Healthcare Business News

Ethics of mental enhancement

Do adults taking ADHD medication have an unfair advantage?

By John D. Thomas
Posted: July 6, 2013 - 12:01 am ET

On a recent business trip, I grabbed a copy of the in-flight magazine and was surprised by a tease on the cover for an article inside: “ADHD in Adults.”

I always thought the disorder was limited to children, but when I turned to the article, it featured a startling statistic writ large in bold black letters: “8,000,000 ADULTS IN THE U.S. WITH ADHD.”

The article quoted a then-53-year-old graduate student who, “By the time she reached the bottom of a page in a textbook, she was not sure what she had read at the top.”

For me, that didn't pass the smell test. What she was describing was what I went through every day in graduate school. I often read passages from textbooks that didn't sink in at all, not one bit. Not even after four or five times re-reading them. But I was pretty sure why I was having these problems—I was reading a lot of very dense and esoteric deconstructionist theory that was really hard to grasp.

Even the definition of deconstruction is a brain buster: “A philosophical movement and theory of literary criticism that questions traditional assumptions about certainty, identity, and truth; asserts that words can only refer to other words; and attempts to demonstrate how statements about any text subvert their own meanings.”

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How did I deconstruct my issues with deconstruction? I had to go over things multiple times and reach out to professors and classmates with questions until I got my head around the concepts. And then I was often still pretty confused.

What did the woman in this magazine story do? She went to a doctor, was diagnosed with ADHD and was prescribed Adderall. Problem solved. The diagnosis and the drug “changed the direction of my life completely,” she exulted.

If only I had done the same thing when I was in grad school, things could have been so much easier for me. (Yes, there is a hint of attitude in that statement.)

The anecdotes in the magazine inspired me to do a little bit of research on ADHD, and I came across an interesting recent story in the New York Times. The article focused on the amazing increase in American children being diagnosed with ADHD.

According to the Times feature, “Nearly 1 in 5 high school age boys in the United States and 11% of school-age children overall have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. These rates reflect a marked rise over the last decade and could fuel growing concern among many doctors that the ADHD diagnosis and its medication are overused in American children.”

Those were some eye-popping figures. Whenever I read an article that includes those kinds of extreme statistics, I like to read the comments section to see what average Joes and Janes have to say about these issues.

The Times story had received more than 1,100 comments, which is about as many as I had ever seen on a news article. The Times now separates its comments to include an “NYT Picks” section. This was the first comment in that section: “It's highly implausible that there has been a 50% increase in ADHD in the past decade. This trend is being driven by Big Pharma, pressure from overwhelmed teachers who find it easier to teach to a drugged classroom, and now by parents and students who are seeking 'performance enhancement.' Perhaps it is time for elite high schools and colleges to 'drug test' for Adderall and Ritalin in applicants and students so that students who are not taking performance enhancing medications aren't left by the wayside.”

That was a take on the issue I had never considered, and it made me reconsider those 8 million adults with ADHD mentioned in the in-flight magazine. Do I have a right to know if someone I am competing against in the workforce is mentally enhanced in any way? It's a question fraught with ethical and privacy issues, but an interesting one nonetheless. I can definitely see a time in the near future when, just like in professional sports, doctors, lawyers, accountants and hospital CEOs are going to demand to know if their colleagues have an “edge.”

Follow John Thomas on Twitter: @MHJThomas

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