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Monday, Oct 6, 2008
More and more adults and teens are popping pills for ADD, "generalized anxiety disorder" and other quasi-societal conditions. Is it time to retire our moralistic distinction between "recreational" and "medical" drugs?
Nov 25, 2005 | They would show up weekly, pulling into my driveway because I wasn't yet old enough to drive: desperate, chronically studious college kids looking for a fix. The year was 1995. I was 15 years old, an acne-spattered high school sophomore who had become, through a peculiar sequence of events I'll get to soon enough, an accidental dealer of Ritalin to those whose doctors had deemed them ineligible for a prescription. Undergrads who couldn't keep their eyes open while perusing Plato, law students with reading loads that would give Harold Bloom an aneurysm, medical residents who deemed sleep a disease -- they all flocked to me, paying between $3 and $5 for pills that converted their minds into binge-studying, test-devouring, world-dominating machines. Until my stockpile dried up, I constantly had at least 70 bucks burning a hole in my pocket. For a kid in the burbs who had food and shelter more or less covered by his mother, this was the equivalent of a doctor's salary.
OK, I know, that analogy is a stretch, though it's the one that comes to my mind as I stare, feeling faintly prophetic, at this recent headline in the New York Times: "Use of Attention-Deficit Drugs Is Found to Soar Among Adults." The article points out that a new study, by Medco Health Solutions, reveals that use of ADD medications has doubled in those between the ages of 20 and 44 in the past four years. Why's that? Likely in part because the first heavily medicated generation of teens is now drifting into adulthood and still renewing their prescriptions, and partly because new diagnoses are steadily increasing. "Adult ADD" -- full name: attention deficient and hyperactivity disorder -- appears to be at the cusp of making the transition of so many psychosocial disorders before it: from unheard of to skeptically acknowledged to culturally sanctioned.
Earlier this year it was the subject of a sober cover story in the New York Times Magazine, after which, curiously, television advertisements for Strattera, Eli Lilly's drug for adult ADD, suddenly seemed impossible to avoid. Robert S. Epstein, Medco's chief doctor, tells the Times that the current data indicates "a clear recognition and new thinking that treatment for A.D.H.D. does not go away for many children after adolescence." Another doctor, James McGough of UCLA, adds that still more adults should be on such drugs -- a sentiment echoed a few days later on the "Today" show by Dr. Edward Hallowell, author of "Delivered From Distraction: Getting the Most Out of Life With Attention Deficit Disorder."
Is it me, or is there something peculiar going on here? Adults have taken what began as a controversial adolescent disorder and coolly co-opted it as their own, as if there were never any doubts about its legitimacy. In the '70s, when ADD drugs were first being tested, they were among the only psychotropic meds for which clinical trials involved children and teens first. The thinking was simple: The adolescent years are ones of hormonal pandemonium that make focusing on pre-calc next to impossible for many; pills like Ritalin eased the pain. In time such reasoning was applied to younger kids -- twitchy, foot-tapping 7- and 8-year-olds, too. As for adults? It was assumed that growing up meant, well, growing up, and that taking such pills would be viewed as a frowned-upon crutch. But today's revised attitude has it that the trouble one had with memorizing state capitals or grasping the quadratic formula may be similar to the trouble one has listening to that PowerPoint presentation. We are all -- or many of us are, potentially -- antsy kids spaced out in the back of the class.
How fitting.
We live in a society where it's increasingly difficult to differentiate between adults and kids. Go to a mall, squint your eyes, and see if you can tell the difference between the alarming 18-year-olds who seem 35 and the much more alarming 35-year-olds trying to pass for 18. A case can be made that recognizing adult ADD isn't so much an enlightened leap in Western medicine as a questionable evolution in a culture that recently welcomed the dubious word "adultescent" into the 2005 edition of Webster's New World College Dictionary. (This, on the heels of "teensploitation," made official in 2004.) More than anything, Medco's findings can be thought of as a small step toward the reinvention of how we view adulthood. Since time immemorial grown-ups have made a point of telling children that adulthood isn't easy -- that it's a constant exercise in (cue affectedly furrowed brows) doing things you don't want to do. But such preaching suddenly sounds archaic, doesn't it, when the same adult superpowers are now patting themselves on the back for acknowledging that those PowerPoint presentations may, like Pink Floyd's "The Wall," be a whole lot more palatable on drugs?
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