ExtendedEssay

Subject:Psychology

Question:Towhatextentdoesthenonmedicaluseofprescriptionstimulantsimproveacademic
performanceandconcentration?

Session:_______

CandidateNumber:____________

WordCount:


Abstract
Towhatextentdoesthenonmedicaluseofprescriptionstimulantsimprove
academicperformanceandconcentration?

Thispaperexploresthepotentialofferingsand
tendencytousestimulantsasamethodoffocusforacademicimprovementandincreased
satisfaction.Thispaperbeginsbyexplainingwhatstimulantsareandexplainingtheprocessthat
stimulantsworkbyreleasingneurotransmitterssuchasdopamine.Asthepaperprogresses,
nonmedicaluseisdefinedandexplainsthevariousbrandedstimulantsthatareused
nonmedicallyinaneducationalenvironment,whichareusuallyonlyusedtotreatdisorderssuch
asADD/ADHDandnarcolepsy,andhownonmedicalopposestheproperuseofprescription
stimulants,asthepreciseamountofstimulantsprescribedisdoneinrelationtotheseverityof
thedisorderandobservedreactiontothestimulant.Thepaperalsoexplainstheconceptofusing
stimulantstoachievebaselinestimulationinthebrainthatallowsforapersonwithadisorderto
concentrate,andhownonmedicalusecanresultinoverstimulationandsometimesseverelong
andshorttermsideeffects.
Thepaperthenexplainstheprocessofstressandstressors,andelaboratesfurtherto
explainhowstressorstriggerastressresponseinanorganism,aswellasmentionastudyofthe
topsourcesofstressreportedbycollegestudents.Next,thepaperconsidersthestressorsthat
collegeanduniversitystudentsexperienceduetoanincreasedworkload.Thesestressorsfurther
causestudentstobelievethatstimulantsaretheironlyoptionforacademicsuccess,andtherefore
beginuseduetoincreasedstressandpeerpressure.


Introduction
Thehumanbrainisthecontrolcenteroftheentirecentralnervoussystem.Itisthereason
whyareabletocontrolourownbodiesand
whyweareabletomovearoundourenvironmentin
aadaptablemanner.
Asourintelligenceconstantlyandrapidlyevolves,theaccesstoharnessed
technologyismuchmoreaccessiblethanitwasyearsago.Albeittechnologicaladvancements,
humanbeingsaresubjecttomistakesandstressfulexperiences.Insocietythatconstantlypushes
towardsdeadlinesandbringsuponimportantexpectations,manyhavesearchedformental
enhancementinamedicinalmedium,especiallyfocusedtowardsacademicsituations.Thereare
veryfewdrugsthatenhancecognitivefunctionsinthemethodsdesired.However,therearesome
drugsintheUSmarketthataredubbedassmartdrugsornootropics.Smartdrugsare
classifiedasdrugsthatenhanceretentionofinformationwithoutpotentiallyharmfullongterm
sideeffects.Thesedrugsareappearingandappealingmoretowardscollegeyouth.Studies
conductedbyAmeliaM.Arriaandcoauthorsshowedthatwhenabroaddefinitionof
prescriptionstimulantswasimplemented,25%of1,253firstyearcollegestudentshadreported
usingprescriptionstimulantswithinthelastyear.1Duetoasurprisinglylargeoutcome,the
questiontowhetherthesestimulantshelpstudentsperformbettercomesintoquestion.
Towhat
extentdoesthenonmedicaluseofprescriptionstimulantsimproveacademicperformance
andconcentration?
Tounderstandwhycollegestudentsuseprescriptionstimulants,onemustdefine
stimulantsandtheirdesiredeffects,andpotentialsideeffects.Onemustalsoanalyzethemost

commonprescriptionstimulantsusednonmedically,whateffectsthesestimulantstypicallyhave
onregularcollegestudentsandthedefinitionofnonmedicalconsumption.Onemustalso
defineastressorandmustlookatthestressorsthatstudentsregularlyencounterandthe
correlationinbetweenincreasedstressandthedecisionprocesstononmedicallyuse
prescriptionstimulants.
Stimulantsandtheireffects
Astimulantisapsychoactivedrugthatusuallyincreasesactivityofthenervousand
cardiovascularsystems.2Stimulantscontainabroadvarietyofdrugsthathavevaryingtoxicity
andeffects.Thisclassofdrugsincludescaffeine,cocaine,nicotine,methamphetamineand
MDMA3However,thedrugsthatareconsideredinthisstudyassmartdrugsare
amphetamine,(Adderall)methylphenidate(Ritalin/Concerta)andmodafinil.(Provigil)4 These
drugsarelegalwithaprescription,andaregenerallyusedastreatmentforpatientswith
ADHD/ADD(attentiondeficithyperactivitydisorder/attentiondeficitdisorder)andnarcolepsy.5
ForapersonwithADHDornarcolepsy,thesestimulantscanbeusedtoincreasefocusand
reducehyperactivity.
Dopamineisoneofthemostimportantneurotransmitters.Althoughveryimportant,very
fewneuronscreatedopamine,whichiswhyitisespeciallynecessarytoretain.Itisreleasedfrom
thepresynapticneuronsvesicles,andpassesthesynapsetohitreceptorsthatsendasignalinto
thenextneuron.6Dopamineisactivatedasarewardsystem,andmakestheorganismfeel
satisfiedandpleasurableatsomethingtheyhavereceivedorhaveseen,suchasreceivingfood,

finishinganassignmentandgettingaperfectgrade,orhavingtheabilitytorelaxbywatching
television,spendingtimewithfamily,and/orbrowsingtheinternet.Anythingthathastodowith
arewardingandrelievingfeelinghastodowithdopamine,buttheneurotransmitteralso
contributestotheabilitytocontrolthemusculoskeletalsystemwiththemind7,theabilityto
movefreelythatmanymayneverconsideroracknowledge.Moststimulantscausethereleaseof
excessiveamountsofdopamine,thereforecontributingtothehighriskofaddiction.
Whenaprescriptionisgivenforastimulant,thepatientmustbediagnosedbyacertified
healthphysiciantohaveADD,ADHDornarcolepsy.Ifthepatientisdiagnosedandtheseverity
ofthedisorderisunabletobemaintainedusingtherapy,thepatientisthenprescribedavery
preciseamountofstimulantstobetakenorallyeachday.Thedosagecanvaryfrompersonto
person,dependingonthedosageneededtoallowforabaselinestimulationofthebrain.When
theseprescriptionstimulantsareusednonmedically,theyareusedinwaysthatareinconsistent
withtheprescribingphysiciansinstructions,suchastakinghighdosesoranyother
consumptionsuchassnortingorinjectingthestimulant.Althoughrare,injecting
amphetamineormethylphenidateisextremelydangerousasitisacardiotoxicdrug,andhigh
doseshavereportedtocausecardiacarrestandstrokes.
Amphetaminesincreasestheconcentrationofdopamineintheneuronandaresimilarin
structuretodopamine. 8Therefore,amphetaminescanentertheneuronandforcedopamineoutof
storagevesicles.Thisprocessworksbyvirtuallyreversingdopaminetransporters,andcausesthe
expelleddopaminetospreadoutinthesynapticgap.9 Amphetaminesalsoreducethereuptake

ofdopaminebypluggingthetransportermolecules,whichholdsdopamineinthesynapticgap
andvesiclesathighlevels.10
Adderall,Ritalin,andProvigilareknowntobeaddictiveregardlessoftheirvarying
chemicalstructures,astheyareallusedfortreatingdisorderswithoverstimulationor
understimulationofthebrain,andarestrictlyprohibitedbyfederallawtosharewithothers.11
Commonsideeffectsreportedarestomachpain,weightloss,moodswings,fastheartrate,
headacheandinsomnia.However,abuseofthemedicineorabadreactioncancauseseriousside
effectssuchaschestpain,troublebreathing,hallucinations,seizuresandchangesinvision.12
Thesesideeffectsseemdangerousuponfirstglance,butthesestimulantsaretemporarysafe
havensforthosewithADHD/ADDornarcolepsy.Prescriptionstimulantsdopromote
wakefulnessnomatterwhousesthem,butdoesnotenhancethoughtwhentakenbythosewho
donothaveADHD.
Stressors
Stressisacommonresponseofthebodythatoccursduetoathreateningsituationor
adaptionofchangingconditions13,whetheritbealifethreateningeventortheinabilitytomakea
simpledecision.Somepeopleareaffectedvisiblyduetostress,whileothersmayhavelittletono
visibleeffects.Itisabiologicalprocessthathappenstoallorganismsthatisadefense
mechanism,andforhumansitcausesthereleaseofadrenalineandcortisol14,thatcanprovidean
instantaneousrushofenergytoescapeadangeroussituationandremainfocused.15Astressor

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simplytriggersthestressresponse,whethertheagentisbiologicalorchemical.Astressorcould
beenvironmental,inwhichbrightlightsorloudnoisescausestress,oralifestylemodification
suchasmarriage,divorce,orhavingafamilymember/closefriendpassaway.16 Stressrelatingto
educationisalmostalwaysduetostresstriggeredbylifestylechangesorasocialstressor,in
whichsocietyhashighexpectationsandisconstantlydemanding.Thisisdefinitelythecasefor
manycollegestudentsastheyracetowardsdeadlinesandstudyconstantly,whilealsopressured
totendtononacademicactivitiesinyouth,suchasmaintainingasociallife.
TheStudentStressSurveywasusedinastudyconductedbypsychologicalauthorsand
professorstodeterminethemostcommonsourcesofstressamongcollegestudents.100students
wereconfrontedwithamultitudeofpotentiallystressfulsituations,andaskedtoratethese
situationsinimportance.17
Itwasfoundthatthetopfivesourcesofstresswere
changeinsleepinghabits,
vacations/breaks,changeineatinghabits,increasedworkload,andnewresponsibilities.
College
freshmanwerereportedtobeparticularlypronetostress,duetothetransitionalnatureof
collegelife,18Manystudentsreportedthattheymustadjusttobeingawayfromhome
maintainahighlevelofacademicachievement,andadjusttoanewsocialenvironment.19The
sourcesofstressreportedareallduetotheadaptationofacollegeenvironment,andthreeoutof
thefivestressorsaremostdefinitelylinkedtowardsacademicshiftsandworkloadincreases.

Reasoningofstimulantuse

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Duetoanenvironmentwhereworkloadappearstobeendlessandconstant,thereare
manystudentswhofallunderextremelystressfulsituations,constantlyattemptingtobeat
deadlines.Manystudentsconsidernonmedicaluseofprescriptionstimulantsasafoolproof
methodtopowerthroughschoolworkandincreaseconcentrationlevels,whichiswhy
prescriptionstimulantssuchasamphetaminesandmethylphenidatearebecomingincreasingly
popularforcollegestudents.Cognitioninvolvesmemory,attentionandanimportantprocess
calledexecutivefunctions,whichdealwithreasoning,planning,anddirectingattentionto
informationthatisrelevant.Executivefunctionsalsoallowyoutomakedecisionsandavoid
regrettableactions,whichisthebasisformorality,shapedbysocietalfunction.
Smartdrugsareusedbymanycollegestudents,butdoescauseaquestiontoariseabout
whetherstimulantsusedinanacademicenvironmentcancountasacademicdishonesty.Dueto
thisuncertainty,manypeerswillputpressureontheirpeerstodolikewise,toavoidbeingata
competitivedisadvantage,thereforecreatingachainofinfluencearoundcollegestudentsthat
risestheexpectancytononmedicallytakeprescriptionstimulantsinordertoperformwell.
Stimulantuseamongstcollegestudentsandmythsversusrealities
The2009NationalSurveyonDrugUseandHealthreportshowsthatfulltimecollege
studentsweretwiceaslikelyastheircounterpartswhowerenotfulltimecollegestudentsto
haveusedAdderallnonmedicallyinthepastyear,Althoughthismayseemlikeaviableoption
tomany,theuseofthesestimulantsmaycauseachangeinthedecisionmakingprocessinthe
frontallobe(orbitofrontalcortex)ofthebrain,anareathatprocessesmemoryandtheabilityto
makedecisions,eventuallyrenderingthebrainsabilitytomakejudgementbasedonpast
experiencecorrupt.StudiesconductedbytheUniversityofMarylandSchoolofMedicineandthe

NationalInstituteonDrugAbusepublishedexplainstheneurologicalpatternsresponsiblefor
substanceabuseandaddiction,whichcausesseveredeficitsinjudgementsandbaddecision
makingonthepartoftheaddict.ThisstudyisprovenbytheNSDUHreport,showingthat
fulltimecollegestudentswhononmedicallyuseAdderallnonmedicallywere3timesaslikelyto
haveusedmarijuanainthelastyearincomparisontothosewhohadnot(79.9%vs27.2%)and
8timesmorelikelytohaveusedcocaine.(28.9%vs3.6%)Itwasshownthatalthough
Adderallcanprovideafeelingoffocusandabilitytoconcentrate,thesebenefitswerenullifiedas
nearly90%offulltimecollegestudentswhousedAdderallnonmedicallywerebingealcohol
users,apotentmixofastimulantandadepressantwhichcancauseseriousdamagetothebrain
longterm,anddoesnothelpastudentbecomemoreacademicallyinclinedanyfurtherthana
stimulantsuchascocainehelpsinanacademicsituation.
WhenanADHDpatientisgivenastimulantsuchasAdderall,itisusedtocontrolthe
overstimulationoccurringinthebrain.Theywillalmostinstantlydropintounderstimulation,
thengraduallyreachabaselineofnormalstimulationthatallowshimorhertoconcentrate.20
However,whenapersonwhodoesnothaveanydisorderusesAdderallnonmedically,itplaces
themfromanormalstimulationleveltooverstimulation,resultinginpleasureablerushesand
increasedprobabilityofaddiction.Allstimulantsusedassmartdrugs,including
methylphenidateandmodafinilaswell,affectthebodyinasimilarwaydependingonthe
existenceofadisorder.
Theprefrontalcortexofthebrainwherethoughtprocessesandcognitionislaidout,anda
lackofchemicalinfluencescausesafeelingoftiredness,stressanddisinterest,especiallywhen

20

oneisburnedoutfromconstantclassesandhomework.Stimulantslistedassmartdrugsare
usedtorestorefunctionandincreasechemicalinfluences,inanattempttorestorefunctionssuch
asconcentration,whichallowstheprefrontalcortextoextenditsbaselinestatewithouttheneed
forrest.Smartdrugsareusuallycomparedtosteroids,howeveritisacommonmisconceptionas
steroidsallowsforthebuildingofmoremuscle.However,usingprescriptionstimulantswill
notmakeonesmarterthanbefore,butwillsimplyoptimizepartsofthebraintoremainina
baselinechemicalstate,thusmakingonebelievethattheyhavetheabilitytoconcentrateand
learnmorethanbefore.
Althoughstimulantshavebeenstudiedfordecadesandourunderstandingofhow
stimulantsworkwasmuchgreaterthanbefore,wearestilluncertainaboutmanyoftheeffects
thatstimulantsusedassmartdrugsdotothebrain,andtheeffectsofthesestimulantscanrange
frompersontoperson,dependingontheirbrainschemicalmakeupandmentalstability.Whilea
personcouldtakeAdderallnonmedicallyandfeelfocusedandalert,itmaybeacatastropheif
onetookthesamestimulantandhadrecentlybeendiagnosedwith,forexample,schizophrenia.
Sincewecannotuncovermanyofthesymptomsthroughlabtestingonmiceorrats,manyofthe
unansweredquestionswillremainunanswered.However,itisworthnotingthatastudyrunby
researchersattheUniversityofSussexshowedthatevensubstancessuchasnicotinecould
improveperformanceonmemoryexaminationsinyoungadultswhocarriedonevariantofa
particulargenebutnotinthosewithadifferentversion.Anotherstudyshowedthatalthough
modafinilimproveperformanceinagroupwhosemeanIQwas106,itdidnotinagroupwith
anaverageof115.Therefore,thereisevidencetoshowthatthemoreintelligentthatyouare,
thelesseffectsarefeltusingstimulants,andforsomestimulantsmaynotaffectconcentrationat

all.Therearefactorstakenintoconsiderationthatwouldgiveoneapredictionofhowonewould
operateonstimulants,butwouldbetakenwithagrainofsaltasthesepredictionswouldnotbe
100%certain.

Conclusion
Althoughtheuseofprescriptionstimulantshavebeenproventoimprovefocusamongst
users,itisshownthatstimulants,especiallythosebrandedassmartdrugs,cannotincrease
intelligence,butrathercreateanoptimalchemicalmindsetinthebrain,thatgivesusersthesense
thattheyareabletoconcentratemore,andcancausestudyingtofeelmoreenjoyable.However,
theeffectsvaryfrompersontoperson,especiallywhenthepersonusesastimulant
nonmedically.However,onemustkeepinmindthatthenonmedicaluseofstimulantssuchas
amphetamine,methylphenidateandmodafinilcanbeverydangerousandhaspotentialserious
sideeffects.Usinganysortofdrugnonmedicallyormixingstimulantswithdepressantssuchas
alcoholcancausebraindamageandinseriouscases,evenfatality.Itisalsoproventhat
stimulantsareineffectiveastheintelligenceofthepersonrises,andhasfartoomanyriskstobe
usedsafelyasanonmedicalsupplement.Therefore,stimulantslabeledassmartdrugsshould
onlybeusedtotreatdisorderstomaintainatemporarybaselinelevelofbrainstimulation,to
promotewakefulnessandconcentration.Althoughprescriptionstimulantsmaybeusedasa
meansofstudyingbetterorrelievingstress,itisalmostalwaysusedimproperlyifnotprescribed
andcancauseaddictionlateroninlifeandhealthconcerns.Prescriptionstimulantsshouldbe
consideredasdrugsandshouldbeusedsparinglyonlyifprescribed.

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