Chantat Krisadawat 1TE16649RProf. M. ArmstrongAcademic EnglishJuly 2017Harms of the Usage of Smart Drugs by Nonprescription College Students and Potential Solutions1. IntroductionIt is inevitable sometimes for college students to commit long sessions of studying in order to cram exam revision or complete an assignment. High attention activities such these come with a tremendous amount of stress, especially for those who are studying under high pressure. To aid the burden, the usage of ‘smart drugs’ have become more prominent as a powerful supplement for students within college society, as they are claimed by the past users to assist studies greatly. As quoted in Smart Drugs vs. Nootropics (2014), the term ‘smart drug’ (sometimes known as ‘study drugs’) shall be defined followingly as “a prescribed medication or off-label drug used primarily to treat some kind of mental or cognitive disorder.
” The example for smart drugs which are commonly mentioned and non medically abused is the one prescribed for Attention Deficit Hyperactivity Disorder (ADHD) patients. Based on the survey with up to 10,220 participants from 18 universities conducted by Bavarian, Flay & Smit (2013), it was discovered that 10.70 percent of students experienced the use of nonprescription drugs in the span of a year. Moreover, another similar study by American Academy of Pediatrics (2014), targeted on high ranked colleges, presented the results; 20% of 616 students reported to misuse ADHD patient’s drugs at least once with up to 24% of those admitting to have experienced the stimulants up to eight occasions.
The number of nonprescription users is high and the current issues with smart drugs can be divided into two categories. The first major concern is the scientifically proven effects of smart drugs on the nonprescription users’ health. Following a popular belief, the smart drugs are often reported to greatly enhance brain abilities and help users concentrate on study. In the online article by Whitehouse (2016), students who reported to use smart drugs were interviewed. Various users revealed that smart drugs help keeping them awake and thus, allow fuller concentration as well as enhancing their learning capabilities. Although the benefits continue to being emphasized, there are still several harmful symptoms mentioned in the interviews which must be examined further and justly elaborated.
Another problem regards the widespread illegal distribution of the smart drugs. According to the survey conducted by Garnier et al. (2010), 35.8% of 483 participants with brain disorder have at least once distributed their prescription drugs to the peers. Of those sample, 61.7% of the drugs diverted were ADHD medications such as amphetamine and dextroamphetamine. In reality, some positive effects of the cognitive enhancement drugs for ADHD patients however have yet to be scientifically concluded. Upon further inspection, there are also still many existing negative effects on the nonprescription users’ health.
Nevertheless, an illicit distribution of smart drugs is still widely spread and remain unsolved. Therefore, the law on prescription drugs must be further reinforced and in addition, better understanding and alternative must be promoted. This paper shall tackle the issues by first identifying the problems, and then offer viable solutions.2.
ProblemsThe issue regarding the benefit of the smart drugs shall be first brought up for examining together with the past researches discovery. Obviously, smart drugs though reported to be beneficial, do come with a variety of side effects which can be severely harmful to user’s health. The major problem, however, lie within the abusing of drugs which can lead to overdose and addiction. The final part of this section shall tackle the problem on the illegal distribution of smart drugs.2.1 Inconclusiveness in the scientific researches of Smart DrugsThis section intend to investigate the problem which are the actual effectiveness of smart drugs. As mentioned in Desantis, Webb & Noar (2008), the major motivation for smart drugs nonmedical usage (in this case, prescription drugs for ADHD patients) are generally for academic purposes expected effect such as staying awake, improving cognitive functions like attention and memorization, and inducing interest. In contrary to popular beliefs, however, many experiments, which tested most of the abused smart drugs, have shown an inconsistency in their short-term benefit.
One experiment conducted by Randall, Viswanath, Bharania, Elsabagh, Hartley, Shneerson & File (2005) investigates the effect of Modafinil on 60 healthy students with sufficient sleep hours. Through cognitive test and comparison with placebo, the result found that Modafinil had no significant impact on the participants’ cognitive functions. Another more recent experiment by Finke et al. (2010) took another approach with the Theory of visual attention (TVA-based study). 18 participants were given modafinil and methylphenidate and then, the investigation divided sample test results into ‘high performance’ and ‘low-performance’ using placebo result as base-line. The result confirmed the enhancement of attention only in the participants with low-performance, who originally have lower levels of dopamine (a substance influenced concentration on task) to begin with. Thus, modafinil is unlikely to aid user with normal base-line. Another trait of smart drugs effect depicted is that it is claimed to boost the interest of users on their tasks.
This claim is possible considering two surveys from the discovery by Ilieva & Farah (2013) on Adderall and Müller et al. (2013) also on Modafinil, which both referred that drugs influenced participants’ motivation significantly. Despite this discovery, the overall result on cognitive function appears to be inconsistent (Lakhan & Kirchgessner, 2012) thus, the clear positive effects on cognitive functions should not be drawn conclusively. The safest scientific assumption that can be made now is that smart drugs will not significantly influence cognitive function but potentially, spike up the motivation which can logically induced users to make claim regarding enhancement in cognitive functions. Though this problem might not be able to cause severe problems on its own, a misconception, by for instance through peer pressure, can escalate users into drug abuse, overdose issue and addiction. 2.2 Potential harmful Effects from Smart Drugs on the Nonprescription User’s HealthAccording to U.S.
Food and Drug Administration medication guide, there are several potential harmful effects caused by ADHD medication. Commonly manufactured drugs such as Adderall cause minor harmful effects such as headache, loss of appetite and so weight, dry mouth, insomnia (which give the appealing alertness for many users). However, in some occasions, there are much more severe problem to be aware. This mentioned medication guide on Adderall, for example, also warned that the usage of drugs can lead to rapid increasing in blood pressure and so, cardiac arrest in some users with heart-related disease. The risk escalates even higher if these drugs are co-usage with alcohol which also heighten the blood pressure (Alcohol – Health Professional Resources, n.
d.). In addition, mental disorders such as mood swing, aggressive behaviours and bipolar illness, can also possibly appear. One incident reported by James (2010) mentioned a case of a college students who abused Adderall committing suicide; the article also mentioned about how the victim’s personality changed. This case study open up the main argument; the greatest danger from ADHD medications is not from the drug itself but, from the users misusing and thus, in risk of overdosing. The survey by Barrett, Darredeau, Bordy & Pihl (2005) discovered an alarming finding that among a group of students who misuse Methylphenidate for enjoyment purpose, 77.1% co-abuse the drug with alcohol, cannabis and other illicit drugs such as cocaine. Another change to be mentioned is the in appropriate route of administration of the nonprescription drug.
A discover from 1025 surveys conducted in 2006 found that up to 40% of the participants preferred intranasal as a route of administration (White, Becker-Blease & Grace-Bishop, 2006). The harm can be worsen by the fact that smart drugs are much cheaper and reachable (Genetic Science Learning Center, 2013). Due to the easily accessible, smart drugs became a substitution to cocaine for college students.
Ritalin (which are designed to take orally for slower absorption rate) if taken in high doses through nasal or injection can lead to overdose due to fast absorption rate and dependence (Genetic Science Learning Center, 2013). All these evidences suggest to one thing that nonprescription users, who obtain the drugs illegally and remain unregulated on dosage control, can be the most vulnerable victims from the danger of smart drugs abusing.2.3 Distribution of Smart Drugs by Prescription Users and Other SourcesNow that the point concerning the attitude toward positiveness of smart drugs and potential in them being abused are fully established, the issue concerning the illegal distribution shall be investigated. According to Mccabe, Teter & Boyd (2006) the main route of prescription drugs distribution is through friends with medical prescribed patients, with up to 310 students out of 458 (approximately 68%) obtained drug this way. Moreover, in the same paper, one senior student gave an interview that “getting Adderall and Ritalin are probably easier than getting alcohol on this campus. I could find 500 pills in 20 minutes” (Mccabe et al., 2006, p.
8 ). White et al. (2006) investigating the cause further, one research found that up to 33.5% of those who medically obtained prescription drug share their stocks with peers. According to a commentary paper on the Massachusetts Institute of Technology (MIT) society concerning the usage of Amphetamine, the author commented on various absurdities; for example, how common it is to find the empty pill bottles, how in a nearby pharmacy store sold ‘pill-crusher’ for snorting purposes or how common it is for students to approach ADHD friends for buying or sharing (Kondrotas, 2006). Clearly, there is a significant issue regarding the route of drugs from ADHD patient but even worse, sometimes the nonprescription users are discovered to be able to simply access the drugs by themselves.
In the paper, Kondrotas also addressed the abnormal number of students who just got diagnosed with ADHD after entering a highly selective college. Event such as ADHD symptoms faking seems to be a common norm and simple tasks, reflecting on the attitude of students who views ADHD as a gateway for illicit drugs and the school psychiatrist as a stockholder. This latest discussed phenomenon is totally believable, considering there is a paper published showing on how the participants can be diagnosed ADHD and properly obtained drugs through symptoms coaching.
Sansone & Sansone (2011) published a summary of various researches which investigate the possibility of malingerers and overall, it is reported that feigning the symptoms checklists is relatively easy. Finally, although the previous data by Mccabe et al. (2006) showed zero participants obtained drugs through online illegal source, the problem still nevertheless present. The article by Whitehouse (2016) claimed that for some users to order them online through readily available sources for instance, overseas online market in Malaysia and India where pharmacy trafficking is unregulated. 3.SolutionsContinuing from the problems section, there are precisely two approaches that must be taken to minimize the smart drugs abuse within college students body. The first being the ADHD drugs prescription methods which be shall discussed further in sub-solutions regarding the law, prescription users monitoring and diagnosis test standard. Second, the understanding of the drugs effects must be transparently promoted through various examples of academic research on the correlation between academics performance and drugs usage.
Final suggesting solution is to facilitate an alternative option for smart drugs.3.1 Law Regards Prescription Drugs, Monitoring and Diagnosing ProcedureTo tackle this non-medical usage issue, there are three aspects to this sub-solution. First is to strengthen the Law on the illegal distribution of the drug. In the article by Liao (2017), many of the mentioned ADHD drugs in this paper, such as dextroamphetamine, amphetamine and Ritalin, are categorized as Schedule II drugs which have high potential for abused as discussed.
In the report by Yeh (2015), the summary clearly stated a heavy fine up to 5 million USD and imprisonment up to 20 years in the case of trafficking. Despite these huge penalties, the majority of the issue still remained unsolved as elaborated. Thus, it is clear that attention on the surveillance and solemnity of the law must be raised.
The government might also consider punishing those prescription users who possess suspiciously high amount of medication drugs, under the possession act. Moreover, to maintain the consistency, every states should also promote the law with similar punishment. This strengthen of law as a first step shall eliminate a comforting environment for the selling or even sharing of ADHD drugs from prescribed user to non-medical users. Second, the ADHD patients who are the main culprit for diverting the drugs as addressed must be monitored carefully.
This policy however, was already carried out in 21 states within America but clearly, current monitorings are not enough consider the non-medical usage still prevail (Sussman, Spruijt-Metz & Miller, 2006). Thus, the law must also reaffirm the medical specialist to control the dosage prescribed to their patients as well as not tolerate any extra dosage withdrawal. The final issue concerning the legitimacy of ADHD diagnosis test, which is mentioned to be weak and vulnerable to false positive. An obvious solution is to restate a necessary procedure to accurately identify ADHD symptoms for any diagnosing. An overview of the study relevant to ADHD feigning by Tucha, Fuermaier, Koerts, Groen, & Thome (2014) showed that there is a reliable diagnosis test called ‘stand-alone effort tests’ which worked remarkably well in combination with other test applications. Nevertheless, the paper concluded that the reliability of measurement has yet to be absolutely discovered.
Hence, the government might also consider allocate some funding into the development of a more accurate approach.3.2 Improvement Through Promoting the UnderstandingEven if the law concern smart drugs are properly strengthens, clearly there are still many misconceptions concerning the smart drugs that must be made well-known. A suggestion that can be made is to promptly establish a workshop that promotes the understandings as well as suggesting alternative for students. The Student Union of Oxford University, for example, has already set up such work shop with the aim to raise the student’s awareness along with strategizing techniques to cope with a general stress and exam anxiety (Fullerton, 2017).
A possible content is to further reinforced the inconclusive positive effects of smart drugs, as several studies show that in reality illicit usage is usually correlated with a negative effect on the GPA earned. Three studies suggested that those with higher GPA (e.g. >= 3.
5) are less likely to illicitly abuse smart drugs during a past year in comparison to those with lower GPA, representing by descending odds-ratios (Guthrie, Teter, Mccabe & Boyd, (2003) Mccabe, Knight, Teter & Wechsler, (2005) Mccabe et al. (2006) ). As one can see from these statistical datas, those who earned higher GPA to begin with are less likely to rely on the smart drugs while those with lower grade are more likely to abuse them. These statistical evidences support that an advisable cause of action for the university is to inform students, who claimed to abused smart drugs for academic reason, of the ineffectiveness. For those who abuse smart drugs for non-academic usage, there are still many underlying potential harmful effects as mentioned. The university should inform the students about the consequence of co-using the drugs with other psychoactive stimulants, which induce tremendous amount of risk as well as the danger from consuming the drugs through any administration routes other than oral.3.3 Possible Substitution to ADHD DrugsOne unique approach worth of considering is to develop a safer alternative for ADHD patience.
From Sussman, Pentz, Spruijt-Metz & Miller (2006), a drug named ‘Lilly’s Atomoxetine’ is claimed by several cited studies to have similar benefits and side effects as other ADHD drugs but, has less potential for the abuse. If the pharmacy manufacturer were to facilitate development of such drug and market them, the danger of potential dependence as well as overdose can be reduced. Noted that, this solution is not going to make nonmedical user give up on abusing drug. Therefore, this policy should be used in cooperate with the dosage control on the prescription user as mentioned.
4. ConclusionIn conclusion, there is an astonishing number of smart drugs abused for non-medical purposes. The root of problems can be mainly traced back to the inconclusiveness of the positive effects as well as the under emphasized harms. These reasons altogether combine into a misconception that smart drugs are an ordinary supplement for academic purpose and hence, lead to the illicit obtaining through prescription users distribution, feigning the symptoms and online purchase.
Viable solutions are first obviously to illegalize the acquiring of smart drugs, monitor the drugs flow and develop the diagnosis tests. Second is to promote the actual truth and understanding about the diluted beneficial effects as well as harmful aspects. Finally, the pharmacy manufacturer can facilitate the development of the weaker dose of potential smart drugs and thus, minimize the dangers. All these solutions will enable us a clean and safe learning facility, where smart drugs can be used truly for the benefits of those who in need.References:Alcohol – Health Professional Resources. (n.d.).
Alcohol and Attention-Deficit Hyperactivity Disorder (ADHD) Medication (Stimulants). QNADA. Retrieved June 22, 2017, from http://qnada.org.au/686/alcohol—health-professional-resourcesAmerican Academy of Pediatrics. (2014, May 01). Many Ivy League students don’t view ADHD medication misuse as cheating: 18 percent use stimulants to help them study.
ScienceDaily. Retrieved June 20, 2017 from www.sciencedaily.com/releases/2014/05/140501132630.htmBavarian, N., Flay, B. R., & Smit, E.
(2013, June). An Exploratory Multilevel Analysis of Nonprescription Stimulant Use in a Sample of College Students. Journal of Drug Issues, 44(2), 132-149. doi:10.1177/0022042613491109Barrett, S. P., Darredeau, C.
, Bordy, L. E., & Pihl, R. O. (2005, July). Characteristics of Methylphenidate Misuse in a University Student Sample. The Canadian Journal of Psychiatry, 50(8), 457-461.
doi:10.1177/070674370505000805Desantis, A. D., Webb, E. M., & Noar, S. M. (2008, November).
Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach. Journal of American College Health, 57(3), 315-324. doi:10.3200/jach.57.
3.315-324Finke, K., Dodds, C. M., Bublak, P.
, Regenthal, R., Baumann, F., Manly, T., & Müller, U.
(2010, March). Effects of modafinil and methylphenidate on visual attention capacity: A TVA-based study. Psychopharmacology, 210(3), 317-329.
doi:10.1007/s00213-010-1823-xFullerton, A. (2017, March 06).
Oxford University Student Union introduces ‘smart drug’ workshops for students. Retrieved June 27, 2017, from http://www.telegraph.co.uk/education/2017/03/06/oxford-university-student-union-introduces-smart-drug-workshops/Garnier, L. M., Arria, A.
M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E.
D. (2010, March). Sharing and Selling of Prescription Medications in a College Student Sample. The Journal of Clinical Psychiatry, 71(03), 262-269. doi:10.4088/jcp.09m05189ecGenetic Science Learning Center. (2013, August 30) Ritalin and Cocaine: The Connection and the Controversy.
Retrieved June 22, 2017, from http://learn.genetics.utah.edu/content/addiction/ritalin/Guthrie, S. K., Teter, C.
J., Mccabe, S. E., & Boyd, C. J. (2003).
Illicit Methylphenidate Use in an Undergraduate Student Sample: Prevalence and Risk Factors. Pharmacotherapy, 23(5), 609-617. doi:10.1592/phco.
23.5.609.32210Ilieva, I. P., & Farah, M. J. (2013).
Enhancement stimulants: Perceived motivational and cognitive advantages. Frontiers in Neuroscience, 7. doi:10.3389/fnins.2013.00198James, S.
D. (2010, November 08). Adderall Abuse Alters Brain, Claims a Young Life. abcnews. Retrieved June 22, 2017, from http://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619Kondrotas, O.
(2006 May 15). Speed culture in the digital generation A commentary on amphetamine use at MIT and colleges nationwide. Retrieved June 20, 2017 from http://ocw.nur.
ac.rw/OcwWeb/Science–Technology–and-Society/STS-062JSpring-2006/Assignments/index.htmLakhan, S. E., & Kirchgessner, A.
(2012, July). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: Misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661-677. doi:10.1002/brb3.78Liao, S. (2017, May 10).
Why Are ADHD Medicines Controlled Substances?. Retrieved July 20, 2017, from http://www.webmd.com/add-adhd/features/adhd-medicines-controlled-substances#1Mccabe, S. E.
, Knight, J. R., Teter, C. J., & Wechsler, H. (2005, January).
Non-medical use of prescription stimulants among US college students: Prevalence and correlates from a national survey. Addiction, 100(1), 96-106. doi:10.1111/j.1360-0443.2005.
00944.xMccabe, S. E., Teter, C. J., & Boyd, C. J. (2006, 03).
Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication. Journal of Psychoactive Drugs, 38(1), 43-56.doi:10.
1080/02791072.2006.10399827Müller, U., Rowe, J., Rittman, T.
, Lewis, C., Robbins, T., & Sahakian, B. (2013, January). Effects of modafinil on non-verbal cognition, task enjoyment and creative thinking in healthy volunteers.
Neuropharmacology, 64, 490-495. doi:10.1016/j.neuropharm.2012.07.
009Randall, D. C., Viswanath, A., Bharania, P., Elsabagh, S. M., Hartley, D. E.
, Shneerson, J. M., & File, S.
E. (2005, April). Does Modafinil Enhance Cognitive Performance in Young Volunteers Who Are Not Sleep-Deprived? Journal of Clinical Psychopharmacology, 25(2), 175-179. doi:10.
214Sansone, R. A., & Sansone, L. A. (2011). Faking Attention Deficit Hyperactivity Disorder. Innovations in Clinical Neuroscience, 8(8), 10–13.Retrieved June 22, 2017, from https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC3173757/Smart Drugs vs. Nootropics. (2014, November 08). Retrieved June 21, 2017, from https://bengreenfieldfitness.
com/2014/11/smart-drugs-vs-nootropics/Sussman, S., Pentz, M., Spruijt-Metz, D., & Miller, T.
(2006, June). Misuse of “study drugs:” prevalence, consequences, and implications for policy. Substance Abuse Treatment, Prevention, and Policy, 1(1), 15. doi:10.1186/1747-597x-1-15Tucha, L., Fuermaier, A.
B., Koerts, J., Groen, Y., & Thome, J. (2014, August). Detection of feigned attention deficit hyperactivity disorder.
Journal of Neural Transmission, 122(S1), 123-134. doi:10.1007/s00702-014-1274-3U.S. Food and Drug Administration. (n.d.).
Drug Safety and Availability – FDA Asks Attention-Deficit Hyperactivity Disorder (ADHD) Drug Manufacturers to Develop Patient Medication Guides.U.S. Department of Health & Human Services. Retrieved June 22, 2017, from https://www.fda.
gov/Drugs/DrugSafety/ucm107918.htmWhite, B. P., Becker-Blease, K. A., & Grace-Bishop, K. (2006, 03). Stimulant Medication Use, Misuse, and Abuse in an Undergraduate and Graduate Student Sample.
Journal of American College Health, 54(5), 261-268. doi:10.3200/jach.54.5.
261-268Whitehouse, H. (2016, March 01). In their own words: Students share their views on smart drugs. Retrieved June 21, 2017, from https://www.theguardian.
com/education/2016/mar/01/in-their-own-words-students-share-their-views-on-smart-drugsYeh, B.T. (2015, January 20). Drug Offenses: Maximum Fines and Terms of Imprisonment for Violation of the Federal Controlled Substances Act and Related Laws.
Congressional Research Service. Retrieved July 20, 2017 from http://www.health.govt.nz/publication/lets-get-real-real-skills-people-working-mental-health-and-addiction