Pubdate: Wed, 13 May 2015
Source: USA Today (US)
Copyright: 2015 USA TODAY, a division of Gannett Co. Inc
Contact: http://mapinc.org/url/625HdBMl
Website: http://www.usatoday.com/printedition/news/index.htm
Details: http://www.mapinc.org/media/466
Author: Lawrence Diller
Note: Lawrence Diller, M.D. practices behavioral pediatrics in Walnut 
Creek, Calif. His latest book is Remembering Ritalin.

WHEN WILL AMERICA JUST SAY NO?

Our love affair with prescription amphetamine is hard to quit

I've decided to create a new psychiatric disorder. Why not? Drug 
companies do it all the time. Shire, which makes Adderall, won 
approval recently from the Food and Drug Administration to market its 
amphetamine drug Vyvanse for the treatment of BED. You haven't heard 
of it? Neither had many people, until Shire funded studies to get the 
bingeeating disorder into the DSM-5 - America's official psychiatric 
bible of common life dilemmas translated into mental disorders. My 
disorder is called achievement anxiety disorder (AAD), and it 
explains the increasing reports of prescription amphetamine misuse, 
most often in the form of Adderall abuse.

Just what is achievement anxiety disorder? Like all psychiatric 
conditions, there are no blood tests or brain scans to make the 
diagnosis. But you can see it all around us - frantic people working 
ever harder to achieve a certain level of material satisfaction and security.

STRUGGLE FOR SUCCESS Because of our country's declining position as a 
global economic empire, along with a widening gap between the 1% and 
everyone else, Americans must now work harder and make more money 
just to maintain the same standard of living our country enjoyed 40 
years ago. And while the U.S. has produced astounding successes, that 
history has left many Americans doubting their own abilities, 
striving to do more and turning to drugs to cope.

A once-personal struggle for self-acceptance and success has turned 
into contagious angst about a collective failure to live up to our 
dreams. Today's Millennial generation is the first group of Americans 
since World War II who will not live as well as their parents did. 
Our young adults who are turning to Adderall are the stark casualties 
of this broken cultural norm that makes happiness difficult to achieve.

Adderall is not a new drug. Amphetamine (legal and illegal) has been 
around since 1929 and has repeatedly found its way into society for 
use in treating depression, asthma, narcolepsy, weight control and 
now attention deficit hyperactivity disorder, ADHD - or ADD (without 
hyperactivity).

Doctors invoke ADD as the most current reason to prescribe a chemical 
that, in the short term, makes anyone who takes it more alert, more 
methodical and more likely to complete tasks that are boring or 
difficult. There is no evidence in either children or adults that 
taking Adderall has longterm benefits.

Rampant Adderall use is a clear sign of our nation's epidemic of ADD 
or AAD. According to the Drug Enforcement Administration, in 2013 
U.S. manufacturers of prescription stimulant drugs produced 211 tons 
of legal speed. This translates to more than two dozen 20 mg Adderall 
pills for every U.S. man, woman and child. While our country makes up 
less than 4.5% of the world's population, it produces 70% of its amphetamines.

SHOPPING ON SILK ROAD

Our ADHD/ADD epidemic is the official reason for our love affair with 
legal amphetamine. But experts estimate that nearly a third of the 
stimulants prescribed in the U.S. are diverted for illegal use. Any 
college student can tell you how easy it is to obtain Adderall during 
exam time. Knowledgeable Internet surfers go to the "dark side" and 
find sites such as the Silk Road, where Adderall is openly sold and traded.

However, we can't just blame drug companies and drug dealers. In any 
epidemic, one must not only examine the qualities of the virus but 
also consider the qualities of the host. AAD is part of our national 
character. Author Horatio Alger and fictional men Jay Gatsby and 
Gordon Gekko chronicle how fundamental AAD is to the American ethos, 
though, as far as I know, none of them used Adderall.

Our relentless pursuit of material acquisition is our unofficial 
state religion. Nothing short of a natural or social catastrophe is 
likely to change our values. But at some point, our use of Adderall 
is certain to peak and then crash. It's a historical inevitability, 
with at least three waves of doctor prescribed amphetamine abuse in 
our country's past. The last was in the 1970s, when dieting women 
became addicted. Doctors were sued and lost their licenses, and the 
practice stopped.

This time is different. There are mega Fortune 500 companies making 
$9 billion a year by selling legal stimulants. Their influence over 
federal regulatory agencies makes it unlikely Adderall use will 
decrease any time soon. Unfortunately, many more young adults will 
become addicted, and some could die before America says no (again) to Adderall. 
- ---
MAP posted-by: Jay Bergstrom