Triumph of the Pill

Why brain doping on campus is no cause for concern


This past January, the prestigious science journal Nature conducted an online survey asking how many of its readers (who are primarily scientists and academics) had ever used "cognition-enhancing drugs," or brain dope. Perhaps unsurprisingly, the informal survey of 1,400 readers found that "one in five respondents said they had used drugs for non-medical reasons to stimulate their focus, concentration or memory." Moreover, Nature found that "a high four-fifths thought that healthy adults should be able to take the drugs if they want to."

In the absence of any large-scale studies measuring illicit prescription drug use among professionals, these results provide a highly suggestive counterpoint to the increasing hysteria over the abuse of "study drugs" by college students. After all, if some professors are doping up before hitting the books, why shouldn't undergrads do the same?

In fact, over the past decade, prescription stimulants such as Adderall and Ritalin—which are typically used to treat Attention Deficit Disorder (ADD)—have become increasingly available on college campuses. While studies disagree on the prevalence of stimulant "abuse" (that is, non-prescription use) among college students, the numbers suggest that anywhere between five and 15 percent of undergraduates have illicitly used such drugs to improve their academic performance. And while college health officials and various government scolds decry this trend as evidence of "drug abuse" by America's best and brightest, the reality is far from alarming.

Part of the growing concern about stimulants comes from the explosion in legal prescriptions doled out to kids. Between 1993 and 2003 the number of children's doctor's visits resulting in a stimulant prescription jumped from 2.7 million to 6.6 million. Over 10 percent of 10-year-old boys in America are now prescribed some kind of drug to control their unruly behavior, and the average starting age is getting lower. Parents are increasingly told that doping their little ones will make the children happy and successful. In 2000, psychiatrist Peter Breggin testified before Congress that, "Teachers, school psychologists, and administrators commonly make dire threats about their inability to teach children without medicating them." This trend is certainly worrying, not least because the long-term effects of regularly administered stimulants are as yet little understood.

So there are legitimate reasons to be concerned about child doping, particularly given the growing frequency of ADD diagnoses. But what about the strategic use of the same drugs by consenting adults, particularly college students? As usual, the law gets it backwards: While it is perfectly legal to feed—even force feed—Ritalin to a child, unsupervised use by knowledgeable grownups is a crime.

At the same time, it is remarkably easy to score prescription brain drugs at many of America's most prominent universities. A quick survey I conducted of stimulant-using students at Harvard reveals that it's possible to obtain a Ritalin prescription after one 20-minute consultation with a psychiatrist. One student, a sophomore who wishes to remain anonymous, obtained a script for amphetamine salts after just two appointments. He's pretty sure he doesn't have ADD, and he definitely never lied about or exaggerated his symptoms, which featured insomnia more prominently than the ADD hallmark of distractibility. Yet his psychiatrist readily prescribed the drugs. "It's not as if there's some medical authority making this decision for you," he told me afterwards. "Any reasonably capable person could walk out of there with just about whatever [drug]."

Still, there is widespread alarm about the possible health problems arising from unsupervised dosing. "Put the pills in the wrong hands and the results can be dangerous," NBC News warned. Henry Chung, Director of the New York University Student Health Center has warned that, "Students may have some kind of manic reaction or a seizure that could occur from taking these medications." For high doses, Chung is correct. But today's performance-enhancing undergraduates exhibit more responsibility than Chung realizes. One NYU senior I spoke to says it's mainly a case of "every now and again for finals. I don't know anyone who abuses Adderall or Ritalin." Moreover, "because they're prescription you can find out so much about them so you know how you can take it safely."

There is also the claim that student dopers—like testosterone-injecting athletes—are cheating because college is a competitive environment in which participants are obliged to play fair. Of course, this argument ignores the fact that most of the abilities being enhanced by such drugs are already unequally distributed (due to a mixture of biological and socioeconomic factors). Why is doping to achieve "normal" functionality a permissible act for ADD sufferers, but wrong for those seeking better grades or greater knowledge?

As the Nature survey suggests, responsible and successful adults dope up for a variety of professional reasons. There is no evidence that student doping is more dangerous or widespread than that done by their professors. Yet many university authorities are nonetheless determined to close Pandora's box. Unlike their Harvard counterparts, for example, students at the University of Michigan typically have to go through $1000 worth of psychometric tests before psychiatrists are willing to prescribe them any neuro-enhancing drugs. And doctors, of course, are loath to relinquish their power over patients.

It's time for such authority figures to admit that performance-enhancing drugs are already part of everyday life for a great many rational, healthy adults and that their use can no longer be dismissed under the title of "abuse" or "cheating."

Juliet Samuel is a writer living in Boston.