Talk:Nootropic/Academic doping

Academic doping, also referred to as cognitive enhancement or neuroenhancement, is the off-label use of a class of drugs called “nootropics” for the purpose of improving cognitive ability or academic success. This class of drugs is normally used to treat neurocognitive disorders such as dementia, attention deficit disorder and schizophrenia. Based on their stimulant properties, it is believed that these types of drugs might also improve cognitive function in healthy people.

History
Academic doping is partially attributed to the meteoric rise in the written prescriptions to combat disorders such as Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. This trend in utilizing these cognitive enhancing drug can be traced before the 21st century. The frequency of diagnoses for Attention Deficit Hyperactivity Disorder (ADHD) has increased substantially in recent years, resulting in a parallel increase in the prescription of the drug methylphenidate (Ritalin). According to a recent investigation, methylphenidate prescriptions in the United States increased by 260% between 1990 and 1995. In an 1999 edition of the New York Times, the author received a student's perspective on the increasingly popular usage: "It keeps you awake for hours and gives you energy," said a junior at Bucknell University in Lewisburg, Pa., who has observed the trend, "It helps you focus." The New York Times reports that students have devised a variety of ways to get them through the night, including chopping up Ritalin and Adderall, amphetamines prescribed for attention deficit disorder, to snort for faster absorption. This story has gained traction over the years resulting in hundreds of scientific studies. In 2006, educators from Harvard University, University of Michigan, and other top universities reported that the primary motives for misuse are not recreational but for academic pursuits. Individuals report misusing prescription stimulants to improve concentration while studying, to be able to study longer, and to feel less restless while studying. In the Journal of American College Health in 2008 increasing statistics of usage state that between 8% and 34% of college students have misused a prescription stimulants at some point, that is, used a prescription stimulant without a valid prescription. So, it is believed that the spike in the number of people that have been prescribed the medicine has led to easy availability to get the drug itself, which leads doctors to believe why academic doping is now so common on college campuses specifically.

Uses (Non-Medical)
Students commonly use academic doping to allow them to complete a large amount of work in a small amount of time. In essence, the reason people engage in academic doping is so they gain an academic advantage over their peers. Some students, however, do not use academic stimulants for an unfair advantage, but so they work faster and complete more things, giving them time to engage in other activities. College students have many things going on at once, often overwhelming them. It is this busy schedule and feelings of immense pressure that the average college student experiences which leads to misuse. For college students who have a lot of academic work to finish, they tend to use these stimulants as cognitive enhancers to increase their productivity in a small amount of time.

Oftentimes in the mind of the users, the benefits the drug provides outweigh the risks of its use. Students are frequently motivated to use the drugs by the amount of work laid ahead of them, not the result it will have on their body as a whole. Sometimes, students will use academic doping as a way of "evening the playing field" with the thought that if some students are allowed to use these cognitive stimulants, they should be too. Another purpose for this abuse of cognitive enhancing drugs is not only to complete work on time, but to have the utmost focus and concentration while taking exams or tests. Most times, if a student is taking Adderall or Ritalin while studying, it is suggested and encouraged by other users to take it during the time of testing to get the best results.

According to a 2006 article published by MSNBC, academic doping first started among students attending extremely competitive universities. As reported in the journal Addiction, as many as one in four college students have misused the drug Adderall. This and other similar drugs may be used to increase focus while studying, and they are more potent than caffeine. Most recently, in April 2011, McGill University in Canada published survey results from a random sample of 400 students, in which 5.4% had used an off-label drug for the purposes of cognitive enhancement. A German study among 4,872 university students by Sattler and Wiegel found a life-time prevalence of prescription drug use of 4.5% for the aim of enhancing cognitive performance.

Recently, student abuse of prescription ADHD medications have attracted attention from the federal representatives. In early 2012, New York's senior senator Charles Schuman called on colleges to crack down on students abusing the drug. He cited studies that said up to 35% of all college students reported to using drugs like Adderall and Ritalin. He called for more stringent checkups by college health centers, saying that campus health centers should "require formal contracts and follow-up diagnostics for that student; and require detailed medical, educational, and psychological history."

Usage has since dropped down to the secondary level, with some parents requesting prescriptions for their children in order to boost grades.

Distribution
A student from Florida State explains that purchasing medications to help them "academic dope" is so easy, especially on a college campus as they can get the medications from friends with prescriptions. Another student from Florida State stated that "[Adderall] really is so easy to get whenever you need it... Usually anyone with a prescription will sell it to you." These medications are sold at a high rate during busy times of the year such as midterm and exam week, enabling the prescribed individual to profit even more greatly. In an anonymous interview submitted to the online website "The Campus Companion", one dealer of Adderall claims they make “$2000--$5000 a semester”. Although the distributors profit greatly from selling the drug, it is not a bad deal for the purchaser either as each pill will go from around $6 to $8. Students can even receive a discount on Adderall if they buy in bulk, when buying 10 at a time they can get them for 3 to 5 dollars a pill instead.

On top of the purchasing/selling of Adderall on college campuses, Adderall and other "academic doping" drugs can be distributed in other ways as well. The list of these examples is as follows: stealing roommates' medication, asking parents with prescribing powers or doctors who are friends of the family, lying to new doctors that they have previously held prescriptions, getting drugs from extended family members, and finally accessing online pharmacies that illegally dispense legitimate/counterfeit prescription stimulants.

Cognitive enhancement
The prescribed stimulant drugs for cognitive enhancement are not only successful in treating people who suffer diseases like ADHD, but also are effective for healthy people who do not suffer such diseases like ADHD. According to Drs. Malenka, Nestler, and Hyman, authors of the textbook Molecular Neuropharmacology: A Foundation for Clinical Neuroscience, “therapeutic doses of psycho-stimulants, including amphetamine, improve performance on working memory tests both in normal functioning individuals and those with ADHD”.

Potential for addiction
As a Schedule II Controlled Substance, the FDA requires that Adderall and all related stimulants carry a black box label warning to caution patients about its potential for abuse. Frequent and improper usage causes the body to build up an increased tolerance towards the drug, requiring users to consume higher dosages to achieve the same effects. By failing to address the underlying issue prompting Adderall use, periods of intense pressure or stress is likely to induce higher consumption among students.

Various publications suggest the stimulant use is linked to other forms of substance-abuse. According to the National Survey on Drug Use and Health, full-time college students who used stimulants for nonmedical purposes in the past year were reported be nearly 3 times as likely to have used marijuana (79.9 vs. 27.2 percent), 8 times more likely to use cocaine (28.9 vs. 3.6 percent), 8 times more likely to use  prescription tranquilizers (24.5 vs. 3.0 percent), and 5 times more likely to use prescription pain relievers (44.9 vs. 8.7 percent) Nearly 90.0 percent of these  students were past month binge alcohol users, and more than half were heavy alcohol users.

Adverse effects and long-term concerns
ADHD medications have been linked to a number of troubling side effects In a study involving 10,566 Adderall users who had experienced a negative reaction to Adderall, 187 of them reported an increased heart rate. Of these 187 individuals, 89.29% claimed that the increase was either moderate, severe, or most severe. Another study found that, 48% of the 325 participants experienced side effects that ranged from a loss of appetite, mood swings, and trouble sleeping. Other complications from stimulants include suicidal thoughts, vomiting, and other cardiovascular issues.

Although its long-term effects have not been closely studied, a study published in a 2009 edition of Molecular Psychiatry reports that "High doses of amphetamines can produce psychotic behavior indistinguishable from schizophrenia in asymptomatic schizophrenics and in some healthy human subjects." Scheske and Schnall sum up from multiple sources that “little is known about the possible negative side effects of cognitive enhancing drugs, especially in the long term”. There is almost no medical or clinic data of enhancement uses of these drugs. According to Mehlman, "Some general safety information about the drugs will be available from studies to support approved uses, but special risks could arise if they were used for enhancement purposes. Unless manufacturers were forced to conduct clinical studies on off-label uses or the government financed trials of its own, these risks would not be known until people stated using the products as enhancements."

Abuse
One of the biggest problems with prescription stimulant medication is its potential to be abused. Stimulants being known for increasing performance, cognitive function and memory. As well as keeping you awake paying the utmost attention, make them are golden ticket for college students looking to finish a lot of homework, study for a test, or even take a final exam.

According to Drug Enforcement Administration (DEA) data, methylphenidate production increased nearly 900% from 1990 to 2000. With the introduction of Concerta and Metadate, the production of methylphenidate has increased by 40% from 2000 to 2002. In addition, the production of amphetamines (Dexedrine and Adderall) increased by 5,767% from 1993 to 2001. In a study conducted by Northeastern US University of 1,025 students, 16 percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin (Methylphenidate). Men and women reported similar use patterns.

With a higher number of these prescriptions being written, it is much easier for students who are not prescribed to get their hands on medication. Some ways students get stimulants include: stealing a roommate's medication, asking parents with prescribing powers or doctors who are friends of the family, lying to new doctors that they have previously held prescriptions, getting drugs from extended family members, and accessing online pharmacies that illegally dispense legitimate/counterfeit prescription stimulants. When asked whether they thought it was easy or difficult to obtain stimulant medications, 58 percent of the misuse and abuse group replied that it was easy or somewhat easy to obtain stimulant medications, whereas 28 percent of the total group (N = 1,025) thought it was easy, 62.6 percent did not know, and 5.3 percent thought it was difficult.

Students are frequently motivated to use the drugs by the amount of work laid ahead of them, not the result it will have on their body as a whole. Students say stimulants keep them awake, so they are not feeling restless while studying or doing homework. In the article, “Illicit Use of Prescribed Medication Among College Students,” a student mentioned, "Stimulant medication has a positive effect on academic achievement in the long run for me". Students also mentioned, "they experienced time pressures associated with college life and that stimulants were said to increase alertness and energy". Most students trying to keep their head above water are looking for any edge they can get. Not thinking too much about the risk, the easy access to psychoactive stimulants is their answer.

Criticism and controversy
A lot of ethical questions arise when discussing who should be taking cognitive-enhancers and who should not. Who is being put at an advantage? who is being left behind? If people who are not prescribed take these drugs, should it be deemed cheating like it is in sports?

An article in The Times [London (UK)] suggests maybe someday, if a safe drug is created then parents will start giving their children these drugs. One argument is that methylphenidate, otherwise known as Ritalin is given to those who have Attention Deficit Hyperactivity Disorder, but is also accessible to those who can already focus at a “normal” rate. Cognitive-enhancers put students who have ADD or ADHD at the focusing level of the average student. If those students start to be allowed to take these drugs, how will the people who already need them be able to keep up? Some argue it should not be considered cheating because the drug does not physically give you the answers. A student who lives in Conway, Arkansas on Talk of the Nation on NPR news said, “I don't necessarily feel like it puts me at an advantage as the work that I could accomplish is the same quality but that I'm able to do more work, I'm able to get more done in times when I'm really stressed out, so.”

Another question that is raised is whether taking a cognitive-enhancing pill should be considered cheating like it is in sports. Lawrence Diller a pediatrician at the University of California at San Francisco says the reason doping in sports is considered cheating is because “In sports we value not only the home-run record but the effort involved in reaching that goal. Taking a performance-enhancing pill cheapens that sense of effort.” In addition he asks the question, “Is it any different if scholars are popping pills instead of athletes?”

According to an article in the Journal of Medical Ethics, “Academic performance is not merely the product of hard work, discipline and other laudable personal attributes, but, it would seem, is a competition partly won by the genes and socioeconomic background of one’s parents. It follows, therefore, that prohibiting nootropics would not even the playing field, because there never was an even playing field to begin with.” If people were able to buy these drugs, the people who would be able to buy them would be the wealthy. Another argument is that, “If socioeconomic inequalities in education are readily tolerated by society, then it would be hypocritical to apply this criterion selectively to nootropics and not to other performance-enhancing strategies.”