Much Ado about Adderall

If the New York Times is to be believed (and it usually is), the latest drug craze among American teens is not marijuana, Oxycontin or so-called “bath salts”. Rather, the next generation of doctors, lawyers, entrepreneurs and politicians seems to be abusing Adderall, a stimulant that is normally prescribed for those suffering from attention deficit disorders.

Opening with the alarming image of a teenage boy snorting Adderall before taking the SATs, the rather alarmist piece that the Times ran earlier this month suggests that the academic and extracurricular demands begin placed on kids today is driving many of them to use prescription stimulants in a desperate attempt to keep up with their peers. If true, this could be a dangerous trend.

Adderall and similar medications to treat attention deficit disorders can cause severe side effects. Like most stimulants, they raise an individual’s heart rate and blood pressure, and long-term use can lead to heart irregularities. In some cases, abuse of these drugs can lead to insomnia, acute exhaustion and severe mental illness. Some drug counselors also fear that Adderall may be a so-called “gateway” drug, leading to abuse of prescription painkillers and other illicit drugs in the future. In the pursuit of academic perfection, America’s youth thus may be destroying themselves mentally and physically.

While the New York Times is usually to be believed, this time they got it wrong. The problem with the Times article is it creates a trend where none exists. This is not to suggest that some teens are not abusing Adderall, or to dismiss out-of-hand the dangers associated with improper and unsupervised use of these drugs. My point is that the article relies on old data and unsupported anecdotes to suggest erroneously that there is a growing epidemic of stimulant abuse.

The Times itself ran a similar article in 2005 about the stimulant abuse among college students in the US. Simply change the words “college student” to “high-school student” and you’d have the very article that ran a few weeks back. Furthermore, while a recent survey by the National Institute on Drug Abuse found that 10 percent of 17- to 25-year-olds nationwide report using prescription amphetamines like Ritalin or Adderall as study aids, the number using these drugs for non-medical reasons has been holding steady for years. Overall, stimulant abuse by teenagers is actually down from the highs seen in the late 1990s.

So why are we seeing this media frenzy over Adderall and its potential abuse? For one thing, it has become a rather ubiquitous drug. Diagnoses of attention deficit disorders, which Adderall is designed to treat, have increased steadily over the past decade. Over five million kids in US are now diagnosed has having ADD or ADHD. That means that as many as 1-in-10 American children between the ages of five and 17 are now taking a drug like Adderall. There probably isn’t anyone listening to this commentary that doesn’t have a family member or a friend with an attention deficit diagnosis. There is an ongoing debate about whether this increase in diagnoses represents a true epidemic in attention deficit disorders or simply the American penchant for the medicalization of relatively normal but rambunctious childhood behavior. Regardless, the number of prescriptions for drugs to treat ADD and ADHD has increased nearly 50% over the last decade. Prescriptions for Adderall alone increased 14% last year.

Adderall is also one of the hundreds of prescription drugs that are in short supply, for reasons that appear to be both regulatory and financial. The US Drug Enforcement Administration places tight controls on the production and distribution of prescription stimulants like Adderall, including limiting the amount of drug that can be manufactured each year. However, DEA-imposed yearly quotas have not kept up with the increasing number of prescriptions for this popular drug. Aggressive marketing by the drug manufacturer exacerbates this problem, as do decisions to limit production and distribution in order to maximize company profits. The popular press has been rife with stories about this shortage. That, coupled with anecdotal reports of Adderall being sold on college campuses for $30 a pill, is the perfect recipe for sensationalist stories about the great stimulant abuse epidemic.

Use of Adderall as a study aid is indeed a problem. Some students who use Adderall will be harmed. Others will face legal consequences when they are caught using or selling this controlled substance. Alarmist media reports to the contrary, however, there is not a great epidemic of prescription stimulant abuse. What we should be alarmed about, rather, is the current epidemic in attention deficit disorders and our increasing willingness to label and medicate otherwise healthy kids.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on June 28, 2012. It is also available on the WAMC website.]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
This entry was posted in Education, Enhancement, Media, Substance Abuse. Bookmark the permalink.

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