Tuesday, January 15, 2013

Passing with Pills: Redefining Performance in the Pharmaceuticalized University

"Adderall," by Flickr user AlexDoddPhotography.
College is a complex cultural object – it is simultaneously a physical place, a social institution, a time frame, a mindset, and an experience. For many Americans, it has also become a rite of passage into adulthood, where students are ritually removed from their pre-college life; faced with certain social, academic and even physical hardships; and then reintroduced to society with the anticipated rights and privileges of a college graduate. In this process, students are experimenting with prescription stimulants, namely Adderall, in order to manage and maximize their college experience. Despite the medical and legal risks involved with unsupervised use of these drugs, prevalence rates have been recorded as high as 35% and continue to grow (Wilens et al. 2008). In this piece, I want to use Adderall as a lens to look more closely at the modern university and how it is reflecting and/or reshaping what it means to a successful student in a pharmaceuticalized culture.

Anthropologists have argued that the increasing availability of pharmaceuticals has generated a sense of agency among healthy Americans who feel they could benefit from these technologies for non-medical purposes. For example, Vuckovic (1999) suggests that America is experiencing a “time famine” which encourages individuals to take medications to increase health and by extension, efficiency. In particular, the demand for prescription stimulants signals a desire for “flexible bodies” which work harder, needless rest, and can adapt quickly to new situations (Martin 2001). Given the rigorous schedules most students face in college, it is not surprising that many are turning to pharmaceuticals to help them keep up.

Most students who try Adderall for the first time do it out of desperation or curiosity, usually both. They see a friend taking the drug and studying for 6 hours straight, or it is offered to them on a silver platter the night before a big deadline. The fetishism over the drug stems from narratives of success, legends of the superhuman feats one can achieve in a matter of hours while on the wonder drug. Hence, it is not surprising that students begin to experiment with Adderall in order to mitigate the stresses of their own academic work. Michael, a non-prescription user explains that before he took Adderall, he had a difficult time studying:
It’s not like I didn’t make time, I would sit at the library for 10 hours and just stress out about how much I had to get done. I studied 30 minutes, and stressed for 9 and a ½ hours... but now I just pop an Adderall and I feel like ‘Hell yes, let’s do this!’ Then I just do it. It might be placebo or something, but for me, it works.
For Jenelle, a sophomore in biology, Adderall allows her to turn school work into a recreational activity and describes it as euphoric experience. She tells me:
When I am on Adderall, calculus is the most fascinating thing in the world to me. I don’t want to stop reading my textbook… solving math problems becomes a game that I have to win no matter how long it takes.
So, while Adderall use may not necessarily increase cognitive function for everyone, it can still generate the motivation, stamina and confidence necessary to complete academic work.

As Adderall continues to become a normative, and even anticipated part the college experience, prior notions of academic performance are being transformed. In the process, the types of work that are logically and ethically appropriate for pharmaceutical interventions come into question. Some students argue that Adderall is best for writing papers or even enhancing artistic abilities, while others are emphatic that it suppresses creativity and is only useful for basic memorization. As Jason, junior in physics puts it,
Adderall is only good for holding onto to information in your head, not its alteration. You just push it into your brain and reproduce it on the exam.
Even then, the length of time Adderall allows the user to commit information to memory rarely appears to be long-term. So while students work under more flexible notions of time, they must also navigate around the fleeting nature of the information Adderall makes available to them.

Stories of success with Adderall are also accompanied by cautionary tales of cognitive tradeoffs such as misplaced focus and quality of work. As a result, students rely on experimentation to directly inform what constitutes both the optimal drug and study experience, as well as when and how they register the usefulness of Adderall. Elizabeth, a freshman in chemistry tells me:
Adderall will make you want to work, but you can’t control the work you actually do. If you are lucky, you spend 10 hours writing a paper, but maybe you end up spending 10 hours cleaning your room or obsessing over making the perfect iTunes playlist.
She goes on to tell me that:
Now when I use Adderall, I make sure I am not in my dorm room, instead I go to the second floor of the main library where it is dead silent… I make sure that I close all the other windows in my computer and leave my cell phone at home so I don’t have any more distractions… I also make an outline of what I need to get done so once I am on the Adderall, all I need to do is fill in the blanks.
Josh, a non-prescription user in psychology argues that while it allows you maximize the quantity of work you can do, the quality of the work suffers greatly. He explains:
Once I wrote a 15 page paper in one night, I thought it was so good! And then I read it the next morning, it was complete rambling BS… but I turned it in and got a 2.5 so whatever, at least I got it done.
According to my informants, it is quite common to experience a false sense of euphoria, invincibility, and grandeur while completing academic work on the drug. In fact, many professors I have spoken with claim they can spot a paper fueled by Adderall based on these self-important narratives. It makes sense than that for students like Josh, Adderall is only used in a pinch for general education classes which are less important to his overall academic goals. Other students who recognize this tradeoff of Adderall use develop strategies to use the drug for long term goals and assignments. Kaitlyn, a junior in journalism tells me:
After turning in three or four shitty papers, I get that I can’t just use it last minute… Adderall gives me the kick start I need to get going on a paper, but now I make sure I have at least two days to revise a paper while I am sober to make sure it actually makes sense.
This shows that although students may feel “enhanced” while doing their school work, Adderall alone does not necessarily result in increased academic performance. Despite the variable experiences students have with the drug and questions of its actual efficacy, Adderall has become a normative part of the college social experience, where students take the pill together in order to get through the rigors of college in solidarity. Josh, a senior in sociology tells me that during finals week, his roommates ritualistically make breakfast, pop a few Adderall and lock themselves in the student union for hours. He tells me:
We know that once we are blasting on Adderall, no one else will be on our level or understand where our minds are at… so we developed a system so that we are in together, you know? Like we can all be blasting together and get shit done.
Sharing one’s acquired Adderall is another way to demonstrate solidarity among students. Allison, a senior in marketing tells me:
When I first met my best friend Kenny, he was standing outside of the lecture hall and he looked exhausted. I asked him what was wrong and he told me he forgot to take his Adderall before the test, so I offered him one of mine. After that, we were best friends for the rest of the semester, it’s the funniest thing!
During my participant observation at the library, I have heard students who are studying together tell each other “I am exhausted, want to split an Adderall and start the next chapter”? In most cases, the recipient is excited to get access to the drug and consumes it quickly. However, in some cases students turn down the offer of Adderall say but it is still taken as a gesture of good will, rather than an illegal proposition.

While questions of morality and merit remain central to neuro-ethical debates around cognitive enhancement, illicit Adderall use has become so normalized that many students admit to never considering these issues. Adam, a non-prescription user says to me:
Is it cheating? I don’t know, I never thought about it... Do people seriously think like that? Like does it whisper the answers in my ear? Or does it just write the paper for me while I sleep? No. What the hell does that even mean...is it cheating?
Abby, a senior in Economics tells me:
I definitely don’t consider it cheating. Your grade still reflects how well you know the material, whether you learned it in 10 weeks or 48 hours.
These rationalized claims over intellectual performance are rooted in a larger rhetoric of responsibility over one’s own academic future – an agenda that most students admit they developed during their college years. For example, Evan, another non-prescription user tells me that before college, he never considered taking Adderall. He explains that:
It wasn’t until I was mature enough to understand that grades actually mattered that I saw the value of something like Adderall. I think that’s why if my parents ever found out, they wouldn’t be pissed, they would be proud of me for taking initiative.
He goes on to tell me:
Everyone here has the opportunity to take Adderall to study if they really want to – so if they choose not to take it, that’s on them.
***

While these brief narratives capture only a snapshot from the lives of these students, they demonstrate how the circulation and use of Adderall on campus is more than just a risky drug behavior. It is a deeply moralized negotiation of health, performance, and social capital, which has become a part of this rite of passage. As educators and anthropologists working in this context, it is our responsibility to recognize shifting expectations that are placed on college students to take these drugs in order to survive college and move onto the “real world”. As society continues to value performance over learning, we distance ourselves from these individuals when they need our understanding and guidance the most.

While there is no hard and fast solution to this drug behavior, we can start by educating ourselves and having an open and honest dialogue with students about why they feel they need to use the drug. Next, we must take that knowledge and implement it into our own teaching strategies –in some cases may mean replacing finals week with more regular and diverse assessments throughout the semester. It may also mean more work on our part to make our courses relevant, exciting and worth their time because most students will never take an Adderall to study or write for a class they enjoy or care about. And finally, we need to have an open dialogue with each other and not assume the worst about our students (those lazy, cheating, drug users). We are a fundamental influence of this rite of passage and unless we acknowledge the problem to ourselves, we only supporting the notion that Adderall use is a legitimate strategy to achieving successful college experience.

Tazin Karim
Michigan State University

Works cited

Martin E. 1994. Flexible bodies: tracking immunity in American culture from the days of polio to the age of AIDS. Boston: Beacon Press. xxiii, 320 p. p.

Vuckovic N. 1999. Fast Relief: Buying Time with Medications. Medical Anthropology Quarterly 13(1):51-68.

Wilens T, Lenard A, Adams J, Sgambati S, Rotrosen J, Sawtelle R, Utzinger L, and Fusillo S. 2008. Misuse and diversion of stimulants prescribed for ADHD: a systematic review of literature Journal of American Academy of Child Adolescence and Psychiatry 47(1):21-31.
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