Once again, attention deficit-hyperactivity disorder (ADHD) is back in the news. Only, this time it’s about ADHD drugs and healthy, bright college kids. The college kids now take the ADHD drugs to improve their memory and mental focus to try to get that “extra edge.”
You’ll be surprised to learn just how easy it is for the students to get the drugs.
And it’s led many to the perennial questions: To whom should these drugs be prescribed and who should prescribe them?
The first cognitive enhancement drugs consisted of stimulants (originally amphetamines) prescribed to children for ADHD or ADD. Paradoxically, we once considered these children “hyperactive.”
But drug makers discovered that stimulant drugs help calm down hyperactive students. This led to parents and teachers placing whole generations of our kids on stimulants to keep them calm and controlled in the artificial environment of the typical classroom.
But now healthy kids–without attention problems–want in on the action. They too want improved memory and focus.
This practice probably started sometime in the 1980s, when a college student wanted to “pull an all-nighter” to cram for a test. As an experiment, instead of using an illicit amphetamine stimulant, he borrowed one of his friend’s ADHD prescription pills. The kid stayed up all night, aced the test, and–voila–a whole new market for ADHD pills was born. Of course, whether this “ace” student actually learned or remembered anything is another question.
New research published in the Canadian Medical Association Journal suggests this now happens all the time on college campuses across America.
In fact, more than 10 percent of college students who do not have ADHD use stimulants to boost concentration and alertness. More than three-quarters of these healthy students get the medication from fellow students. Presumably, the students with the pills have ADHD themselves or they’re simply making early careers for themselves as high-end drug pushers.
But the remaining quarter of these students apparently get their drugs the old-fashioned way…from their doctors. Now, it’s hard to imagine a credible psychiatrist prescribing a stimulant to someone without ADHD. But some suggest that family doctors may be more liberal in doling out drugs to kids striving to get through the rigors of college like the rest of us did…with coffee or just old-fashioned discipline (in short supply among most students and faculty at our modern-day colleges)!
Let me be clear…
Scientific and professional literature does not support the use of any neuroenhancers for healthy individuals. Physicians should not prescribe them to healthy people. Indeed, the authors of the CMAJ report clearly stand against doctors prescribing them to healthy patients.
However, R. Scott Benson, MD, a child and adolescent psychiatrist in Pensacola, Florida, who is also a member of the American Psychiatric Association (APA), sounds like he’s on the fence. In an interview with Medscape Medical News, he said research shows that stimulants do improve concentration and focus.
“If you are a normal person with a normal attention span and you took one, then your attention span probably will go longer,” Dr. Benson told Medscape.
(Meditation will do the same exact thing…and it’s not a drug.) [hyperlink to 1/1/13 Daily Dispatch] And mindfulness meditation is easier than you may think as we explain in my book with Don McCown, New World Mindfulness.
Dr. Benson also said, “I don’t think physicians are going to be in a position to prescribe [stimulant] medications to healthy people because in order to get paid for it, they have to say that the patient has a condition. I can’t see healthy people in my office and treat them for something they don’t have.”
Well, the kids are getting the drugs somehow. And only three-quarters of them “borrow” the drugs from friends. Apparently, some doctors don’t let a small trifle such as an “official diagnosis” get in the way of prescribing a stimulant.
The American Academy of Neurology (AAN) issued guidance on the use of “neuroenhancement” for healthy individuals. In essence, the AAN says that physicians may grant requests for cognitive enhancers to healthy individuals but are not obligated to do so.
Sounds like carte-blanche to me. Go ahead docs, prescribe all the drugs you want. Just don’t feel “obligated” to do so.
By the way, this is the same enlightened organization that made history last year by recommending butterbur and non-drug alternatives for the treatment of migraine headache, as we reported in the Daily Dispatch.
Unfortunately, the American Psychiatric Association–the most important mental health organization in this country–has nothing to say about giving cognitive enhancers to healthy patients. It hasn’t issued an official position on the problem.
However, Dr. Benson attempted to illuminate the APA’s position. He said the APA believes “doctors should always be good doctors.”
Here, I can agree with Dr. Benson. Pushing drugs like stimulants–which are also abused for illicit, “recreational” purposes–is tantamount to substance abuse or at least misuse.
If you’re concerned about improving your memory and mental performance in your everyday life, research shows the benefits of natural constituents like those in green tea, coffee, and cocoa.
Lastly, keep your mind active. It’s one of the best ways to keep your memory and mental performance strong. So keep reading the Daily Dispatch. That, along with a good cup of coffee, tea, or hot cocoa, will help keep your mental pistons firing.
1. Cynthia Forlini, Serge Gauthier, and Eric Racine Should physicians prescribe cognitive enhancers to healthy individuals? CMAJ cmaj.121508; published ahead of print December 17, 2012.
2. Neurology 2009;73:1406-1412