When Alexis got to the University of Oregon her freshman year, she was introduced to Adderall by someone selling it in her dorm. She went on to use it a couple of times a month for long readings and writing essays, as well as during exam periods.
“If I needed to get things done quickly or jam a bunch of info into my head, it would be crazy easy,” Alexis said.
Alexis, who asked that her real name not be used because it’s illegal to possess Adderall without a prescription, is just one of many UO students introduced to prescription stimulants when they come to college. A 2016 study conducted by the University of Maryland reported that 61.8 percent of students are offered prescription stimulants at some point during their college career. The same study found that up to one in five college students reported using those prescription stimulants.
These students take and sell the drug despite the legal risks. It’s against the law to sell stimulants or possess them without a prescription. In 2005, a UO student was arrested for selling the drug from his dorm room.
Nootropics, or “smart drugs,” are establishing themselves in mainstream society, similar to how athletic performance-enhancing drugs like anabolic steroids grew in popularity and notoriety in the past. The dangers of athletic doping are well documented. In the world of cognitive enhancement, the jury is still out on determining whether taking these drugs are worth the possibility of unknown long-term side effects.
In 1957, businessman Peter Drucker predicted that “the most valuable asset of a 21st-century institution, whether business or nonbusiness, will be its knowledge workers and their productivity.” This prediction seems to have come true. Knowledge workers, workers whose main capital is knowledge, are increasingly sought after as opposed to service and production employees in the information age that we live in. Many jobs are becoming more automated or outsourced elsewhere.
Unlike previous classes of working people who competed based on physical prowess or through their ability to do repetitive menial tasks, knowledge workers require a different set of skills. Brainpower — being able to think critically and creatively to solve complex problems — has become the differentiating factor required to succeed in knowledge-based jobs.
Best-selling author and entrepreneur Tim Ferriss explains that in business, “The difference between completely failing and losing all of your money, and going home with your tail between your legs, making a million dollars, and making a billion dollars is right here [pointing to his head].”
With an increased emphasis on critical thinking and problem solving, it makes sense that people are becoming more interested in cognitive-enhancing substances that hold the promise of potentially increasing focus, motivation, mood, attention and even out-of-the-box thinking ability.
Nootropics encompass a wide array of natural and synthetic drugs, dietary supplements, amino acids and other substances that are said to improve some aspect of cognition. Nootropics range from common and well-studied substances like caffeine and nicotine to pharmaceuticals like Modafinil and Adderall.
Most people are already smart drug users on a daily basis, whether they realize it or not. The FDA estimates that 80 percent of adults in the U.S. use caffeine daily. Caffeine can also improve energy, attention and certain aspects of memory.
Caffeine seems to be enough of a kick for most, though stronger stimulants such as Adderall or Ritalin — Attention Deficit Hyperactivity Disorder drugs — make common appearances as study drugs on college campuses.
Adderall increases dopamine levels in the brain, hitting the pleasure centers such as the ventral tegmental area and the nucleus accumbens to elevate mood, focus and vigilance.
That 10-page paper that’s due tomorrow morning might be enough of a temptation for a student to take Adderall in an attempt to pull an all-nighter and get more done in less time. While Adderall may help in the short run, its side effects can include insomnia and loss of appetite, and consistent use can cause withdrawal symptoms.
For Alexis, the benefits of using Adderall came at a high price.
“A side effect I’ve had nearly every time I’ve used it is a nasty comedown — I get a really lonely and depressing feeling for a couple of hours after it wears off.”
According to university physician Dr. Anna Hejinian, Adderall is a Schedule II drug — the same category as cocaine and methamphetamine. The FDA classifies medications as Schedule II if they have a high abuse potential, leading to possibly severe psychological or physical dependence. Despite the problems with drugs classified in Schedule II, these medications still have effective medical uses, according to the FDA.
The process of filling a prescription for Adderall and other prescription psychostimulants is “similar to the opioid painkillers Vicodin and Oxycontin,” Hejinian says. In order to get legally prescribed ADHD medications, Hejinian explained that patients must undergo rigorous testing to determine whether they really have ADHD.
Because it’s so time intensive, the health center doesn’t usually prescribe for or diagnose ADHD, Hejinian says.
“It’s illegal to the point where you could be in jail if you offer these medicines [prescription stimulants] to someone else for their use,” she said.
There are other cognitive-enhancing pharmaceutical alternatives to amphetamines, such as Modafinil, a wakefulness-promoting drug (not a traditional stimulant) prescribed to counter fatigue in conditions such as narcolepsy or sleep apnea. While commonly studied in sleep-deprived individuals, recent studies have shown benefits in healthy subjects. Twenty-six percent of students at Oxford University had taken the drug, according to a campus newspaper survey in 2014, and many professionals already use Modafinil in an effort to enhance their performance. Modafinil, a Schedule IV drug, has gentler side effects than ADHD stimulants.
Dave Asprey is an entrepreneur and founder of Bulletproof, a lifestyle brand that sells coffee and supplements engineered to improve performance. He went on CNN and ABC Nightline to publicly discuss the impact of Modafinil in his life. He gives the drug credit for allowing him to work full-time at a startup that sold for $600 million, while getting an MBA from Wharton.
“One reason I like [Modafinil] is that it shares many of the benefits other stimulants do, without the addiction or withdrawal,” Asprey said. “Modafinil is a prescription drug though, so you will need to talk to a physician to obtain it.”
Modafinil is compared to the fictional NZT-48 pill that Bradley Cooper’s character takes in the movie “Limitless.” In the movie, Cooper’s character is a disheveled bachelor with writer’s block who starts taking the pill and is able to quickly finish a novel, learn multiple foreign languages and make millions trading stocks.
A review paper found that Modafinil improves decision making, planning ability and performance on lengthy tasks. Anna-Katharine Brem, a co-author of the study, stated, “In the face of vanishingly few side effects in these controlled environments, Modafinil can be considered a cognitive enhancer.”
While smart drugs steal the show and gain lots of media coverage, natural substances can also enhance brain performance. Vitamins and minerals are essential for healthy brain function. Vitamin B12 deficiencies can cause cognitive difficulties and memory issues, and can even result in severe depression and paranoia in extremely deficient individuals. Low vitamin D levels can result in as much as twice the cognitive impairment as compared to people with optimal levels, according to a recent study.
Steven Fowkes, an organic chemist and founder of the Cognitive Enhancement Research Institute, said fixing nutritional deficiencies can result in the same effects that a drug delivers.
“The first place to start is with B-complex vitamins. See if there’s an objective increase in cognitive performance,” said Fowkes.
This approach, working from the ground up to improve our neurochemistry, is a safer and potentially more impactful option than taking pharmaceuticals that carry risks.
Asprey said exercise, sleep, and nutrition “are bigger levers than drugs.”
While popping a pill is much easier than developing a healthy lifestyle to increase your brainpower, it might not be the most effective choice.
An Uncertain Verdict
Smart drugs also carry risks, many of which are not well-studied in humans, and the long-term side effects have not been determined in many of these substances. Smart drug usage certainly presents ethical dilemmas. Some argue that smart drugs, like doping in sports, provide an unfair advantage. People might feel compelled to take smart drugs if their co-workers and classmates are taking them and doing better as a result.
Smart drugs and other cognitive enhancing substances offer the possibility of altering human cognition. A radical leap ahead in human consciousness is possible in the ever-expanding world of nootropics, although weighing the rewards with the risks of taking cognitive enhancers is a necessary component.