Q. I am halfway through law school,
and, because I'm not anywhere near the top of my class, have been
told not to expect interest from major law firms upon graduating.
In high school, it was suggested that I might have ADHD. Even if
not, many of my fellow students routinely use Adderall to enhance
their academic functioning. I have been philosophically opposed to
using a chemical boost, and did quite well in college on regular
brain power, but that position has certainly worked against
A. We of course invite you to come to Lawyers Concerned for
Lawyers for a more thorough evaluation or your situation, state of
mind and options.
But we would like to take this opportunity to address the issue of
Adderall. As you indicate, we are hearing more and more reports
suggesting that Adderall (or its newer siblings, such as Vyvanse)
is being used regularly (by some, just at academic crunch times,
but by others on an ongoing, daily basis), not only by those who
have Attention Deficit Hyperactivity Disorder (or at least claim to
have it), but by students with normal attention spans who want to
augment their studying capacity, and also by young professionals
seeking to be more productive or competitive in their work.
Stimulants (originally Ritalin) have been used to treat ADHD for
many years, especially for children otherwise unable to settle down
in class. Many parents of these kids have opposed medications,
arguing that what is needed is to restructure the schools to be
able to accommodate the common behavior patterns of youngsters who
happen to be less contained by nature. But there is no question
that the medications are very often effective, producing the
"paradoxical" effect (since they are stimulants) of increased
composure and focus.
Since the "discovery," perhaps 25 years ago, that ADHD often
persists into adulthood, use of Ritalin and its successors (such as
Concerta and Adderall) have increased astronomically among adults.
Indeed, we have seen a number of lawyers who complained of chronic
errors and disorganization and who saw clear benefits from such
medications. We respect your philosophical opposition to ingesting
drugs that are essentially optional, if helpful, but, if you truly
have ADHD, using something like Adderall would be considered
However, use of heavy-duty stimulants to lift performance from
normal to supernormal is another matter. At one time, experts
maintained that people without ADHD would not get the beneficial,
"paradoxical" effect, and that these medications were rarely
abused. Those contentions seem to have turned out to be false.
Using stimulants (years ago, much more commonly caffeine, in such
products as No-Doz) at exam time is certainly not a novel
phenomenon. But there is, indeed, something highly unsettling,
especially about unimpaired individuals chronically
revving up their nervous systems by using "speed."
This old street term is not an overstatement. Adderall is an
amphetamine, just like the pills that became something of a scandal
when used in the 1960s by many Americans for weight loss and
depression (or to seek euphoria), leading to their removal from the
While the benefits of amphetamine use may well outweigh its risks
for those who otherwise cannot accomplish important tasks, elective
use of these drugs (whether purchased illicitly or obtained by
describing the right symptoms to a psychiatrist) should be balanced
with awareness of the potential cumulative side effects. These
include: severe increases in blood pressure; irregular heart rhythm
or heart attack; stroke; respiratory difficulty; seizures;
hyperthermia; internal bleeding; and liver/kidney damage.
If also taking antidepressants or decongestants, the dosages may
need to be changed. All of these dangers are increased when one
uses Adderall or other amphetamines by crushing and snorting (which
can also injure sinuses, nostrils and lungs) or when exceeding the
recommended dosage. Amphetamine use is subject to abuse (especially
by those who develop tolerance and find the need to take more and
more in order to get an effect) and dependence (users may become
virtually unable to function without the drug, and may develop
withdrawal symptoms if unable to obtain the pills).
It seems that our society becomes more Darwinian every day, but
let us all balance our immediate professional survival strivings
with an eye toward long-term survival. Adderall may be an absolute
boon to those with attention deficits, but the decision to use it
(as in the case of any psychoactive or potentially addictive
medication) is not a casual one. n
Questions quoted are either actual letters/e-mails or paraphrased
and disguised concerns expressed by individuals seeking assistance
from Lawyers Concerned for Lawyers.
Questions for LCL may be mailed to LCL, 31 Milk St., Suite 810,
Boston, MA 02109; or called in to (617) 482-9600.
LCL's licensed clinicians will respond in confidence.