‘Smart drugs’: from campus culture to the real world

It’s not all that hard to find a college student who is, or who knows someone, taking Ritalin or Adderall.

“Yeah, I know a few people who take these drugs,” says Farrah Rahaman, a junior at Drexel University. “[They] get them from friends who are prescribed, who source them from other places without being prescribed.”

Surveys show that as many as one-third of undergraduates have used so-called “smart drugs” without a prescription. 

And there’s no real taboo regarding their use at this point, according to Rahaman. Students speak openly about these stimulants, and don’t see much risk in giving pills away or taking them.

Rahaman, who has not used a stimulant, says the reasons behind their use isn’t just about getting ahead: in some ways, it’s about simply keeping up.

“People are taking these drugs because of the excessive pressures they face to perform, to meet the demands of a rigorous curriculum, but more than that, to meet the extracurricular demands, and that is really hard,” she says. “It is hard to be a student.”

It’s not like it necessarily gets easier after graduation. Between jobs and family and kids’ sports and work emails at all hours, a lot of people feel like they’re stuck on a hamster wheel. Or to use a less photogenic animal, the rat race.

“What’s not clear is how you get off the rat race,” says Anjan Chatterjee, chair of the neurology department at Pennsylvania Hospital.

Chatterjee, who coined the term ‘cosmetic neurology’ in 2004 to describe the use of drugs to enhance cognitive performance, has begun taking the position that people should have wider access to smart drugs. That if people believe these pills help them succeed, their doctor shouldn’t necessarily stand in the way.

“It would be a mistake to think that I’m a proponent of people using these smart drugs as much as being a proponent of people having the choice to use smart drugs,” he says.

The same way people have the choice to use alcohol and nicotine. They’re drugs that can also be abused, but adults are reasonably free to use them as they wish. It’s a libertarian take on the doctor/patient relationship, although, Chatterjee doesn’t think smart drugs should be available at every 7-Eleven.

“For the time being, I think they need to go through physicians, in large part, to be able to educate people about [what] the potential risks and benefits are, and so people know what, when we think they are relatively safe, what the parameters of that are.”

He points to research showing Ritalin and Adderall are relatively safe when taken in the correct dose, at least in the short-term. The long-term effects and the addictive qualities are less understood, something he would like to see more research done on.

But that shortage of concrete evidence about their safety makes this position of wider access to smart drugs controversial.

Plus, there’s the fact that even the benefits aren’t clear.

“The results are really inconclusive at this point,” says Eric Racine, director of neuroethics research unit at the Clinical Research Institute of Montreal. “We really don’t have that much of an understanding that the drugs have the effect of enhancing cognition in healthy individuals.”

In one study on otherwise healthy young adults–that is, people without ADHD — test scores and memory retention don’t improve when they are given Adderall. 

Instead, these pills seem to have more to do with motivation and drive. They make monotonous or unpleasant tasks more tolerable.

Kind of the same way coffee does.

“Caffeine is also a ‘smart drug.’ It can help us, especially when we are fatigued,” says Amy Arnsten, a professor of neuroscience at Yale Medical School.

She says the desire for a chemical boost is an understandable reaction to the demands of today’s economy.

“We are in the information age, where to succeed, to thrive, you need the full functioning of a part of your brain called the prefrontal cortex, which is what my lab studies. Our work has shown that the prefrontal cortex is like Goldilocks, has to have everything just right.”

But fatigue and even small amounts of stress impair the prefrontal cortex, and limit our ability to compete and succeed.

Arnsten says stimulants like Ritalin and Adderall don’t turn us into geniuses. They work by correcting the neurochemical environment so our brains are in an optimal state.

“You can’t produce a supernormal brain with these drugs. You are simply trying to make up for fatigue or stress,” she says.

Arnsten doesn’t think these compounds are safe enough for widespread use without a prescription, in part because of how easily patients can abuse them.

Plus, she adds, the coffee is always going to taste better.