No Study Drugs for Healthy Kids

no-pillsLast weekend, during our ritual Saturday morning power walk, my friend, Lisa, shared a concerning story about her niece — a college student in the Northwest. It seems this niece, who we’ll call Meg, has been using Adderall as a study aid. A LOT of Adderall.

When Meg’s mom called her recently to see how midterms were going, Meg reported that she was facing her fourth night without sleep because there was soooo much work to do. WHAT?!?!, her mom asked. How can you stay up for four nights straight? The answer: Adderall.

Adderall is a stimulant drug used to treat attention deficit/hyperactivity conditions, but as any high school or college student will tell you, its more common application is to enhance the ability to focus on school work for hours at a time, and it’s incredibly easy to get. In Meg’s case, she sought out a physician near campus and went in complaining of difficulty with concentration. She was overwhelmed by her work load, she said, and would become distracted as soon as she sat down to study. She left the office with a prescription.

What started out as a sincere effort to maximize her study time, soon became a way to manage her body clock and stay awake almost indefinitely — with a doctor’s seal of approval.

Meg is in great company. More and more students are using and abusing stimulant meds solely to boost their capacity for school work. The media has taken note, and in-depth investigations, like this frightening NY Times story about Richard Fee, a college class president and aspiring medical student who lost his life to these drugs, are getting lots of face time.

My own kids tell me how easy it is to score Adderall, Concerta, Strattera, and other stimulants on campus. And how easy it is to get legitimate prescriptions from doctors who underplay the risks.

But it looks like that may be starting to shift — on the part of physicians, at least. Take a look at the statement recently published by the American Academy of Neurology (and note the emphasis on parents who request these drugs for their kids):

Prescribing drugs solely to boost thinking and memory functions in children and adolescents who do not have neurologic disorders is not justified, nor should physicians acquiesce to parents seeking such medications to improve their children’s academic performance.

Academy researchers note that prescriptions written for stimulants and other psychotropic medications to treat children diagnosed with attention-deficit/hyperactivity disorder have increased substantially during the past 20 years. However, there also is a growing trend of healthy adolescents using the same neuroenhancing drugs to improve their own cognitive functioning before exams and of parents asking physicians to prescribe these drugs to boost their children’s focus or memory.

The researchers also point out the alarming rise in recreational use of stimulant medications as teenagers and college students illegally share these prescription drugs with friends.

The position paper, the first to focus on the practice of prescribing stimulants for healthy children, is supported by several years of research that studied ethical, legal, social, and neurodevelopmental issues related to pediatric neuroenhancement and the role of physicians who care for children and adolescents.

Based on its research, the AAN finds that the long-term health effects of taking neuroenhancement drugs have not been established; that children should be free to develop their cognitive skills, emotional abilities, and decision making without the influence of medications; that physicians have ethical and moral obligations to evaluate requests for neuroenhancing medications from pediatric patients or their parents so to safeguard their physical and mental health; and that prescribers are obligated to prevent the misuse or diversion of controlled drugs.

The position paper concludes that prescribing neuroenhancement drugs to children without a diagnosis of a neurologic disorder is “not justifiable.”

Wow.

Meg’s mom is worried, of course. She’s educating herself about the real risks of Adderall and other stimulants, and has spoken to Meg’s doctor about her concerns. But Meg is over 18, and her mom no longer calls the shots. For those of us with college-age kids, this is scaryland. For those with high schoolers who have considered using these drugs, there’s still time to intervene.

A telling piece of information: for kids and teens who actually have ADD or ADHD, these meds don’t have the classic stimulant effect. They improve focus, but won’t, for example, keep you awake for days at a time. The effect on brain activity is different. In fact, a trial on meds is often used as a diagnostic tool.

One national expert notes; if kids aren’t identified with signs of ADD/ADHD in elementary or high school, and don’t have obvious problems with concentration in those earlier years, it’s exceedingly unlikely that they will suddenly appear during college and respond appropriately to these medications.

Mamas: be concerned … be very concerned.

 

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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