Between 2002 and 2005 U.S. Adderall sales skyrocketed by 3,100%, vaulting Adderall to the head of the ADHD market. In recent years Adderall has also become the most popular illicit study drug, with 34.5% of college students admitting use in 2012. But not all parties agree that Adderall has a net benefit in society. Twenty sudden deaths caused Canada to pull Adderall XR in 2005. Indeed, Canada and the U.S. are the only countries in which Adderall is licensed at all-- in most other countries, amphetamines remain highly controlled substances.
Arguably, there are some people-- people with severe ADHD-- who need stimulants like Adderall to live healthy and productive lives. Before medicating swaths of the population, we should ask: where does ADHD stem from in the first place, and why are rates of ADHD in children increasing? Studies have linked ADHD to toxin exposure, over-stimulating media, low birthweight, smoking mothers, and a variety of other potential causes.
Should we treat effects (like ADHD), or causes (deeper societal and environmental issues)? What are the broad consequences of making amphetamines available to a significant portion of the population? The search for the answers to these questions uncovers some hard truths about Adderall’s place in the United States.
Disorder vs. Lifestyle
ADD and ADHD are some of the broadest diagnoses out there. The Diagnostic and Statistical Manual (IV) requires that a person experiences six or more of nine “symptoms” to be diagnosed with ADD or ADHD. Symptoms align into two categories; you have to be (a) poor at giving sustained attention and/or (b) unusually active/impulsive. Many people experience the listed symptoms to some degree, but we certainly don’t all need drugs to be calm and productive. There are plenty of options beyond popping amphetamines that allow people to meet their physical and mental needs unstimulated.
In a TED talk in 2006, Ken Robinson told the story of Gillian Lynne. As a child, Gillian couldn’t concentrate and fidgeted in class so much her school thought she had a learning disorder. When brought to a specialist, the specialist examined her, then stepped outside for a private conversation with Gillian’s mother, leaving music on in the room.
They watched through the door as Gillian immediately got to her feet and began moving to the music. The specialist told Mrs. Lynne; “Gillian isn’t sick; she’s a dancer. Take her to a dance school.” Gillian became a world renowned dancer and choreographer, responsible for Cats and Phantom of the Opera, among others. She’s also a millionaire. This, all because a specialist recognized that Gillian didn’t need drugs; she needed a lifestyle change. Ken Robinson notes: “Somebody else might have put her on medication and told her to calm down.”
The fact that some people need Adderall to perform in our society is not evidence of faulty people; it’s evidence of a faulty society. Attention spans in children are decreasing, yet credential inflation and ever-increased specialization privilege concentration and long study hours. We’re carving a gap between people’s capabilities and their obligations, and we’re filling that gap with Adderall. According to CDC 2009 statistics, 9% of children have ADHD. Additionally, according to the Partnership for a Drug-Free America, one-in-ten kids of middle and high school age use psychiatric drugs such as Adderall or Ritalin without a prescription. Is a healthy society one in which some 20% of youth must pump up on amphetamines to be “productive”?
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People with attention “disorders” shouldn’t be told there’s something wrong, but there’s something right. You can’t sit still for hours and write a paper? Good. There are more (there should be more) active, engaging ways for you to learn. Meanwhile, toxin and media exposure in formative years should be reined in before the ability to think deeply goes extinct entirely.
In most competitive college majors, class scores are “curved.” This means that grades are set based not on a student’s percentage of correct answers, but on how a student ranks against the rest of the class. Students who take Adderall study longer, write faster, and remember better than their amphetamine-free classmates, ensuring higher grades for themselves-- and lower grades for their classmates.
If a few people in a class use amphetamines, a significant portion of the class is essentially guaranteed lower scores-- unless they can enhance their performance as well. Adderall essentially resets the bar for academic performance, forcing many students to make an unfair choice: use Adderall, or fall behind.
Adderall doesn’t only affect curved classes. The Washingtonian spoke with Lisa, who used Adderall to augment her SAT scores. According to the Washingtonian, “The first time Lisa took the SAT, she scored 950. This time, with Adderall, she improved to 1050. Her father, a college professor, wasn't satisfied. She took an SAT class, dropped another 30-milligram dose of Adderall, and scored 1150.”
You see the same cycle with physical performance enhancers. A minority employs performance enhancing drugs to gain an edge, forcing the majority to hop on the bandwagon to stay competitive. But most people don’t even want to take the drug. Ask bodybuilders at strongman competitions if they would support mandatory steroid testing, and most will tell you they’d be first in line. As long as some people opt for the medical advantage, everyone is pressured to join just to remain relevant. If not for the excess of unnecessary Adderall prescriptions, academic doping wouldn’t be nearly so prevalent-- indeed, it would be impossible. But over-diagnoses of ADHD lead to over-prescriptions of Adderall, and a ripe, cheap market for struggling students to buy the drug that starts with an A.
Adderall and Health
We can debate the ethics of using and prescribing Adderall, but it remains an amphetamine with a high addictive potential. Adderall stimulates the release of norepinephrine and dopamine in the mesolimbic reward pathway, the same chemical process created by methamphetamine and cocaine. Even for ADHD patients, addiction may result as the brain becomes familiarized to Adderall’s artificial chemical processes and makes adjustments that compromise normal functioning.
But Adderall’s perceived benefits can also induce a psychological dependence. Jenna, a student at Yale University, admitted her dependence on Adderall after recognizing that she could hardly study without some of the drug. Says Jenna: "’I can do work without it, but my concentration is just not there... I never had a problem studying before I started taking Adderall.’" At a prestigious and highly competitive institution, it’s easy to imagine the temptation posed by a concentration booster. Ignoring Adderall’s potential for chemical dependence, quitting can still be diffictult when your brain on Adderall consistently outperforms your brain without.
Adderall has other frightening and unpredictable consequences. Like many medications, the list of Adderall’s side effects is exhaustive: cardiovascular complications, insomnia, weight loss, psychosis, impotence, dizziness, dry mouth, headache, and so on. As previously stated, Canada suspended the product in 2005 following its association with twenty sudden deaths, but U.S. didn’t deem these figures significant enough to require prohibition. And so: Adderall continues to be prescribed in the United States at an increasing rate each year.
Removing Adderall from our lives requires cultural change. To reduce the necessity of stimulants for patients diagnosed with ADHD, the factors which cause ADHD must be addressed. Environmental toxicity concerns everyone, but particularly rigid controls should limit pesticides in baby food and products fed to children. A smoke and drug free pregnancy should be more than a recommendation; it should be a requirement. Children’s media exposure should be reduced, and children’s shows themselves should be less hyperactive.
Symptoms of ADHD will always be present in some children of the most moderate upbringing; these children shouldn’t be forced to sit in a chair and “learn” in exactly the same way as other kids.
Different levels of sympathetic nervous system arousal aren’t a disease; they bring flavor into our collective life. Education should explore more varied settings and experiences through which students may learn. And, in the end, not everyone may be cut out to learn the same things. Active, inattentive people may never write as well as their calmer counterparts, but they’ll do other things far better-- and this kind of variety will benefit society far more than it will cause harm.
In the final analysis, Adderall is an attempt to use medicine to suppress a vibrant personality-- something we complacently discredit as a “learning disorder.” A pill may seem easier than helping children find truly suitable lifestyles, but medication is a short-sighted and oppressive solution. With more investment in alternative education and steps taken to eliminate the external causes of ADHD, Adderall may be discontinued without detriment to individuals or society. Furthermore, excising Adderall from the medicine cabinets of the ADHD diagnosed will, by eliminating the stimulant supply, re-level the academic playing field-- a major step toward restoring healthy academic lifestyles for students everywhere.
There’s no sense in designing diagnoses based on an arbitrary norm, and then medicating outlier individuals toward the desired equilibrium. There’s also no sense in flooding our youth with a cheap source of psychoactives. Instead, let’s broaden the academic standard, rethink education, and keep the minds of the future off of amphetamines. And let’s act soon, before this vicious, medically-endorsed cycle worsens such that parents and professionals can’t help but see the contorted society our beloved Adderall is building.
Written by Bailey Rahn and Chance Campbell, researchers for AllTreatment.com.