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Ella Benson was a junior in college the first time she took it. With a class assignment due, she was offered the drug as a means to stay up all night and crank out something respectable by morning.
It worked, and Benson now says it was the first time she “really connected” with something she was working on.
“It was the first paper I wrote where I felt like I came up with an idea that was meaningful and important,” she said. “I got an A on it.”
An A for Adderall.
Now, at 26, Benson is a professional writer who reports for a major news publication and has had her byline in The New York Times. She keeps an “emergency stash” of Adderall nearby for when she’s working on a big story and has to stay awake all night.
Benson (whose name, like all the people in this story who discuss their ADHD drug use, has been changed to protect her identity) is typical of a growing population of young adults who went to college in the 2000s. As they age out into the workplace, they’re taking with them the ADHD med habits they developed in college — and finding the drugs still work.
When I take Adderall, I think, ‘This must be how really successful, smart people are all the time.’
While it is tempting to chalk up the rising use of ADHD drugs among young adults to a generational trend of lax morals and blind eyes towards addiction and other health risks, a more complete explanation suggests an environment that encourages stimulant use. A hugely popular New York Times op-ed written by Tim Kreider pointed out what is fast becoming the modern condition: guilt and anxiety over any minute not spent working or promoting that work.
In this culture of perfection, in which the worst thing someone could be is not busy, many young adults have latched onto a drug that makes them go faster, harder and stronger at work.
“When I take Adderall, I think, ‘This must be how really successful, smart people are all the time,’” said Jonathan Collier, 27, who works in a senior position at a New York production house. “I wish so badly I was one of those people.”
In his 2008 book, “Outliers,” Malcolm Gladwell theorized that it takes 10,000 hours of practice to master a skill and share the kind of success enjoyed by “those people” — the Bill Gateses and Paul Allens of the world. His theory may serve as both an explanation and a product of the current culture. Gladwell, after all, came to the conclusion that the way to succeed is to put the blinders on: to ignore all the distractions inherent in contemporary society and to single-mindedly and doggedly pursue a goal.
Dr. Henry Abraham, a psychiatrist who has treated doctors, lawyers and other high achievers, said stimulants now are used often in a way that is closer to sports medicine than it is to psychiatry: to enhance performance. That’s because the working world — like college before it, and, for some, prep school before that — is a competition, and people are looking to get an edge. Everyone wants to get those 10,000 hours, but not everyone is wired to do it naturally. So, many turn to Adderall and other ADHD drugs.
The modern brain
It’s unclear how many adults take ADHD drugs, but it is evident that use is skyrocketing. According to IMS Health, in 2007, 5.6 million monthly prescriptions for ADHD medications were written for people ages 20 to 39. By 2011, that number had jumped to 14 million, a staggering 150 percent increase. Anecdotal evidence also shows a large number of people illegally taking ADHD drugs without a prescription.
“I think part of the increase in the rate of (ADHD drug) prescriptions,” said Dr. David Meyer, a professor of psychology, cognition and perception at the University of Michigan, “is that people both younger and older are coming to feel totally overloaded with bunches of information and are trying to cope with the increasing demands as best they can.”
Our brains have mechanisms of executive function, similar to a computer operating system, he said. These mechanisms keep people’s situational awareness up to speed and coordinate progress on various real-world tasks. But these executive functions are under constant attack in the modern world.
“Even a 10- (or) 20-second interruption can make you lose your situational awareness entirely,” Meyer said.
I feel uncomfortable using it to write. It would mean that what I consider my greatest skill is a lie.
In many of the information-based jobs available to young professionals, those interruptions are not just unavoidable collateral damage; they are baked into the job itself.
“I’m expected to consume so much media and data every day on top of what I’m already supposed to do,” said Cristina Long, a 24-year-old public-relations professional. “I need to stay ahead of the trends.”
Long was hired to click everywhere and look at everything, all the while creating cohesive results.
The active ingredients in Adderall target the parts of the brain responsible for executive function. In other words, Adderall solves the very problems the modern world creates. Long now uses the drug daily, as do the many adults who don’t have ADHD but are seeking an edge in the workplace.
The drugs are so popular because they work.
“Adderall opens up time for you,” Collier said, emphasizing that using it enables him to get all his work done and still have time to work on other projects.
Long said the stimulant clears her thoughts and helps her produce better work.
For Benson, taking Adderall is like playing a video game and getting an extra life. She said she gets more done and is a better writer.
All three said using the drug made their lives better.
At the same time, Benson admitted she struggles with her use.
“I feel uncomfortable using it to write,” she said. “It would mean that what I consider my greatest skill is a lie.”
So she now stays up all night writing, then, if necessary, takes Adderall the next morning to get through the workday.
Benson’s complex relationship with the drug illustrates problems Dr. Anjan Chatterjee, a professor of neurology at the University of Pennsylvania, has highlighted in connection to what he refers to as “cosmetic neurology” — the use of drugs like Adderall for performance enhancement.
Essentially, Chatterjee argues that the advances in cognitive neuroscience and neuropharmacology mean the question of to what extent we want to create and live in a drug-enhanced society may no longer be relevant. That way of life is already here, and society must now account for the moral implications it brings.
Like cosmetic surgery, cosmetic neurology will likely be available only to those with the disposable income to afford elective medicine, expanding the already wide gap between the haves and have-nots. Drugs like Adderall already tend to circulate among the wealthy — those who come from competitive universities and have access to health care that covers expensive prescriptions.
An added concern is that the growing use of stimulants in the workplace will produce a new work environment in which use of neurological enhancement through pharmaceuticals is just one more thing expected of the perfect worker.
Benson said using the drugs doesn’t make her feel guilty. Collier agreed, saying, “It’s more about being honest with yourself — if it’s something you’re comfortable with.”
But not everyone feels comfortable with it, yet they might feel compelled to use such drugs because of the pressure to keep up.
“Everyone is in an arms race of accomplishment,” Chatterjee said.
How can society account for the coercive nature of a culture of perfection?
Dr. Todd Essig, a psychologist in New York, said medical professionals must address neurological performance enhancement openly and facilitate safer use and better oversight of such drugs rather than sweep it under the rug.
“Adderall is just the tip of the iceberg,” Essig said. “There are lots more drugs coming down the pike. The way we set up our cultural model for dealing with psychologically performance-enhancing drugs is a real serious question.”