POINT: Try and seek benefit in Adderall
Jonathan Zelken M'07Ask yourself: how fine is the line between pathologic attention deficit disorder and normal? Can doctors really draw that line in the sand? How accurate are diagnostic instruments and can behavior be quantified? Do patients have the power to construct fake answers? Can doctors tell? And does a “biologic need”, as we define it, qualify dependence on stimulants? Just wondering.
Ever since my friend increased his score 11 points on the MCAT, I have been intrigued by stimulants like Adderall and Ritalin. And ever since I entered medical school, I fantasized about thirteen uninterrupted hours of studying. I never pursued a source, and I will never do so, but it’s tempting. I do not objectively need stimulants; I need more sleep and improved peace of mind. But that’s not to say I am anti-Adderall, because I’m not. Although I frown upon abusers, I cannot justifiably equate study-drug abuse with cheating. Nor do I entirely denounce the morality of abusers, considering medical school is a time and a place for learning.
What deters me from the aforementioned drugs is a reported tendency among abusers toward more self-destructive drugs. It is a gateway drug, according to my college professors. And I heard stories of people staring at walls for hours. The idea of dependence, down regulation, and so forth, concerns me most. The law does not scare me, but bypassing my brain’s own reward system does. Still I cannot deny that it might benefit me, at times, and only in the short-tem. Just think about it: no more staring at page fifteen for twenty-six minutes. No more hourly ping pong breaks that last forty minutes. No more changing study spots seven time a day in the pursuit of mental stimulation. No more jokes about my undiagnosed ADD. Just efficient study-time, with excess time that might be spent taking practice AMWA tests I always disregard and later regret having disregarded. I could put some time into Sharewood. I could cycle. No more checking my email twice an hour hoping to find people I know downstairs. Admit it: legal or not, it’s a tempting potential outcome.
They say it’s for cheaters. They say it’s an unfair advantage and accounts for, or masks, sleepless nights and a poor work ethic. I might agree with the latter, but not so much the former. I think study drugs can be considered a tool, on the grounds that ‘mechanic’ is not using the tool as a weapon. On the grounds that medical school is a collegial place of learning, not a place where the proverbial men are separated from the mice. Appreciate this scenario: Billy Hyper is studying physical diagnosis under physiologic duress and he misses an important tidbit that might save a future patient’s life. Under the influence of drugs that result in increased alertness, Billy will “unfairly” receive a higher grade on the physical diagnosis exam; he will also walk away with more knowledge. We must then decide what is more valuable: equitable study conditions or the quantity and quality of learning?
I contend that in the short-term, benefits of stimulant abuse by students who do not require pharmacotherapy may outweigh costs. Unfortunately, the problem lies in the prospect of dependence. I do not believe there is a short-term when it comes to drug abuse. And that ‘slippery-slope’, as it were, is what keeps me away from drugs like Adderall and Ritalin. I never experimented with stimulants beyond caffeine and nicotine. But shit, sometimes I think I should try it. Right now, for example. I cannot study physiology right now. I simply can’t. It’s 1:20 AM and I am writing a point-counterpoint with Tony Lassaletta. [HI-TECH TIME WARP] Now its 1:37AM the next day, the exam is in 7 hours and 23 minutes, and I’m *proofreading* a stream of consciousness I whipped out last night. Imagine that. [WARP BACK] Times like this, I could use a magical pill that would make me look at my watch and see three hours later, twenty-seven pages later, next time I look. I want to wake up tomorrow knowing more than I did twelve hours prior. But I’ve gotten this far without ‘help’; I’m doing very well in medical school. And while a little yellow pill seems especially tempting now, I don’t want to be a Resident coke-head either. But imagine the potential…I’d be all el-Bermani after, like, 3 jam packed hours.
Take home message: I studied the
biology of the brain in great detail in my formative years. And that has
made me a firm opponent of un-prescribed prescription stimulants. Still,
we should not immediately denounce abusers as cheaters or cop-outs, or as
unfit for medical school, or malicious. Stupid -- maybe. Appreciate the
possibility that a drug abuser’s intention is good, albeit unwise.
Take a moment to appreciate the abuser’s rationale. Ignore stereotypes.
Try and entertain the possibility that seven years hence, Jimmy Coughsalot
might be healthier because a previously self-medicated Billy Hyper, MD got
a better read on pulmonary edema. It’s a tough struggle to rationalize
a campaign condoning stimulant use among students of higher education. Damn
near impossible. Heck, I’d personally vote against Adderall any day.
But there may be some good in it. Think about the little Jimmy Coughsalots
out there.