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Adderall for an A-Plus?

Op-Heads: a virtual chat on the issues that matter

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Click on the video above to watch George Annas (left) and David Farb discuss the ethics and safety of cognitive enhancers. Click here to watch short version. Click here towatch full version.

While all-nighters and study groups are still the path to better grades for most students, more than a few are willing to pop a pill in search of an academic edge. The study drugs of choice are mild stimulants such as Adderall and Ritalin, prescribed mainly for the treatment of attention deficit hyperactivity disorder (ADHD). When taken “off label,” they can improve the ability to focus and retain information. One recent survey found that nearly 7 percent of university students in the United States have used prescription drugs for a mental boost.

Critics of such cognitive enhancement say it’s cheating — and dangerous. Defenders say it’s no different from downing a cup of coffee. As it stands, it’s a crime. But last month, in a Nature commentary, seven academics and scientists argue for new approaches to regulation that “avoid making felons out of those who seek to use safe cognitive enhancements.”

These drugs, “along with newer technologies such as brain stimulation and prosthetic brain chips, should be viewed in the same general category as education, good health habits, and information technology — ways that our uniquely innovative species tries to improve itself,” the authors write.

The article also discusses concerns about safety and fairness and urges further debate on all these issues.

BU Today asked George Annas, Edward R. Utley Professor of Health Law, Bioethics, and Human Rights and chair of the School of Public Health’s department of health law, bioethics, and human rights (left), and David Farb, chairman and professor in the department of pharmacology in the School of Medicine, to discuss whether enhancement through drugs is progress or a Pandora’s box.

Got an issue to debate? E-mail today@bu.edu with “Op-Heads” in the subject line.

Robin Berghaus and Edward A. Brown assisted on this piece.

Chris Berdik can be reached at cberdik@bu.edu. Robin Berghaus can be reached at berghaus@bu.edu. Edward A. Brown can be reached at ebrown@bu.edu.

12 Comments

12 Comments on Adderall for an A-Plus?

  • Anonymous on 01.22.2009 at 6:40 am

    I have been taking Adderall as an adjunct medication to treat my clinical (major) depression, however what the “Nature” study proposes is preposterous. Adderall (D,L-amphetamine) and Ritalin (methylphenidate) as well as other stimulants (Focalin, Dexedrine, Concerta, Vyvanse, etc.) are properly classified as Schedule II substances due to their abuse potential. Dispensing amphetamine (and its derivatives) in an uncontrolled way would enable students (and anyone else) to ingest doses way higher than the therapeutic ones in search of a “high” – at that point, psysical and psychological dependence form and the person becomes an addict. By regulating the amphetamine market, the potential for abuse is minimised, at least as far as the “legal” sources of procurement are concerned. Moreover, amphetamine (and its derivatives) can cause life-threatening cardiovascular events in susceptible individuals (tachycardia, sudden fluctuations in blood pressure), as well as seizures and psychotic episodes, especially when used above the maximum therapeutic dose that would be prescribed for adults with ADHD.

  • Anonymous on 01.22.2009 at 9:22 am

    Nice to see the full video available for viewing.

  • Anonymous on 01.22.2009 at 9:36 am

    i don’t think they are suggesting that you can just pop over to the pharmacy and get adderall, i think they are suggesting broadening the reasons by which it may be prescribed, and allowing choice on the part of the patient, with the consultation of a doctor.

  • Anonymous on 01.22.2009 at 10:04 am

    Honestly, I’m disgusted by the whole thing. My peers claim they use Adderall because they “can’t concentrate.” What ever happened to self-discipline? It appears that my generation is obsessed with instant gratification and taking the easy way out. Just like how an overweight individual takes a diet pill to magically melt the fat off their stomachs, today’s college teens pop pills believing that it will magically give them the ability to concentrate and get an A on an exam.

    This new cultural fad is in no way one of the “ways that our uniquely innovative species tries to improve itself”; rather, it is one of the many practices our race uses to pump ourselves full of chemicals in mere hopes of self-improvement. The truth is: we’re actually killing ourselves.

  • amlaskow on 01.22.2009 at 12:57 pm

    Thoughts

    I watched the debate about letting everyone take Adderall or other enhancing drugs. This is a subject that is very sensitive for me and I have strong opinions about. First of all, I was actually recently
    diagnosed with ADD after a lifelong struggle in the classroom. I would sit in class for an hour and walk away with nothing learned, unintelligible notes, and huge frustration. When it came time for tests, I would be in a hole with no way out (not to mention that I
    could not even find the focus to study). For most of my life, I have felt stupid compared to my other classmates, especially when they would talk about things that a teacher or professor taught that I had
    not even heard of because of my difficulties to pay attention.

    However, I have been prescribed a medication to help with my difficulties and it has made all the difference for me.

    So, my main problem with this is if we let everyone take the drug for the equal edge, what happens with the people who REALLY need it, you know, the ones that the drugs were created to help? People with ADD or ADHD. We are then at a disadvantage. Taking the medicine helps give people with disabilities a boost up to the level that everyone else is at; a level that we could not reach with ADD. If everyone takes it,
    especially people who are fine and do not need it, then they have an unfair advantage over people with real disabilities.

    Another thing- enhancers do NOT make a person smarter. No one can make a person smarter except for him or herself through rigorous studies. Enhancers
    simply help people focus, which for people with ADD and ADHD, makes all the difference. I think that people who do not have troubles focusing would not really benefit from it.

    If someone is really having trouble focusing and feels that he or she needs enhancers, then he should get tested for ADD just like the rest of us.

    My last point is that research is still being done on these drugs, there have been serious side effects such as sudden death, seizures, tourettes, and (the biggest one) addiction. The earlier side effects are mainly concern if people have other health conditions, but either way, if a school is going to freely hand these out, then there could be some serious situations that involve law suits. Addiction, however, can happen very very easily. If someone takes the drug every single
    day, a tolerance is built and then he will keep going up in doses and can become dependent on it. Studies show that addiction to adderall leads to addiction to other substances such as speed or cocaine. Does
    a school really want to promote or start something like that? I really hope not. I take the prescription safely, but I do not trust that everyone in a school would.

    Overall, I think that this idea is a terrible one and will discredit the institution of school.

  • Stephanie on 01.22.2009 at 1:30 pm

    I think this is a terrific article. I agree with the authors that there are no moral grounds for prohibiting such use, though there are some very justified concerns and possible risks, which I feel they have really tried to address. I am most concerned about the health risks, especially within the context of direct or indirect coercion, but I feel it is better to seek ways to protect people by regulating the institutions such as schools and employers while allowing individuals the freedom to choose for themselves.

  • Emily on 01.22.2009 at 7:20 pm

    Questionable Information

    I am confused about the following quote:
    “When taken “off label,” they can improve the ability to focus and retain information.”
    As far as I know, they increase your blood flow (by increasing your heart rate) and can make you feel more alert, but there is no evidence of the drugs enhancing your ability to retain information.
    A lot of people begin taking the drugs to improve their schoolwork, and then switch to recreational use, often resulting in serious problems, including dependency, psychosis, depression and anorexia.
    When cocaine and LSD were first introduced into society they were used for medical purposes and considered by many doctors and scientists to be beneficial, before they realized the many extremely devastating side effects. Clearly mistakes have been made by people with PhDs in the past…and now history has begun to repeat itself with amphetamine abuse.
    All it takes is one article to change a students mind and make him or her consider using this drug to get an “edge” which “nearly 7 percent” of his classmates have.
    Get by with what you have. If you are in a university or college that is expecting great things from you, it is because in the past you have proven that you are capable of great things, and to convince yourself that you now need to use a substance to achieve at that level is an insult to your intelligence. Think of whether you could be proud of a degree that you feel they could not have earned on your own.

  • Anonymous on 01.23.2009 at 1:15 pm

    “Think of whether you could be proud of a degree that you feel they could not have earned on your own. ” If one is taking PRESCRIBED ADHD/ADD medication, how can you say he/she did not own the degree on their own? It is a prescription that “mildly enhances cognitive functions.” Adderall certainly does not enhance grades that much that you could educationally suggest that people on it would not have earned their degrees otherwise. Seems like you should keep studying, though.

  • Anonymous on 01.23.2009 at 1:38 pm

    Re: Thoughts

    Your argument appears very flawed and makes you sound like you are whining. What you’re equating this too is a weak guy who takes steroids so he can play on the football team and then says it would be unfair for the other players to take the same drug because then you’d fall behind again. Everyone should be on a level playing field, and if one person gets to take the drug, everyone should. I might have ADD, might not, but I know it helps people concentrate, so if someone wants to take it they should be free to do the same as you. No reason you should get a privelage others don’t, that seems selfish.

  • Anonymous on 01.23.2009 at 6:33 pm

    RE:RE: Thoughts

    A person who is not athletic has the choice to play sports at whatever level s/he is capable of. The person who is healthy and normal but uses performance-enhancing steroids is doing so with the intention of exhibiting abilities s/he does not normally possess and are not essential to living a normal life. This should not be equated with a person who is born with ADD and does not have the choice in life to compete in normal learning activities on a level playing field without using a therapeutic that helps treat the disorder. The person who wrote “Thoughts” describes a struggle that should be understood of rather than criticized. “Thoughts” is not whining….

  • Anonymous on 02.25.2009 at 9:23 pm

    Response to "Honestly, I'm disgusted..."

    This comment is insulting to anyone who has diagnosed ADHD. As an individual with this neurological disorder, I sincerely wish that the only problem was self-discipline. If this was the case, however, then Adderall would not have been approved after years of rigorous research and tests, which have confirmed that the benefits of this drug on a particular type of brain outweigh the costs (side effects). I know I’m not just speaking for myself when I say that many of those with ADHD have received substantial amounts of criticism throughout life – from our peers, parents, and teachers – of our deficient levels of “self-discipline.” I’m not offering an excuse for the actions of those with ADHD, I am merely pointing out a common misunderstanding of the disorder. The focus of this person’s response seemed to reflect more on their own anger at the motivations of the individuals who take these prescriptions than on the actual prescriptions themselves. This argument is completely flawed, and any informational source on this prescription medication will render this argument useless. Those who take Adderall do not magically receive the ability to get A’s on exams. However, those who lack normal levels of brain dopamine, a neurological chemical responsible for learning and memory, are un-magically benefited in these corresponding brain regions by the administration of this drug. As for my opinion on the comment of “instant gratification and taking the easy way out,” see above, or read a medication guide from a pharmacy. Finally, the side effects and tolerance that builds with everyday Adderall use is completely undesirable for many patients. The psychiatrist will only prescribe this medication if the benefits of the drug to the individual will outweigh the costs. After this decision, it is still up to the patient to decide if they are willing to put up with the large number of physiological and psychological side effects.

  • Anonymous on 03.23.2009 at 2:14 pm

    I was reading this article and got bored. Time for my “Magic Pill” LOL

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