Exam extremes: adhd drug msuse and abuse

The use of performance enhancing drugs among athletes is something most people have become accustomed to hearing about in the news from time to time.  What is far less common however is the reporting of the use of brain stimulants used by students and medical professionals to help them perform better in school, college and at work, but this does not mean it is not occurring.
The drugs in question are known as methylphenidates or cognitive enhancers and work by increasing the activity in the central nervous system.  This can increase awareness, decrease fatigue and improve an individual’s attention span, hence why it is used to treat illnesses such as attention deficit hyperactivity disorder (ADHD).  
Some drugs which are classed as cognitive enhancers are Adderall, Modafinil and, probably the most well-known and commonly prescribed to ADHD patients, Ritalin.
Research into the use of methylphenidates by students and professionals has been carried out in the United States and Great Britain but there has yet to be any research conducted into the matter in Ireland.
Through numerous online searches the drug is relatively easy to find available for purchase.  The price can vary, but Ritalin can be bought in batches of between 30 and 180 pills for less than 50 cent per pill.  However, buyers cannot be 100% certain that what they’re buying actually is Ritalin, as some online pharmacies are reportedly run by drug gangs who add banned toxins and chemicals to the drugs available on their websites.
It is illegal to buy methylphenidates in this way as they are classed as a “strictly controlled medical product” in the Misuse of Drugs Act; therefore, it is illegal to be in possession of, produce or distribute methylphenidates without a prescription from a doctor.  
According to records, 150 Adderall, 980 Ritalin and 214 Modafinil were seized in 2011 by An Garda Síochana and Irish customs.  
Professor Anjan Chatterjee wrote in the British Medical Journal study on Ritalin and explained that it is dangerous for healthy people to use Ritalin: “Unfortunately, the case for healthy people taking this drug is not so straightforward.  Doctors routinely decide whether to intervene based on a calculation of relative risks and benefits.  Here, the risks outweigh the benefits.” 
Despite being available for decades, the long-term effects of using drugs such as Ritalin are unknown so far.  What is known is that it is possible to overdose on Ritalin and that the drug is addictive because it releases dopamine, the body’s chemical that makes you feel happy.
James Martin Research Fellow at the Future of Humanity Institute at Oxford University, Dr Anders Sandberg, argues in an article published by Medical Independent that further studies on the drug’s long-term effects need to be conducted.
“Studies on these topics would provide useful evidence to guide policy, but have not been done so far, most likely because the use is irregular or seen as illicit.  Giving people who participated in studies controlled access to these drugs, perhaps on the condition of health check-ups, would help give that evidence base,” he said.
American medical student Richard Fee became addicted to a similar drug, Adderall, when it was prescribed to him by his doctor.  As a result Fee became depressed; he even ended up spending a week in a psychiatric hospital for treatment before being prescribed another 90-day treatment of Adderall prior to committing suicide in 2011.
Irish doctors are somewhat conservative when prescribing methylphenidates for ADHD patients, unlike their American counterparts.  In the US in 2010 there was a 13.4% increase in the number of prescriptions for Adderall written by doctors, with a figure of approximately 18 million.
A Care Quality Commission report published in 2012 and a study conducted by Cambridge University psychiatrist, Professor Barbara Shakian, shows that NHS  prescription numbers for methylphenidate drugs in the UK rose by just under 200 per cent from 220,000 in 1998 to 657,000 in 2012, with the highest increase occurring between 1998 and 2004.
Speaking to the Medical Independent in 2013, Professor Richard Costello, a Consultant Respiratory Physician in Dublin’s Beaumont Hospital said: “If I was to prescribe Modafinil to a normal, healthy individual who was getting the required sleep, he would feel nothing at all; it would have no impact.  You won’t find that result in the literature, the web pages, or in a college internet blurb.”
Professor Costello stated that insufficient sleep is the cause for lower cognitive performance, he said that Modafinil helps by giving, “a slight improvement in the cognitive performance skills of normal individuals, but only in those who were running a little low on sleep beforehand.  I have given Modafinil to large numbers of patients – some with chronic fatigue – to no effect. The only people, who see an improvement, in my experience, are those who, unknown to themselves, have been low in sleep for some time.”
If you have been affected by any of the topics discussed in this article you can call the Samaritans’ helpline on 116 123 or visit their website at www.samaritans.org.