spoke candidly of his choice to take Adderall in order to facilitate success at school and continued participation in valuable extracurricular activities. “One of the most impressive features of being a [college] student is how aware you are of a 24-hour work cycle,” he said.
Neuroenhancing drugs present a rabbit hole of ethical questions in medical and academic communities. Are they safe? Does their use constitute cheating? I don’t think it’s either one: Adderall doesn’t do your work for you; it merely offers the focus needed to use your time efficiently. And as long as you’re willing to accept the slow poison of sleep deprivation, the imminent depressive crash and the murky question mark of long-term effects, you should be allowed to decide for yourself.
Boynton Health Service will not write new prescriptions for Adderall, as they do not have the staff nor the resources to conduct the costly, comprehensive tests required for diagnosing ADHD. The hiring freeze is partly to blame, but so is the demand. I implore the University to recognize the need for a specialist in this area and, furthermore, to consider the possibility that students who don’t suffer from ADHD might benefit from Adderall in significant ways worthy of the legitimate prescriptions and follow-up care central to a safe use of pharmaceuticals. At the very least, if you’re going to take a drug that hasn’t been prescribed, consult your doctor or pharmacist to learn your individual risks in doing so. Confidentiality is on your side.
I do fear the apocalypse and the idea of living in a world where everyone is a passively medicated worker bee pushed far beyond the limits of human endurance. The best solution would be a societal shift toward eliminating the perceived need for neuroenhancement in the first place. But since that seems unlikely, the alternative is a good, hard look at the reality of what science can do — and is doing — whether we like it or not. Adderall is not a wonder drug; it’s a symptom of society’s exponentially increasing expectations. Let’s sleep on it.

Allison Fingerett welcomes comments at afingerett@mndaily.com.