All About Ethics Blog

Once the province of stressed-out college students during exam week, the non-prescription use of stimulant drugs such as Adderall is moving into the American workplace, according to a spate of articles from Forbes, the New York Times, and other publications.

While there are no reliable figures on the extent of this practice, all the publications concur based on anecdotal evidence that it is growing. Is that a problem from the point of view of ethics? That was this week’s topic in the Center’s Emerging Issues meeting, a group of staff and scholars who discuss the ethical issues in the news.

Since a key step in making an ethical decision is to “Get the Facts,” here are some of the important factual considerations in the debate over cognitive enhancement:

What do stimulant medications like Adderall do? According to Forbes mental health writer Todd Essig, “These ADHD stimulant medications are not smart drugs, despite their name and reputation. They are drive drugs. They focus attention and help extend time awake. They boost motivation to do the boring.”

Are there side effects? Yes, stimulants can be addictive. They can also cause anxiety and insomnia.

Is it legal to take them without a prescription? No.

With those facts in mind, one response might be to weigh the risks against the benefits. Is getting a leg up on productivity worth the chance of addiction or incarceration? Many members of the group answered no, at least with the current fact set.

But it’s not hard to imagine that several of these facts might change in the not too distant future. A drug could be developed that had fewer or no side effects. The country could change its policy about stimulants and allow them to be dispensed legally without a prescription.

That left us with the deeper question: Is there anything inherently wrong with using a drug to enhance performance? Or are drugs only to be used to address problems or deficits?

The first problem we ran into was defining enhancement and distinguishing it from therapy. We do, after all, use many enhancements without ethical fretting: We drink coffee, for example. How is this different from taking a stimulant? One participant suggested that the bright line between therapy and enhancement should be the question: Do you need the drug to function? Do you have an illness that needs a remedy?

But to a certain degree, wellness and illness are socially constructed. A person we might diagnose in the U.S. as suffering from an attention deficit disorder might function perfectly appropriately in a society that required less sitting still and paying attention. Similarly, one parent might easily tolerate a child receiving a C, while to another, this might be seen as a sign of a disorder requiring treatment.

A second ethical issue the group raised was the problem of access. The price of prescription Adderall is about $0.83 a pill. On the street, it might be $5. Doesn’t the cost of the stimulant mean that only people with means will be able to enhance their performance? Is that fair?

In conversations about the honor code at SCU, many students on the honor code committee wanted taking stimulants without a prescription to be explicitly listed as an honor code violation because they felt the practice conferred an unfair advantage on those who could afford and chose to take the drugs. Still, some members of the Emerging Issues group argued that creating a totally level playing field is impossible. As one put it, “Early adopters are always people with means. It means that rich people are guinea pigs for everyone else.”

Finally, the group talked about the societal impact of a rise in stimulant use for enhancement. What will be the effect on our society of singling out one trait—productivity—at the expense of other traits, like creativity, which might be depressed by stimulant use? And how will we feel if stimulants ratchet up workplace expectations of productivity to a level that can’t be reached without them? One member cautioned that with stimulants, “The norm will become ever more productivity, so everyone will become a hamster running on a wheel.”

What’s your take on the non-prescription use of stimulant drugs in the workplace? We invite your comments.

Miriam Schulman is the associate director of the Markkula Center for Applied Ethics.