Use of ADHD Drugs to Enhance Performance Rampant among College Students

I watched CBS 60 Minutes tonight, and was surprised to hear how many college students are using stimulants like methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderal) to get better grades. These drugs are amphetamines, and Schedule 2 drugs that require a written prescription, cannot be faxed or called into pharmacies, and are considered to have high abuse and addiction potential by the FDA. They have the same type of effect on the brain that other amphetamines like crystal methamphetamine have, can be addictive, and can cause dangerous side effects of high blood pressure like stroke and heart attack, as well as anxiety and psychosis. These potential adverse effects aside, they do appear to function as stimulants that allow students to stay awake longer and study more effectively when sleep deprived. This alone can be a strong temptation to students wanting to perform well on an exam after pulling an all-nighter studying, or to stay up and be able to focus on writing a paper when they otherwise would be exhausted and have trouble staying focused. The evidence that these drugs actually improve cognitive ability is far less clear-cut.

There is some evidence that in sleep deprived brains Adderal and Ritalin can improve the ability to stay focused in much the same way they work in people with ADD.

The statistics quoted on the 60 Minutes piece are staggering. 50-60% of college juniors and seniors, and >80% of college juniors and seniors who are members of sororities or fraternities use these drugs illegally. How do they get them? They either fake the symptoms of ADD and get a prescription from a physician, or they buy left over pills from other students who are prescribed ADD meds to use 30 days a month, but take them only some days, so they have excess pills that they sell to their classmates.

What do I think of all of this? Most importantly I think we need to do more research to see whether these meds actually work to improve maximal intellectual capacity, or if they just allow students to stay awake longer and focus when sleep deprived. We also need more data on the risks of use, incidence of addiction and adverse effects. If the drugs prove to be safe and actually lead to improved performance, then we as a society need to make a decision on whether we feel these drugs should be legal for use by people with normal attention abilities to improve performance. We are already using them in U.S. Air Force pilots on really long flights. We use another drug called Provigil for shift workers and others with trouble staying awake. How far are we from saying , “What’s the difference between a student during finals week and a pilot flying a 24-hour mission?” This is yet one more tough choice we as a society will need to make. We don’t have a great track record of electing legislators with the courage to make tough choices so far, so I suspect we will keep our heads in the sand, and the illegal use of these drugs by students and others will continue as long as there is the perception, true or not, that they give an advantage to the user over the student they are competing with who does not use them.

The 60 Minutes video is about 13 minutes long. Click here to see the video online: Boosting Brain Power

Ed Pullen, MD, is a board-certified family physician practicing in Puyallup, WA. He blogs at DrPullen.com — A Medical Bog for the Informed Patient.

This article originally appeared online at DrPullen.com.