It’s an old question: would you eat the apple to know the answer?
We’ve traveled far beyond the gates of Eden, clothed our conscience with a fig leaf in a land where apples are antiquated. These days, smart pills roll en masse off assembly lines into little yellow prescription bottles.
It might be just what the doctor ordered. Or not. Either way, there are final exams to tackle.
SIT STILL AND TAKE YOUR PILL
Children can be exhausting. They run and play and yell and do all the things they aren’t supposed to do. Some are “handfuls” or “holy terrors”.
“Old School” alumni point to the rod…or a paddle, a belt, a switch, a hand. But spanking—now considered barbaric—has been relegated to the shadows.
The brave, new world of medicine—of wonder drugs that kind-of-cure—offers another way. The kid can be still, can be quiet. The kid can study. Their brain can be brought into tighter focus.
“Typically, we would get them when they’re between five and seven,” explained Dr. Lielanie Aguilar, a child psychiatrist with Baptist Health Care’s Lakeview Center. “They didn’t do so well in kindergarten and their parents are worried that it’s going to happen again.”
Children used to be “hyperactive”. Now, they have disorders. One of the most common disorder diagnosis for a child is Attention Deficit Hyperactivity Disorder, or ADHD.
The condition describes symptoms generally associated with hyperactivity. While widely accepted in the medical community, the concept of diagnosing children with attention deficit-related disorders and medicating them does have its critics. Neurologist Dr. Fred Baughman testified before Congress that ADHD isn’t real, and actor Tom Cruise went bananas on NBC’s “Today Show”, but both are tied to the Church of Scientology and are thus written off as lunatics by some medical and psychiatric establishments.
Instead, the American Psychiatric Association estimates that 3 to 7 percent of school age children have ADHD. Approximately 9.5 percent of children ages 4 to 17, about 5.4 million, had been diagnosed as of 2007.
When a child is exhibiting signs of ADHD, a school official or parent might request that an evaluation be conducted. If a doctor deems it beneficial, the child may be prescribed a medication to combat the attention deficit issue.
Ritalin, the trusty ADHD standby, has been in use for years. More recently, a new amphetamine has joined the collection of pharmaceutical stimulants in the medicine cabinet: Adderall.
“It does help with focusing,” said Aguilar, who considers the drug 80 to 90 percent effective. “It does help a person stay on task.”
Once a child is started on attention-deficit medications such as Adderall, the regimen is meant to be continued for some length of time, usually years. “Fifty percent of the time, you’ll have a child go into adulthood needing medicine,” Aguilar said. “At the very least, throughout school you’ll need it.”
THAT SOUNDS LIKE ME
Did ADHD-like conditions spontaneously appear on Earth within the last few decades? If so, it’s extremely fortunate, both medically and financially, that pharmaceutical companies were able to unveil relevant medications in tandem.
But Aguilar suggested that such conditions have always existed. The difference, she argues, is that people are now better able to identify such conditions. She says there is a “heightened awareness” as opposed to an increase in cases.
“Part of that has been early recognition,” Aguilar said. “You know, being diagnosed earlier.”
In addition to evaluating children earlier, the medical community has also seen an increase in older patients asking about attention deficit disorders and medications such as Adderall.
“I’ve had adults come in and say, ‘I’ve always been like that,’” Aguilar said.
While she works primarily with children, the doctor says that it’s understandable that adults are interested in attention-related disorders and medications. As the concept becomes wider known, people have begun to retroactively self diagnose, wondering if they might benefit from such medicines.
“Certainly, the heightened awareness makes people wonder if they have ADHD,” Aguilar said. “You hear a lot of people talking about it, a lot of people asking about it, and that’s welcome…it is welcome that people are curious.”
Doctors use a list of criteria to determine if a person has an attention deficit disorder before prescribing Adderall. It’s not a hard science, but rather, objective.
“There’s really no blood tests—parents often ask,” explained Aguilar. “There’s no MRI or scan that will tell us if a child has ADHD.”
Researchers are currently looking into brain functions as they relate to ADHD, but the medical community has not settled on a cause for the disorder.
“Well, that is up for debate,” Aguilar said, adding that there has also been research exploring the possibility that the disorder could be related to environmental factors or diet, “but there’s really nothing solid that is coming out of that.”
Doctors give children drugs to focus. They’re told it will enable them to study, to concentrate, to better perform in the world they live in. Is it any wonder the kids’ friends want some too?
Over the course of the last few years, this generation of children, who grew up pill-focused with society’s approval, have gone off to college where the tests get harder.
Some students with ADHD continue to take their Adderall. Others—without a disorder or prescription—do as well.
“They might use it before finals,” said Dr. Terry Ptacek, a doctor with Baptist Health Care who is board certified in Addictionology. “They just stay up all night and study.”
While the medication has the same effect as on someone without ADHD, that person is self-medicating without the benefit of a trained medical professional. According to Aguilar, that’s a bad idea (and illegal).
“There are certain risks, for example,” she said. “All these medications have side effects.”
Some side effects from Adderall include loss of appetite and lack of sleep. A person’s heart rate can elevate. They might get moody.
“There are people who get more whiney and more emotional,” Aguilar explained.
Ptacek, who as a medical student participated as an observer in trials for Ritalin, said he has noticed a trend in people without ADHD taking Adderall over the last few years.
“It’s clearly been the last five years that I’ve seen it in college students,” Ptacek said.
The drug is fairly easy to obtain. Often, a prescription is readily available; if not, perhaps a friend will share.
“If the kids know what to say—and it seems they all know what to say—it’s fairly easy for the doctor to get bamboozled,” Ptacek said.
While Adderall is produced primarily for children and youth, it is being used more widely. In addition to students giving it a try, the drug also entices pretty much anyone looking for something to jazz their brain up a few gears.
“Not only students, but also housewives,” said Myrna Bobet, a psychiatrist with Psychological Associates in Pensacola. “They find that they can do more chores, be more productive.”
Aguilar said that she has seen instances when prescriptions make their way out of the patient’s hands.
“There have been some cases where diversion has been a problem,” she said, explaining that sometimes another family member will take a child’s medication to either use or sell.
Aguilar said she looks for red flags that will alert her to abuse. She lists two red flags—lost prescriptions and requests for higher dosages—before losing the third in the recesses of her mind.
“I guess I lost my train of thought,” she said.
There’s a pill for that.