A Pill to Tip the Scales

October 17th, 2012 by Andrea Bennett

As ADHD drugs spread in low-income schools, a question arises: Are performance-enhancing drugs ever justifiable?

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The Responsibility Project

A few months ago, we wrote about a problem that had been reported on by Alan Schwarz of The New York Times; namely, an increasing demand among competitive high-income high school students for prescription stimulants like Adderall and Ritalin in order to enhance academic performance. The allure of the “laser sharp focus” provided by these drugs – usually prescribed to treat attention deficit hyperactivity disorder (ADHD) – was tempting for students trying to compete in increasingly pressure-filled academic environments. Demand became so high, Schwarz reported, that enterprising students were faking ADHD symptoms in order to get prescriptions from their doctors, and then selling the drugs to their peers.

But the issue doesn’t only exist in high-income schools. Increasingly, it seems low-income students are turning to such stimulants to compensate for inadequate schools. That’s the rationale that some doctors are giving for prescribing the drugs to low-income students, according to Schwarz’s latest report. While wealthy students abuse stimulants to meet ever-rising expectations, doctors are issuing fraudulent ADHD diagnoses to low-income elementary school children in order to give them an academic edge.

“I don’t have a whole lot of choice,” Atlanta-area pediatrician Michael Anderson told Schwarz. Dr. Anderson further explained, “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

According to Dr. Nancy Rappaport, a child psychiatrist in Cambridge, Mass. that works with children from lower-income families, Anderson is a “social justice thinker” whose prescriptions are leveling the playing field. Not everyone, however, sees the justice in tipping the balance. Some point out that these doctors could be exposing children to health risks such as growth suppression, increased blood pressure and even psychotic episodes.

Matthew Herper of Forbes points to an anecdote Schwarz gives about one child whose Adderall use served as a gateway drug to Risperdal, an antipsychotic approved for treating aggression in autistic children, but carrying side effects including insomnia, parkinsonism and drooling. He writes, “We’re overdue for more national conversation on how [drugs] should be used that gets beyond both the puritanical strain of saying drugs are bad and the utopian idea that we can use drugs to improve academic performance without other, potentially big, costs.”

What do you think? Is taking academic performance-enhancing drugs ever justifiable, or is there a better solution? Weigh in here.