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Ned Potter is the science correspondent for ABC's "World News with Charles Gibson." He has reported on such topics as space exploration, the human genome and climate change.

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Better than Fine? People Say They Take Medicines to Help Concentrate

April 09, 2008 3:42 PM

Ritalin_students_080409_main When you hear complaints about performance-enhancing drugs, you usually think of ballplayers or runners.  But what about the rest of us?  Turns out a surprising number of people use "cognitive-enhancing" prescription medications to help themselves through work, tests they have to take at college, talks they have to give.

Editors at the journal NATURE got curious, especially when there was heated response to an EDITORIAL they ran on this last November. 

So they did an informal online survey of visitors to their website, and say they got some surprising results: "One in five respondents said they had used drugs for non-medical reasons to stimulate their focus, concentration or memory."  You can read their summary, written by Feature and Commentary Editor Brendan Maher, HERE.

They asked about three types of drugs:

--Ritalin (methylphenidate), the stimulant often used to control ADHD, which is also known on some college campuses as a "study aid."  (The quotation marks are NATURE's, not mine.)
--Provigil (modafinil), a medication that increases alertness and allows people to go without sleep.
--Beta blockers, commonly used for cardiac arrhythmia or high blood pressure, that are also known to control anxiety. 

Keep in mind that this was not a controlled study--people were answering if they wanted, not because they were part of a representative group.  NATURE's readership is not typical as well, consisting in large part of people on campuses or in research institutions.  But the numbers are consistent with some past studies of college students.

"This is really just a finger in the breeze," Maher wrote to me in an e-mail.  "It’s not scientific, but it points to areas where maybe more research should take place."

Of those who said they took the medicines, Maher adds, "Almost all respondents (96%) thought people with neuropsychiatric disorders who have severe memory and concentration problems should be given cognition-enhancing drugs. But perhaps surprisingly, a high four-fifths thought that healthy adults should be able to take the drugs if they want to. And 69% reported that they would risk mild side effects to take such drugs themselves."

Maher says 1,400 people from 60 countries answered the survey.  Most of them didn't answer questions about where they got the medications, but of the few (201) who did, slightly more than half said they had prescriptions, and a third ordered them online.  More discussion HERE.

If you have a deadline or a test to pass, or you have to speak in public, is it cheating to take a pill?  Do you make yourself "Better than Well," to borrow the title of a 2003 book by bioethicist Carl Elliott?  Or is modern medicine offering a benefit that we will one day routinely accept?

April 9, 2008 | Permalink | User Comments (37)

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I have severe rheumatoid arthritis, which causes constant, and sometimes serious, fatigue. This makes concentrating difficult. If one of these medications could aleviate this problem I'd take it in a heartbeat. I guess I should ask my doctor about it.

Posted by: Bob | Apr 9, 2008 3:57:51 PM

There's no news here. Students have used drugs to improve academic performance for years. When I was in college, we commonly used drugs during "hell week" (final exams). Only then, hell week really was hell and we called the drugs speed.

Posted by: Bill | Apr 9, 2008 4:56:25 PM

Just as many students and business people used cocaine as an "upper", they now use Ritalin and Adderal. Ritalin is the #1 street drug in many cities. Children are given these drugs, nearly identical to SPEED in chemical composition, at very young ages and it's causing SEVERE side effects. Side effects which include homicidal and suicidal actions and even death. The psychiatric labelling and drugging business is one of the most evil industries that has ever existed. Join the fight against it.
IT'S TIME TO FIGHT BACK AMERICA! GET IN THE ARENA. WE NEED YOUR HELP.

Posted by: DRUGS | Apr 9, 2008 5:05:06 PM

I'm a senior in college and have been taking adderall for approx 2 years; yes i have a prescription from my doctor. I take the 10 mg dose, which i believe is the lowest dosage, and it simply helps me pay attention for about 3 hours, while i am in a very difficult class. I don't use it at work, and i don't take it for fun. By the way, unless you are taking a larger dose, there is not a "high" feeling present from this medication. If my doctor deemed that my attention problems warranted some medication, then i think its acceptible for me to take it. It doesn't make you smarter, just more attentive and less anxious. What people should be concerned with is children who shouldn't be on this medication, taking it for pleasure. It is similar to speed in that you do not have to rest for a few hours, but i imagine if anyone were to take too much, then it would be dangerous- and please don't talk to me about similar chemical compositions of medications- i saw something in my food ingredients the other day which was chemically similar to cyanide- and im still breathing. Everyone needs to stop whining about certain people having an "edge" over others by taking medication- i could just as easily say that since mommy and daddy fund another students entire college and life, that they have the "edge" over me- a full-time student with 2 jobs. If they want the medication, go talk to a doctor- but any good doctor will not simply write you a perscription for it- you must be evaluated to see if you actually would benefit from it, and if ou actually need it-not simply want it. I would say that this or any mind-enhancing legal drugs are a far better choice than cocaine or speed. Im not willing to destroy my body to get an A and i wouldn't take adderall if i thought it would cause me harm.

Posted by: jen | Apr 9, 2008 5:27:40 PM

Note from Ned--

Alan and Bill, I think your points are well-taken. Drug use is hardly new. I think what got Maher and his cohorts interested was the use of prescription medications that people may feel will give them an edge safely -- something stronger than coffee but weaker than speed.

If you drink a cup of coffee, you're doing as others have done for centuries. As for amphetamines, well, I was taught as a kid that they were dangerous. But a blood-pressure medication? Doesn't my uncle take that? And if it helps me do better, even if I was doing okay...is that a good thing, or is that somehow dishonest? That's the question they raised.

Posted by: Ned Potter | Apr 9, 2008 5:27:43 PM

The bar for getting into college keeps getting raised financially and academically. You're a sucker if you're not taking stimulants.

This is our system - this is the way to weed out the elite from the peasants.

As a result, the best and brightest Americans will be pill poppers - and they will be running the country.


Posted by: doug | Apr 9, 2008 5:41:53 PM

I'm a high school student and I'm always tired. My counselor told me that I should sign up for some extra-cirricular activities to help me get into college but I already feel like I'm burning out and I'm not even getting all As - I got 3 Bs. How do I get these drugs?

Posted by: cass | Apr 9, 2008 5:50:50 PM

Blood is on the hands of anyone who recommends these drugs. It's not a "mind-enhancing" drug, it's a "mind-damaging" drug. In smaller doses it can act as a stimulant because the body identifies it as a poision and goes into fight or flight response. In larger doses it will kill you. That's what poisons do. They suppress normal body reactions or stimulate them termporarily because the body doesn't know what to do with it. Bottom line is that your risking your life taking these drugs. Your risking your sanity. All to often we've seen kids on these drugs shoot up schools. We try and stop the methamphetamine trade yet we allow kids to pop drugs similar to this so they can get throw a test? Sorry, getting high on speed doesn't make you smarter, it makes you jacked up on speed. Do a little research before you promote these dangerous drugs.

Posted by: SPEED ANYONE? | Apr 9, 2008 6:02:56 PM

Why would anyone think it's cheating to take extra measures to do well on a test or presentation if the measures don't involve faking knowledge or sabotaging a colleague? Does anyone ask students or employees to certify that work or academic performance is done without cognitive enhancing drugs? I don't know whether it's bad for a person's long-term health to use these measures, but if they help you actually learn or process material, and the point of the exercise is to learn or process material, where's the cheating? Why is it "worse" than hiring a tutor, etc.?

Posted by: justannesopinion | Apr 9, 2008 7:05:16 PM

I've been on a beta blocker for five years. I'm not a student but I can see how this drug takes the edge off anxiety and slows your heart rate. I heard some people take it for stage fright.

Posted by: Dave | Apr 9, 2008 7:19:12 PM

I don't know anything about pier presure for these kids. My daughter is a layed back kid, as I was. There's no presure on her. I don't know if these anxioties are because of how their raised or does it develope itself? Just wondering. Thanx

Posted by: curious | Apr 9, 2008 7:26:40 PM

jen... when you say adderall is similar to speed, i think you mean adderal is speed. it is composed of an amphetamine salt; and by not sleep for a few hours, you mean stay up all night studying and then heading to your exam.... then yeah thats this stuff does for most people who abuse it.

it works as a quick fix... and if by making you smarter you mean "cram a bunch of stuff in your head write it down a few hours later and then forget all of it after your high ends and you crash" then yes, it makes you smarter.

Posted by: McMevan | Apr 9, 2008 8:07:09 PM

When I was a college student, the majority of my classmates were take unprescribed ritalin and aderall to allow themselves to stay up for 4 nights straight to study. Taking these medications to "enhance performance" is no different than baseball players taking steroids to enhance their performance. The fact that most college students not only don't consider it cheating, but don't understand that it is illegal to take prescription medications with a prescription (they are getting it from their friends) says a lot about where our society is these days. The majority of these kids are the ones who go on to get their MDs, PhDs, and law degrees. Great. I'm glad ABC finally did a story on this.

Posted by: Hmm...Interesting | Apr 9, 2008 8:11:55 PM

It is sad but we are now a Pharmaceutical culture. Remember that song by the band Steppenwolf? “God Dam The Pusher Man” ? I could see a documentary about Pfizer and Merck and Bristol/Meyers and Squibb (along with our doctors/AMA) and any of the other big drug pushers of today with that music in the background. Where is our FDA? Lobbied into compromise and into bed with the pharm- boys? “In order to control a population you keep them ‘Preoccupied’ (working/busy/struggling), ‘Misinformed’ (confused) and ‘Drugged’ (Alcohol, Pharmaceuticals and Televison/DVDs/Gameboys).” Was that Hitler or Stalin (Quotation)? At any rate our kids are zombies!

Posted by: abcdebate | Apr 9, 2008 8:33:51 PM

I do not believe in taking drugs of any kind but I always knew that college students were taking drugs and its widespread. Why are they taking drugs and why are they so stressed out. Back in the early days students didn't take drugs. Maybe their staying up to late partying and boozing, not enough sleep. You can't have it both ways. You either set your goals and accomplish what you set out to do or your wasting your time going to college.

Posted by: Mariann Pepitone | Apr 9, 2008 9:20:03 PM

I wonder what other kind of drugs Obama took besides cocaine. Besides being a boozer I am sure he took the same drugs as mentioned on these comments. That's why so many young people are voting for him because he's in their category.

Posted by: Mariann Pepitone | Apr 9, 2008 9:25:17 PM

Mariann Pepitone: I agree with what you're saying. These kids now aren't sleeping enough, partying is sooo like way important to them. Parents have absolutely no restrictions at all. Back in our days, curfew on weekdays was 9pm. Thru childhood we were in bed by 8pm. My daughter is 13 and in bed by 9:30. she sleeps a full 9 hours. High school and college kids can still go to bed by 11pm and still sleep at least 7 hours. Tops 8. As for heavy homework, my daughter has that and she's done in 2-3 hours. If more parents would just put their foot down these kids wouldn't have nervous breakdowns, peer pressure, taking meds for staying awake or meds to fall asleep. It all comes down to how the rules are set at home.

Posted by: mom | Apr 9, 2008 9:29:14 PM

Mom, your comparison of college age adults to your teenage daughter is inaccurate at best. As a graduate student, I can tell you the amount of homework given in college is rather high compared to Jr High. Ocassionally an 'all nighter' is required. Wake up, at some point you will indeed have to cut the apron strings.

Posted by: Ms.IvyLeague | Apr 9, 2008 9:45:39 PM

Marianne- you don't get it..These kids are NOT out partying!! They aren't taking drugs so they can party and study. These kids are asked to be superheros to get into med school, law school, college, etc! They are working full time jobs, volunteering, and are trying to make good grades. Have you seen a medical school application lately? Do you have any idea what it takes to get into professional school? At my high school, everyone was up until 1 or 2 in the morning doing homework. We went to school from 8-3, then soccer/football, etc. practice, and then home to study, but we had 5/6 hours of homework a night. If you didn't get your homework done, you got a failing grade.

Posted by: hmmm...interesting | Apr 9, 2008 9:48:23 PM

She has enough freedom on the weekend hanging outside with her friends, of course with a watchful eyes of mine. I trust no strangers in our courtyard. But when it comes to education, she needs plenty of sleep. Thank God she's a A & B student. My brother who partied most of the night, not only failed subjects in college, he was sleeping in class. He got hooked on these frigen pills and became a druggy. It hurts when we had to put him away twice in a drug rehab because he was always crying and wanted to kill himself. Took over 20 years but now he's doing excellent. I don't need my child to go thru this horid life. He couldn't be controlled, whereas I was easy to control and I had a wonderful childhood right up till I got out of college. No booze, no drugs. And mega sleep.

Posted by: mom | Apr 9, 2008 10:02:25 PM

Oh she's been sleeping now since 9:00, wow that made me happy. It's just past 10:00pm and now it's my turn to sleep. I have to get up at 4:30 for work. 6 hours is plenty for this old lady. Good night ms.ivy - don't stay up too late now.

Posted by: mom | Apr 9, 2008 10:05:26 PM

During undergrad I took some of these so-called study enhancers along with many of my friends. As an earlier post put it, most of us were cramming for exams. Some of us dabbled in other drugs like ecstasy, etc. too. Thank God for conversion.

Posted by: Damon | Apr 9, 2008 11:12:23 PM

Taking drugs to get through school shows only weakness. I went back to college at the age of 39 i had three small kids and i was divorced. I got a BA in business in three years because of perseverence not drugs. I graduated with a 3.75, I had also joined a volunteer fire department and took an EMT class while i was doing this. If i can do this with no drugs anyone can.

Posted by: Linda | Apr 9, 2008 11:56:43 PM

When I was in medical school, I heard lots of rumors about medical students taking drugs. I have no idea how many were, but any number is significant. These are the doctors today who are prescribing drugs to patients.

If they felt that it helped (it probably did, based on published experimental trials), they would have few qualms about prescribing them for their patients. But the fact remains, many of these medications have serious risks from side effects or adverse behaviors.

The risk of side effects doesn't seem significant when you are trying to help a borderline Alzheimer's patient stay at home. The risk might also be justified for troops in some battlefield situations. When you are dealing with college students who may be compensating for poor study habits, those risks seem very important.

Of course, some of the medical students wouldn't have been able to pass the tests without the boost. Should they be allowed to use cognitive enhancers? If they did, wouldn't you wonder about how well they can practice medicine unless they are continually "boosted" by drugs.

Other medical students taking drugs were good students who took drugs to get a competitve edge for the best residencies. For those, you just question their ethics.

The bottom line, if you are going to improve problems with abuse of prescription drugs, you better monitor medical students, residents, and practicing doctors. The incidence of drug abuse is higher in this population, and they are (or will be) responsible for handing out the prescriptions.

Posted by: Jack | Apr 10, 2008 12:49:39 AM

I have to go with Ms. Ivy on this one, I work at Harvard university and I see it firsthand daily. These kids are not out partying and just using Adderall to supplement an out of control lifestyle they are using it because of the overtly competitive atmosphere.

We are not talking about your 15 year old daughters who get A's or B's in the local high school. (wheee) We are talking about young adults who are fighting like sharks for entrance to exclusive grad schools or cutthroat investment banking jobs on Wall Street and the like. Balancing time between writing a thesis, working full time hours while still heading up social clubs and functions requires more time than a human should be awake.

"Sleep is for fools" - Thomas Edison

There is no right or wrong here just the world we have created and people are adapting to live in it.

Posted by: TangFiend | Apr 10, 2008 1:46:19 AM

Is it cheating? That's one of the big questions here. What is cheating? Anything that give you an unfair advantage, I'd say. That's why people cheat, to get a leg up on the competition. Can everyone use these drugs? Technically, yes; legally, probably not. So, yeah, these drugs give their users an unfair advantage.

Consequently, I'd be inclined to say that using these drugs is cheating. I'm currently working on my PhD, and I've never taking any of these drugs, and I know people who were able to get them simply by asking their doctors for them (I'm thinking specifically of Adderal). Could I do the same? Sure, but where's the honor in that? It's like winning a gold medal because you took some performance-enhancing substance. Even if you're not caught, it still cheapens the victory because you're no longer fully responsible for your own actions--the drugs get some of the credit.

If you're not disciplined enough to do your studies correctly--NOT partying and drinking and then cramming--then you DESERVE whatever happens to your grades. And even if you make the grades, what kind of life are you preparing yourself to live for? Maybe you should consider the possibility that you're not college material. Just get a job--the experience will be more valuable and you'll be contributing something to your community.

That's my two cents.

Posted by: Jake | Apr 10, 2008 1:49:58 AM

Ever see the movie "The Paper Chase"? It was about a bunch of students at Harvard Law School. In the movie, the students weren't doing blow to get through finals but in real life they were - still are.

Same can be said for medical school.

Why do we slap the best and brightest with impossible coursework?

Google is the General Practitioner of my generation. You don't have to pop Ritalin to do a google search.

To date, Universities are still the gatekeepers to a good job - but all that may be changing. Especially when the kids with degrees enter the real world to find that there are very few jobs out there.

Posted by: doug | Apr 10, 2008 2:16:40 AM

This is just like the Major League steroid debate, justifiable use because: 1. Everybody else is doing it. 2. The competition and stakes are so high, that using substances is OK. Gee, I hope every reader is OK when they need surgery, and find out that their doctor partied all night, but is doing fine with the adderal he just took.

Posted by: Jensen | Apr 10, 2008 2:24:20 AM

Is it cheating to take cognitive enhancing drugs to improve your test scores? Answer that question by answering this question. Would you trust your doctor if you knew they had used cognitive enhancing drugs to pass medical school?
I believe cognitive enhancing drugs have been proven to improve test scores, but have not been shown to improve long term retention of information. In other words, take two doctors who have scored equally well on a test, but one achieved it by taking cognitive enhancing drugs. If you retest those doctors 2 years later (and neither takes cognitive enhancing drugs the second time), the doctor who never used the "juice" would score better than the doctor who had originally been "juiced".
If you do say that it is okay for the medical students to use drugs to pass tests, then shouldn't doctors have on their medical licenses whether or not they are required to use cognitive enchancing drugs to practice medicine? It would be just like a driver's license stating that you are required to have vision correction in order to drive.

Posted by: Jack | Apr 10, 2008 2:25:08 AM

Interesting topic. My daughter is a junior in college. Just recently she was complaining to me about all the students she knows who use Alderall to help them study for mid-terms and finals. She does not use such "aids" herself, and I commend her for that. She knows better than play with fire. Yet, she is a bit bitter about what she considers to be unfair competition.

However, in the end, she has still come out ahead. An accounting major, she got one of the coveted summer internships at a Big 4 firm. She does not have the best GPA (grades). But they are good enough, and I do believe that her part time work experience and her people skills made a big difference.

The lesson? Life is not all about grades and extra curricular activities. If only students would learn that...

Posted by: Veronica | Apr 10, 2008 2:29:46 AM

If it is ok to use these types of drugs, it is also ok for athletes to use steroids and for hippies to smoke pot. Who is to decide what drugs are right for the individual and for what purpose? Only you can decide that for yourself. This makes the case for the legalization of pot more than any argument I've ever heard. Why not just legalize all drugs? In fact, why not MANDATE drug use. Everyone must take drugs all the time. Don't give me these lame excuses for taking drugs - if you can't do it without them you can't do it. Period.

Posted by: stan | Apr 10, 2008 3:18:23 AM

Interesting. If one has to take drugs to make it at the University then maybe one should not be there. Reliance on drugs will continue during careers where stress is greater than at the University. Would be very interesting to have brain scans of before and after a certain period of years to observe what organically happens to the brain.

Posted by: Longtree | Apr 10, 2008 5:59:37 AM

Sports, school, or life. Performance enhancing drugs = cheating. This comment from a libertarian who is in favor of decriminalizing all recreational drugs.

Posted by: bogart sensa | Apr 10, 2008 6:51:32 AM

I can't help but wonder if this isn't a symptom of the failure of the educational system in this country. Students are so ill-prepared for college courses that they have to resort to such measures to get anywhere. As one poster also pointed out, this kind of behavior in college will be resorted to again and again in life. Not a good prospect if your doctor engaged in this behavior in medical school.

Posted by: Andy | Apr 10, 2008 8:53:52 AM

DON'T BE FOOLED BY THIS REPORT WHICH COVERTLY TRIES TO CONVINCE YOU THAT RITALIN HELPS YOU. RITALIN AMD ADDERAL ARE "SPEED". DO YOU REALLY KNOW WHAT YOUR DOING TO YOUR BODY AND MIND GIVING THESE DRUGS TO KIDS OR YOURSELF? DO YOU HAVE ANY REAL CLUE? AND IF YOU THINK A PERSON IS ENHANCING THEIR PERFORMANCE BECAUSE THEY'RE ON COKE OR SPEED THEN, YES MAYBE YOU WOULD CALL THIS "PERFORMANCE ENHANCING". I CALL IT BEING A DEPENDENT DRUG ADDICT WHO IS SUFFERING THE SYMPTOMS OF A MIND-ALTERING DRUG. A FEW YEARS BACK ADHD WAS INVENTED AND NO ONE EVEN THOUGHT OF POPPING DRUGS TO GET SCHOOL WORK DONE. THEY'D DRINK COFFEE OR TEA OR A COKE FOR A LITTLE BIT OF CAFFEINE BUT NOTHING LIKE RITALIN. MY GOD! KIDS DIDN'T USE SPEED NOR DID THEY NEED IT JUST LIKE THEY DON'T NEED IT TODAY. SCHOOLS ARE ALSO DOING KIDS A DISSERVICE BY GIVING THEM 4 OR MORE HOURS OF HOMEWORK. WHO HAS THE TIME? RITALIN AND ADDERAL ARE SPEED, MAKE NO MISTAKE ABOUT IT FOLKS AND THEY SIDE EFFECTS OF SPEED ARE THE SIDE EFFECTS OF THESE "PERFORMANCE ENHANCING" DRUGS.

Posted by: Ritalin=Speed | Apr 10, 2008 10:04:36 AM

I hate it when people who don't know what they are talking about talk and act like they are all knowing. My daughter is highly ADHD. She is also very smart and in advanced classes in High School. I fought putting my daughter on ritalin. It became a matter of quality of life for her. Does anyone think that ADHD people like the disability that comes with this type of condition? Without the medication these kids are labeled as trouble makers and as adults usually become addicted to alcholol or drugs.
My daughter does not have excess energy and stamina on her adhd medication. It infact calms her down and gives her quality of life. I don't know how kids can get these drugs so easily. My daughter's adderall xr and strattera are very expensive. I am ADD it is no fun being ADD. It can be very diabilitating. As a teacher I have seen how students with ADD are ostrasized if their medicine isn't well regulated to help control their symptoms. You can be doing well on your ADHD medication and one day it stops helping. Its a very rough road to be ADHD. My daughter has more energy when she is off her adhd medication. But then she is prone to impulsive acts and mental meltdowns.

It be great if some of you who put down these medications could walk in my daughter's and my shoes for a day

Posted by: savetheaverageamerican | Apr 13, 2008 1:21:39 PM

My son has ADDH, the inattentive kind. He is on Strattera which is not a stimulant. At some point though, he may need Adderal since some drugs just suddenly quit working. These meds are NOT prescribed willy-nilly. Obviously some posters on here have NO experience with ADDH. I waited five years to put my son on the meds and he was miserable at school. Homework was simply a nightmare. He is now a straight A student and please note, grades were not a reason for him being on meds. I was just worried sick he would get lost, hit by a car or start drinking (it runs in the family). He is a sucess story now.

Posted by: ADDH Mom | Apr 21, 2008 10:16:16 PM

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