Dr. Harold Urschel, chief medical strategist of Dallas-based Enterhealth and author of the New York Times best-seller Healing the Addicted Brain, on the implications of using “smart drugs” to improve performance
As students wrap up semester-long projects and cram for final exams, more and more students are turning to “smart” drugs to boost their brain power. Drugs like Adderall and Ritalin, generally prescribed for attention-deficit hyperactivity disorder (ADHD), are being used by students to help enhance their memory, concentration, alertness, attention and motivation.
But even just taking a cognitive-enhancing pill once can have negative effects, according to Dr. Harold Urschel, chief medical strategist of Dallas-based Enterhealth and author of the New York Times best-seller Healing the Addicted Brain.
“If you have ADHD, your body has a natural neurochemical imbalance, which can be resolved with prescribed stimulants like Adderall, Ritalin or the narcolepsy-drug-turned-smart-drug Modafinil,” Urschel says. “Without the pre-existing brain chemical imbalances these drugs treat, like ADHD or depression, they become powerful stimulants that affect your body either similarly or exactly the same way methamphetamines does, which is terrible for your brain.”
Unfortunately, most students don’t understand the implications of using smart drugs to improve their performance. According to a recent study, one in five students at an Ivy League college misuses a prescription stimulant to get ahead academically, and more and more high school students are turning illegally to these study drugs.
Urschel sat down with Renew to talk about what to say, how to begin the recovery process for healing an Adderall addiction, as well ways providing recommendations for natural ways of dealing with stress.
Renew: Who are you, and what do you do?
Harold Urschel: I am a board-certified addiction psychiatrist. I have a company in Dallas called Enterhealth, a drug and alcohol addiction treatment company offering the full continuum of care. Our goal is to create a treatment program where you take the latest scientific research and put it into the clinical setting. We apply the science to the treatment of addiction. We’re not an Alcoholics Anonymous-based model. We’re a science-based model. I published a best-selling book, Healing the Addicted Brain, which takes the latest science on addiction and summarizes it in lay speak.
Renew: What are “smart” drugs, and how did you get interested in their use and abuse?
HU: Smart drugs are the medications that students are using inappropriately to study for exams. Smart drugs, like Adderall and Ritalin, are nothing more than meth. They help you focus. They release neurotransmitters in your brain so you can focus for 12 hours. They make your appetite go away. You don’t need any sleep, so you can cram for a test. You can write that really long paper you’ve been putting off.
Smart drugs are FDA-approved to treat ADHD. ADHD is a medical disease. It’s a real problem to have. But when you take these medications, it brings your wiring back online. You can focus and concentrate. When you have the disease and you take these medications, they’re safe for your brain. Not only does it not hurt your brain, but you have a much lower chance of getting addicted to anything. Most people with ADHD don’t want to be on these medications. They don’t get a high from them.
But if you don’t have ADHD, they can be extremely corrosive to your brain. It can cause brain injury and addiction. Most people who get on these smart drugs, they don’t get addicted, but they become dependent. If you have a whole semester worth of work and it comes down to midterms or final exams and you have to cram six weeks of information in a few days, these medications will let you do it. But now you get the message that you need these medicines. The worst thing it is the user believes they can’t do it themselves. They’re not physically addicted, but they believe they can’t take tests or compete with other people if they don’t take these medications.
But it is true you can do serious brain injury to yourself by being on these medications. They’re playing with fire, but it’s not seen as such. Most people can’t see the brain injuries that are occurring.
Renew: What are the long-term damaging effects of misusing these drugs?
HU: The detrimental effects start with the first dose. The more you take, the longer you take them, the longer you're injured. Meth is the most corrosive drug out there. If you’re taking this for two or three days in a row and you’re a teenager, your brain is still growing at warp speed. Any injury you do it from 12 to 21, it’s magnified. You injure your brain when it’s developing. There is no safe dose when it’s not prescribed for you. One dose can give you seizures, cause a heart attack, cause a stroke. None of the kids are talking about that. They’re talking about its effects on concentration. The same thing is true for alcohol, pot. Any substance use up through 21 will hurt your brain way more than if you do it after. There's not a safe dose. Plus, when they’re just using them, they’ll use Adderall, then after the test, they can’t calm down so then they’ll drink or take Xanax. Mixing those is highly damaging to the brain.
Additionally, if you take more than you’re supposed to, you change the chemical balances in your brain, and you get extremely paranoid. You feel people are putting thoughts in your head. You see things crawling on your skin. It’s extremely uncomfortable. The kids panic. The paranoid is very scary. These very powerful medicines are changing neurotransmitter levels in their brains.
Renew: Are you seeing more students abusing smart drugs than in decades past? Why?
HU: Much more so, especially in the past 15 years. Without question. You’ve seen this pain pill epidemic. People in our country are more into pills than they used to be. There’s been an explosion of doctors prescribing these medications for ADHD. They're prescribing excessive amounts of them, and the street value for these is very high: $20 to $50 a pill. It’s the culture and the norm. There’s this myth in our society that if a medication is FDA-approved or if a doctor prescribes it, then it’s safe. But it’s only safe if the doctor diagnosed you with the disease and you’re taking it at the right dose. Kids don’t know any of that stuff. People who come to Enterhealth, they’re taking between 10 and 20 pills a day. Their body is used to it. If you’re thinking, “Oh, I don’t take that many.” Well, the people who come to see me, there was a point where they weren’t taking that many, either.
Renew: What are the biggest misconceptions students have when it comes to these drugs?
HU: The main misconception is that they’re safe. Another is that they won’t get addicted to them or that because everybody else in my classes is taking them, if they don’t take them, they won’t be competitive. Smart drugs don’t make you smarter. They help you pay attention more. So if you can pay attention, you can remember better. But the way to learn something is not to memorize it but to learn it. They don’t make you smarter. If anything, they make you dumber because they hurt your brain, and you don't really know the material.
Renew: How do you begin the recovery process for healing an Adderall addiction?
HU: The most important thing is you need to go to an expert. To just stop on your own is extremely difficult. Once you can’t stop using them, then your brain is changed. It’s injured. The frontal lobe helps you regulate your emotions, helps your memory. All those things are injured or impaired. You need to get professional help. Usually, somebody who comes in is also addicted to benzos. If you’re just addicted and you stop, you’re not going to have any life-threatening withdrawal, but you’ll feel very lethargic. You’re going to eat a lot. You’re going to crash for about five days. The only thing to take that away is another stimulate. It’s hard to make it through that first week or two. You end up relapsing before you can stay off it long enough. That’s why you need formal treatment.
Renew: What are you working on next?
HU: I’m working on a book about trying to help the family be engaged in treatment. The idea is to help the family to get better. So often treatment programs don't focus on that. They get lip service, and that’s it. It’s important for the family to understand the best way to get your loved one better is to get yourself better.
Healing the Addicted Brain offers a comprehensive look at the latest advancements in drug and alcohol addiction, treatment and recovery. Written by Urschel III, the book provides accurate, science-based information about the medical treatment of addiction as a chronic brain disease. Read the first chapter of Healing the Addicted Brain.