Adderall: The Neuroenhancement Debate

On college campuses and in high-pressure, professional workplaces, the illegal use of Adderall (amphetamine and dextroamphetamine) and other stimulant drugs has been on a steady rise since the 1990s. These so-called neuroenhancing drugs are used to increase attention, concentration, and problem-solving abilities. For students desperately cramming for midterms or finals, the perceived boost of a stimulant is not only justified—it’s often seen as a positive decision. The use of prescription medications in this fashion is distinctly different from traditional recreational drugs. Users are not seeking relaxation or a “high;” they’re seeking an edge, and the implications of this usage pattern are unsettling.

From a purely medical perspective, the unsupervised use of prescription medications by otherwise healthy adults can have a variety of nasty consequences. Adderall, Ritalin, and similar drugs have a strong potential for addiction. By increasing feelings of positivity in the user while under the influence, users may feel a corresponding “let down” sensation when the drug wears off. Adderall also suppresses appetite, leading to possible undernourishment or even malnutrition in the most severe cases of abuse. Those with eating disorders may turn to stimulants as a way to bypass food, a slippery slope with potentially tragic consequences waiting at the bottom.

The misuse of Adderall raises profound ethical questions as well. Because widespread access to black-market prescription drugs is unlikely, the use of prescription drugs like Adderall will be disproportionately enjoyed by the wealthy or privileged. If neuroenhancement becomes socially acceptable, then the achievement gap between rich and poor may only widen further. DeSantis and Hane interviewed Adderall users on a college campus to learn about the students’ justifications for their illegal use of the drug. What they discovered was a powerful and shared myth structure that positioned Adderall use as “good” when the purpose was to study and do better in school. Users contrasted their Adderall use with other drugs like cocaine or marijuana, which were viewed as “bad” because of their street natures and intoxicating effects.

Apart from the obvious dangers of stimulant abuse, some clinicians have suggested that Adderall may boost certain kinds of cognitive performance at the cost of creativity. A study by Farah et al. (2009) sought to answer the question of whether Adderall negatively impacts the creative impulse. The results of this double-blind, placebo-controlled study revealed no evidence that Adderall either harmed or impaired most aspects of creativity. Subjects even showed improved creativity on one specific test out of four administered. However, the study was too small to draw any larger conclusions about Adderall’s effect on individual creativity.

The abuse of prescription stimulants, particularly Adderall, has profound negative effects both on the individual and societal level, ranging from addiction to performance inequities. Public health officials must seek a full understanding of the underlying reasons for abuse before progress can be made in this debate. If the myth of neuroenhancement as a positive, desirable objective is allowed to take hold, then the consequences will be alarming and difficult to undo.

References

1. DeSantis, A., & Hane, A. C. (2010). Adderall is definitely not a drug: justifications for the illegal use of ADHD stimulants. Substance Use & Misuse, 45, 31-46.
Flaskerud, J. (2010). American culture and neuro-cognitive enhancing drugs. Issues in Mental Health Nursing, 31, 62-63.

2. Farah, M., Haimm, C., Sankoorikal, G., & Chatterjee, A. (2009). When we enhance cognition with Adderall, do we sacrifice creativity? A preliminary study. Psychopharmacology, 202, 541-547.

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  • Dan

    Dan

    August 26th, 2013 at 11:49 AM

    I propose that after using amphetamine long term understanding the effects it has on me, along with switching to dextroamphetamine sulfate, the D-isomer of the amphetamine salts, that usage of those willing, motivated to taper off long term amphetamine(mixed salts) can be comfortably done by taking the amphetamine dosage in the morning, than using small dosages of dextroamphetine sulfate to decrease the impulsiveness many patients are prone to when they have used Adderall for various indications outside the realm of ADD associated behavior. While most psychiatrists, may not agree, or prescribe usage of taking the mixed amphetamine in the morning, to get a faster relief on onset of symptoms, allowing to take dextroamphetamine which acts for many as a calming agent, along with reduced drug cravings, this mechanisms I believe will prevent further if any neurotoxicity on specified Dopamine receptors such as the D2 which Adderall is known to strongly act on, while the D-salt acts primarily on more focus, cognitive related receptors, many believe deal with the D1 and D4 receptors, not the D2.

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