Monday, June 20, 2011

"Can I have my drugs now?"

After so many years of writing for the Daily Bruin, I wrote my final column a few weeks ago about the culmination of my research to date.  Below is my version, which I think the editors tweaked a little (and made up their own (inferior) headline) for the version found online here:


Four years ago I started researching students who used drugs like Adderall and Ritalin for academic purposes.  Maybe you’ve seen my flyers around campus or have a friend who was actually brave enough to sit down with me and let me interview them.
This project became my dissertation, which is almost finished, as is my time at UCLA.  But if I could summarize the culmination of my graduate education into a single bold statement/prediction, it would be that college students really like their drugs, and see no compelling reason to stop doing anything that they see as potentially enabling their success.
Before I go any further, I want to apologize in advance to anybody who reads this and was previously unaware of the dilemma of cognitive enhancement.  It’s the kind of topic that makes any prevention-oriented research self-defeating, since the idea alone of a drug with academic utility is bound to be virally appealing in fiercely competitive climates like UCLA.
In other words, how can I, or any researcher, talk truthfully about cognitive enhancement in the name of prevention or “responsibility” without making it sound appealing to anybody?
It’s not for everybody.  Stimulant medications are controlled substances with physiological, psychological, and legal risks.  But the truth is that many college students feel that the associated risks are far outweighed by the academic benefits of use.  What’s even more problematic is that research doesn’t completely disagree.
Concern over collegiate “cognitive enhancement” is nothing new, but higher education has done little since ADHD-diagnosed students first began bringing their renewable Ritalin prescriptions to college in the mid 1990s.  Word quickly got out that there was something “better” than coffee.
National databases on collegiate substance abuse put non-medical use of stimulant medications at around 8%, which doesn’t include the approximately 7.5% of American students diagnosed with ADHD.  Independent studies conducted on college campuses report illicit use prevalence at 25% and as high as 34%, with over half of upperclassmen and students in Greek life having used prescription stimulants.
From The Beatles and Elvis to JFK and Hitler, speed scares are not without historical precedent.  Desoxyn and Pervitin were used heavily by both allied and axis military soldiers in World War II, (Provigil and Adderall are still used today by British forces and Air Force pilots).  The then over-the-counter stimulant Benzedrine allowed Jack Kerouac to pen “On the Road” in 20 days, while domestic use of amphetamine pills were immortalized in the Rolling Stones’ song “Mother’s Little Helper."
Two things separate this generation of stimulant use from the past: medical sophistication and the advent of ADHD.  Today’s drugs are better, and we’re vastly more knowledgeable about what they do.  Leading clinical researchers and bioethicists have recently started conceding that these drugs may actually work, leading to real gains in concentration, memory, and sustained cognitive performance.
ADHD is a different kind of game changer in that it medically legitimizes the everyday use of amphetamines for a relatively broad swath of the population.  This separates our current dilemma with prescription amphetamines over controversies in past decades.
Despite skepticism from conservative pundits, the Church of Scientology, and my dad, ADHD is a real condition with real genetic determinants.  It is about 70% heritable, which is as much as height, or blood pressure.  But this doesn’t mean that our diagnostic system isn’t flawed.  Many savvy, opportunistic students and parents have been known to feign ADHD symptoms just to seek medications.  This is called “doctor shopping.”
I certainly saw some of this in my own research, but it was surprising to see how the situation with unstoppable drug-seeking behavior mirrored the burgeoning medical cannabis scene that erupted throughout Los Angeles over the past several years.
I recruited students who used “any drug” for academic purposes, and to my surprise, many inquired about using marijuana and salvia (which is currently legal) for creative purposes.
Whether you find the premise of creativity-enhancing drug use plausible or not, there is an historical precedent for that too.  Literary greats generally preferred booze, but prolific drug using artists and intellectuals included the beat poets and bebop jazz generation, Francis Crick, Aldous Huxley, and again, The Beatles.
As seen with medical cannabis, some drug policies seem to be in flux, or at least newly reopen to public debate.  Distinguishing what’s legal or illegal, however, isn’t as important as what’s “responsible” or “moderate,” and it may be moot if anybody can get what they want, whenever they want.  We may be there already.