We live in a society where we have a pill to cure/treat or enhance just about everything. As college students, we feel as if there's never enough time in the day to finish all our school works and also get enough sleep; therefore, when we hear about a pill that can enhance our learning, we jumped right on that new. So what's this magic pill and what is its main function? Last semester in my Biochemistry class, I had done extensive research on the chemistry behind ADHD and its treatments such as Adderall (amphetamines) or Ritalin (methylphenidate) along with the long term and short term effects of the medication. This is just an overview of what i learned while researching about this topic.
ADHD is attention deficit hyperactivity disorder and it’s most prevalent in children and early teenagers. According to recent research, one of the main causes of ADHD is the low levels of dopamine in the striatum. Dopamine in neurotransmitter that helps to regulate our brain’s reward and pleasure center. Low levels of dopamine can cause attention deficit, hyperactivity/impulsivity and motivation deficit. Different components within Adderall attacks different parts of the brain and helps reduce symptoms. Adderall can help with those who are diagnosed with ADHD, however, a large amount of healthy individuals have also started taking Adderall in hope that it’ll help them be more focused and efficient. Long term use of amphetamine can result in a further decrease in dopamine levels when the medication is not longer being used. Studies have shown that individuals who abused this medication actually lower G.P.A. than those who don't. Amphetamines are usually used for treatment of narcolepsy and abnormal behavioral syndrome in children such as ADHD. Amphetamine are potent stimulants of the central nervous system. Catecholaminergic actions of amphetamines include inotropic and chronotropic effects on the heart, which can result in arrhythmias, hypertension and myocardial infarction (MI). Most of the abuse of amphetamine comes from the fact that it gives the temporary high. Continuous use of amphetamines can lead to addiction/drug dependence and tolerance. because the more people use it, the higher dosage they would need in order to reach the euphoric effects.
The number of prescriptions written for ADHD patients increased significantly over the past two decades and this has caused many concerns because a large number of these prescriptions might be abused across campus for their illicit use. Reports have shown that 34% of college students had used Adderall or other ADHD medications to enhance their academic performance and sometimes, for recreational use.
As of right now, we don't really have a specific guideline of how to diagnose a patient with ADHD so the misuse of this medication is increasing. How do we prevent that from happening? Should we try alternative methods to kids focus? rather than just giving them pills and hoping the problem will go away.
For more information:
http://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines
There is no doubt that the abuse of such stimulant medication is a serious problem. However there are a few things to consider further to fully evaluate the increase in prescribing of such medications. One of the main reasons "the number of prescriptions written for ADHD patients increased significantly over the past two decades..." is due to the fact that Attention Deficit and Hyperactivity Disorder did not exist as an accepted diagnosis until 1987. The condition was described before that as ADD and was thought to be something that could only affect a person from ages 7-17. Also there are many laws in place to prevent the abuse of the medication and prevent severe side effects. Some of these include the requirement of having a cardiac evaluation clearance before the medication will be prescribed, limiting the amount of medication that can be distributed to the patient and mandating the patient meet with a psychiatrist before every refill to ensure adequate dosage and that there have been no adverse affects. Additionally the criteria to be diagnosed with ADHD is actually very stringent as was revised in the most recent DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) which include 8 hours worth of testing, numerous written accounts from those close to the patient, and records from primary school. I don't think the problem is in over diagnosing patients, but from the illegal sale and distribution of the medication to those who do not suffer from the disease.
ReplyDeleteFor more on the history of ADHD:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000907/
I really appreciate this post because I have done extensive research into the medicalization of ADD and ADHD. As the director of Health Awareness for RUSGA I am also spear heading a campaign about the risks of taking Adderall illegally. A really awesome resource for this topic is anything medical sociologist Peter Conrad has published in the past 20 years. Although this is a medical topic, there are so many social factors that are important to consider. As Brittany mentioned in her comment, the condition of ADHD didn't formally exist until 1987. There have been many changes to the diagnosis in the past few DSMs. I do believe that over diagnosis has occurred within the past twenty years, but again as Brittany mentioned, the diagnostic criteria has become more strict and specific. Medicalization has taken place with many disorders other than ADHD (i.e. erectile dysfunction and hair loss) and it really fascinates me. If you are interested in the socioeconomic factors of medicine, I highly suggest researching the process of medicalization. It may make you question some of the common medical beliefs and practices you hold!
ReplyDeleteI think this is a really fascinating topic, especially because as college students I think that we are likely amongst a demographic that demonstrates a greater incidence of non-medical use (abuse) of psychostimulants than most other demographics. Witnessing a great deal of this abuse among classmates and peers during my undergrad inspired me to research the physiological mechanisms underlying Adderall's behavioral effects and present that in a video (https://youtu.be/h1N3tIUrkhE) intended for non-science students for a "Teaching and Learning Biology" course I took senior year. (It's really corny but a quick way to learn about this topic if you're interested)
ReplyDeleteI thought you brought up an interesting point, An when you mentioned that students who abuse Adderall had lower GPAs than those who don't. I think this is interesting because research has shown that low-doses of psychostimulants such as Adderall cause improvements in cognition and other prefrontal cortex functions in patients with and without ADHD. Considering this, one might assume that students who do take adderall despite not being prescribed would potentially have higher GPAs than those who aren't taking it. I think one explanation to this paradox might be a correlation v. causation argument postulating that the effects of Adderall aren't causing the students to have worse GPAs, but rather that students who get poor grades in the first place are more likely to turn to illegally abusing prescription drugs for help than students who naturally have high GPAs. An alternative explanation might be that the non-medical abusers--since they aren't being prescribed a clinical dosage--are taking excessive amounts of Adderall, which has actually been shown to impair working memory and response inhibition (http://www.sciencedirect.com/science/article/pii/S0006322314007124). Ironically, the many college students who are illegally taking Adderall without prescriptions with the goal of increasing academic performance might actually just be making themselves really excessively attentive and cognitively inefficient...