How The University Works

“There’s no way I could have kept my scholarship if I didn’t use it.”  

I’m working on a piece about undergraduate academic freedom that relates changes in campus culture to changes in the culture of schools. One area of particular interest is the medicalization of youth relations with authority. In a previous section, I discussed the 1980 introduction to the DSM IV of Oppositional Defiant Disorder (ODD).

College faculty will be more familiar with another intersection of pharmacology and curriculum, the widespread diagnosis of attention deficit and hyperactivity disorders (ADD and ADHD), and the corresponding prescription of amphetamines and cognate medicines. In 2003, six million American schoolchildren–about 15%–took methlphenidate (Ritalin) alone. Methylphenidate has replaced Prozac as the drug defining an entire cohort, with authors beginning to speak of a “Ritalin nation,” a “generation Ritalin,” and the like.

Students themselves actively seek the ADHD diagnosis. The pills have many uses related to the spectacularized culture of testing, overwork, stress, and body-consciousness–they aid in concentration, provide wakefulness, suppress appetite, assuage certain emotions, and improve athletic performance. They can be crushed and snorted or smoked recreationally in ways similar to methamphetamines. The diagnosis itself directly addresses high-stakes testing: medicated or not, ADD and ADHD-diagnosed students can request additional time in many testing circumstances.

Many more students than diagnosed use the medication: there is an active black market in Ritalin in every educational environment from primary school through graduate degrees. Students pay up to $10 a dose for “vitamin R.”

Just as thematized in the mass culture of the professional-managerial class (in tv shows like Desperate Housewives) there are widespread reports of parents using Ritalin prescribed to their children to meet the demands of their own “standards-based” existences. In families trapped in low-wage jobs, parents may also take Ritalin to meet the demands of their own working lives in the service economy or, sometimes, illegally sell it to make ends meet.

Leonard Sax reports one case of a teacher fired for stealing his students’ Ritalin. After belatedly banning amphetamines in 2005, diagnosis of Major League Baseball players with ADHD quintupled.

Though NCAA has banned “illicit” use of ADHD medications, college athletes are routinely issued “exemptions” upon showing a diagnosis, in many cases continuing usage patterns begun in high school or earlier. I have had former high-school athletes describe to me their decisions not to continue in college sport as in part a decision to stop taking medication to keep up with the demands of teams, tests, and employment.

The use of methylphenidate and related drugs has exploded in close relation to standards-based education reform (what we call “the assessment movement” in higher education). Between 1990 and 1997, production increased 700%, and two million children were using it; between 1997 and 2003, use tripled again, to six million. In recent years, the FDA has restricted some ADHD medications and required its most serious black-box warning on others, and questions have emerged about the late-90s studies urging medication over therapy. Better-designed studies have raised questions about those studies and suggest that in many cases therapy may be more effective, certainly with fewer side effects, but usage continues to soar. With the wide availability of ADHD drugs direct to children and small dealers via offshore Internet pharmacies, usage becomes more difficult to track.

A coalition across the admittedly narrow political spectrum of the United States has begun to question the relationship between educational practice & policy and medication, bringing together the readership of the New York Times with figures like Phyllis Schlafly and John Silber.

Ritalin appears on college campuses as part of the performance culture of the “winners” in the regime of high-stakes assessment. In a Youth Radio report for the PBS NewsHour, Michelle Jarboe reported on widespread use at UNC-Chapel Hill. Her own usage followed professional-managerial usage patterns: she got her pills from a boyfriend whose parents were both psychiatrists:

But I was driven to do well in school, and couldn’t see my way through all the papers, tests and projects on two or three hours of sleep a night. That is, until I encountered my friends’ little pills. Sometimes they were free, and sometimes a single pill could cost as much as seven or eight dollars. Whatever the cost, the returns were amazing.

Her report and similar reports in campus newspapers across the country closely align black-market use of attention-deficit medication to being “driven to do well.” Many users are individuals who won’t use other drugs, such as ectasy or even marijuana. Those with prescriptions for the pills report being deluged with requests from friends (or customers) at exam time and resorting to stockpiling

Much of the journalism, official campus and other institutional discussions of the issue (such as the Bush administration’s Department of Education page) emphasize the voluntary nature of the use of nonmedical prescription stimulants, almost universally raising the specter of recreational use–as the Bush DOE says, seeking wakefulness to continue studying “or partying.”

While student respondents acknowledge this use, overwhelmingly the main use is to keep up with work or performance pressure in a high-stakes culture. “I don’t think I could keep a 3.9 average without this stuff,” said one high-achieving college student (Jacobs, NYT). Another report shows that continuous assessment of scholarship recipients leads to usage: “I don’t know what I would do without it,” said another. “There’s no way I could have kept my scholarship if I didn’t use it.” (Stice).

Performance-culture users report that taking the pills made them feel “normal” in their pressured world. One of Jarboe’s interviewees, who took Adderall with her study group says, “The whole time you’re on it, you just feel like that’s the way things are supposed to be. You feel like it’s gotten you normal.”

In these accounts the medication is a precision tool, helping to more closely engineer the mind and bodies of the already performance-oriented to an even tighter fit with their high-performance educational environment. “I remember everyone sitting around and thinking, “You know, maybe we all have ADD, because this stuff makes me feel great, like I don’t feel weird. I feel like I want to do my work.”

A New York Times reporter who interviewed two dozen Columbia students concluded that attention-deficit drugs were part of the “prevailing ethos,” seen by high-achieving straight-arrow college students as “a legitimate and even hip way to get through the rigors of a hectic academic and social life,” quoting one student who said that Columbia’s culture “encourage’s people to use stimulants” to keep up, while recreational use was “generally frowned upon” (Jacobs).

Another college journalist interviewed a typical user who said, “I don’t know that many kids that have done coke, none that have tried crack, and only a few that have dropped acid. I can’t even count all of the ones who’ve taken Adderall.” (Stice)

The normalization of prescription stimulant abuse in collegiate performance culture, athletic and scholastic alike, points to a significant transformation in subjectivity, in the role that the pressured, high-stakes culture of schooling and assessment plays in the formation of personality, values, and behavior.

The “Ritalin generation” is adopting the drug that best suits the disciplinary and spectacular matrix of their lives, framed by performance culture, high-stakes assessment, and vocational schooling–schooling for the purpose of work.

What other drug can help a student display themselves simultaneously as physically fit, academically high-achieving, alert and confidently in command of high-stakes circumstances?

Late 1990s studies found college student abuse of prescription methylphenidates and dextroamphetamines in the 5-10% range and a large 2001 study of four-year schools found lifetime nonprescription use of these medications close to 7%, while more recent studies found usage ranging up to 20% on individual campuses.

Several studies have found that college students are more likely to abuse these drugs than “noncollege peers,” and the 2001 study found that usage rates tended to be higher at colleges with more competitive admissions, and in fraternities and sororities.

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