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Is Non-Prescription ADHD Medication Use Ever Ethical?

derekmead writes "College students' voracious appetite for study drugs like Adderall is widespread enough that it was one of the main topics of a marquee lecture on neuroethics at Society for Neuroscience's 2012 conference called 'The Impact of Neuroscience on Society: The Neuroethics of "Smart Drugs."' It was excellent stuff by Barbara Sahakian, faculty at Department of Psychicatry at the University of Cambridge. Her focus is on prescription drugs for diseases and conditions like Alzheimer's, attention deficit hyperactivity disorder, and depression, with the fundamental goal of understanding the neural basis of dysfunction to develop better drugs. Specifically, she wants to create drugs with no risk for substance abuse which means drugs that have no effect on dopamine. The true goal then of her research, fundamentally and briefly, is to repair the impaired. But doing so brings us to the discussion of how much repair is ethical when the repair can be disseminated to people who don't actually need it. Divisions abound on what is to be done. Some experts say that if people can boost their abilities to make up for what mother nature didn't give them, what's wrong with that? Others say that people shouldn't be using these drugs because they're designed for people with serious problems who really need help. So another question for the ethicists is whether cognitive enhancers will ultimately level the playing field or juice the opposing team."

12 of 487 comments (clear)

  1. drug use is like the ring in the Lord of the Rings by circletimessquare · · Score: 5, Interesting

    in the short term, it gives you superpowers. in the long term, it turns you into a soulless ghoul

    that's right, i just said the lord of the rings is a parable about drug addiction

    --
    intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
  2. or, by Ralph+Spoilsport · · Score: 5, Interesting

    it's just another way for the pharmaceutical industry to remove money from your wallet. Perhaps ADHD is just a reasonable and rational response to a completely insane world of hyper-focus. Perhaps we should all be chasing buffalo and living in tipis because, it's better. Maybe depression is a correct response to a world gone mad - a civilisation hell bent of murdering the biosphere. Maybe mental health, isn't.

    --
    Shoes for Industry. Shoes for the Dead.
    1. Re:or, by Dasuraga · · Score: 5, Insightful

      As someone who has had to deal with ADD for his entire life , I can assure you that it is not just a pharmaceutical ploy. I can barely write this sentence , and I have already been distracted three times. When I was in middle school, I was prescribed Adderall to deal with my ADD, and my concentration capabilities shot up immensely (going from 90 minutes to do math homework to 10). In high school I stopped taking it, and forgot mainly about it ( I moved to a different country at the time, and was having problems with the language and culture).

      Now in the "real" world, I realise how handicapping this affliction is, where I'll take an hour to write a 2-sentence e-mail, and where I can't read through a research paper without taking a break every 2 minutes. Unfourtunately I now live in a country where Adderall is illegal, and the country I lived in before doesn't recognize ADD/ADHD in adults. There are people with worse problems, but it's still extremely frustrating to have the attention span of a goldfish.

      As an aside, the best way I've found to deal with the problem is to say things out loud as I do them, I think that somehow the speech centers of the brain help with concentration (though I still tune out quite frequently in conversations). I'm less than comfortable about doing that with my coworkers though.

  3. Highly unethical. by pushing-robot · · Score: 5, Funny

    I can't imagine a world where perfectly healthy people feel the need to take addictive stimulants just to help them focus throughout the day.

    Now, if you'll excuse me, I'm off to Starbucks.

    --
    How can I believe you when you tell me what I don't want to hear?
    1. Re:Highly unethical. by girlintraining · · Score: 5, Insightful

      I can't imagine a world where perfectly healthy people feel the need to take addictive stimulants just to help them focus throughout the day.

      You joke, but it's a serious problem. We have the fewest number of vacation days of any industrialized country, poor health care, and many of our poorer citizens work north of 50 hour work-weeks, some with two jobs, others balancing college and a full-time job (and still wind up hundreds of thousands in debt from student loans). We are literally working ourselves to death -- obesity rates are skyrocketing, and the average person consumes 2.25 cans of soda per day. Frankly, it's worse for you than smoking -- each of those cans is 130 calories, and then it amps your metabolism and simultaniously acts as a dieretic so your appetite increases. I read something about how the average American consumes something like 2,800 calories per day. My weight and build puts my daily consumption at around 1,500 calories a day... which means the average person consumes 86% more food than I do. And we pack in the stimulants, along with the pounds. Then to top it off, we don't get enough sleep because of our LCD screens, 26 hours of TV a week... our lifestyles are killing us.

      Now, I have severe ADHD. I've been tested repeatedly by neuropsychologists, and there is no question I have it. I have to take it just to keep pace with this "Type A with rabies" culture I live in, and it isn't easy. The side effects aren't terribly pleasant either -- shaking, insomnia, anxiety... I can't understand why someone would want to deal with these effects unless they had to. People, strong stimulants aren't fun. They will give you energy, but at a cost -- the candle that burns twice as fast burns half as long. I have to take it, and it's expensive. And I don't take it on the weekends, or vacation, etc. I take as little as I can functionally get away with.

      Please guys, I'm telling this to you as someone with the attention span of -- oh look, a kitty -- life is too short. Don't take medication you don't need. Please. It isn't worth it. You're young, and stupid, and your body can tolerate it now... but you're wearing it out faster, and it's for stupid silly shit that twenty years from now, you won't care about. Stop being obedient slaves and putting in 60 hour work weeks. Stop working yourself into an early grave. Go out, see friends, see family. Leave work in the office... don't take it home.

      Drugs without side effects are like unicorns -- they don't exist. They all have risks. I have a cousin right now who's a pain pill junkie. They were prescribed by her doctor. She was told they were safe, and the addiction crept up on her slowly. Now, she's on parole for five years after getting so doped up she didn't know her head from her ass -- all on legally prescribed drugs at the doses prescribed by competent physicians -- and she did something stupid. And the thing is, she got out and went right back to doing it. Stimulants do the same thing to some people -- everyone has their drug of choice. Everyone. Not everyone has found it yet.

      Now I'm not against recreational drugs; It's your choice. And if tomorrow they decided to hand out bottles of Adderall and Ritalin next to the aspirin, I wouldn't complain. It's your life, it's your body, it's your choice. But please people, think. Think long and hard about whether finishing that TPS report is really worth the extra minutes off your life, the high blood pressure, the sleepless nights, and the cold sweat when you're so amped you feel like there's a strange presence in the room with you, watching. Just ask yourself that. Choose well.

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  4. Re:Is this different from sport? by plover · · Score: 5, Insightful

    No, it's not nearly the same thing as steroids in sports today. Steroids are used to gain an advantage in an playing field kept as level as possible through external rules and a large suite of referees watching every move, in order to maximize the entertainment value. But this is about life, where the playing field is never level, the rules are far more vague, and enforcement all but non-existent.

    In school, the idea is that these drugs improve your grades. But that might mean you remember "more", or somehow end up "smarter" than you would have otherwise. You might go be a more productive member of society. What if these drugs make the difference, enhancing someone enough to recognize a novel cure for some horrible disease, or design a new class of CPUs, or a new energy source?

    Many of us spend our livelihoods trying to enhance human knowledge and experience and abilities through improved software. Hell, half of us would sign up today for an internet implant chip. What's wrong with improving the wetware directly?

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    John
  5. I've been taking Adderall for almost 13 years by proca · · Score: 5, Insightful

    In high school, I had my own web development company and was an accomplished, award-winning saxophone player but I struggled getting the grades I should have been able to get for a reason that I couldn't understand. I was diagnosed with ADHD in 10th grade and set upon a journey involving virtually every drug recommended for the disorder. I settled upon Adderall and have been taking it ever since. Reading through the comments on this page, I find it amusing that everyone seems to have such a black and white opinion on the subject. I, on the other hand, really don't know what to think.

    Studies show that nothing is more effective at treating ADHD than stimulants and cognitive therapy does virtually nothing without drugs. Furthermore, people who control their ADHD with medication are FAR more likely to avoid substance abuse than if they leave their condition untreated. I'm sure everyone knows a really smart kid in high school who smoked their life away on weed and never made anything of themselves. I know that I personally would have probably gone this route, as I was already heading in that direction. Finally, stimulants like Adderall haven't been shown to have any real long term health consequences and (contrary to popular belief) are not particularly addictive if taken as directed.

    Anyone who has been to college in the past decade can tell you that Adderall can certainly help you cram for tests. Does that mean it gives them an advantage? I really don't think so. I've crammed for a lot of tests, and unless you're a business or mass communication major, you are not going to get an A by cramming. Try cramming a month's worth of organic chemistry in one night with some Adderall. You'll probably pass, but you definitely aren't getting an A. People get A's on tests by keeping up with the work. Not to mention the horrific day you have after cramming all night on speed. The biggest advantage I saw with Adderall was playing Quake 3, and even then there were people a lot better than me that used nothing but Mountain Dew.

    I guess what I'm saying is that I think that people are overestimating the power of stimulants. Their biggest advantage is that you can stay up later, but if you don't take the drug regularly, you will also not be able to get to sleep. You'll also not eat enough and will probably have issues with sexual dysfunction. If that sounds like an unfair advantage to you, I don't know what to tell you.

  6. Re:Is this different from sport? by Anonymous Coward · · Score: 5, Funny

    Now you are assistant manager?

  7. Re:Is this different from sport? by girlintraining · · Score: 5, Insightful

    What's wrong with improving the wetware directly?

    Your brain isn't a computer. You can't just upgrade the processor and it works 20% faster from that point on, but otherwise does the exact same stuff. Anytime you tweak something in a brain, any brain, you're making a tradeoff. You're getting one thing by giving up another. Millions of years of evolution have figured out the most efficient way to balance survival, intelligence, and metabolic conservation. You start tweaking that on your own, and while you might get something you want, and may not notice a downside right away -- eventually, one will become apparent. And it could be irreversible.

    There was a drug used to treat anxiety a number of years ago... and it's still on the market... and some patients who were taking it had their symptoms re-appear (shaking, nervous facial tics, etc.)... so the doctors thought the underlying pathology had worsened and increased the dose. And this went on for several years -- the dose levels creeping slowly upwards to combat the apparently chronic and worsening underlying disease. And then one day, someone noticed a correlation: For this subset of patients, the drug was simultaniously the cause of, and the cure for, muscle twitching. And when the patients were taken off the drug, the symptoms were unbearable to watch... they'd flop about like a fish out of water. As it turns out, the drug turned what had been a mild problem into a permanent and severe neurological condition.

    So the next time you get the notion in your head that tweaking your brain with chemicals, wires, magnets, or whatever else you happen to read about: Remember the law of unintended consequences. In biology, there is always a price to pay. Every evolutionary step is a tradeoff. Every. Single. One.

    --
    #fuckbeta #iamslashdot #dicemustdie
  8. Re:Is this different from sport? by Roger+W+Moore · · Score: 5, Insightful

    Millions of years of evolution have figured out the most efficient way to balance survival, intelligence, and metabolic conservation.

    True but the environment that they have optimised us for is the one that we were in during the Stone Age. Evolution is great at optimising but very slow to adapt to changes which is why we are so successful as a species: our intelligence lets us adapt far faster than evolution.
    That being said, while I have no objection in principle to intelligence enhancing medication, in reality the problem is that while the short term effects can be easily determined the long term effects are far harder to figure out. So, just like sport, you do not want to end up with people being forced to take drugs to compete which may have deleterious long term effects.

  9. Re:Is this different from sport? by Lando · · Score: 5, Insightful

    Sorry but what?
          As far as I know brain workings are still experimental, but you are saying that there always has to be a negative along with a positive. That somehow doesn't sound correct, in fact it sounds more like intelligent design than evolution. Evolution isn't smart, it just randomly affects things, some things work, some don't it doesn't have a mind to "balance" anything. Saying that there has to be a trade off for getting the mind to operate better, is the same as saying, we shouldn't cure cancer because people will just die of something else. Or even, we shouldn't educate people because we will suppress their own natural intelligence.

    As to the main article, personally I couldn't care less if others are able to make themselves smarter, having more people smarter than me would be a boon. I assume the article is trying to say that norms shouldn't be taking drugs because it gives them an unfair advantage, but I would think the only people that would care about that are those that want to compete with others and probably unfairly. I don't care if John is smarter than me, if he is more productive, doesn't that help me in the long run?

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  10. Re:Is this different from sport? by Fred+Ferrigno · · Score: 5, Interesting

    Millions of years of evolution have figured out the most efficient way to balance survival, intelligence, and metabolic conservation.

    It's just not the case that evolution always leads to an optimal design. Evolution has a tendency to get stuck on "pretty good" solutions because some random decision early on limited the future solution space.

    It's also not true that evolution is somehow finished with humans, having already figured out how to squeeze every ounce of efficiency from our brains. We are not the end product of evolution. For all we know, future generations may have more efficient brains than we have.