By Dr. Mercola
Performance-enhancing drugs were once only found consistently in the athletic world. Athletes were kicked out of performances and Olympic medals stripped when testing revealed they had used drugs giving them a performance boost over their competitors. Today, students and adults in the workplace are seeking out similar drugs to enhance their productivity.
The documentary "Take Your Pills," a trailer for which is included above, tells the story of adults taking prescription stimulants and the dependence these drugs are triggering. Produced by Christina Schwarzenegger and Maria Shriver, the film explores the fine line between using prescription medications for an undiagnosed medical condition and using street drugs to obtain the same results.
One of these drugs is Adderall, a medication often prescribed to treat attention deficit hyperactivity disorder (ADHD).1 The drug is a combination of amphetamine and dextroamphetamine belonging to a class of drugs known as stimulants. The drug is used to treat children with ADHD who have low levels of neurotransmitters needed to stimulate the brain and people suffering from narcolepsy, a sleeping disorder characterized by extreme tendency to fall asleep whenever the sufferer finds themselves in a relaxed environment.
However, Adderall is an addictive prescription drug with effects on the brain similar to cocaine. Over time, habitual use increases tolerance and the user is unable to function normally without it.2 While it has demonstrated positive short-term use in children suffering from ADHD, as a performance-enhancing drug, it has the same negative effects on health and life as any other addictive drug.
Adderall Sold for More than ADHD
Cramming for final exams, in an environment where the workload appears endless, college students may seek a quick fix to help them power through their studies and remain alert for more hours than the body was meant to be awake. Prescription medications like Adderall, Ritalin and Vyvanse have become increasingly popular on college campuses.
Sean McCabe, research associate professor at the University of Michigan Substance Abuse Research Center, comments,3 "Our biggest concern … is the increase we have observed in this behavior over the past decade." While some reviews of the documentary believe the film is filled with propaganda, featuring only people who make poor choices,4 research has documented a rising number of students using Adderall and other stimulants over the past decade, calling them "study drugs."
More than 90 percent of users claim they use the drugs to increase their ability to concentrate for longer periods of time.5 In fact, the National Survey on Drug Use and Health6 report found full-time college students younger than 22 were twice as likely as their counterparts who were not full-time college students to use Adderall nonmedically in the past year. Nonmedical use of Adderall was almost three times higher than the use of nonmedical marijuana and eight times higher than the use of cocaine.
As the potential for drug dependence or abuse is high, this is a significant public health concern. The report also found some students who took nonmedical Adderall also used central nervous system depressants to counteract the stimulant effect, which increases their risk of dependence or abuse.7 In many cases the central nervous depressant used was alcohol.
Although the numbers of students who use Adderall for nonmedical purposes vary significantly by school, the greatest proportion of users were found at private universities. Some researchers have estimated nearly 30 percent of all college students are using stimulants nonmedically.8 While all students interviewed recognized these stimulants are illegal, they believe they're taking them to become more productive in class and to stay competitive.
In 2008, researchers interviewed 1,800 college students9 and discovered 81 percent thought illicit use of ADHD medication was not dangerous as it helped them stay focused and become more efficient. However, Adderall is a Schedule II drug, right next to cocaine, methamphetamine and morphine on the Drug Enforcement Administration (DEA) list of scheduled controlled substances. As defined by the DEA:10
"Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous."
Women at Greater Risk
ADHD was originally diagnosed primarily as a pediatric condition. However, the number of adults who have been prescribed medication to treat the disorder increased by 90 percent from 2002 to 2005.11 Interestingly, adults received one-third of all prescriptions prescribed for ADHD in 2006, with Adderall being the most widely prescribed in both children and adults. Despite Schedule II restrictions, illegal use became increasingly popular during the late 1990s on college campuses.
Millennials were the first generation to be prescribed Adderall for ADHD and the first to misuse and abuse the drug in high schools and colleges. In 2012, stimulant drugs were second only behind marijuana in colleges.12 American workers testing positive for amphetamine use increased by nearly 44 percent in a short four-year period leading up to 2015.13
In the years between 2003 and 2015, a sample of more than 4 million women per year found prescription rates for ADHD drugs sharply increased in all age groups. However, they rose most steeply, by nearly 700 percent, in women between ages 25 and 29. The shocking rate of increase continued in women between 30 and 34 with a 560 percent rise in prescription rates.14
The report also broke the prescription rate down by region, finding the largest increases in the southern and western U.S. states. The rate of new ADHD diagnosis has outstripped the estimated prevalence of the disorder. As the first line of treatment is almost always a prescription for stimulant medication, this recent study questions changes in diagnostic guidelines and the diagnosis of adult onset ADHD, when symptoms emerged well after adolescence.
Lead author of the study, Margaret Sibley, Ph.D., associate professor of psychiatry and behavioral health at Florida International University, commented:15
"If adult symptoms are being reported by patients, it shouldn’t necessarily be immediately classified as ADHD. A more careful evaluation often finds that there’s something else causing the problems, like depression or drug use — which is what we found."
The Cost of Material Progress and Productivity
Rising rates of addiction to ADHD prescription medications may be the price paid for the struggle to attain material progress and greater productivity in the workplace. Unfortunately, women continue to suffer higher levels of work-related stress, anxiety and depression than do men, likely the result of balancing workplace and home responsibilities.16 This pressure often peaks between ages 35 and 44 when women are juggling additional responsibilities, such as caring for their children and/or aging parents.
Attempting to stay plugged in to both work and family, women continue to bear a heavier burden, according to a Pew Research Center survey.17 Among parents with at least some work experience, women with children under 18 were three times more likely as their fathers to say being a parent made it more difficult for them to advance in their career.
Government economic data18 backs up the survey results, showing women start their careers near parity with men but struggle to keep pace in wages as they begin to juggle work and family life.
Cognitive Enhancement Is Perceived and Likely Not Actual
Although college students and adults in the workplace believe psychostimulants like Adderall and Ritalin will help improve cognitive abilities, the empirical literature has demonstrated very little conclusive evidence.19 The possibility for this discrepancy may in part be explained by the increased motivation a user experiences, rather than an actual improvement in cognitive performance.
Thus, a user perceives an increased effect of energy and motivation and reports this as an improvement in cognition and productivity. Literature analysis demonstrates the use of amphetamines has little effect on executive function and learning in normal healthy young adults.20 Laboratory evidence also suggests that while these medications may enhance motivation-related processes, the cognitive benefit is a subjective perception at best.
Your Brain on Adderall
In children with ADHD, Adderall and Ritalin help control a biochemical imbalance. However, without ADHD, the amygdala, the part of your brain controlling emotions and aggression, may become overactive and lead to an increase in dopamine levels. It is vital to understand Adderall is a prescription name for amphetamines. The ingredients in Adderall include dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate.21
These ingredients are commonly found in other prescription stimulant drugs as well, including dexedrine and Ritalin. The difference between Adderall and methamphetamine is one methyl structure, which means the two drugs are chemically very similar and may trigger many of the same symptoms.22
Both Adderall and methamphetamine produce a rush of neurotransmitters, stimulating the body and mind. In an experiment using lab animals,23 researchers found sex increases dopamine levels in the brain from baseline by 100 to 200 units; cocaine increased it to 350 units; but methamphetamine increased dopamine levels approximately 1,250 units or nearly 12 times as much as you normally get from food or sex. Richard Rawson, associate director of UCLA's Integrated Substance Abuse Program, explains:24
"This really doesn't occur from any normally rewarding activity. That's one of the reasons why people, when they take methamphetamine, report having this euphoric [feeling] that's unlike anything they've ever experienced."
However, amphetamines may ultimately result in severe depression, mood dysregulation and violent behavior. In one study,25 47 percent of the sample committed a violent crime and half of those associated their violence with amphetamine use; 62 percent of the sample reported ongoing problems with aggression related to their amphetamine use.
People who have ADHD normally have lower levels of dopamine in their brain, so Adderall releases dopamine to what would be considered a normal level. However, people without ADHD will experience a sudden surge resulting in a high and euphoria, sometimes accompanied by anxiety, psychosis and schizophrenia.26 Even in people who have no previous history of psychiatric problems, the use of Adderall for nonmedical reasons may trigger a psychotic or depressive episode.27
How You Can Improve Productivity Without Drugs
People have been searching for a magic pill to enhance performance and enable achievement greater than is humanly possible for decades. However, it is critical to understand each decision has a significant impact on your health and your longevity. The attitudes of some parents, students, college administrators and law enforcement officers toward Adderall abuse may have been ambivalent in years past, as the drug has been used for studying and assumed to be little more than a boost of caffeine.
However, misuse and abuse have resulted in a rise in emergency room visits for sleep disruption, mental health problems and high blood pressure.28 There are several options you can consider to improve your productivity without using performance-enhancing drugs.
Reduce electromagnetic field exposure
Although wireless technology has improved our ability to communicate quickly, heavy exposure is likely leading to ill health. A number of devices, kept close to your body on a regular basis, are negatively impacting mitochondria, the power plants in your cells which provide your cells, and thus your body, with energy.
Electromagnetic fields negatively impact mitochondrial energy production. You can read more about this in my previous article, "'Wi-Fried' — Is Wireless Technology Dooming a Generation to Ill Health?"
Reduce sugar intake
While sugar may give you a quick energy boost, in the long run you'll experience a greater loss of motivation and energy. Instead, use nutritional ketosis to create a healthier long-term energy supply for your body, burn fuel more efficiently and produce ketones, which help your brain to work more efficiently.
You can read more about sugar and ketosis in my previous articles, "Big Sugar Buried Evidence to Hide Sugar Harms" and "Health-Conscious Public Increasingly Embraces Ketogenic Diet."
Get high quality sleep, and enough of it
In the search for greater energy and more motivation, remember the importance of getting adequate amounts of quality sleep. Certain regions of your brain continue to function while sleep deprived, but those controlling memory, learning and logic are impaired.
Lack of sleep from taking stimulants to stay awake longer actually reduces your productivity. It is better to plan to get at least seven hours of quality sleep a night to improve your ability to achieve your goals. Read more about what lack of sleep does to your brain in my previous article.
Reduce anxiety and depression
As you reduce anxiety and depression, your levels of energy and motivation will rise, thus improving your ability to get more done in a shorter amount of time. For optimal health you'll need effective stress relieving tools.
One of my favorites is the Emotional Freedom Techniques (EFT), developed in the 1990s by a Stanford engineer specializing in healing and self-improvement. It's based on some of the same concepts as acupuncture, which means you don't have to believe it will work to enjoy the benefits. Julie Schiffman describes how to use EFT for stress release in the video below.
Your body can only function on the food you feed it. This means if you are attempting to fuel your cells with soda, chips and vending machine food, you'll likely experience the effects in lower energy levels, higher risk for colds and reduced mood and motivation.
When your objective is to do more in less time you must give your body the fuel it requires to do the task well. My previous article, "The Clinical Use of Nutritional Ketosis" describes why switching to a diet high in high-quality fats will help improve your health and your ability to work harder and longer.
Exercise and movement
Research demonstrates exercise and movement increase your energy levels, improve your health, help you sleep better, improve your insulin resistance and boost creativity. Each of these factors are important for increasing your efficiency and productivity without the use of drugs.
A simple 30-minute daily workout and movement every 15 minutes to break up periods of sitting will help your brain stay focused and productive without the risks associated with amphetamines.
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