The ultra-ambitious, overbooked teen is becoming increasingly common, as college acceptance becomes more competitive and the job market more dire. Modern teenagers often feel pressure to do it all, and better than anyone else: make straight A’s, ace the SATs, excel at sports or music or art and still have time for fun and friends. Unproductivity has become impractical, sleep a waste of time.
Which is why healthy teens across the country are turning to stimulants like Adderal, Ritalin and other medications traditionally prescribed to treat attention-deficit/hyperactivity disorder (ADHD). When used for reasons other than those intended, ADHD drugs are believed by some to increase concentration, focus, wakefulness and short-term memory, allowing teen-agers to be hyper-productive and, some say, smarter. For this reason, the drugs—along with a newer drug, called Provigil, prescribed as an aid to chronic drowsiness—have become known as “cognitive enhancers,” “neuroenhancers” or “smart drugs.” Students report doing better in school—whipping through term papers, speaking more in class—and conveniently needing far less sleep. And since the drugs are FDA-approved and so widely prescribed (most kids are likely to have classmates who take prescribed ADHD medications, which is often where they get them), teenagers tend to view the drugs as relatively harmless.
As illegal drug use declines nationwide, prescription drug abuse is climbing—with stimulants near the forefront—in affluent suburbs and at elite colleges. In 2005, a study led by John Knight, MD, director of the Center for Adolescent Substance Abuse Research at Children’s Hospital Boston, found that 7 percent of college students surveyed used stimulant medications for non-medical purposes. Similar studies have shown levels of use as high as 35 percent at individual schools. “Prescription stimulant misuse is the fastest growing segment of the drug abuse problem, and growing exponentially,” says Knight. “It’s going to be the epidemic of the next decade or two or three.”
According to Knight, medications for treating ADHD, when used as directed, are among the safest around. When misused by kids who don’t have the disorder, however, the results can be damaging, and in some instances deadly. “Compare it to a person with normal vision wearing eyeglasses,” Knight says. “At first, the eyeglasses will magnify vision. But soon, they’ll damage the eyes to the point where the person can no longer see straight without them.” Side effects can include nervousness, headaches, sleeplessness, depression and decreased appetite.
And while Knight allows that misuse of stimulants can marginally improve certain areas of focus, those improvements don’t last. The brain has a way of correcting itself, he says; this is called tolerance. Soon, a teen needs to take twice as much medication to get the same effect. (In contrast, kids who do have ADHD typically stay on a stable dose for years and years.) Some young people seeking to feel “high” from stimulants begin to grind the pills and snort or inject them—this gets the drug into the bloodstream immediately, enhancing its effect—which can lead to cardiac arrest. Others “graduate” to street drugs, like cocaine and heroin. “By the time most kids come to see us at the hospital, they’ve reached a very sad place,” says Knight.
What’s worse, is “there is absolutely no scientific proof these drugs, when not prescribed for ADHD, aid performance,” says Knight. “What we have are reports of individuals saying they did better in school. But did they do better in school, or did the drug just make them think they did better? It’s a stimulant. Stimulants make you feel better about things.” In fact, many kids admit that when studying on cognitive enhancers, their papers are too wordy, their participation in class more scattershot. They can spend hours over-eagerly writing and rewriting a single paragraph until it’s “perfect.”
An increasing number of kids are taking stimulants simply because they like the high they provide. And there are those who use drugs to make up for social excesses that might otherwise have a negative effect on their studies: With the help of cognitive enhancers, the modern-day superkid studies all week, dances all weekend and has no need for sleep. Until, that is, she crashes.
“The problem with the prescription drug epidemic is that kids are only getting the first part of the message,” says Knight. “Yes, the drugs are FDA-approved. They are safe and effective when prescribed by doctors, but the key phrase there is ‘when prescribed by doctors.’”
Popular TV shows, like “Gossip Girl” and “Nurse Jackie,” depict generally sympathetic characters misusing prescription pills without significant consequences; these have made the drugs seem less dangerous, and a little more glamorous, than ever before. But, warns Knight, unprescribed use almost always leads to problems and, in the worst cases, addiction or even death. In this story, the ending is never happy.