Professionalism/(Mis)use of Adderall in Academics

Background

About Adderall

Adderall is a commercial drug prescribed to those with attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD).^[1] The drug is an amphetamine, a class of drug that stimulates a person’s nervous system by releasing dopamine. ^[2] The release of dopamine increases alertness and impulsiveness, thus decreasing inattentiveness.^[3] The United States Drug Enforcement Agency (DEA) classifies drugs and substances into five schedules based on the drug's medical use and dependency potential. ^[4] Schedule I drugs, such as heroin and LSD, are considered the most dangerous because of their high potential for abuse and severe dependency.^[5] Schedule II drugs, although not as dangerous, also have a very high potential for abuse.^[6] Cocaine, Adderall, and Ritalin are a few of the drugs that fall into this classification.^[7] Some of the negative side effects of taking Adderall include loss of appetite, headaches, difficulty sleeping, disrupted heart rhythm, increased blood pressure, long term cardiovascular problems, and strokes.^[8] A person taking Adderall may also experience withdrawal effects such as fatigue, disorientation, and depression.^[9] Despite these risks, Adderall is a widely used drug, used often by people without a prescription.

Adderall in Universities

During his commencement speech to the University of Virginia class of 2013, comedian Stephen Colbert recited the school's honor pledge with a slight modification: “On my honor, I pledge that I have neither given nor received help on this assignment…so help me Adderall.”^[10] This was a reference to the growing trend in the unprescribed use of Adderall on college campuses. A 2011 national Monitoring the Future study reports: “1 in every 10 college students in the United States has engaged in non-medical use of prescription stimulants in the past year.” This number has been increasing with time.^[11] Although purchasing or taking Adderall without a prescription is illegal, many students feel as though it is the only option when faced with continuing academic rigors. A 2012 survey from the American College Health Association revealed that 80% of college students have felt overwhelmed by all they had to do in the past year and 45% have felt things were hopeless.^[12] These students take various measures to handle the workload of their courses and in order to meet their expectations for success. Many students have turned to Adderall for assistance because it increases concentration and allows them to focus on their work with no distractions, including the need to eat or sleep. Jared Gabay a senior at Auburn University explains the appeal of using the study drug: "I'm more driven. I don't focus on anything else. If I have a paper, that's all I'm doing. No distractions, no socializing, just on with it."^[13] He adds that he used to get C's in his classes but with the help of Adderall his grades have improved to A's and B's.^[14] Because of these advantages, students like Jared choose to commit a felony and expose themselves to health risks by using unprescribed Adderall.

The Spectrum of Cheating

If we consider a variety of performance enhancing methods, we find that they lie on a spectrum of cheating, from well-accepted practices to serious, punishable cheating. We analyze this spectrum for Adderall in an academic setting as a way to visualize the social issue. We then draw a potentially useful analogy to anabolic steroid use in the sports world.

Case: Adderall in Academics

On the extreme end of the spectrum of cheating, there is “conventional” cheating – things like plagiarism, taking someone's homework, or copying off of someone’s test. These practices are stated explicitly to be against the rules of any academic organization. On the tame end of the spectrum of cheating, there are things like caffeinated products such as coffee, monster, red bull, and 5-hour energy drinks. It can be argued that caffeine gives an advantage in academics – however, these are well-accepted practices in any professional setting. Somewhere in the middle of the spectrum lies Adderall. However, where the line is drawn between what is ethical and what is not is a subject of differing opinions. Should Adderall be a publicly accepted method to enhance academic performance or should it be considered cheating?

Analogy: Steroids in Sports

On one extreme, again, there is “conventional” cheating such as bribing judges or referees. On the tamer end, there are things like Gatorade and protein shakes – things that are well-accepted practices by athletes across the board. However, anabolic steroids lie somewhere in the middle of the spectrum, similar to Adderall. Both steroids and Adderall are addicting drugs that have real health consequences, but are chosen over “conventional” cheating under pressure or greed to achieve greater performance, whether in an academic or sports setting. However, one key difference is that all large sports organizations have officially banned the use of steroids while the general academic community has made no such stand against the unprescribed use of Adderall.

Ethics Perspectives

For Adderall

Academic Pressure

The term “Academic Doping" was coined to describe the use of stimulants to achieve academic excellence. Student perspectives range from active participation to last resort study tactics, all resulting from the immense academic pressures in the university setting. An economics major from Columbia University says, “If you don't take them, you'll be at a disadvantage to everyone else." ^[15] A 2011 graduate of Indiana University - Purdue University Indianapolis said: “Adderall was a better option than failing and a better option than actually cheating — the traditional type of cheating." ^[16] In his research on Adderall at the University of Kentucky, DeSantis discovered reoccurring themes in how students justified their illegal use of Adderall. He found that they often compare Adderall to “party drugs” such as cocaine and marijuana. Since they are using it to perform better in school rather than to get high or buzzed, they believe that the use of Adderall is morally justifiable. ^[17] One student in the study commented: “Adderall is definitely not a drug. No way. It is a study tool. You don’t get high or anything like that. I take it to do good in school. How can that be bad?” ^[18] Students also believe that there are no serious health risks associated with the drug. Despite FDA warnings, they believe that it is not addictive and that it cannot “ruin your life like coke or other drugs like it.” ^[19]

Moral Obligation

Another perspective supporting the use of Adderall in academics stems from a more philosophical root. According to these pro-Adderall participants, Adderall not only shouldn't be considered cheating, but it also should be used to enhance academic performance. “There is a moral obligation to enhance our capacities for reason, intelligence, and self-control," says James Hughes, the Trinity College director of Institutional Research and Planning. ^[20] This perspective purports that use of performance-enhancing drugs is a moral obligation of humans as it improves our cognitive capabilities. Henry Greely of Stanford Law School echoes this thought: "We should welcome new methods of improving our brain function...Safe and effective cognitive enhancers will benefit both the individual and society."^[21] This opinion maintains that all safe, performance-enhancing methods are positive and ethically sound. Supporters of this perspective would likely disagree with the term "misuse" of Adderall in academics, as they only identify Adderall, a safe, performance-enhancing drug, as positive.

Against Adderall

Unsafe Practice

While Adderall can help students concentrate and maintain a task, using it without a prescription can have adverse side effects, as mentioned previously. Opponents of Adderall in academics argue that regular use of Adderall can be an extremely risky behavior that not all students are aware of. To combat this, a student group at the University of Colorado at Boulder started a campaign to bring awareness to some of the unexpected consequences associated with abusing Adderall. The campaign consists of a series of memes, or cartoons, printed on cards and distributed around campus. Each meme featured an exasperated cartoon student who has discovered a negative side effect of Adderall with a "#AdderallProblems" caption. Examples included "Sat down at night to crank out a ten-page paper. Ten hours later, I'd color-coded my sock drawer...twice #AdderallProblems", "Stayed up all night studying, slept through the test #AdderallProblems" and "Yelling at yourself to stop talking to yourself #AdderallProblems."^[22]

Unfair Advantage

One argument against the use of stimulants such as Adderall is the unfair advantage it gives (mis)users. Adderall and Ritalin can only be obtained through a prescription and to purchase the drug through illegal means requires connections and money. Furthermore, students that have conditions such as ADHD and Narcolepsy who require these drugs for treatment, feel as though it is a misuse of the prescription. "Adderall allows those students who are given a disadvantage by this disease to keep up and be on the same level academically as those who do not have ADHD."^[23]

Students are not the only ones who feel as though unprescribed use of Adderall and Ritalin is unfair. Some universities have recognized the use of these study drugs as an honor code violation. In 2010, Wesleyan University decided to add an "Adderall Clause" to their honor code, which states that students must complete their work without "improper assistance", which includes prescription drugs in the definition.^[24]

Adderall and Professionalism

In the 1970s, psychologist Mihaly Csikszentmihalyi began to explore the idea of a state of complete and effortless focus and attention. He called this state "flow" and described it as a "single-minded immersion" where a person is both highly challenged and highly skilled in the activity they are doing. Csikszentmihalyi argued that those who often experience "flow" in their lives will be the happiest.^[25] Aristotle had a similar philosophy. He claimed that every person has an innate excellence, or arete, and will live a life of happiness (he called eudaimonia) if they live in accordance with this excellence. Both of these concepts can be applied to professionalism as well. A professional can be someone who, when using their expertise, achieves a state of flow and enjoyment of their work, especially when it aligns with their arete.

The increasing mis(use) of Adderall, however, introduces the question: Is the flow you achieve while under the influence of Adderall artificial? Furthermore, can you be considered a professional if your work and expertise are influenced by these stimulants? As technology and medicine advances, humans will be more able to control and enhance their abilities, both cognitive and physical. Even now, new drugs are being developed to improve our cognitive processes. Modafinil, for example, has the ability to inhibit inappropriate impulse responses and methylphenidate, another new drug, can significantly enhance the brain's working memory.^[26] As a society, we must think about what the repercussions of these advancements may be and how our definitions of expertise, achievement, "flow", and professionalism will change.

References