Over the Limit?
Americans young and old crave high-octane fuel, and doctors are jittery
Consumer watchdog groups think so, too. The government puts caffeine in its category of "generally recognized as safe" and so doesn't require food and drink manufacturers to list caffeine content. For more than a decade, the American Medical Association and the Center for Science in the Public Interest have been lobbying the Food and Drug Administration to require caffeine content labels, as well as the words "not appropriate for children." Meantime, soft drink manufacturers, seeing growing concern in Congress and among local politicians about children's access to energy drinks, announced in February that they'll now list caffeine content on drinks. The Coca-Cola Co. has already relabeled Full Throttle energy drink (141 mg per 16 ounces) and its new Enviga sparkling green tea (100 mg in 12 ounces); classic Coke will reveal its 34 milligrams in May. PepsiCo will have caffeine content on Pepsi and other drinks this summer.
Even as they're upping their dosage of caffeine, many high schoolers and college students are seeking a stronger boost than it can give. Prescription stimulants such as Ritalin, Concerta, and Adderall, widely prescribed to treat the inattention of ADHD, have become a source of alertness and energy for studying, and for late-night parties. About 3 percent of college students say they've used prescription stimulants illegally, according to a March 2007 study by the National Center on Addiction and Substance Abuse at Columbia University. The number is small compared with students' use of alcohol, marijuana, and tobacco, but stimulant abuse is increasing faster, almost doubling between 1993 and 2005, according to Susan Foster, vice president and director of policy research and analysis.
The drugs are "universal performance enhancers," says Lawrence Diller, a pediatrician in Walnut Creek, Calif., and author of The Last Normal Child. He thinks doctors, including himself, overprescribe drugs for mild ADHD. About 1.5 million adults and 2.5 million children-some 10 percent of all 10-year-old boys-now have prescriptions.
That means just about everybody under age 20 knows someone with a potential source of Adderall or Ritalin. (Most nonmedical users prefer Adderall to the slower-acting Ritalin.) On college campuses, prices rise as exams approach, from $7 to $15 for a 10-mg pill.
Marshall Dines, 23, a senior at the University of Michigan, even had strangers E-mailing him to sell them medicine after he joined a Facebook group about Adderall. (He refused and later left the group.)
Prescription stimulants can be big trouble when used to excess; that's been apparent since World War II, when both Axis and Allies gave troops amphetamines like Dexedrine to keep them alert on the front lines and many soldiers came home addicted (Adolf Hitler was reportedly a fan). More recently, stimulants have been popular with truck drivers and dieters. In 1971, the federal government added amphetamines (Adderall and other brands) and methylphenidates (Ritalin, Concerta, and other brands) to its Schedule II list of controlled substances-drugs with legitimate medical uses that also have a high potential for abuse. Stimulants account for just 1 percent of drug-related emergency room visits. But the number of people showing up with symptoms like confusion and convulsions after nonmedical use rose 33 percent from 2004 to 2005, according to a Substance Abuse and Mental Health Services Administration survey. Visits due to Ritalin and other methylphenidates more than doubled.