The use of Adderall, the amphetamine salt used to treat attention deficit hyperactivity disorder (ADHD), as well as other ADHD medication, is on the rise among young adults.
This might not sound surprising, as the combination of amphetamine and dextroamphetamine has gained popularity on college campuses as a “study drug,” an easy fix for helping students write papers and cram for tests. However, the use of Adderall isn’t stopping after students don a cap and gown; instead, the use of stimulants is continuing into the workplace.
Wanting a Competitive Edge
Adderall, Ritalin, Vyvanse, and other ADHD medications are increasingly being used in a manner similar to how athletes use steroids. Young adults are taking it to succeed in post-graduate degree programs or to work harder in their new jobs.
Tech companies and Wall Street have gained notoriety for their employees’ use of the drugs — not just to enhance work performance but to keep up with other colleagues. Lawyers use the drug to bill more hours to clients in the race to make partner; reporters use it to make deadlines. For many, their doctor is their drug dealer.
In 2013, former college baseball player and class president Richard Fee took his own life at age 25 after battling an addiction to Adderall. His story gained national attention — not just because it told of an aspiring medical student who developed a dependence on the drug rather than the stereotype of someone with a substance use disorder, but because it showed how the prescription pill industry can fail those who develop a dependence on their medications.
Adderall can appear to be the golden ticket to getting ahead. However, there is no evidence of reliable enhancement.
Richard Fee, like several of his college-age peers, first took the drug to gain a competitive edge at school. When he decided to obtain his own prescription, he was able to tell doctors exactly what they were looking for. He selected all the right answers on the Conners Scale, an ADHD questionnaire often used by doctors as a shortcut to a diagnosis.
His parents, concerned their son had never shown any symptoms of ADHD growing up and had developed odd behaviors, pleaded with his doctor to stop prescribing the drug. However, two different doctors continued to ignore the signs of dependence and his parents’ pleas. They wrote scripts — often within the span of a few weeks from each other and in higher dosages — for fast-acting Adderall, which has a higher potential for abuse than the extended-release version. A few months later, likely after abruptly stopping his use of the amphetamine salt, Fee took his own life.
‘National Disaster of Dangerous Proportions’
For many, Adderall can appear to be the golden ticket to getting ahead in both professional and personal life. Adderall can also suppress appetite and lead to weight loss. For the “Adderall generation,” this drug has become the new coffee, used to enhance cognitive performance. However, according to a 2013 study published in Neuropharmacology, there is no evidence of reliable enhancement across 13 different measures of cognitive performance.
ADHD is a very real disorder and medication can help treat its symptoms; but misdiagnosis has become a growing national health crisis.
Often, it only takes a few minutes for someone to be diagnosed with ADHD or sluggish cognitive tempo (also known as concentration deficit disorder) — a controversial deficit disorder that is new to psychiatry. Dr. Keith Conners, known as the father of ADHD and the creator of the Conners test, has since begun speaking out against ADHD misdiagnosis after reading The New York Times’ exposé of how doctors failed to notice signs of misuse and addiction in Fee, calling the current state of ADHD diagnosis “a national disaster of dangerous proportions.”
Fixing a Broken System
Experts are taking steps to rework the Conners test language and scoring methods to prevent misdiagnosis. Unfortunately, intentionally faking symptoms of ADHD are not the only way to score the drug. Some people purchase the pills through friends or dealers. For others, a prescription is the result of a childhood misdiagnosis.
Data show that as many as 15 percent of kids are diagnosed with ADHD by the time they leave high school, and one in five high school boys received an ADHD diagnosis. Population surveys, however, suggest that in most cultures, the deficit disorder occurs in only about 5 percent of children and 2.5 percent of adults.
ADHD remains both over-diagnosed and under-diagnosed — a contradiction that has existed since the deficit disorder was originally named minimal brain dysfunction in the 1950s. ADHD is a very real disorder and medication can help treat its symptoms, but its misdiagnosis has become a growing national health crisis. ADHD, however, remains under-diagnosed among adult females.
Doctors have become quick to diagnose patients with ADHD and prescribe Adderall, a Schedule II drug, which means it has a high potential for addiction. Ten percent of adolescents and young adults who misuse ADHD medication become addicted. However, someone misusing ADHD medications likely won’t match the stereotypical image of a drug dealer; instead, they’ll appear to be driven, productive employees.
Dr. Kevin Wandler, a national leader in the treatment of substance abuse and eating disorders, is chief medical officer for Advanced Recovery Systems in Fort Lauderdale, Florida, and founding medical director for The Recovery Village.