Cognitive Neuroenhancement and its Role on College Campuses

Stimulants such as Adderall, Ritalin, and Concerta are commonly used to treat disorders such as ADHD, but some users of stimulants choose to use these drugs to give themselves a “mental edge:” the ability to study for longer periods of time, increased concentration or greater focus. However, once the question of whether or not use of prescribed stimulants are safe to use has been discussed, another question arises: is it “ethical” to take prescribed stimulants for nonmedical reasons?


The Ethics of Adderall

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This is a question that everyone has an opinion on, but for some scientists, a new idea has formed. Some call for “cognitive neuroenhancers:” drugs that will stimulate focus, concentration and memory for those who do not have medical conditions that require such stimulations. Barbara Sahakian, a prominent clinical neuropsychologist who works at Cambridge University, contributed to an article titled “Towards responsible use of cognitive-enhancing drugs by the healthy,” which argues in favor of these “mind-hacking” drugs.

In this article, Sahakian and her colleagues call for an evaluation of the risks of cognitive enhancing drugs, research on their impact on healthy individuals, collaboration in developing these drugs, and “careful and limited legislative action” to channel these new technologies into productive paths.[3] The ideas of the article can be summed up into one quote:

As for an appeal to the ‘natural’, the lives of almost all living humans are deeply unnatural; our homes, our clothes and our food — to say nothing of the medical care we enjoy — bear little relation to our species’ ‘natural’ state. Given the many cognitive-enhancing tools we accept already, from writing to laptop computers, why draw the line here and say, thus far but no further?[4]

However, not everyone agrees with the idea that cognitive neuroenhancement would contribute positively to society. In a 2009 New Yorker article, psychiatrist Paul McHugh described his own skepticism about “cosmetic neurology.” McHugh, who works at Johns Hopkins University, said that in his private practice he will sometimes see children whose parents worry that their son or daughter could be performing better in school, and that medication could solve their child’s academic woes.[5] McHugh disagrees with this, saying “Maybe it’s wrong-footed trying to fit people into the world, rather than trying to make the world a better place for people. And if the idea is that the only college your child can go to is Harvard, well, maybe that’s the idea that needs righting.”[6]

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Whether one agrees with neuroenhancing drugs or not, it is obvious that they are present in today’s society, on college campuses and beyond. In a survey conducted by scientific journal Nature, one in five respondents (who varied in age from 18 to 66 and older) said that they had taken drugs for non-medical reasons to stimulate their focus, concentration or memory.[7] With this kind of popularity level being reported, there is a chance that cognitive neuroenhancement may be here to stay.

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Cognitive Neuroenhancement at Tufts

With college tuition going up and a highly competitive job market, the conditions that feed student desire for an “academic edge” are prevailing, as are cognitive enhancers on college campuses. Enigma wanted to learn more about the prevalence of Adderall usage on our campus as well as student perception of drugs being used for cognitive enhancement so we conducted a survey to get a better idea.

So where does Tufts stand in in regard to other schools in student stimulant abuse? The graphic below represents the proportion of non-prescribed students using stimulants for academic gain at Ivy League Schools, Tufts University, and other colleges, where “other colleges” represents a sample of 18 colleges of variable selectivity in the US. (Tufts was only surveyed on Adderall, so actual results could indicate a higher prevalence of stimulant misuse than shown.)

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Used in this infographic are results from the 2014 National Survey on Drug Use and Health as well as information from An Exploratory Multilevel Analysis of Nonprescription Stimulant Use in a Sample of College Students published in 2014.

The classic question is: what is different about Tufts from other schools, such as Harvard? For one, it could be that we are less competitive, which is suggested by the results shown above and the general correlation that exists between stimulant abuse for academic gain and the selectivity/competitiveness of academic environments.

What about those who haven’t taken Adderall before? When students were asked about trying Adderall for different purposes we received the following results.

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We also asked students to give a written response as to how they feel about non-prescribed use of Adderall for the purpose of cognitive enhancement on college campuses. Out of 133 written responses recorded, the top subjective words used were unfair (used 19 times) and cheating (used 13 times). A majority of responses expressed only negative feedback.

Tufts students are concerned about unfair academic advantage, addiction or dependency, lack of knowledge about side affects, and prevention of learning good study habits and organization skills in regards to Adderall being used for cognitive enhancement. They are also concerned about misuse of the drug making it harder for those with ADHD to attain the drug, and diminishing the seriousness of an ADHD diagnosis.

Among those who disagreed with such stimulant abuse, there was a theme of pointing a finger at what or who was to blame. Some blamed arduous academic expectations put on students, while others blamed the weakness of an individual who is choosing to “take the easy way out”. A few positive responses towards Adderall’s use for cognitive enhancement were recorded and the rest include responses of mixed or unsure feelings.

While Adderall and other drugs may be perceived as casual drugs, there is clearly a population here at Tufts who is very opposed to its non-prescribed use, with some going as far as calling it cheating. Stimulants used as study drugs are obscured and should be the topic of more informative conversations, including conversation between the school administration and student body. Nonetheless, cognitive enhancers are not going anywhere and only becoming more prevalent in academia. Therefore, the question of their ethicality and knowledge of their presence should be brought to students’ attention.


Perception of Adderall

Last year the American College Health Association, in a survey of universities nationwide, reported that 5.7%[8] of students admitted to abusing prescription stimulants for which they were not prescribed in the past 12 months, and Tufts itself had an 8.0% rate of abuse.[9]

These numbers might surprise you – Adderall is one of the most prevalent drugs on our campus and certainly not too difficult to come across. Some estimates even put the proportion of college students abusing Adderall around 30%.[10] According to a study published in 2010, 61.7% of college students with ADHD medication diverted (e.g. shared, sold) their prescription at some point in their college career.[11]

So what is causing this gap? Why are self-reported numbers significantly lower than estimates?

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There is a distinct difference in the perception of drugs, largely tied to their relative levels of acceptance in popular culture, that leads to variances in the accuracy of self-reported data. Ian Wong, Health Services Director of Health Promotion and Prevention, weighs in on the issue:

Good people do ‘good drugs’… good people drink alcohol, bad people do heroin. The perception of Adderall and Adderall abuse keeps people from reporting information that reflects reality.

Having a few drinks too many and spending the remainder of the night holding your head over the toilet bowl is seen as “part of the college experience.” While this may not be anyone’s ideal night, it happens often enough. Adderall, on the other hand, falls into a social-acceptability gray area. As detailed in our survey, the words most commonly associated with Adderall abuse are “unfair” and “cheating” – much the same as how anabolic steroids are considered “unfair” and “cheating” in the sports world, yet are still widely abused by those looking to gain a competitive edge.

What is the real story, then? Why is Adderall abuse so common despite the negative perceptions? According to a 2010 publication[12], the answer is simple: Adderall is a patchwork remedy for the segment of students who party often and study irregularly.

Nonmedical prescription stimulant users typically have lower grade point averages than non-users… [and] are more likely than other students to be heavy drinkers and users of other illicit drugs… In summary, nonmedical use of stimulants as a ‘shortcut’ to compensate for partying or not going to class does not appear to be an effective strategy to increase academic performance.

Research, analysis, and infographics contributed by Mary Kate Skitka, Ryan Havens, and Brian Taintor


Citations

[1] Desalts, A. D. (2008). Illicit use of prescription ADHD medications on a college campus: A multimethodological approach. Retrieved May 20, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/18980888

[2] Popping Pills: Prescription Drug Abuse in America. (2014, January 02). Retrieved May 20, 2016, from https://www.drugabuse.gov/related-topics/trends-statistics/infographics/popping-pills-prescription-drug-abuse-in-america

[3] Greely, H., Sahakian, B., Harris, J., Kessler, R. C., Gazzaniga, M., Campbell, P., & Farah, M. J. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456(7223), 702-705. doi:10.1038/456702a

[4] Greely, H., Sahakian, B., Harris, J., Kessler, R. C., Gazzaniga, M., Campbell, P., & Farah, M. J. (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature, 456(7223), 702-705. doi:10.1038/456702a

[5] Talbot, M. (2009, April 27). Brain Gain. The New Yorker. Retrieved April 25, 2016, from http://www.newyorker.com/magazine/2009/04/27/brain-gain

[6]  Talbot, M. (2009, April 27). Brain Gain. The New Yorker. Retrieved April 25, 2016, from http://www.newyorker.com/magazine/2009/04/27/brain-gain

[7] Maher, B. (2008, April 9). Poll results: Look who’s doping. Retrieved April 25, 2016, from http://www.nature.com/news/2008/080409/full/452674a.html

[8] American College Health Association. American College Health Association-National College Health Assessment II: Reference Group Executive Summary Spring 2015. Hanover, MD: American College Health Association; 2015.

[9] American College Health Association. American College Health Association-National College Health Assessment. Specific data for Tufts University is not publicly available but was acquired through a liaison at Tufts University Health Services, Ian Wong. 2015

[10] Desantis, A. D., Webb, E. M., & Noar, S. M. (2008). Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach [Abstract]. Journal of American College Health, 57(3), 315-324. doi:10.3200/jach.57.3.315-324

[11] Garnier, L. M., Arria, A. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2010). Sharing and Selling of Prescription Medications in a College Student Sample [Abstract]. J. Clin. Psychiatry The Journal of Clinical Psychiatry, 71(03), 262-269. doi:10.4088/jcp.09m05189ecr

[12] Arria, A. M., & Dupont, R. L. (2010). Nonmedical Prescription Stimulant Use Among College Students: Why We Need to Do Something and What We Need to Do. Journal of Addictive Diseases, 29(4), 417-426. doi:10.1080/10550887.2010.509273

Melissa Kain

Lead Editor.

Melissa Kain is a junior majoring in mathematics and Spanish and minoring in English. She can be reached at melissa.kain@tufts.edu.


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