Teenagers, ADHD, College Competition and Stimulant Use

Eighty percent of college age kids report using Adderall to improve their academic performance.  There are some Neuro-biologist who believe that there is absolutely nothing wrong with this practice.  They argue that in this increasingly competitive academic climate, "Cognitive Enhancers" are appropriate.  If you look at the most recent statistics from the CDC on the rate of ADHD diagnosis and treatment, it would seem that many students, parents and teachers agree with this conclusion.

I attended a conference in November where the Centers for Disease Control and Prevention (CDC) presented findings that had been published in the MMWR the Morbidity and Mortality Weekly Report regarding the diagnosed ADHD rate in this country. The report looked at the number of diagnosed cases of ADHD from 2003 to 2007 and found that the rate of diagnosis of ADHD in this country had increased by twenty-two percent. This put the number of children diagnosed with ADHD in this country, as of 2007, at a staggering 9.5 percent.  There is every indication, that the number in 2011 is even greater than that.

As concerning as these numbers were, even more concerning was the fact that the number of older teens receiving a diagnosis and treatment for  ADHD increased tremendously. The rate of ADHD in older teens in 2003 was 9.6 percent while the rate of older teenagers with a diagnosis of ADHD in 2007 was 13.6 percent.

The CDC was uncertain of what had caused this precipitant rise but the researchers speculated that the current pressure on teenagers to excel at school and the competitive nature of college admission might be playing a role in this increase. Historically, the rate of ADHD diagnosis has declined with age. ADHD was once considered a developmental disorder and, even today, most psychiatrist agree that a good number of children diagnosed with ADHD will outgrow their symptoms by adulthood.

Symptoms of ADHD generally improve in the late teen years but these new findings from the CDC are indicating that other factors may be at play that are changing the course of Attention Deficit Hyperactivity Disorder treatment.  Of the older teenagers diagnosed with ADHD, about 60 percent are on medication. 

There has been a concern, for some time now in the college community, about college age students abusing ADHD stimulants. Adderall and Ritalin are considered by some college age students to be "Steroids for the Brain".  This sentiment is documented in a video on Adderall abuse made at the University of Central Florida by one of my readers. 

The problem with the diagnosis of ADHD is that conditions such as sleep deprivation, that run rampant on college campuses, cause ADHD symptoms.  Stimulants greatly improve the ADHD symptoms caused by sleep deprivation.  In the old days we drank coffee.  Today these kids pop an Adderall.  Sixty Minutes also did a report on Adderall use at universities and reported that while four percent of college age students had a legal prescription for an ADHD stimulant, 60-80 percent of college seniors had taken Adderall at some point in their college years to enhance performance.

In the University of Central Florida video the students clearly report that the Adderall that they are taking is to impove their performance in a highly competative environment and that it does not usually make them feel too great. One of the symptoms of either unnecessary stimulant use or too high a dose of a stimulant prescription is a symptom that is described by one of the students in the video as , "Adderall makes me feel like a zombie."
Remember this post about the response to stimulants in normal children. When an ADHD prescription is necessary because of a neurotransmitter imbalance, the patient does not generally respond with symptoms of excess hypo-activity.

It is clear that the stimulants are being used by college age students as performance enhancers. In 2008, the British Journal Nature published an article entitled, "Cognitive Enhancers." In this article the authors stated that there was nothing wrong with using stimulants as brain enhancers and reported that taking Ritalin to help you do better in school was no different that wearing glasses to see better. Several ethicist and scientist weighed in on this discussion after the article was publised and agreed with the authors that "Brain Enhancers" were here to stay and that we should embrace their use.

I disagree. I believe that if you are sleep deprived that you should sleep.  Taking any medicine unnecessarily is simply dangerous.  You may say, "Well you use caffeine, what is the difference?".  I believe that there is a difference.  For one, caffeine is not a controlled substance.  For two, it has been around for thousands of years and is considered by most researchers to be extremely safe and lastly it is a plant compound with other organic benefits that a chemical such as Adderall, that is manufactured in the laboratory, does not have.

Please let me know your take on the use of Adderall in colleges and Universities.

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Increasing Prevalence of Parent-Reported Attention-Deficit/Hyperactivity Disorder Among Children — United States, 2003 and 2007

CDC Division of News and Electronic Media
(404) 639-3286 

Rates of parent-reported ADHD diagnosis are increasing and the patterns of ADHD diagnosis are changing in the United States. We now have 5.4 million children who have been diagnosed with ADHD and 2.7 million are currently taking ADHD medication. That is nearly one in ten school age children with an ADHD diagnosis. Of those with a current ADHD diagnosis, approximately two-thirds were taking medication for ADHD. The findings of this report indicate that a million more children 4-17 years of age had a parent-reported ADHD diagnosis by 2007 as compared to 2003. That's a 22 percent increase in ADHD diagnosis in four years. In addition, significant increases in rates of ADHD diagnosis among older teens and Hispanics suggest that health care providers may be managing a larger and different demographic than they were four years ago. CDC will continue to investigate the variability noted in this report in order to characterize the public health impact of ADHD and improve the outcomes of children and families impacted by this disorder.