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Potential for Misuse

The dramatic increases in stimulant prescriptions over the last 2 decades have led to their greater availability and to increased risk for diversion and nonmedical use. When taken to improve properly diagnosed conditions, these medications can greatly enhance a patient’s quality of life. However, because many perceive them to be generally safe and effective, prescription stimulants such as Adderall and Modafinil are being misused more frequently.

Stimulants increase wakefulness, motivation, and aspects of cognition, learning, and memory. Some people take these drugs in the absence of medical need in an effort to enhance mental performance. Militaries have long used stimulants to increase performance in the face of fatigue, and the United States Armed Forces allow for their use in limited operational settings. The practice is now reported by some professionals to increase their productivity, by older people to offset declining cognition, and by both high school and college students to improve their academic performance.

Nonmedical use of stimulants for cognitive enhancement poses potential health risks, including addiction, cardiovascular events, and psychosis. The use of pharmaceuticals for cognitive enhancement has also sparked debate over the ethical implications of the practice. Issues of fairness arise if those with access and willingness to take these drugs have a performance edge over others, and implicit coercion takes place if a culture of cognitive enhancement gives the impression that a person must take drugs in order to be competitive.