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Sunday, June 10, 2012

Addies Amping Intelligent High Schoolers' ACTs

I graduated high school in 1969. I remember the stress and pressures of getting good grades, but many in my class put much more effort toward scholastic achievement than I did. Then, I marveled as I saw the "cream" of my class working diligently on every assignment in every class and consistently outscoring others on tests and papers. I knew then these scholars deserved every accolade they accomplished because of their initiative, dedication, and sacrifice. They were "A" workhorses, and I loved having them as "brainy" friends.

I say this because I enjoyed the social aspects of high school so much that I would often let my "fun" take priority over my studies. I was in the same college preparatory classes with the scholars; however, I was usually very satisfied to earn the "B" or the "A"- "B-" average. And, I also learned my academic talents and interests lay in subjects other than math and science.

So, I took these "undesirable" classes and did my best, but my report card testified to my mathematical and scientific stumbles: I never liked to take home a "C" but those classes just seemed tougher to me. C'est La Vie.

High school -- to me, those years were the best years. I loved everything about attending a small rural high school, and I still value all of my experiences there. Our graduating class was very close, and it seemed we less grade-minded students appreciated and freely interacted with the "brains" not only out of respect for their work but also out of the realization that they would someday be the doctors and the lawyers who would get the rest of us out of some serious situations. Call it a "pecking order" or whatever you wish, but most class members seemed to settle very comfortably into their places. We were a happy bunch.

High School Today

How about now? Talk about stress and pressure. High school students are under a tremendous strain to achieve. So many feel the highest grade and the highest ACT score are vital to their futures. As a teacher, I witnessed students who would actually experience test anxiety to the point of becoming physically ill. Other high achievers would even cry or get depressed over a "B" -- a grade they felt was not indicative of their past excellent performance. Other "grade freaks" with a low score would assure me that the problem was mine as I had delivered some sub-standard instruction before the exam.

Would you believe many high school scholars
today take a pill to jolt them
with the energy and focus
to push through all-night homework binges
and to stay awake during exams afterward?

These medications are meant
to calm people with A.D.H.D.,
but those without the disorder
take them to "get the grade."

"It's like it does your work for you," said William, a recent graduate of the Birch Wathen Lenox School on the Upper East Side of Manhattan.

Alan Schwarz of The New York Times reports, "The number of prescriptions for A.D.H.D. medications dispensed for young people ages 10 to 19 has risen 26 percent since 2007, to almost 21 million yearly, according to IMS Health, a health care information company — a number that experts estimate corresponds to more than two million individuals. But there is no reliable research on how many high school students take stimulants as a study aid. Doctors and teenagers from more than 15 schools across the nation with high academic standards estimated that the portion of students who do so ranges from 15 percent to 40 percent." (Alan Schwarz, "Risky Rise of Good-Grade Pills," The New York Times, June 9 2012)

Adderall is an amphetamine prescribed for attention deficit hyperactivity disorder that students share to study late into the night, focus during tests and ultimately get the grades worthy of their prestigious high school in places like Upper East Side, an affluent neighborhood of New York City.

Gary Boggs, a special agent for the Drug Enforcement Administration says, "We're seeing it all across the United States."

The drugs do more than just jolt them awake for their 8 A.M. classes, it causes them to develop a tunnel focus tailor-made for the marathon of tests long known to make or break college applications.

Schwarz reports, "The D.E.A. lists prescription stimulants like Adderall and Vyvanse (amphetamines) and Ritalin and Focalin (methylphenidates) as Class 2 controlled substances — the same as cocaine and morphine — because they rank among the most addictive substances that have a medical use. (By comparison, the long-abused anti-anxiety drug Valium is in the lower Class 4.) So they carry high legal risks, too, as few teenagers appreciate that merely giving a friend an Adderall or Vyvanse pill is the same as selling it and can be prosecuted as a felony."

One senior at Lower Merion High School in Ardmore, a Philadelphia suburb, said he made hundreds of dollars a week selling prescription drugs, usually priced at $5 to $20 per pill, to classmates as young as freshmen. "They’re the quote-unquote 'good kids,' basically."

And, the risks of taking these prescriptions extend to the health of students. Abuse of prescription stimulants can lead to depression and mood swings (from sleep deprivation), heart irregularities and acute exhaustion or psychosis during withdrawal, doctors say.

Very little is known about the long-term effects of abuse of stimulants among the young. Drug counselors say that for some teenagers, the pills eventually become an entry to the abuse of painkillers and sleep aids. One New York high school student who frequently took Adderall became addicted to Percocet and eventually heroin. He said it was easy abusing these other drugs when he was getting "A's."

Paul L. Hokemeyer, a family therapist at Caron Treatment Centers in Manhattan, said: "Children have prefrontal cortexes that are not fully developed, and we’re changing the chemistry of the brain. That’s what these drugs do. It’s one thing if you have a real deficiency — the medicine is really important to those people — but not if your deficiency is not getting into Brown."

Adderall From Professionals

Consider this: Some students are abusing Adderall through professional counseling. A number of teenagers Schwarz interviewed laughed at the ease with which they got some doctors to write prescriptions for A.D.H.D. Many youngsters with prescriptions said their doctors merely listened to their stories and took out their prescription pads.

Dr. Hilda R. Roque, a primary-care physician in West New York, N.J., said she never prescribed A.D.H.D. medicine but knew many doctors who did. She said many parents could push as hard for prescriptions as their children did, telling her: "My child is not doing well in school. I understand there are meds he can take to make him smarter."

Schwarz reports, "During an interview in March, a dealer at Lower Merion High reached into his pocket and pulled out the container for his daily stash of the prescription stimulants Concerta and Focalin: a hollowed-out bullet. Unlike his other products — marijuana and heroin, which come from higher-level dealers — his amphetamines came from a more trusted, and trusting, source, he said.

"'I lie to my psychiatrist (said the dealer) -- I expressed feelings I didn’t really have, knowing the consequences of it,' he said, standing in a park a few miles from the high school. 'I tell the doctor that I find myself very distracted, and I feel this really deep pain inside, like I'm anxious all the time, or something like that.'"

"He coughed out a chuckle and added proudly, 'Generally, if you keep playing the angsty-teen role, you’ll get something good.' (Alan Schwarz, "Risky Rise of Good-Grade Pills," The New York Times, June 9 2012)

Nan Radulovic, a psychotherapist in Santa Monica, California says that within a few days, an 11th grader, a ninth grader and an eighth grader asked for prescriptions for Adderall solely for better grades. From one girl, she recalls, it was not quite a request. "If you don’t give me the prescription," Dr. Radulovic says the girl told her, "I’ll just get it from kids at school."

A Prescription for Adderall Is Known As the "Golden Ticket"

A high school senior in Connecticut says, "These are academic steroids. But usually, parents don’t get the steroids for you."

A recent graduate of McLean High School in Virginia, one of the top public schools in the Washington area, relates his story. He said that late in his sophomore year, he wanted some help to raise his B average — far from what top colleges expected, especially from a McLean student -- to get into the "right" school.

So he told his psychologist what she needed to hear for a diagnosis of A.D.H.D. — even gazing out the window during the appointment for effect — and was soon getting 30 pills of Adderall every month, 10 milligrams each. They worked. He focused late into the night studying, concentrated better during exams and got an A-minus average for his junior year.

As senior year began, when another round of SATs and one last set of good grades could put him over the top, the boy said he still had trouble concentrating. The doctor prescribed 30 milligrams a day. When college applications hit, he bought extra pills for $5 apiece from a girl in French class who had fooled her psychiatrist, too, and began taking several on some days.

The boy said that as his A-minus average continued through senior year while no one suspected that "a kid who went to Bible camp" and had so improved his grades could be abusing drugs. By the time he was accepted and had enrolled at a good but not great college, he was up to 300 milligrams a day — constantly taking more to stave off the inevitable crash.

One night, after he had taken about 400 milligrams, his heart started beating wildly. He began hallucinating and then convulsing. He was rushed to the emergency room and wound up spending seven months at a drug rehabilitation center.

To his surprise, two of 20 fellow patients there had also landed in rehab solely from abusing stimulants in high school.

"No one seems to think that it's a real thing — adults on the outside looking in," the boy said. "The other kids in rehab thought we weren't addicts because Adderall wasn't a real drug. It's so underestimated."  (Alan Schwarz, "Risky Rise of Good-Grade Pills," The New York Times, June 9 2012)

My Point

Is the grade or the college worth the risks? Considering the potential problems with taking Adderall, including the real risk of addiction, I believe the answer is "no." This problem is just another indication that the Prescription Nation mentality is beginning to affect our most sacred institutions.

If intelligent, perfectly well high school students choose to alter their brains with chemicals to "better" their future, where will they draw the line? Certainly not in college where stress and work loads grow. Will they continue to abuse drugs while working in their professions? It is a very real possibility.

Is this what the best and most intellectual among us has become? We've come a long way from 1969, baby. And, I think, we are going in the wrong direction.

Look at these findings about physicians:

(1) Physicians are as likely to experience drug and alcohol addiction as anyone in the general population. They are more likely than others, however, to abuse prescription medications. (Marvin D. Seppala, M.D., and Keith H. Berge, M.D. "The Addicted Physician: A Rational Response to an Irrational Disease." Clinical and Health Affairs, February 2010)

(2) In California, the state medical association says there are between 200 and 400 doctors in the diversion program on any given day.

(3) A study by the Federation of State Physician Health Programs found about one percent of all physicians practicing in the United States are in confidential treatment. That's about 8,000 doctors whose patients may have no idea they are addicts.

* Please read the entire article by Alan Schwarz:
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