The silent rave

Study drugs, ethics and addiction

The silent rave. Image: Justine Landis-Hanley and Nick Bonyhady The silent rave. Image: Justine Landis-Hanley and Nick Bonyhady

The end of semester one is nigh, and exams are once again upon us. While most students will rely on willpower and concentration to conquer oceans of revision this coming stuvac, others have a secret solution.

James* is 21. He is in his third year studying law and economics. Unlike his peers, James’ study companion is not the ostentatiously heavy Cases and Materials on International Law, but a small, white pill crushed into a fine powder: Concerta. The drug is a stimulant commonly prescribed to treat Attention Deficit Hyperactivity Disorder (ADHD). Although he has never been diagnosed with hyperactivity, James says he takes the drug because it makes the studying process more pleasurable. “You sit there for 4-5 hours at a time,” he says. “You’ve got complete tunnel vision. You don’t want to talk to anyone else, you’re just in there for that purpose … you just want to work.”

Like James, Anna*, a 22 year old Commerce/Arts student, seeks hyperactivity medication to mediate vigorous periods of study. “I’ve taken it with every major assessment, more or less,” she says. “Personally, I think it really helps. You pop a pill, then shoom. You’re intensely focused. You can power through lectures at a time.”

Research conducted in American universities found that around 7 per cent of students use ADHD medication — Ritalin, Concerta, Metadate, Adderall — to improve their grades and gain a competitive edge. While no comparable study has been undertaken in Australia, a similar culture exists. “I’ve been in the law library late at night and I’ve seen people just sitting there with [the] pills at their desk,” Anna says. “To be honest, I think that’s pretty bold. I tend to be more subtle.”

Whether it’s done in the open amphitheatre of Eastern Avenue Auditorium, or more discretely behind closed doors, taking medication that has been prescribed for another is illegal in Australia. In New South Wales, Ritalin is classified as a schedule 8, or controlled, drug and is regulated more strictly than other prescription-only medication. GPs must obtain a permit from a psychiatrist to prescribe it. Possessing Ritalin without a script is a punishable offence.

Yet at $5 a pop, ‘cognitive enhancers’, ‘smart drugs’ or, more colloquially, ‘study pingas’, offer students a quick fix. Facing masses of revision in the coming weeks, James and Anna have already secured their supply. To someone who notoriously neglects lectures and readings, the prospect of heightened awareness for hours at a time sounds tempting. But is it fair? Comparing Ritalin ingestion in academia to the use of performing enhancing drugs in sports, Kylie*, 21 and studying Arts/Law, thinks not. “I know the drugs don’t actually make you smarter, but it’s the opportunities [that] they allow. It’s like using steroids in weightlifting,” she says, “you use steroids, you become stronger, you can lift more weights. You take Ritalin [and] you’re more concentrated; you can study for longer periods of time. If I could study for six hours straight each night in stuvac, I’d ace my exams. But I can’t. No normal person can.” To an extent, James agrees with this argument. “If I didn’t use Ritalin, my results would be at least 10 marks lower across the board. So yeah, I guess it is a performance enhancing drug”, he says. “But why not enhance your performance? It’s hypothetical, but imagine if everyone in the entire economy took Ritalin, our nation’s productivity would be much, much higher.”

Writing in science journal, Nature, Stanford law professor Henry Greely advocates for the widespread use of Ritalin and other ‘cognitive enhancers’. “Human ingenuity has given us the means of enhancing our brain through inventions such as the written language, the printing press and the internet,” he writes. “These drugs are just another way our uniquely innovative species continues to improve itself”. Comparing Ritalin to the invention of the iPhone is a contentious argument, and very few in the world of science and academia agree with Greely. But his argument has a certain utilitarian appeal.

Certainly the risks of being caught taking study drugs is low. Given the cost of drug testing, it is highly unlikely the university would ever swab our tongues or test our pee before exams. With no feasible way to police Ritalin use, perhaps we should all just act on Greely’s advice: jam our pockets with pills and strap ourselves in for one hell of a long night in Fisher, each tablet edging us towards unlocking our mind’s potential like Bradley Cooper in Limitless.

When I put this notion to Kylie, she responds bluntly, “but surely it isn’t good for you”.

I ask Anna if she knows of any side effects. Her response is a silent shrug accompanying a vacant stare.

I put the same question to James. “I’ve never actually looked into it,” he tells me, “So many people take it legally, worldwide, to treat ADHD — I mean, how bad can it be?”

Neuroscientist Dr Daniel Hermens from the University of Sydney’s Brain and Mind Centre warns that study drugs are potentially addictive and pose similar risks to more commonly known amphetamines, but at a much lower level.

The relationship between the white powder James enjoys and the risks it poses is almost as complex as the principles of international law that he’s supposed to be revising. First thing’s first: while Ritalin, Concerta, Metadate, and Methylin are flashy brand names; they’re almost chemically identical. The active ingredient in each drug is known as methylphenidate.

Naturally, our brains release chemicals, or neurotransmitters. These neurotransmitters are fundamental to our body’s function. You’ve probably heard of them before: adrenaline, serotonin and dopamine. Described as the ‘rewards’ chemical, dopamine is responsible for motivation, attention and lust. The ‘this-feels-good-I’m-going-to-keep-doing-it’ sensation is simply dopamine.

In the simplest organisms, dopamine is released during activities that are essential to existence, such as eating and sex. For more complex creatures, the chemical is released through a range of activities from eating and sex to beating your flatmate in FIFA, reading Honi’s ever-so insightful feature articles, and, yes, strangely enough, studying as well. How often have you felt that ‘this-feels-good-I’m-going-to-keep-doing-it’ feeling when you’ve nailed an assignment or begun to grasp a new concept? I’m confident most of us can relate.

But not everyone is so lucky. “People diagnosed with ADHD biologically produce lower levels of dopamine,” says Dr Hermens, “this makes many simple tasks which require concentration more difficult.”

Around 8 per cent of children in Australia live with ADHD. As a result, many experience symptoms that include inattention and impulsivity. 50 per cent of these people carry the symptoms on into their adult life. In such cases, drugs like Ritalin are advantageous, adjusting the brain to a function level that is considered normal.

“Methylphenidate works by blocking the dopamine transporters in the brain,” says Dr Hermens, “for someone with ADHD, that increases the lower levels of dopamine to normal”.

Confused? Let me break it down for you. Dopamine is carried away from the brain and absorbed into the body through a series of fixed molecules called dopamine transporters, or ‘reuptake inhibitors’. If you picture your brain as a lake, the water as dopamine, and your body, an ocean, the dopamine transporters would be like a river, meandering downstream, gradually emptying the lake.

As people with ADHD produce less dopamine, their lake is naturally emptier. When they take their prescribed medication, the methylphenidate obstructs the transporter, concentrating dopamine in the brain. It’s like building a dam at the head of the river. With gradual rainfall, the lake slowly fills, eventually reaching capacity. By normalising dopamine levels, the symptoms of ADHD are minimised.

“If you have normal levels of dopamine and take Ritalin, then the blocking of the transporter leads to excessive amounts of the chemical in the brain” explains Dr Hermens, “and this is where you can get into dangerous territory.” Other illicit and highly addictive stimulants function in the same way, blocking our brain’s reuptake inhibitors. You’ve heard of these — speed, ecstasy, MDMA, and methamphetamine (crystal meth). “Ritalin is from the same class or family of drug as methamphetamine; it is essentially amphetamine” says Dr Hermens, “and in that, there’s an inherent abuse potential.”

We’ve all seen Breaking Bad: crystal meth is serious shit. I’m not trying to say your mate who took Ritalin that one time to smash out his gender studies take home exam is on the verge of becoming a Jesse Pinkman-style junkie. It would take a lot to get to that point. But scientifically, what’s happening inside the brain is pretty similar.

For James, the initial hit of Concerta is comparable to other party drugs he’s taken. “When you first take it you get this heart pumping feeling in your chest,” says James, “it’s like a semi come-up, your heart starts beating really fast, but it’s different, you don’t want to dance, you just want to focus.” According to Dr Hermens, the difference James describes comes down to the type of neurotransmitters that are released. While methylphenidate only increases dopamine, stronger amphetamines cause peaks across a range of neurotransmitters.

For example, MDMA causes spikes in levels of serotonin (responsible for mood) and noradrenalin (arousal and alertness) as well as dopamine (motivation). So when you’re on it, you’re more likely to stay awake, dance all night and wind up leaving Home Bar at 4am with a group of oddly attractive English backpackers. However, as methylphenidate only acts on the dopamine pathway, its sensation is purely motivational. Breaking Bad would have been a very different show if Walter and Jesse gallivanted through New Mexico stealing medication from primary school kids.

Ritalin’s risks lie in the way it’s consumed. When taken as prescribed, by those with a dopamine deficiency, the drug is effective and safe. Each tablet is designed to mimic the brain’s natural patterns, ensuring a slow release of methylphenidate over a long period of time. However, when stressed-out students start equating more pills with more concentration, the potential for abuse increases. Like any drug consumed habitually, the human body will slowly grow tolerant to methylphenidate. For regular users, one tablet eventually won’t be enough.

“I suspect many students use it because they assume it’s relatively safe”, says Dr Hermens. “But through prolonged exposure, a few at a time can turn into many at a time, and then many a week. Then the user starts thinking about faster modes of delivery. That is where you get well into the realm of abuse and dependence.

“We don’t really know what the long-term effects of Ritalin are. But judging from its chemical similarities, psychotic and depressive symptoms, like those displayed in methamphetamine users, are not improbable from prolonged methylphenidate use.”

A couple of concentrated doses of Concerta are a daily regularity for James during intensive blocks of study, but he insists he’s not addicted. “I can study perfectly fine without Ritalin,” he says, “when I can’t get my hands on any, I just drink coffee.” However, he does acknowledge the drug’s moreish tendency. “I guess it is a bit addictive, I mean, when you’re studying without it, the thought is always in your brain, ‘I could just eat a Concerta and smash this out.’”

I ask if James has thought about carrying the habit on into his professional career.

“To be honest I wouldn’t mind it,” he tells me, “I just got back from a work experience stint in the United States, and all the economic analysts at the company I was working for were on it. I really don’t feel like it’s an unethical thing to do. A lot of people in the industry do already, so yeah I guess I will.” However, if Dr Hermens’ warnings ring true, the time may come for James when work and Ritalin are inseparably fused.

Therein lies the problem with Greely’s argument. In 1954, Roger Bannister was the first person to run a four-minute mile. That time is still fast, but hundreds of people have run a mile in that time since. The feat no longer has the same lustre. When performance rises, so do expectations. In the same way, if everyone were to consume study drugs then employers would likely expect more of their workers. Productivity may rise on net, but that is not a goal in itself — unlike, say, going to Scubar five nights in a row and still finishing your essay.

Exams are fast approaching. We’re all sleep deprived and stressed-out. Everyone just wants to do their best — whether that’s simply passing, improving on last year’s results or pursuing an elusive, high distinction average. Revising is both arduous and monotonous, and we all have our own ways of negotiating the process. For me, it’s a Ralph’s coffee and a packet of Extra chewing gum. For others, it’s Ritalin.

To those considering turning to methylphenidate to mediate their exam preparation this stuvac, it is at least worth understanding how the drug is affecting your brain. From what I’ve learnt, it may be the beginning of a burgeoning habit.

*Names have been changed.