Dear Dr. Wes and Katie: My son was caught “borrowing” someone else’s Adderall during finals in December. I’m really frustrated with him. He’s claiming that this is not like drug abuse because he’s doing it to help, not hurt himself, and everyone else is using stimulants so without them he’s at a disadvantage. This is breathtaking for me. What are your thoughts and advice about this?
Dr. Wes: Yeah. Breathtaking. That’s how I felt last spring when a college freshman expressed her frustration that “everyone in my biology class was loaded on Adderall for the final.” And just like your son, she felt it ruined the curve.
Initially, I was incredulous about this. I’m no stranger to amphetamine abuse, but it didn’t seem possible that stimulants were falling down like candy from heaven.
Unfortunately, I’ve heard this same story a number of times since, and not only among college students.
Stimulants are a godsend for people with ADHD. The research supports that and all the major associations and academies agree that medication works.
But that benefit comes at a substantial cost. These are powerful meds, they have side effects and they build tolerance quickly in the brain, requiring either quarterly breaks or dosage increases that can further multiply the side effects. Most people I see who take stimulants correctly have a love-hate relationship with them. If they could get by without them, they would happily do so.
So why would anyone want to use them unless they were absolutely necessary? Because of the unproven belief that anyone can benefit from them, like they’re a super cup of coffee that magically improves test scores.
The New York Times reported in October that some physicians are actually going along with this trend to try to “even the scales” between low-income children and the rest of society. And what’s the problem with that? We have no research on whether these meds really help a nondiagnosed population, and if they do, for how long and under what conditions.
Simply put: These meds just don’t work that way.
Parents who suspect their child has ADHD should get an evaluation using a standardized, norm-referenced test, along with a clinical interview that rules out other causes. There are several good scales available and plenty of professionals who follow recognized guidelines for evaluation and treatment.
If teens and young adults are coping with competition in the learning environment this way, they’re going to be disappointed. This isn’t leveling the playing field. It’s pinning your hopes on an illusion.
Katie: In many ways, modern education more closely resembles the Tour de France than it does a classroom learning experience. As soon as students hit high school, our classmates become competitors: in class rankings, standardized tests, bell curves, college admissions, and perhaps most importantly, the job market. We are encouraged not merely to do our best, but to be the best.
And just as the world’s most famous bike race is plagued by dangerous performance-enhancing drugs, schools face a flourishing market for stimulants like Adderall and Ritalin that give students a temporary competitive edge.
The key word there is “temporary.” One pill might boost a B on a test to an A, but one pill for every grade that needs boosting puts a student one dose closer to dependency. In terms of the potential for abuse, the Drug Enforcement Administration ranks drugs like Adderall and Ritalin as Schedule II Controlled Substances — just one level below illegal drugs like LSD and Ecstasy.
Stimulant addictions typically develop gradually. Under the pressure of a highly competitive environment, a student might try a drug during finals or midterms before using it for a few other tests, then for all tests, then for study nights, then to pay attention in class, until it’s a daily — even multi-daily — pattern.
Wes is right. This may be the first time your son has taken Adderall, but it should be the last. Convincing him that temporary rewards aren’t worth the long-term payments may be hard. In doing so, try to help him understand that the only person he should compete against is himself. He doesn’t need to share or compare grades with anyone else. In the long run, he’ll be best off playing by the rules and taking care of his mind and body.
After all, even Lance Armstrong eventually crashed.