Who Gets To Decide If You ‘Take Your Pills’?
WHEN Eben Britton received a prescription for Adderall along with a diagnosis of attention deficit hyperactivity disorder (ADHD), the former NFL player’s wife says in the new Netflix documentary “Take Your Pills,” she believed he had “a medical issue that was being treated.” By contrast, when she and her friends used Adderall as a study aid in college, “I looked at it basically as abuse.”
Those clashing views of the prescription amphetamine mixture reflect our culture’s ambivalence toward drugs that affect mood and cognition. With a few historical exceptions that straddle work and play, Americans prefer to treat psychoactive substances as medicines, dispensed only with clearance from a doctor who certifies that we need them. ADHD, a fuzzily defined “mental disorder” that many critics think is overdiagnosed, plays havoc with the false assurances of that approach.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, ADHD is “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.”
At least some symptoms are supposed to appear by age 12, but ADHD isn’t just for kids anymore. While some 6 million American children (nearly 1 in 10) have been diagnosed with ADHD, the vast majority of people taking ADHD medications like Adderall, Ritalin and Vyvanse are adults.
This raises a couple of concerns highlighted by “Take Your Pills.” Are too many kids taking the pharmaceutical equivalent of speed? Are adults pretending to have ADHD so they can get drugs to boost attentiveness and productivity? The answer to both questions is probably yes, although it’s hard to figure out the “actual” incidence of a condition that cannot be objectively verified.
To her credit, director Alison Klay- man presents a range of views on the pros and cons of stimulants for children. One mother, an African-American special-education teacher who was convinced that ADHD drugs were used far too readily as “an instant cure” for the behavior problems of “little black boys,” adamantly rejected them for her son. He is now a musical artist manager who takes Adderall, saying it “definitely does help you to be a better capitalist.”
Another mother thinks her son might not have finished high school without the Adderall he began taking in third grade. Now a college student and a budding artist, he’s angry about all the pills he had to swallow, even while acknowledging they helped him focus.
The people in the documentary who continued or began taking prescription stimulants as adults generally report that the drugs did what they were supposed to do, helping them excel in school and at work.
“Side effects may include being awesome at everything,” jokes a software engineer, who says his professional achievements would’ve been impossible without Adderall. “That might be because I have really severe ADHD and have a hard time performing in the ways needed, or it might be because it was jet fuel and it got me where I needed to go. I don’t try to draw a line between those.”
The question is whether anyone needs to be drawing that line. Although the law pretends otherwise, drug use that improves someone’s life, whether by helping him produce or by helping him unwind, doesn’t become “abuse” in the absence of a doctor’s note. Why not let adults make their own decisions about whether the benefits of drugs like Adderall outweigh the risks?
“Take Your Pills” plays up the risks, but the results are less than terrifying. “Most people can use amphetamine without becoming addicted,” concedes Lawrence Diller, a pediatrician who wrote a book about Ritalin. “But ultimately, too large a group of people become addicted, so it becomes unacceptable for society to put this much speed out there.”
In 2016, according to the National Survey on Drug Use and Health, 18.4 million Americans used prescription stimulants, both legally and illegally. Based on their responses to survey questions, about 3 percent of them experienced a “substance use disorder.” The corresponding number for drinkers was 9 percent.
Even more than addiction, “Take Your Pills” invites us to worry about the “hypercompetitive order” that pushes people toward stimulants, which UC-Berkeley political theorist Wendy Brown thinks may deprive us of “creativity, art [and] extraordinary moments of human connection.”
But these are quintessentially personal matters best left to the individuals directly concerned. As an Adderallassisted college student interviewed by Klayman says, “It’s kind of just a balance you have to figure out.” Jacob Sullum is a senior editor at Reason and a syndicated columnist.
It’ s hard to figure out the“actual” incidence of ’ a condition that cannot be objective ly verified.