Stimulated Sheep: Adderall Use in the Office
Do you remember yourself at age six?
I certainly recall those glorious days as an era of classical romanticism. I was driven by my lust for life. My days were simple yet fulfilling. I awoke each day, added ten spoonfuls of sugar to my Lucky Charms, went for a romp in “the park”, and occasionally crapped my pants just to make adults feel awkward.
Even if your childhood was not filled with heavy underwear and sugar-highs, you must concede that it was easier to arise each morning when you were six. The anticipation of cartoons and crayons is more motivating than productivity reviews and phone conferences. It is not surprising that you do not see a high rate of stimulant abuse in six year-olds. Their lives are better than ours, and they have yet to discover casual sex and recreational drug use.
Given that your life was initiated with such an epic phase, it is understandable that you would need an extra boost to keep you motivated, focused, productive and endured at work. Caffeine formerly achieved this end, but after two-thousand skinny cafe lattes you are tolerant to the compound. This seemingly necessitates the use of more potent stimulants, and explains why an increasing number of young professionals are taking prescription amphetamines like Adderall. In this week’s Functional Friday, we will review the benefits and detriments of amphetamine use in the office.
Why sheep feel the need to get jacked-up
As Americans, we are born winners. We live in a culture driven by achievement and ambition, all under the philosophy of unlimited opportunity. As a consequence, we have average douchebags at the gym injecting steroids into each other, fratty bros sampling Viagra to emulate porn stars, and young professionals taking Adderall to stay competitive in the office.
A 2010 article in the journal Substance Use & Misuse analyzed college students’ attitudes towards amphetamine use, and it is not unreasonable to extrapolate the findings to young professionals. The most common justifications for amphetamine use were the “I’m doing it for the right reasons“, the “It comes from the medical establishment“, and the “There are no physical side-effects” arguments. This is not the forum to refute the first argument, but the last two should be addressed, because 81 percent of individuals in one survey stated that Adderall was either “not dangerous at all” or only “slightly dangerous”. Additionally, the number of American adults who were prescribed medications for ADHD increased 90 percent from 2002 to 2005.
Amphetamine salts (Adderall) are FDA approved to treat ADHD and narcolepsy. The medication can also act as an appetite suppressant, although it is not FDA approved for this indication. There is clinical evidence that Adderall improves attention, productivity, and cognitive performance while decreasing impulsivity. In conjunction, these qualities transform you into the ultimate robotic worker-drone, devoid of any personality or ability to conversate with other human beings, but amazingly adept at Microsoft Excel. Before you were tepidly grinding through your work day. Now you are an example of enthusiastic efficiency.
How it gets the job done
Amphetamine salts are sympathetic amines that act as central nervous system stimulants. They inhibit the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase their release into the extraneuronal space. In simple terms, they keep the neurotransmitters that get you jacked-up around and functioning. Coincidentally, cocaine has a very similar mechanism of action in the central nervous system.
An organ system approach will best-detail the adverse outcomes of Adderall use:
Cardiovascular: Norepinephrine and dopamine are cardiac stimulants and can also cause vasoconstriction. This leads to hypertension and heart attacks in the short-term. Chronic, daily use of Adderall has been associated with an increased risk of cardiomyopathy (“heart failure”). All of that excess stimulation causes the heart to work in overdrive, and eventually this causes it to fail prematurely. Amphetamine use is also associated with dangerous heart arrhythmias leading to sudden death.
Nervous system: The aforementioned hypertension and vasoconstriction associated with Adderall can also lead to strokes, and insomnia is an extremely common side-effect as well. The overstimulation leads to increased rates of tics/tremors, and also lowers the seizure threshold.
Gastrointestinal: Amphetamines cause decreased appetite, which is good if you have an eating disorder and bad if you are a meathead.
Psych: Adderall can induce mania and psychosis, especially in individuals with previously diagnosed mental health disorders.
Getting jacked-up in a responsible fashion
Most of the side-effects of amphetamine salts can be minimized at low doses and with intermittent use. The drug has a half-life of 10 to 13 hours, which means that half of the medicine is still floating around in your body ten hours after you took it. Adderall achieves it’s maximum concentration in your body approximately three hours after ingestion, although this can be delayed by two hours if ingested with a fatty meal. To avoid insomnia, do not take the medicine in the evening. I would also avoid taking the medicine on a daily basis, as it increases the risk for cardiomyopathy. But if you’re down for drowning in your own fluid-filled lungs, then continue to pop the pills like mints.
As a young, new physician with a small group of friends consisting of individuals with tractable morals, I am frequently asked two questions. The first: “Do you and your co-workers really have call-room orgies?” The second: “Can you get me some Adderall?” To the former, I must issue a “yes”. To the latter, I must request that you search for another shady physician to provide your uppers. The DEA is all over this column, and I’d be like a door knob in prison.