Smart Drugs: Penn Professor Martha Farah Speaks to Students about Adderall and Ritalin

How do stimulants work? What is their effect on the body, both long term and short term? In Provost Tower on Wednesday, March 13, Professor Martha Farah answered such questions and led a discussion about the nonmedical use of stimulants, or “smart drugs,” like Ritalin and Adderall. Farah, the Annenberg Professor of Natural Science and Director of the Center for Neuroscience and Society, said that according to data collected in 2001, 7% of students have used a stimulant nonmedically in college. This number has likely increased since then. Some factors that increase the frequency of use by the student body include Ivy League or elite institutions, coastal location and fraternity members. “B” students are more likely to use smart drugs than “A” or “C” students due most likely to a desire to excel without having to sacrifice extracurriculars and other activities. On some campuses, usage rates are as high as 25%.

Many people think of drugs like Adderall and Ritalin as cognitive enhancers but Farah debunked this myth. She explained that their main effect is to keep the user awake and improve his or her attitude. Thus, it is mainly a motivational factor, especially because it improves one’s evaluation of their own work while they are under the influence. These drugs work by directly acting on dopamine neurons, which, due to their role in the reward pathway, also give the user a high. This makes such drugs carry the risk of dependence for nonmedical users. Medical users, like patients with ADHD on the other hand, tend to bear less risk of addiction. In patients with ADHD, Farah said “drug treatment seems to do nothing but help patients.”

It is difficult to study the long term effects of stimulant use but Farah said that for the most part, long-term use is probably fine for medical users. Nonmedical users on the other hand bear the risks associated with self-medicating and dependence. She explained that “1 out of 10 non-medical users of stimulants have symptoms of physical dependence.” Despite advocating for medical Adderall and Ritalin use, she did mention an animal study that showed shorter swim times for adult rats using those drugs long term. This is a sign of decreased psychological health. Such risks are due to the effects of dopamine which include not only focusing attention but possibly schizophrenia and psychosis as well.

Despite knowing much about the different studies done on Ritalin and Adderall use, Farah was unable to come to many concrete conclusions about long term their effects. This is due to many factors including the difficulty of determining who actually has ADHD (“There is no lab test,” Farah said) and the self-selection inherent in experiments on long term stimulant users. The short term effects of dopamine, which is increased in concentration by stimulants, are much easier to determine. One of the main purposes stimulants are used for is to fight off sleep; Farah said this is terrible because sleep deprivation is not only bad for memory consolidation and mood, but it is bad for the immune system and related to cancer as well. Stimulants also have the possible side effects of heart attack, sudden death and psychosis. Farah described the nonmedical use of Adderall and Ritalin as “playing a little bit of a Russian roulette.” With millions of people addicted to a weaker stimulant, caffeine (which acts indirectly on dopamine neurons), where is the line drawn between acceptable and unacceptable stimulant use? What is risk is staying awake worth? Farah, despite being a long time coffee drinker, exclaimed that is much safer to just “get your eight hours of sleep!”

Robbed by the One – Armed Bandit

Over the course of evolution, our brains have adapted to try and predict the outcomes of certain events. We make predictions, compare them to what actually happens, and then learn from error and adjust. When we make correct predictions, our body possesses a mechanism to ensure that we continue to do so: the reward areas of our brain. The brain’s reward circuitry releases the neurotransmitter dopamine, the chemical responsible for the pleasures we feel from sex, drugs, alcohol, music, chocolate, love, and even gambling. If we receive a positive outcome as a result of our actions (reinforcement), then we will repeat our behaviors.

The more “off-target” that our predictions are, the faster we will learn because as a species, we don’t like to be wrong. In fact, human beings do not like being wrong so much, that the fear of losing can be considered even greater than the pleasures of winning. Loss-aversion is a key factor that drives our everyday decisions; we are much more willing to settle for a lesser, guaranteed reward, than a reward of greater magnitude for which there is a risk of losing. So it is within the boundaries of human nature to avoid losses at all costs…with the exception of one circumstance: the “near-miss”.

What is a “near miss”? Imagine yourself in front of a slot machine, pulling the arm, as you’re watching the colors of each of the characters whiz by in a blur. Bing...Bing...Bing. You’ve managed to match two pictures in a row, but the third one is just one away from the desired spot, and now you’re itching to try for it again. That is a “near miss”. “Near misses” are extremely addictive, because they raise activity in the exact same reward circuitry of the brain as wins do (perhaps suggesting that if the behavior continues, a win is soon to follow). Wins activate reward pathways in the midbrain, as well as losses that could be considered a “near-misses”. People will continue to return to the slots after a near miss due to a sense of reward, leading to addictive behavior. For problem gamblers, the activation of these specific brain areas is even more enhanced than in casual gamblers.

Our evolutionary flaw is that, while the brain is efficient in most circumstances, it will try desperately to fit occurrences of “random chance” into a predictable model, striving to figure out explanations for what there is simply no explanation for. Unfortunately, this makes our brains fully capable of misinterpreting information, and so we may be fooled into making a decision that is not logically sound, overwhelmed by a rush of emotion from dopamine.

“Although near-misses while playing a slot machine felt less pleasant than wins, they increased the desire to play just as much as long as players felt they had some control over their spins—supporting the idea that the illusion of skill underlies the phenomenon,” says Luke Clark of the University of Cambridge. People who play the lottery or stock machines often confuse phenomena resulting from pure chance (wins/losses) with those that are caused by personal skill and ability. The key here is that the gambler believes that he is at least partially in charge: that some type of his personal skill is involved. This convinces gamblers to try their luck, even after several consecutive “near-misses”.

Think about it. This is essentially the power to convince someone, at least at the neurological level, that they have won without actually letting them win…a dangerous idea, but a reality that has not gone unnoticed by business. Businesses (particularly casinos) and slot-machine makers actually use virtual reels to create a high number of “near-misses”. While your neurons desperately attempt to decode the “logic of luck”, you keep emptying your bucket, feeding the one-armed bandit more quarters...business is booming.

It is common belief that emotions derail us from logic, inhibiting us from our ability to reason. Yet, without emotion we would be indecisive, forced to analyze every possible option. Emotions may provide us with the impetus to make our decisions, but when our emotions are out of control, perhaps we are just as good without them.

To read more click this link:

http://www.newsweek.com/2010/05/11/hit-me-again-the-gambling-brain.html