"Smart pills" and the zero-sum education game
In today's Washington Post, there is an article misleadingly entitled "A Dose of Genius" which talks about the increasing usage of ADD meds by those who haven't been diagnosed with the disorder. That is, "recreational" use of medication to artifically enhance one's attention span for gainful purposes — not exactly what springs to mind when considering traditional recreational drug use.
Joel Garreau refers to these drugs as "smart pills" — a term that is misleading and downright inaccurate. (And shows that he's never actually taken them, which isn't necessarily a bad thing.) More accurately, they can allow one to focus for inhuman amounts of time, depending on the drug and the dosage taken. Having taken Adderall in the past, I can remember studying organic chemistry for 16 hours a day, 3 days in a row. This is not normal human behavior, but on the other hand, this marathon study session did enable me to pass the course. These medications can also help make tedious and uninteresting tasks more appealing — like studying organic chemistry, cleaning the house/apartment/dorm, and even watching TV.
Garreau alludes to some interesting questions while avoiding coming right out and asking them. Most likely this is because the article is written as a factual health piece instead of an op-ed article. The two main questions that are avoided are "Is this drug use detrimental to students' health?" and "Is this drug use a product of the educational system itself?"
The answers are no and yes, respectively.
Is this drug use detrimental to students' health?
The kneejerk reaction is "of course it is!" — and as a health care professional, I should probably join this chorus, but instead I'm going to fly my pirate flag and be contrary. Perhaps it is because school is so fresh in my mind that I hold my contrary opinion. The answer is, quite frankly, a resounding "no." This drug use is not harmful to most students, in the same way that it is not harmful to those that are actually prescribed it. If a student doesn't have cardiovascular problems (such as high blood pressure, arrythmias, etc.) and takes a dose that is within normal prescribing limits, they will be okay. Mr. Garreau talks about some of the side effects that are possible with prescription stimulants, but fails to note that these possible side effects apply to those that "need" it — that is, those that have been diagnosed with ADHD — and those that technically don't. Side effects do not select for one group over the other, and side effects largely disappear when the drug wears off.
What do the drugs allow people to do? Well, like I said above, their primary function is to improve one's ability to concentrate. Depending on the type of drug, and whether it is time release formulation and its half life, this can allow for short bursts of intense studying lasting an hour or two, or marathon sessions — such as the ones I used to pull.
They do not make you smarter.
It is true that these stimulants can lead to addiction, but the type of "abuse" (I use that term loosely) Mr. Garreau refers to does not lend itself to addiction. The type of use he refers to is not daily pill-popping, but is instead highly-specific use to accomplish a specific goal, e.g. getting a good test grade.
I have written extensively about the subject of neuroethics and the discipline's current and future impact on society, and I still have mixed feelings about the subject overall — just like I did when I wrote that first essay years ago. (The timestamp on that page is wrong, the actual work is probably circa 2001-2002.) The medical community has yet to fully wrestle with the topic, but it is one that is going to confront us more and more in the coming years.
Is this drug use a problem of the educational system itself?
The answer is, quite simply, yes. I'll quote from the article here, because it makes the case for me:
A student Web site for a consortium of tony Philadelphia prep schools makes the point with one of those jokes that's not really a joke: You know you are part of this elite educational set if:
- "You applied to Penn as a backup school."
- "You tend to think anything below a 1400 is a mediocre SAT score."
- "You could get adderall in less than 5 minutes at practically any time of the school day."
People drink alcohol and smoke cigars to relax; they drink coffee to wake themselves up; and now they're taking stimulants to give them a competitive advantage in the classroom. I can think of more destructive habits — like drinking one's problems away instead of dealing with them — and I can assure you that taking these drugs is not akin to taking steroids, though the comparison might seem obvious. Unlike steroids where the muscle shrinks after usage stops, the knowledge one gains during a marathon study session does not disappear when the drug wears off.
I'd like to end with a quote from the article that nicely sums up the mainstream reaction to this phenomenon:
Eric R. Kandel is shocked by the idea that powerful elixirs like the ones he is developing might rapidly trickle down to ambitious college kids. He shared the 2000 Nobel Prize in medicine for his research on the physiological basis of memory storage in neurons. He also founded Memory Pharmaceuticals.
"That's awful! Why should they be taking drugs? They should just study! I think this is absurd. What's so terrible about having a 3.9? The idea that character and functioning and intelligence is to be judged by a small difference on an exam — that's absurd. This is just like Barry Bonds and steroids. Exactly what you want to discourage. These kids are very sensitive. Their brains are still developing. Who knows what might happen. I went to Harvard. I like Harvard. It ain't worth it."
But kids' parents push them toward this sort of "excellence." I don't know of a single student that wants a 4.0 for personal reasons that isn't in some way pushed by either his parents or her desire to gain acceptance into an(other) institution of higher learning. Why should they take the risk? Because they are often castigated by their families if they do not, particularly among ethnic minorities. When perfection is demanded, kids will do whatever they must to attain it.
Education has become a zero-sum game for highly competitive schools and courses of study. In an environment where grading is done on a strict bell curve; or X number of positions are open to Y applicants; or one is simply trying to get into an ivy league school, students are going to look for a competitive advantage wherever they may, and they are not wrong for doing so. Throughout our evolutionary history, we have taken advantage wherever we have been able. Using drugs to focus more effectively is a natural extension to this natural, biological phenomenon.
That said, I wish it wasn't necessary. Education shouldn't have to be a zero-sum game, but for the meantime, it is, and we should not be surprised when students treat it as such.
In the interest of full disclosure, I was diagnosed with ADD and got my Adderall and Ritalin legally.
[tags]medicine, pharmacy, education, adderall, stimulants, drugs, drug usage, recreational drug usage, psychopharm[/tags]
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