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Jones F, Newton PM. Prevalence of the use of prescription stimulants as "study drugs" by UK university students: A brief report. Brain Behav 2024; 14:e3419. [PMID: 38346719 PMCID: PMC10861350 DOI: 10.1002/brb3.3419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION There is media concern over students using prescription stimulants as "cognitive enhancers" to try and improve their academic performance. However, there is limited evidence about the prevalence of this behaviour in the United Kingdom, or whether it has increased in recent years. METHODS We review survey studies on students' use of cognitive enhancers. RESULTS Overall reported use is low, with some inconclusive evidence that it is increasing. Use of modafinil appears to be higher than that of methylphenidate or dexamphetamine. CONCLUSION There is a clear need for large-scale research in this area, using representative sampling and survey methods that protect student anonymity.
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Affiliation(s)
- Ffinian Jones
- Swansea University Medical SchoolSwansea UniversitySwanseaUK
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2
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Hersey M, Tanda G. Modafinil, an atypical CNS stimulant? ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 99:287-326. [PMID: 38467484 DOI: 10.1016/bs.apha.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Modafinil is a central nervous system stimulant approved for the treatment of narcolepsy and sleep disorders. Due to its wide range of biochemical actions, modafinil has been explored for other potential therapeutic uses. Indeed, it has shown promise as a therapy for cognitive disfunction resulting from neurologic disorders like ADHD, and as a smart drug in non-medical settings. The mechanism(s) of actions underlying the therapeutic efficacy of this agent remains largely elusive. Modafinil is known to inhibit the dopamine transporter, thus decreasing dopamine reuptake following neuronal release, an effect shared by addictive psychostimulants. However, modafinil is unique in that only a few cases of dependence on this drug have been reported, as compared to other psychostimulants. Moreover, modafinil has been tested, with some success, as a potential therapeutic agent to combat psychostimulant and other substance use disorders. Modafinil has additional, but less understood, actions on other neurotransmitter systems (GABA, glutamate, serotonin, norepinephrine, etc.). These interactions, together with its ability to activate selected brain regions, are likely one of the keys to understand its unique pharmacology and therapeutic activity as a CNS stimulant. In this chapter, we outline the pharmacokinetics and pharmacodynamics of modafinil that suggest it has an "atypical" CNS stimulant profile. We also highlight the current approved and off label uses of modafinil, including its beneficial effects as a treatment for sleep disorders, cognitive functions, and substance use disorders.
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Affiliation(s)
- Melinda Hersey
- Medication Development Program, NIDA-IRP, NIH, Baltimore, MD, United States
| | - Gianluigi Tanda
- Medication Development Program, NIDA-IRP, NIH, Baltimore, MD, United States.
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Habib DRS, Giorgi S, Curtis B. Role of the media in promoting the dehumanization of people who use drugs. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:371-380. [PMID: 36995266 PMCID: PMC10759778 DOI: 10.1080/00952990.2023.2180383] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 03/31/2023]
Abstract
Dehumanization, the perception or treatment of people as subhuman, has been recognized as "endemic" in medicine and contributes to the stigmatization of people who use illegal drugs, in particular. As a result of dehumanization, people who use drugs are subject to systematically biased policies, long-lasting stigma, and suboptimal healthcare. One major contributor to the public opinion of drugs and people who use them is the media, whose coverage of these topics consistently uses negative imagery and language. This narrative review of the literature and American media on the dehumanization of illegal drugs and the people who use them provides a perspective on the components of dehumanization in each case and explores the consequences of dehumanization on health, law, and society. Drawing from language and images from American news outlets, anti-drug campaigns, and academic research, we recommend a shift away from the disingenuous trope of people who use drugs as poor, uneducated, and most likely of color. To this end, positive media portrayals and the humanization of people who use drugs can help form a common identity, engender empathy, and ultimately improve health outcomes.
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Affiliation(s)
- Daniel Roy Sadek Habib
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Salvatore Giorgi
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Brenda Curtis
- Technology and Translational Research Unit, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
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Dominik P, Waßmer MP, Soyka M, Franke AG. Stimulant abuse as a coping strategy-Forensic and criminal consequences of stimulant abuse for neuroenhancement. Front Public Health 2022; 10:1028654. [PMID: 36388290 PMCID: PMC9650539 DOI: 10.3389/fpubh.2022.1028654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/12/2022] [Indexed: 01/29/2023] Open
Abstract
Pharmacological neuroenhancement (PN) describes the use of divergent psychoactive substances to enhance mental performance (cognition) without medical need. This kind of substance abuse takes place predominantly in stressful situations. Users implicitly-or even explicitly-describe this kind of drug abuse to be a coping strategy. Regarding the decision making process whether to use PN drugs or not, users indicate that legal aspects to be decisive. However, the legal situation has been neglected so far. To elucidate the German legal situation, PN substances have to be divided into over-the-counter drugs, prescription drugs and illegal drugs. Amphetamines have the highest cognition-enhancing potential, followed by modafinil and caffeine-containing substances. It is pointed out that the use of both freely available and prescription PN substances and narcotics without medical indication have so far been largely exempt from punishment under German law. However, individuals (physicians, bus and truck drivers, etc.) taking PN substances may expose others at risk due to wrong decisions (driving or treatment), errors based on side effects of the used substances. Therefore, the protection of life and health of others could legitimize criminal regulation.
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Affiliation(s)
- Philipp Dominik
- Institute for Criminal Law and Criminal Procedure Law, University of Cologne (UoC), Cologne, Germany
| | - Martin P. Waßmer
- Institute for Criminal Law and Criminal Procedure Law, University of Cologne (UoC), Cologne, Germany
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University (LMU), Munich, Germany
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Effort–Reward Imbalance at Work and Prescription Drug Misuse—Prospective Evidence from Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137632. [PMID: 35805300 PMCID: PMC9265319 DOI: 10.3390/ijerph19137632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 12/04/2022]
Abstract
This study examines how work stress affects the misuse of prescription drugs to augment mental performance without medical necessity (i.e., cognitive enhancement). Based on the effort–reward imbalance model, it can be assumed that a misalignment of effort exerted and rewards received increases prescription drug misuse, especially if employees overcommit. To test these assumptions, we conducted a prospective study using a nationwide web-based sample of the working population in Germany (N = 11,197). Effort, reward, and overcommitment were measured at t1 and the 12 month frequency of prescription drug misuse for enhancing cognitive performance was measured at a one-year follow-up (t2). The results show that 2.6% of the respondents engaged in such drug misuse, of which 22.7% reported frequent misuse. While we found no overall association between misuse frequency and effort, reward, or their imbalance, overcommitment was significantly associated with a higher misuse frequency. Moreover, at low levels of overcommitment, more effort and an effort–reward imbalance discouraged future prescription drug misuse, while higher overcommitment, more effort, and an imbalance increased it. These findings suggest that a stressful work environment is a risk factor for health-endangering behavior, and thereby underlines the importance of identifying groups at risk of misusing drugs.
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Parents’ Perceptions on the Debated Parenting Practice of Cognitive Enhancement in Healthy Children and Adolescents. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 6:373-388. [PMID: 35966365 PMCID: PMC9360129 DOI: 10.1007/s41465-022-00243-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 12/03/2022]
Abstract
First evidence shows that some parents engage in the health-endangering practice of (mis-)using prescription drugs to boost their children’s school performance. But little is known about parental perspectives on this phenomenon. This study aims to better understand parents’ perspectives on the non-medical use of prescription drugs to improve healthy children’s cognitive functioning. We conducted twelve semi-structured face-to-face interviews with a diverse sample of parents in Germany, and applied qualitative content analysis to explore their perspectives on instrumentalizing prescription drugs for improving the performance of healthy children, including their underlying knowledge (gaps), moral evaluations, evaluations of accompanied risks and benefits, opinions on potential motivators, and wishes regarding policy-making. The results show that parents typically believed themselves knowledgeable about such prescription drug (mis-)use, although they were not aware of anyone in their social environment taking them for enhancement. Parents generally considered such behavior to be morally reprehensible, cheating, and similar to doping in sports, and they typically claimed that no situation or occasion could motivate them to administer prescription drugs to their healthy children. Health risks (including side effects or addiction) were a typical expectation of drug use. That doctors should give such drugs to healthy young people was seen as unjustifiable. The results suggest that morality and risk–benefit evaluations of parents play a major role in their decision-making concerning this potentially risky instrumentalization of non-medical drugs. These insights are of distinct importance, especially for future research and further discussions on this topic, such as an evidence-based public dialog and ethics debates.
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Schönthaler EMD, Hofer G, Grinschgl S, Neubauer AC. Super-Men and Wonder-Women: the Relationship Between the Acceptance of Self-enhancement, Personality, and Values. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractDue to ongoing technological innovations, self-enhancement methods are publicly discussed, researched from different perspectives, and part of ethical debates. However, only few studies investigated the acceptance of these methods and its relationship with personality traits and values. The present study investigated to what extent people accept different enhancement methods and whether acceptance can be predicted by Big Five and Dark Triad traits, vulnerable narcissism, and values. In an online survey (N = 450), we measured personality traits and values. Additionally, participants read scenarios about enhancement methods and answered questions about their acceptance of these scenarios. Factor analysis indicated a general factor of acceptance across scenarios. Correlation analyses showed that high agreeableness, agreeableness-compassion, conscientiousness, conscientiousness-industriousness, and conservation- and self-transcendence values are related to less acceptance of self-enhancement. Moreover, individuals high on Dark Triad traits, vulnerable narcissism, and self-enhancement values exhibit more acceptance. Hierarchical regression analysis revealed that said values and Big Five traits explained unique variance in the acceptance of self-enhancement. These findings highlight the importance of considering personality and values when investigating self-enhancement—a topic that is receiving increasing attention by the public, politicians, and scientists.
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Cavaco AM, Ribeiro J, Nørgaard LS. Exploring the use of cognitive enhancement substances among Portuguese university students. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100097. [PMID: 35478516 PMCID: PMC9032074 DOI: 10.1016/j.rcsop.2021.100097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background Prescription drug use and the consumption of substances to enhance college students' cognitive performance, described as pharmacological cognitive enhancement (PCE), is a known phenomenon potentially impacting individuals' health. University and college students are two specific subpopulations noted to use PCE (up to 17%, on average). To our knowledge, no data have been published on the use of PCE drugs among university students at a national level in Portugal and the factors that might be associated with this usage. Objective The main objective was to estimate the prevalence of PCE use by Portuguese university students and to identify the PCE substances commonly used by university students, i.e., those classified as prescription drugs and other legal and nonprescribed substances, including food supplements. Methods The study followed a cross-sectional exploratory, descriptive design and pursued a convenience sample of students from Portuguese public and private universities (22 higher education institutions). Results From a sample of 745 university students, 32% indicated the use of prescribed and nonprescribed substances. The most consumed substances were food supplements with CNS stimulants being the most frequent prescription-only drugs but not necessarily accessed through a medical prescription. A significant statistical association was found between substance consumption and the field of study. Health science students reported more food supplements and drug intake, allegedly under prescribed regimens, compared to humanities and exact sciences students. The study discusses the need to better understand the competitive societies that produce and support young students' outputs and the perceived ‘need’ for performance-enhancing substances. Conclusions One-third of the university students aimed to improve their performance by pharmacological cognitive enhancement, with a preference for food supplements dispensed in pharmacies. PCE substance consumption in higher education is thus non-negligible. The study suggests the need to improve regulations on potential inequalities in academic rankings and success and an observant attitude concerning implications that negatively affect health in the long run.
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Heller MK, Chapman SCE, Horne R. Beliefs About Medicines Predict Side-Effects of Placebo Modafinil. Ann Behav Med 2022; 56:989-1001. [PMID: 35512392 DOI: 10.1093/abm/kaab112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients receiving placebo in clinical trials often report side-effects (nocebo effects), but contributing factors are still poorly understood. PURPOSE Using a sham trial of the cognition-enhancing "smart pill" Modafinil we tested whether medication beliefs and other psychological factors predicted detection and attribution of symptoms as side-effects to placebo. METHODS Healthy students (n = 201) completed measures assessing beliefs about medication, perceived sensitivity to medicines, negative affectivity, somatization, and body awareness; 66 were then randomized to receive Deceptive Placebo (told Modafinil-given placebo, 67 to Open Placebo (told placebo-given placebo, and 68 to No Placebo. Memory and attention tasks assessed cognitive enhancement. Nocebo effects were assessed by symptom checklist. RESULTS More symptoms were reported in the Deceptive Placebo condition (M = 2.65; SD = 2.27) than Open Placebo (M = 1.92; SD = 2.24; Mann-Whitney U = 1,654, z = 2.30, p = .022) or No Placebo (M = 1.68; SD = 1.75, Mann-Whitney U = 1,640, z = 2.74, p = .006). Participants were more likely to attribute symptoms to Modafinil side-effects if they believed pharmaceuticals to be generally harmful (incidence rate ratio [IRR] = 1.70, p = .019), had higher perceived sensitivity to medicines (IRR = 1.68, p = .011), stronger concerns about Modafinil (IRR = 2.10, p < .001), and higher negative affectivity (IRR = 2.37, p < .001). CONCLUSIONS Beliefs about medication are potentially modifiable predictors of the nocebo effect. These findings provide insight into side-effect reports to placebo and, potentially, active treatment.
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Affiliation(s)
- Monika K Heller
- Centre for Behavioural Medicine, UCL School of Pharmacy, UCL, Tavistock Square, WC1H 9JP, London, UK
| | - Sarah C E Chapman
- Centre for Behavioural Medicine, UCL School of Pharmacy, UCL, Tavistock Square, WC1H 9JP, London, UK.,Department of Pharmacy & Pharmacology, University of Bath, Claverton Down Road, Bath, UK
| | - Rob Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, UCL, Tavistock Square, WC1H 9JP, London, UK
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Feigning Symptoms to Obtain Prescription Stimulants: A Vignette-Based Study on Its Conditions. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211055433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This vignette-based study examined the willingness to feign symptoms to obtain a prescription following an analysis on who might use prescription stimulants to enhance performance ( N = 3,468). It experimentally manipulated three factors: the social disapproval of prescription stimulant use for enhancement purposes, the physicians’ diagnostic efforts, and the medical condition (attention-deficit/hyperactivity disorder and narcolepsy); respondent characteristics of self-control, personal morality, and self-efficacy were also measured. Our results showed that social disapproval of prescription drug use, a personal morality that disapproves of drug use, high self-control, and high self-efficacy were negatively associated with the willingness to use. Willingness increased especially in situations of social approval when there was a stronger personal approval of drug use, or surprisingly when physicians’ diagnostic efforts were higher. The feigning willingness was lower in situations of social disapproval and when personal morality disapproved of feigning. Thus, personal and situational characteristics are relevant to understand both behaviors.
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Sümbül-Şekerci B, Bildik Ö, Bektay MY, İzzettin FV. Attitudes of medicine, pharmacy, and dentistry students about psychostimulant use to enhance cognition. Int J Clin Pract 2021; 75:e14608. [PMID: 34231947 DOI: 10.1111/ijcp.14608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/28/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The use of psychostimulant drugs to increase academic success is common among young people. There is no study examining this issue in Turkish population. In this study, the prevalence, attitudes, knowledge, and ethical evaluations of Pharmacological Cognitive Enhancement (PCE) in university students were investigated. METHOD A structured online survey was carried out with 1148 undergraduate and postgraduate (master, PhD and residency) students in different faculties of Medicine, Dentistry and Pharmacy in Turkey. Comparisons between groups, correlation and regression analysis about associated variables were made. RESULTS The general prevalence of PCE in our study was found to be 7.4%. The highest prevalence was seen in the faculty of medicine (8.4%), among the residency students (15.5%). There was no significant difference prevalence of PCE between the faculties. Education level, smoking, study performance satisfaction, and knowledge level were found to be factors associated with PCE. Around 40% of PCE users stated that they used it with the recommendation of their friends. PCE users had a lower perception of harm and risk, and rated the use of it as more acceptable and normal behaviour. CONCLUSION PCE is a method used by young with high knowledge, low study performance satisfaction, to increase their academic success, especially during exam periods. Peer effect is an important factor in increasing prevalence.
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Affiliation(s)
- Betül Sümbül-Şekerci
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakif University, Istanbul, Turkey
| | - Özlem Bildik
- Department of History of Medicine and Ethics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- Graduate School of Health Sciences, Medical History and Ethics, Istanbul University, Istanbul, Turkey
| | - Muhammed Yunus Bektay
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakif University, Istanbul, Turkey
- Department of Clinical Pharmacy, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Fikret Vehbi İzzettin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakif University, Istanbul, Turkey
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Racine E, Sattler S, Boehlen W. Cognitive Enhancement: Unanswered Questions About Human Psychology and Social Behavior. SCIENCE AND ENGINEERING ETHICS 2021; 27:19. [PMID: 33759032 PMCID: PMC7987623 DOI: 10.1007/s11948-021-00294-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/10/2021] [Indexed: 05/23/2023]
Abstract
Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement.
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Affiliation(s)
- Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Medicine and Department of Social and Preventive Medicine, Université de Montréal, 7101, Av du Parc, Montréal, QC, H3N 1X9, Canada.
- Departments of Neurology and Neurosurgery, Experimental Medicine, and Biomedical Ethics Unit, McGill University, 3801, University Street, Montréal, QC, H3A 1X1, Canada.
| | - Sebastian Sattler
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Sociology, University of Cologne, Universitätsstrasse 24, 50931, Cologne, Germany.
| | - Wren Boehlen
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada
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Antshel KM, Parascandola T, Taylor LE, Faraone SV. Achievement goal orientation and stimulant misuse in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:125-133. [PMID: 31498751 DOI: 10.1080/07448481.2019.1656635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 04/04/2019] [Accepted: 08/11/2019] [Indexed: 05/18/2023]
Abstract
Objective: The prevalence of stimulant medication misuse is rising in college students. Motivations to use stimulant medications differ from motivation to use other substances such as alcohol or cannabis. However, no previous research has examined the impact of achievement goal orientation on stimulant misuse in college students. Participants: 309 college students (mean age = 18.9; 117 males) without an ADHD diagnosis were invited to participate. Methods: Participants completed an online research questionnaire that assessed factors associated with stimulant medication misuse as well as achievement goal orientations (Learning and Performance Orientations). Results: Approximately 12% endorsed a history of stimulant misuse within the past year. More males (17.1%) than females (9.4%) reported stimulant misuse. Those with and without a history of stimulant misuse differed on Performance Orientation (misuse > no misuse) yet were comparable on Learning Orientation. Conclusions: Having a higher Performance Orientation independently predicted stimulant misuse.
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Affiliation(s)
- Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
| | | | - Lea E Taylor
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY-Upstate Medical University, Syracuse, New York, USA
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Daubner J, Arshaad MI, Henseler C, Hescheler J, Ehninger D, Broich K, Rawashdeh O, Papazoglou A, Weiergräber M. Pharmacological Neuroenhancement: Current Aspects of Categorization, Epidemiology, Pharmacology, Drug Development, Ethics, and Future Perspectives. Neural Plast 2021; 2021:8823383. [PMID: 33519929 PMCID: PMC7817276 DOI: 10.1155/2021/8823383] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022] Open
Abstract
Recent pharmacoepidemiologic studies suggest that pharmacological neuroenhancement (pNE) and mood enhancement are globally expanding phenomena with distinctly different regional characteristics. Sociocultural and regulatory aspects, as well as health policies, play a central role in addition to medical care and prescription practices. The users mainly display self-involved motivations related to cognitive enhancement, emotional stability, and adaptivity. Natural stimulants, as well as drugs, represent substance abuse groups. The latter comprise purines, methylxanthines, phenylethylamines, modafinil, nootropics, antidepressants but also benzodiazepines, β-adrenoceptor antagonists, and cannabis. Predominant pharmacodynamic target structures of these substances are the noradrenergic/dopaminergic and cholinergic receptor/transporter systems. Further targets comprise adenosine, serotonin, and glutamate receptors. Meta-analyses of randomized-controlled studies in healthy individuals show no or very limited verifiability of positive effects of pNE on attention, vigilance, learning, and memory. Only some members of the substance abuse groups, i.e., phenylethylamines and modafinil, display positive effects on attention and vigilance that are comparable to caffeinated drinks. However, the development of new antidementia drugs will increase the availability and the potential abuse of pNE. Social education, restrictive regulatory measures, and consistent medical prescription practices are essential to restrict the phenomenon of neuroenhancement with its social, medical, and ethical implications. This review provides a comprehensive overview of the highly dynamic field of pharmacological neuroenhancement and elaborates the dramatic challenges for the medical, sociocultural, and ethical fundaments of society.
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Affiliation(s)
- Johanna Daubner
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Muhammad Imran Arshaad
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Christina Henseler
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Jürgen Hescheler
- Institute of Neurophysiology, University of Cologne, Faculty of Medicine, Robert-Koch-Str. 39, 50931 Cologne, Germany
| | - Dan Ehninger
- Molecular and Cellular Cognition, German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen, DZNE), Sigmund-Freud-Str. 27, 53127 Bonn, Germany
| | - Karl Broich
- Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Oliver Rawashdeh
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Anna Papazoglou
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
| | - Marco Weiergräber
- Experimental Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175 Bonn, Germany
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16
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Fuermaier ABM, Tucha O, Koerts J, Tucha L, Thome J, Faltraco F. Feigning ADHD and stimulant misuse among Dutch university students. J Neural Transm (Vienna) 2021; 128:1079-1084. [PMID: 33439363 PMCID: PMC8295135 DOI: 10.1007/s00702-020-02296-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/20/2020] [Indexed: 12/03/2022]
Abstract
The increasing number of university students seeking diagnosis of attention-deficit/hyperactivity disorder (ADHD), and findings of an increased stimulant misuse among university students, has raised concerns regarding the credibility of the symptoms of those students. However, most of our current knowledge refers to university students in North America and less is known about this issue on European campuses. The present survey aimed to collect opinions on feigning ADHD and to estimate the prevalence of stimulant misuse among 1071 university students in the Netherlands. The majority of students expressed liberal attitudes towards feigning ADHD. Also, a substantial number of respondents considered feigning ADHD themselves or know someone who feigns ADHD. Furthermore, 68% of students assumed benefits of taking stimulants without prescription and 16% have indeed already taken stimulants without prescription. Feigning ADHD and misuse of prescription medication are prevalent issues among Dutch students. The results underline the need for a careful diagnostic evaluation of individuals for ADHD. Furthermore, efforts are required in order to prevent stimulant drug trafficking and misuse among university students.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Frank Faltraco
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
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Dave AA, Cabrera LY. Osteopathic Medical Students’ Attitudes Towards Different Modalities of Neuroenhancement: a Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2020. [DOI: 10.1007/s41465-020-00163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Mayor E, Daehne M, Bianchi R. The Dark Triad of personality and attitudes toward cognitive enhancement. BMC Psychol 2020; 8:119. [PMID: 33160397 PMCID: PMC7648998 DOI: 10.1186/s40359-020-00486-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Cognitive enhancement (CE) refers to the voluntary improvement of human cognitive capabilities. Few studies have examined the general attitude of the public towards CE. Such studies have suggested that the use of CE is considered largely unacceptable by the public. In parallel, past research indicates that individuals scoring high on the Dark Triad of personality (Machiavellianism, narcissism, and psychopathy) and competitiveness have atypical views of ethical questions. In this study, we examined (a) whether attitudes towards CE are associated with individual differences in the Dark Triad of personality as well as in trait and contextual competitiveness and (b) whether the Dark Triad moderates the effect of trait and contextual competitiveness on attitudes towards CE.
Method US employees (N = 326) were recruited using Mechanical Turk. Participants completed a web survey. Data were analyzed by means of (robust) hierarchical regression and (robust) ANCOVAs. Results The Dark Triad of personality and one of its subscales, Machiavellianism, predicted positive attitudes towards CE. Neither trait competitiveness nor contextual competitiveness were linked to general attitudes towards CE, but the DT was a positive moderator of the association between contextual competitiveness and positive attitudes. Conclusion Our findings extend the incipient knowledge about the factors relating to favourable views of CE by highlighting the role of dark personality traits in shaping such views. Our study further shows contextual factors can play a differentiated role with respect to such attitudes depending upon dark personality traits. Implications for policy-making are discussed.
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Affiliation(s)
- Eric Mayor
- Department of Clinical Psychology and Epidemiology, University of Basel, 4055, Basel, Switzerland.
| | - Maxime Daehne
- Institute of Work and Organizational Psychology, University of Neuchâtel, 2000 Neuchâtel, Switzerland
| | - Renzo Bianchi
- Institute of Work and Organizational Psychology, University of Neuchâtel, 2000 Neuchâtel, Switzerland
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19
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Philbin MM, Greene ER, Martins SS, LaBossier NJ, Mauro PM. Medical, Nonmedical, and Illegal Stimulant Use by Sexual Identity and Gender. Am J Prev Med 2020; 59:686-696. [PMID: 32981768 PMCID: PMC7577928 DOI: 10.1016/j.amepre.2020.05.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/13/2020] [Accepted: 05/17/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Major knowledge gaps regarding medical and nonmedical prescription stimulant use and illegal stimulant use (i.e., cocaine/crack/methamphetamine) by sexual identity and gender have implications for individuals' health and well-being. This study improves stimulant use measurement by differentiating the type of stimulant use and focusing on lesbian, gay, and bisexual subpopulations. METHODS Data were pooled for adults in the 2015-2017 National Survey on Drug Use and Health (n=126,463; analyzed in 2019). Gender-stratified logistic regression models examined associations between sexual identity and past-year illegal stimulant use. Gender-stratified multinomial logistic regression models estimated odds of (1) medical use only versus no past-year prescription stimulant use, (2) any nonmedical stimulant use versus no past-year use, and (3) any nonmedical stimulant use versus medical use only. RESULTS Illegal stimulant use varied by sexual identity (men: gay, 9.2%; bisexual, 7.5%; heterosexual, 3.2%; women: gay/lesbian, 3.2%; bisexual, 7.8%; heterosexual, 1.5%), as did nonmedical prescription stimulant use. Relative to same-gender heterosexuals, gay (AOR=2.61, 95% CI=2.00, 3.40) and bisexual (AOR=1.70, 95% CI=1.24, 2.33) men had higher odds of past-year illegal stimulant use, as did gay/lesbian (AOR=1.63, 95% CI=1.16, 2.28) and bisexual (AOR=2.70, 95% CI=2.23, 3.26) women. Sexual minorities reported higher odds of nonmedical prescription stimulant use than heterosexuals. Any nonmedical prescription opioid use was reported by 26.4% of people who reported nonmedical stimulant use and 27.0% of people who reported illegal stimulant use. CONCLUSIONS Lesbian, gay, and bisexual individuals had a higher prevalence of stimulant use than their heterosexual counterparts. This has important implications for health disparities, especially given the high levels of polysubstance use. Taking a multilevel approach is crucial to reduce stimulant-related harms for lesbian, gay, and bisexual individuals.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York.
| | - Emily R Greene
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | | | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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20
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Weber K, Frommeld D, Gerhards H, Krug H, Kokott LE, Bittner U. Speaking About Enhancement-Methodological Issues and Historical Examples. AJOB Neurosci 2020; 11:254-256. [PMID: 33196361 DOI: 10.1080/21507740.2020.1831650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | | | | | | | | | - Uta Bittner
- OTH Regensburg
- Heinrich Heine University Düsseldorf
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21
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Roberts CA, Jones A, Sumnall H, Gage SH, Montgomery C. How effective are pharmaceuticals for cognitive enhancement in healthy adults? A series of meta-analyses of cognitive performance during acute administration of modafinil, methylphenidate and D-amphetamine. Eur Neuropsychopharmacol 2020; 38:40-62. [PMID: 32709551 DOI: 10.1016/j.euroneuro.2020.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/11/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Modafinil, methyphenidate (MPH) and d-amphetamine (d-amph) are putative cognitive enhancers. However, efficacy of cognitive enhancement has yet to be fully established. We examined cognitive performance in healthy non-sleep-deprived adults following modafinil, MPH, or d-amph vs placebo in 3 meta-analyses, using subgroup analysis by cognitive domain; executive functions (updating, switching, inhibitory control, access to semantic/long term memory), spatial working memory, recall, selective attention, and sustained attention. We adhered to PRISMA. We identified k = 47 studies for analysis; k = 14 studies (64 effect sizes) for modafinil, k = 24 studies (47 effect sizes) for Methylphenidate, and k = 10 (27 effect sizes) for d-amph. There was an overall effect of modafinil (SMD=0.12, p=.01). Modafinil improved memory updating (SMD=0.28, p=.03). There was an overall effect of MPH (SMD=0.21, p=.0004) driven by improvements in recall (SMD=0.43, p=.0002), sustained attention (SMD=0.42, p=.0004), and inhibitory control (SMD=0.27, p=.03). There were no effects for d-amph. MPH and modafinil show enhancing effects in specific sub-domains of cognition. However, data with these stimulants is far from positive if we consider that effects are small, in experiments that do not accurately reflect their actual use in the wider population. There is a user perception that these drugs are effective cognitive enhancers, but this is not supported by the evidence so far.
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Affiliation(s)
- Carl A Roberts
- Department of Psychological Sciences, University of Liverpool, United Kingdom.
| | - Andrew Jones
- Department of Psychological Sciences, University of Liverpool, United Kingdom
| | - Harry Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Suzanne H Gage
- Department of Psychological Sciences, University of Liverpool, United Kingdom
| | - Catharine Montgomery
- Department of Psychology, John Moores Liverpool University, Liverpool, United Kingdom
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22
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Modafinil potentiates cocaine self-administration by a dopamine-independent mechanism: possible involvement of gap junctions. Neuropsychopharmacology 2020; 45:1518-1526. [PMID: 32340023 PMCID: PMC7360549 DOI: 10.1038/s41386-020-0680-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/15/2020] [Accepted: 04/09/2020] [Indexed: 12/21/2022]
Abstract
Modafinil and methylphenidate are medications that inhibit the neuronal reuptake of dopamine, a mechanism shared with cocaine. Their use as "smart drugs" by healthy subjects poses health concerns and requires investigation. We show that methylphenidate, but not modafinil, maintained intravenous self-administration in Sprague-Dawley rats similar to cocaine. Both modafinil and methylphenidate pretreatments potentiated cocaine self-administration. Cocaine, at self-administered doses, stimulated mesolimbic dopamine levels. This effect was potentiated by methylphenidate, but not by modafinil pretreatments, indicating dopamine-dependent actions for methylphenidate, but not modafinil. Modafinil is known to facilitate electrotonic neuronal coupling by actions on gap junctions. Carbenoxolone, a gap junction inhibitor, antagonized modafinil, but not methylphenidate potentiation of cocaine self-administration. Our results indicate that modafinil shares mechanisms with cocaine and methylphenidate but has a unique pharmacological profile that includes facilitation of electrotonic coupling and lower abuse liability, which may be exploited in future therapeutic drug design for cocaine use disorder.
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23
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Philbin MM, Mauro PM, Greene ER, LaBossier NJ, Giovenco DP, Martins SS. Medical cannabis laws and medical and non-medical prescription stimulant use among a nationally representative sample of US Adults: Examining the role of sexual identity and gender. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102861. [PMID: 32717704 DOI: 10.1016/j.drugpo.2020.102861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/29/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Medical marijuana laws (MMLs) can impact marijuana and opioid use, but the relationship between MMLs and other drugs, such as prescription stimulants, remains unexamined. Because lesbian, gay and bisexual (LGB) individuals report higher levels of prescription stimulant use than heterosexuals, we explored the relationship between MMLs and past-year medical and non-medical stimulant use by sexual identity and gender. METHODS We pooled 2015-2017 National Survey on Drug Use and Health data for adults (n = 126 463), and used survey-weighted multinomial logistic regression to estimate odds of past-year (a) medical prescription stimulant use, (b) non-medical prescription stimulant use and (c) non-medical versus medical stimulant use. We stratified by gender, adjusted for sociodemographic characteristics, and tested the interaction between MML state residence and sexual identity. RESULTS Bisexual men had higher medical (6.4% versus 4.1%; aROR=1.93[1.29-2.88]) and non-medical stimulant use 6.6% versus 2.4%; aROR=2.23[1.44-3.44]) than heterosexual men. Bisexual women had higher non-medical stimulant use (6.8% versus 1.6%; aROR=1.54[1.23-2.93] than heterosexual women. Female (aROR=0.70[0.62-0.78]) and male (aROR=0.74[0.66-0.82]) heterosexuals in MML states had lower odds of medical stimulant use than in non-MML states. Bisexual men in MML states had lower odds of medical (aROR=0.36[0.21-0.61]) and non-medical stimulant use (aROR=0.48[0.29-0.81]) than bisexual men in non-MML states. Similar patterns emerged for bisexual women's non-medical use (aROR=0.57[0.40-0.81]). CONCLUSION Prescription stimulant use was higher in non-MML states for most LGB subgroups. MMLs may differentially impact stimulant use, primarily for bisexual men and women. States enacting MMLs should consider potential impacts on drugs other than marijuana, especially among LGB populations.
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Affiliation(s)
- Morgan M Philbin
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health. New York, NY, 10032, USA.
| | - Pia M Mauro
- Department of Epidemiology, Columbia University Mailman School of Public Health. New York, NY, 10032, USA.
| | - Emily R Greene
- Department of Epidemiology, Columbia University Mailman School of Public Health. New York, NY, 10032, USA.
| | - Natalie J LaBossier
- Boston University School of Medicine, Boston University. Boston, MA, 02118, USA
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health. New York, NY, 10032, USA.
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health. New York, NY, 10032, USA.
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24
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Lam C, Figueroa W, Yomogida K, Bavarian N. Prescription stimulant diversion on a college campus: Intrapersonal, interpersonal and environmental correlates. JOURNAL OF DRUG ISSUES 2020; 50:329-340. [PMID: 34305170 DOI: 10.1177/0022042620917103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates. Methods Data are from a probability sample of 499 undergraduate college students attending one California university. Participants completed a 100-item survey related to prescription stimulant misuse and diversion. We first calculated prevalence of diversion and associations with demographic variables. Next, to examine intrapersonal, interpersonal and environmental correlates of diversion, we estimated three separate nested logistic regression models. Results Prescription stimulant diversion was reported by approximately 10% of the sample. In the nested logistic analyses, diversion was found to be associated with intrapersonal, interpersonal and environmental variables. Conclusions These findings highlight the importance of examining a comprehensive set of correlates to identify subgroups of students at risk for engaging in sharing and/or selling of prescription stimulants.
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Affiliation(s)
- Cammie Lam
- California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840
| | - Wilma Figueroa
- California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840
| | - Kyle Yomogida
- California State University, Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840
| | - Niloofar Bavarian
- Health Science Department, California State University Long, Beach, 1250 Bellflower Blvd, Long Beach, CA 90840
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25
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Hupli A. Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence? DRUGS AND ALCOHOL TODAY 2020. [DOI: 10.1108/dat-07-2019-0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs.
Design/methodology/approach
This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey.
Findings
There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context.
Originality/value
Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.
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Ricci G. Pharmacological Human Enhancement: An Overview of the Looming Bioethical and Regulatory Challenges. Front Psychiatry 2020; 11:53. [PMID: 32127792 PMCID: PMC7037021 DOI: 10.3389/fpsyt.2020.00053] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 01/21/2020] [Indexed: 12/12/2022] Open
Abstract
Cognitive enhancement, a rather broad-ranging principle, can be achieved in various ways: healthy eating and consistent physical exercise can lead to long-term improvements in many cognitive domains; commonplace stimulants such as caffeine, on the other hand, temporarily raise levels of alertness, attentiveness, and concentration; sedative substances are also used as an indirect form of enhancement to relax before an exam or an important meeting. Such approaches raise no ethical issue. Nonetheless, clinical research has led to the off-label use of drugs called nootropics or "smart drugs", which can, under certain conditions, elicit some degree of cognition-improving effects: methylphenidate and modafinil can enhance working memory and concentration in healthy individuals, although the significance and effectiveness of such applications are dubious. Such "cognitive enhancement" methods, however, do raise multiple ethical issues, and their contentious nature has caused bioethical authorities to lay out opinions and recommendations meant to regulate their use. Most notably, the Italian Committee on Bioethics has extensively dealt with the spread of nootropics, which resulted in the Italian Code of Medical Ethics including "cognitive enhancement" drugs and their prescription by doctors as critical points, along with cosmetic surgery (the latest version of the Code, updated in December 2017, deals with the two separately, in Article 76 and 76 BIS). The United States Presidential Commission for the Study of Bioethical Issues broadened the scope of cognitive enhancement techniques so as to include neural modifiers, i.e. mechanisms of brain and nervous system change: a much wider array of interventions, technologies, behaviors, and environmental conditions that may potentially affect several aspects of the human brain and nervous system. The potential of neuroscience to profoundly reshape society is nothing short of mind-blowing.
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Affiliation(s)
- Giovanna Ricci
- Section of Forensic Medicine, School of Law, University of Camerino, Camerino, Italy
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27
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Abstract
Sporting authorities and policy makers have warned of a radical increase in the availability and use of so-called 'smart' drugs, which putatively deliver cognitive enhancements in the form of improved focus, concentration, alertness, and rapid decision-making. Although the potential for health risks is well documented when it comes to performance enhancing drugs in sport, the health implications of cognitive enhancing drugs (CEDs) remain unclear. Objectives: This article aims to provide a foundational understanding about CEDs and their application in sport. It considers what little is known about the types, nature, impact, and implications of their use for athletes and sport policy. Method: A narrative literature review was undertaken to ascertain the emerging role of CEDs beyond their clinical use to treat prescribed disorders, including the limited studies in the sporting domain. This review also considered literature pertinent to the impact of CEDs in sport and the challenges for sport policy. Results: Given the prospects of negative health impacts, policy-makers interested in preventing and controlling the use of CEDs, as well as reducing harm to athletes at all levels of performance, need guidance. This article highlights multi-faceted concerns and shines a spotlight on key issues for sporting bodies to consider regarding the critical impact that widespread use and adoption of these substances might entail. Conclusion: While the World Anti-Doping Agency (WADA) is seemingly awake to the threat posed, actions to circumvent the spread of CEDs throughout sport are nascent and require greater understanding and attention.
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Affiliation(s)
- Aaron C T Smith
- Institute for Sport Business, Loughborough University London, London, United Kingdom
| | - Constantino Stavros
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
| | - Kate Westberg
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
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Schleim S. Neuroenhancement as Instrumental Drug Use: Putting the Debate in a Different Frame. Front Psychiatry 2020; 11:567497. [PMID: 33088276 PMCID: PMC7498688 DOI: 10.3389/fpsyt.2020.567497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
Abstract
The use of performance-enhancing drugs to study or work better is often called "cognitive enhancement" or "neuroenhancement" and sparked a debate between scholars from many disciplines. I argue that such behavior can better be subsumed under the more general category of "instrumental drug use". This broader perspective allows understanding neuroenhancement better from the perspective of addiction medicine and public health and supports a more consistent drug policy. I also summarize the most important systematic reviews and individual surveys of nonmedical substance use to study or work better. Different definitions and methodologies limit the comparability of these studies. The unified approach of drug instrumentalization would partially solve such problems. Finally, prevalence studies from the 1960s to 1980s as well as anecdotal evidence since the late 19th century show that instrumental drug use is and has been for a long time a common phenomenon. It should thus also be investigated and treated accordingly.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Heymans Institute for Psychological Research, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
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29
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Goodhines PA, Taylor LE, Zaso MJ, Antshel KM, Park A. Prescription Stimulant Misuse and Risk Correlates among Racially-Diverse Urban Adolescents. Subst Use Misuse 2020; 55:2258-2267. [PMID: 32749179 PMCID: PMC7665830 DOI: 10.1080/10826084.2020.1800740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Most research on prescription stimulant misuse has focused on college students, and research on high school-aged adolescents is limited. OBJECTIVES This study aimed to characterize risk correlates of prescription stimulant misuse among a racially-diverse and socioeconomically-disadvantaged sample of urban adolescents. METHOD Cross-sectional data were drawn from an ongoing study of adolescent health behaviors, Project Teen. Participants were 414 9th to 11th graders (Mage=16.00 [SD = 1.08]; 57% female; 41% Black or African American, 22% White, 18% Asian, 17% Multiracial, 2% Pacific Islander, and 1% Native American; 12% Hispanic/Latinx). Participants completed a web-based survey assessing prescription stimulant misuse, demographics, mental health and personality, social environment, and substance use. RESULTS Eight percent of participants endorsed past-year prescription stimulant misuse. Compared to non-misusing peers, participants endorsing past-year prescription stimulant misuse reported greater depression/anxiety symptoms, sensation seeking, perceived peer risk behavior, and alcohol and cigarette use, as well as a lower level of parental monitoring; null group differences were observed for academic goal orientation, perceived peer approval of risk behavior, and cannabis use. Binary logistic regression demonstrated that binge drinking and cigarette use were significantly associated with prescription stimulant misuse over and above all other identified risk variables. CONCLUSIONS Adolescent prescription stimulant misuse appears to overlap with general adolescent substance use, sharing several known risk correlates. Results highlight potential targets for identification of emerging prescription stimulant misuse risk profiles at earlier stages of development. Longitudinal replication is needed to examine directional associations and risk mechanisms underlying adolescent prescription stimulant misuse.
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Affiliation(s)
| | - Lea E Taylor
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Michelle J Zaso
- Clinical and Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | - Kevin M Antshel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, New York, USA
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In search of optimal psychoactivation: stimulants as cognitive performance enhancers. Arh Hig Rada Toksikol 2019; 70:150-159. [PMID: 32597132 DOI: 10.2478/aiht-2019-70-3298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/01/2019] [Indexed: 12/21/2022] Open
Abstract
An increasing number of people, students in particular, seek substances that improve their cognitive functioning. The most popular group of pharmacological cognitive enhancers (PCEs) are stimulants. Available studies suggest a small beneficial effect of methylphenidate and amphetamine on memory, executive functions, and processing speed. However small, this effect can make the difference between success and failure. In recent years, research has focused on the additional beneficial effect on the emotional state, increased motivation, and placebo-induced cognitive enhancement. This paper briefly reviews the latest and most important research on the relationship between popular stimulants and cognitive enhancement. One cannot understand this relationship without understanding the Yerkes-Dodson law, which explains the relationship between the degree of arousal and performance. It suggests that the effect of stimulants is a dose-dependent continuum. This law has repeatedly been confirmed by studies in which an optimal level of psychoactivation for cognitive enhancement was obtained with low stimulant doses, whereas exceeding the effective dose resulted in cognitive deficits, psychomotor agitation, and addiction. A separate section has been devoted to modafinil, an increasingly popular stimulant that differs from the rest in neurochemical profile and behavioural effects.
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Keighron JD, Giancola JB, Shaffer RJ, DeMarco EM, Coggiano MA, Slack RD, Hauck Newman A, Tanda G. Distinct effects of (R)-modafinil and its (R)- and (S)-fluoro-analogs on mesolimbic extracellular dopamine assessed by voltammetry and microdialysis in rats. Eur J Neurosci 2019; 50:2045-2053. [PMID: 30402972 PMCID: PMC8294075 DOI: 10.1111/ejn.14256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 02/06/2023]
Abstract
Psychostimulant use disorders remain an unabated public health concern worldwide, but no FDA approved medications are currently available for treatment. Modafinil (MOD), like cocaine, is a dopamine reuptake inhibitor and one of the few drugs evaluated in clinical trials that has shown promise for the treatment of cocaine or methamphetamine use disorders in some patient subpopulations. Recent structure-activity relationship and preclinical studies on a series of MOD analogs have provided insight into modifications of its chemical structure that may lead to advancements in clinical efficacy. Here, we have tested the effects of the clinically available (R)-enantiomer of MOD on extracellular dopamine levels in the nucleus accumbens shell, a mesolimbic dopaminergic projection field that plays significant roles in various aspects of psychostimulant use disorders, measured in vivo by fast-scan cyclic voltammetry and by microdialysis in Sprague-Dawley rats. We have compared these results with those obtained under identical experimental conditions with two novel and enantiopure bis(F) analogs of MOD, JBG1-048 and JBG1-049. The results show that (R)-modafinil (R-MOD), JBG1-048, and JBG1-049, when administered intravenously with cumulative drug-doses, will block the dopamine transporter and reduce the clearance rate of dopamine, increasing its extracellular levels. Differences among the compounds in their maximum stimulation of dopamine levels, and in their time course of effects were also observed. These data highlight the mechanistic underpinnings of R-MOD and its bis(F) analogs as pharmacological tools to guide the discovery of novel medications to treat psychostimulant use disorders.
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Affiliation(s)
- Jacqueline D. Keighron
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - JoLynn B. Giancola
- Medicinal Chemistry Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Rachel J. Shaffer
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Emily M. DeMarco
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Mark A. Coggiano
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Rachel D. Slack
- Medicinal Chemistry Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Amy Hauck Newman
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
- Medicinal Chemistry Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
| | - Gianluigi Tanda
- Medication Development Program, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Department of Health and Human Services; 333 Cassell Drive, TRIAD Bldg., Baltimore, MD, USA, 21224
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Heyes AR, Boardley ID. Psychosocial factors facilitating use of cognitive enhancing drugs in education: a qualitative investigation of moral disengagement and associated processes. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1586831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Andrew Robert Heyes
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Ian David Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
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Hupli A, Berning M, Zhuparris A, Fadiman J. Descriptive assemblage of psychedelic microdosing: Netnographic study of Youtube™ videos and on-going research projects. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mayor E, Daehne M, Bianchi R. How perceived substance characteristics affect ethical judgement towards cognitive enhancement. PLoS One 2019; 14:e0213619. [PMID: 30870469 PMCID: PMC6417673 DOI: 10.1371/journal.pone.0213619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/25/2019] [Indexed: 11/18/2022] Open
Abstract
Some individuals seek to enhance their cognitive capabilities through the use of pharmacology. Such behavior entails potential health risks and raises ethical concerns. The aim of this study was to examine whether a precursor of behavior, ethical judgement towards the use of existing biological cognitive enhancers (e.g., coffee, legal and illegal drugs), is shaped by the perceived characteristics of these cognitive enhancers. Students and employees completed an online questionnaire which measured perceived characteristics of 15 substances presented as potential cognitive enhancers and a measure of ethical judgement towards these cognitive enhancers. Results of mixed model regression analyzes show that ethical judgement is more favourable when cognitive enhancers are perceived as being legal, familiar, efficient, and safe for users' health, supporting all hypotheses. Results further show that 36% of variance (in the null model) lies at the level of cognitive enhancers and 21% at the level of participants. In conclusion, cognitive enhancers vary widely in terms of ethical judgement, which is explained by the perception of the mentioned characteristics. Implications regarding prevention and policy-making are discussed.
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Affiliation(s)
- Eric Mayor
- Institute of Work and Organizational Psychology, Faculty of Sciences, University of Neuchâtel, Neuchâtel, Switzerland
| | - Maxime Daehne
- Institute of Work and Organizational Psychology, Faculty of Sciences, University of Neuchâtel, Neuchâtel, Switzerland
| | - Renzo Bianchi
- Institute of Work and Organizational Psychology, Faculty of Sciences, University of Neuchâtel, Neuchâtel, Switzerland
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Bugbee BA, Beck KH, Fryer CS, Arria AM. Substance Use, Academic Performance, and Academic Engagement Among High School Seniors. THE JOURNAL OF SCHOOL HEALTH 2019; 89:145-156. [PMID: 30604451 PMCID: PMC6373775 DOI: 10.1111/josh.12723] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Substance use is prevalent and is associated with academic performance among adolescents. Few studies have examined the association between abstinence from all substances and academic achievement. METHODS Data from a nationally representative sample of 9578 12th graders from the 2015 Monitoring the Future survey were analyzed to examine relationships between abstinence from substance use and 4 academic variables: skipping school, grades, academic self-efficacy, and emotional academic engagement. Participants were categorized as lifetime non-users, former users, and past-year users based on the use of 14 substances. RESULTS Approximately one-fourth of participants had never used cigarettes, alcohol, or other drugs during their lifetime, and 8%wt used at least one substance during their lifetime but not during the past year. Adjusting for demographic variables, past-year substance users had 2.71 greater odds of skipping school during the past month than lifetime non-users and 1.74 greater odds of having low grades. Lifetime non-users reported greater academic self-efficacy and emotional academic engagement than past-year users. CONCLUSIONS Many 12th graders have abstained from all substance use during their lifetime, and these adolescents experience better academic outcomes than their substance-using peers. Substance use prevention programs should be evaluated as a way to promote academic achievement.
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Affiliation(s)
- Brittany A. Bugbee
- Center for Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland
School of Public Health, 1234 School of Public Health, College Park, Maryland 20742, Phone: (301) 405-9748, Fax: (301)
314-9167,
| | - Kenneth H. Beck
- Department of Behavioral and Community Health, 1234 School of Public Health, College Park, Maryland 20742, Phone:
(301) 405-2527, Fax: (301) 314-9167,
| | - Craig S. Fryer
- Department of Behavioral and Community Health, 1234 School of Public Health, College Park, Maryland 20742, Phone:
(301) 405-0818, Fax: (301) 314-9167,
| | - Amelia M. Arria
- Center for Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland
School of Public Health, 1234 School of Public Health, College Park, Maryland 20742, Phone: (301) 405-9795, Fax: (301)
314-9167,
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Saeed M, Naveed M, BiBi J, Ali Kamboh A, Phil L, Chao S. Potential nutraceutical and food additive properties and risks of coffee: a comprehensive overview. Crit Rev Food Sci Nutr 2019; 59:3293-3319. [PMID: 30614268 DOI: 10.1080/10408398.2018.1489368] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Coffee is a composite mixture of more than a thousand diverse phytochemicals like alkaloids, phenolic compounds, vitamins, carbohydrates, lipids, minerals and nitrogenous compounds. Coffee has multifunctional properties as a food additive and nutraceutical. As a nutraceutical, coffee has anti-inflammatory, anti-oxidant, antidyslipidemic, anti-obesity, type-2 diabetes mellitus (DM), and cardiovascular diseases (CVD), which can serve for the treatment and prevention of metabolic syndrome and associated disorders. On the other hand, as a food additive, coffee has antimicrobial activity against a wide range of microorganisms, inhibits lipid peroxidation (LPO), and can function as a prebiotic. The outcomes of different studies also revealed that coffee intake may reduce the incidence of numerous chronic diseases, like liver disease, mental health, and it also overcomes the all-cause mortality, and suicidal risks. In some studies, high intake of coffee is linked to increase CVD risk factors, like cholesterol, plasma homocysteine and blood pressure (BP). There is also a little evidence that associated the coffee consumption with increased risk of lung tumors in smokers. Among adults who consume the moderate amount of coffee, there is slight indication of health hazards with strong indicators of health benefits. Moreover, existing literature suggests that it may be cautious for pregnant women to eliminate the chances of miscarriages and impaired fetal growth. The primary purpose of this narrative review is to provide an overview of the findings of the positive impacts and risks of coffee consumption on human health. In conclusion, to date, the best available evidence from research indicates that drinking coffee up to 3-4 cups/day provides health benefits for most people.
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Affiliation(s)
- Muhammad Saeed
- Department of Animal Nutrition, College of Animal Sciences and Technology, Northwest A & F University, Yangling, Shaanxi Province, P.R. China
| | - Muhammad Naveed
- Department of Clinical Pharmacology, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
| | - Jannat BiBi
- Department of Physical Education, Shaanxi Normal University, Xian, Shaanxi Province, P.R. China
| | - Asghar Ali Kamboh
- Department of Veterinary Microbiology, Faculty of Animal Husbandry and Veterinary Sciences, Sindh Agriculture University, Tandojam, Sindh Province, Pakistan
| | - Lucas Phil
- Department of Pharmaceutical Analysis, China Pharmaceutical University, School of Pharmacy, Nanjing, Jiangsu Province, P.R. China
| | - Sun Chao
- Department of Animal Nutrition, College of Animal Sciences and Technology, Northwest A & F University, Yangling, Shaanxi Province, P.R. China
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Lehne G, Zeeb H, Pischke CR, Mikolajczyk R, Bewick BM, McAlaney J, Dempsey RC, Van Hal G, Stock C, Akvardar Y, Kalina O, Orosova O, Aguinaga-Ontoso I, Guillen-Grima F, Helmer SM. Personal and perceived peer use and attitudes towards use of non-prescribed prescription sedatives and sleeping pills among university students in seven European countries. Addict Behav 2018; 87:17-23. [PMID: 29940387 DOI: 10.1016/j.addbeh.2018.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 06/05/2018] [Accepted: 06/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of non-prescribed prescription sedatives and sleeping pills (NPPSSP) among university students has been described as an important public health issue. However, the impact of perceived social norms on students' use and attitudes towards use of NPPSSP is still unclear. Our aim was to investigate whether perceptions of peer use and approval of use are associated with students' personal use and approval of NPPSSP use. METHODS Cross-sectional data from the Social Norms Intervention for the prevention of Polydrug Use (SNIPE) project containing 4482 university students from seven European countries were analyzed to investigate self-other discrepancies regarding personal use and attitudes towards NPPSSP use. Associations between personal and perceived peer use and between personal and perceived approval of use were examined using multivariable logistic regression. RESULTS The majority (51.0%) of students perceived their peers' NPPSSP use to be higher than their personal use. 92.6% of students perceived their peers' approval of NPPSSP use to be identical or higher than their personal approval. Students perceiving that the majority of peers had used NPPSSP at least once displayed higher odds for personal lifetime use (OR: 1.95, 95% CI: 1.49-2.55). Perceived peer approval of NPPSSP use was associated with higher odds for personal approval (OR: 5.49, 95% CI: 4.63-6.51). CONCLUSIONS Among European university students, perceiving NPPSSP use and approval of use to be the norm was positively associated with students' personal NPPSSP use and approval of use, respectively. Interventions addressing perceived social norms may prevent or reduce NPPSSP use among university students. Final trial registration number: DRKS00004375 on the 'German Clinical Trials Register'.
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Lucke J, Jensen C, Dunn M, Chan G, Forlini C, Kaye S, Partridge B, Farrell M, Racine E, Hall W. Non-medical prescription stimulant use to improve academic performance among Australian university students: prevalence and correlates of use. BMC Public Health 2018; 18:1270. [PMID: 30453936 PMCID: PMC6245847 DOI: 10.1186/s12889-018-6212-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some university students consume pharmaceutical stimulants without a medical prescription with the goal of improving their academic performance. The prevalence of this practice has been well documented in the US, but less so in other countries. The potential harms of using prescription stimulants require a better understanding of the prevalence of this practice within Australian universities. METHODS An internet survey of 1136 Australian students was conducted in 2015 in three large Australian universities. Students were asked about their personal use of prescription stimulants, attitudes and experiences with prescription stimulants. They were also asked about their use of caffeine, energy drinks and illicit drugs to enhance their academic performance. RESULTS Lifetime self-reported use of stimulant medication to improve academic performance was 6.5, and 4.4% in the past year. Students were far more likely to report using coffee and energy drinks (41.4 and 23.6% respectively, lifetime use) than prescription stimulants to help them study and complete university assessments. Non-medical use of prescription stimulants was strongly associated with a history of illicit drug use. CONCLUSION The prevalence of nonmedical prescription stimulant use to improve academic performance is low among university students in Australia, especially when compared with their use of coffee and energy drinks.
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Affiliation(s)
- Jayne Lucke
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, College of Science, Health and Engineering, Building NR6, La Trobe University, Bundoora, VIC, 3086, Australia. .,School of Public Health, The University of Queensland, Herston, Brisbane, QLD, Australia.
| | - Charmaine Jensen
- The University of Queensland Centre for Youth Substance Abuse Research, St Lucia, Brisbane, QLD, Australia
| | - Matthew Dunn
- School of Health and Social Development, Deakin University, Geelong, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Gary Chan
- The University of Queensland Centre for Youth Substance Abuse Research, St Lucia, Brisbane, QLD, Australia
| | - Cynthia Forlini
- Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Bradley Partridge
- Research Development Unit, Caboolture Hospital, Caboolture, QLD, Australia.,School of Clinical Medicine, Prince Charles Hospital Northside Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Quebec, Canada
| | - Wayne Hall
- The University of Queensland Centre for Youth Substance Abuse Research, St Lucia, Brisbane, QLD, Australia
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Pighi M, Pontoni G, Sinisi A, Ferrari S, Mattei G, Pingani L, Simoni E, Galeazzi GM. Use and Propensity to Use Substances as Cognitive Enhancers in Italian Medical Students. Brain Sci 2018; 8:brainsci8110197. [PMID: 30423911 PMCID: PMC6266090 DOI: 10.3390/brainsci8110197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/31/2018] [Accepted: 11/06/2018] [Indexed: 02/06/2023] Open
Abstract
International media has paid attention to the use of substances by healthy subjects to enhance cognitive performance. Medical students are liable to use cognitive enhancers (CE) with the aim of improving academic performance. The study explored use and attitudes toward the use of CE in Italian medical students. The authors anonymously surveyed 433 medical students of the University of Modena and Reggio Emilia with an ad hoc 36-items questionnaire. CE were broadly defined as any substance taken with the purpose of improving cognitive functions, from readily available beverages and substances, such as coffee, tea, energy drinks, and supplements to prescription only medication, such as psychostimulants and modafinil. Response rate was 83.8% (n = 363). While the majority of the students (74.7%; n = 271) said that they had used substances to improve cognitive functions, only 2 students (0.6%) reported the use of prescription-only medications in the last 30 days. Main reasons for not taking prescription-only drugs were concerns about safety and side effects, reported by 83.3% of students (n = 295). A positive attitude toward use was held by 60.3% (n = 219) subjects. The surveyed Italian medical students used many substances as CE, but this did not seem to apply significantly to psychostimulants. A multivariable analysis showed that the following variables were related to the propensity to use substances as CE: male gender, self-reported memory impairment, concerns about worsening of cognitive performance, lifetime use of at least one illegal substance, use of any substance (both legal or illegal) in the last 30 days.
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Affiliation(s)
- Marcella Pighi
- Villa Rosa, Private Accreditated Hospital, Modena 41125, Italy.
| | - Giancarlo Pontoni
- Psychiatry Section, Psychophysiological Selection Office, Italian Army National Recruitment and Selection Center, Foligno 06034 (PG), Italy.
| | - Arianna Sinisi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
| | - Giorgio Mattei
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
- Marco Biagi Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, 41121 Modena, Italy.
| | - Luca Pingani
- Human Resources, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Elena Simoni
- Villa Rosa, Private Accreditated Hospital, Modena 41125, Italy.
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41124, Italy.
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Maier LJ, Ferris JA, Winstock AR. Pharmacological cognitive enhancement among non-ADHD individuals—A cross-sectional study in 15 countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 58:104-112. [DOI: 10.1016/j.drugpo.2018.05.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 04/17/2018] [Accepted: 05/18/2018] [Indexed: 12/25/2022]
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Abstract
BACKGROUND This study investigated the misuse of prescription stimulants among undergraduates for academic purposes. This research is important as existing literature has indicated that this type of prescription drug misuse is a growing concern, especially among college undergraduates aged 18-25. OBJECTIVE This study focused on how various types of academic strain (i.e., academic strain, grade strain, and academic impediments) influenced the misuse of prescription stimulants. METHODS Roughly 900 quantitative surveys were collected at a large Southeastern university in May 2014 that specifically addressed prescription stimulant misuse. RESULTS Results from regression analyses indicated that college students are at an increased likelihood of misusing prescription stimulants for academic purposes if they experienced academic impediments and/or grade strain during the past academic year. Conclusions/Importance: It is necessary to identify how academic strain impacts undergraduates' likelihood of engaging in the misuse of prescription stimulants as this information may aid in college based educational and prevention programs.
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Affiliation(s)
- Lauren Norman
- a Division of Social Sciences and History , Delta State University , Cleveland , Mississippi , USA
| | - Jason Ford
- b Department of Sociology , University of Central Florida , Orlando , Florida , USA
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Holden JT, Kaburakis A, Wall Tweedie J. Virtue(al) games—real drugs. SPORT, ETHICS AND PHILOSOPHY 2018. [DOI: 10.1080/17511321.2018.1459814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- John T. Holden
- Department of Sport Management, Florida State University, Tallahassee, FL, USA
| | - Anastasios Kaburakis
- Department of Management, Richard A. Chaifetz School of Business, Saint Louis University, St. Louis, MO, USA
| | - Joanna Wall Tweedie
- Department of Sport Management, Florida State University, Tallahassee, FL, USA
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Johnstad PG. Powerful substances in tiny amounts: An interview study of psychedelic microdosing. NORDIC STUDIES ON ALCOHOL AND DRUGS 2018; 35:39-51. [PMID: 32934512 PMCID: PMC7434115 DOI: 10.1177/1455072517753339] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/21/2017] [Indexed: 11/17/2022] Open
Abstract
Aims: This article presents a qualitative interview study of people who microdose with psychedelic drugs, which means that the user takes about one tenth of an ordinary recreational dose. Design: Respondents (n = 21) were recruited at several Internet fora for individual interviews via private messaging. Every participant was male, and the median respondent was in his 30s with a stable job and relationship and extensive entheogen experience. Results: Respondents tended to experiment with microdosing in phases, reporting mostly positive consequences from this form of drug use. Reported effects included improved mood, cognition, and creativity, which often served to counteract symptoms especially from conditions of anxiety and depression. There were also reports of various challenges with psychedelic microdosing, and some did not find the practice worth continuing. Conclusion: The study obtained evidence of a group of users taking small doses of psychedelics not for the purpose of intoxication but to enhance everyday functioning. While the study’s findings are not generalisable, they may inform subsequent investigations with research questions and hypotheses.
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Nematolahi P, Mehrabani M, Karami-Mohajeri S, Dabaghzadeh F. Effects of Rosmarinus officinalis L. on memory performance, anxiety, depression, and sleep quality in university students: A randomized clinical trial. Complement Ther Clin Pract 2018; 30:24-28. [DOI: 10.1016/j.ctcp.2017.11.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 12/11/2022]
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Schleim S, Quednow BB. How Realistic Are the Scientific Assumptions of the Neuroenhancement Debate? Assessing the Pharmacological Optimism and Neuroenhancement Prevalence Hypotheses. Front Pharmacol 2018; 9:3. [PMID: 29403383 PMCID: PMC5786508 DOI: 10.3389/fphar.2018.00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022] Open
Abstract
Since two decades, neuroenhancement is a major topic in neuroethics and still receives much attention in the scholarly literature as well as in public media. In contrast to high hopes at the beginning of the “Decade of the Brain” in the United States and Europe that we subsume under the “pharmacological optimism hypothesis,” recent evidence from clinical neuroscience suggests that developing drugs that make healthy people smarter is even more difficult than finding new treatments for patients with mental disorders. However, cognitive enhancing drugs even for patients with impaired intellectual performance have not been successfully developed yet and new drugs that might have a disruptive impact on this field are unlikely to be developed in the near future. Additionally, we discuss theoretical, empirical, and historical evidence to assess whether cognitive enhancement of the healthy is common or even epidemic and if its application will further increase in the near future, as suggested by the “neuroenhancement prevalence hypothesis.” Reports, surveys, and reviews from the 1930s until today indicate that psychopharmacological neuroenhancement is a fact but less common than often stated, particularly in the public media. Non-medical use of psychostimulants for the purpose of cognitive enhancement exists since at least 80 years and it might actually have been more common in the past than today. Therefore, we conclude that the pharmacological optimism hypothesis and neuroenhancement prevalence hypotheses have to be rejected and argue that the neuroenhancement debate should take the available evidence more into account.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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Wexler A. Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0062-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cognitive Enhancement and Coping in an Australian University Student Sample. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0046-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Urban KR, Gao WJ. Psychostimulants As Cognitive Enhancers in Adolescents: More Risk than Reward? Front Public Health 2017; 5:260. [PMID: 29034227 PMCID: PMC5626934 DOI: 10.3389/fpubh.2017.00260] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/12/2017] [Indexed: 12/25/2022] Open
Abstract
Methylphenidate and other psychostimulants, originally developed to treat attention deficit-hyperactivity disorder, are increasingly abused by healthy adolescents and adults seeking an advantage in scholastic performance and work productivity. However, how these drugs may affect cognitive performance, especially in the young brain, remains unclear. Here, we review recent literature and emphasize the risks of abuse of psychostimulants in healthy adolescents and young adults. We conclude that while the desire for cognitive enhancement, particularly with rising costs of education and increasingly competitive nature of scholarship programs, is unlikely to diminish in the near future, it is crucial for the scientific community to thoroughly examine the efficacy and safety of these stimulants in healthy populations across development. The current dearth of knowledge on the dose–response curve, metabolism, and cognitive outcomes in adolescents following methylphenidate or other psychostimulant exposure may be perpetuating a perception of these drugs as “safe” when that might not be true for developing brains.
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Affiliation(s)
- Kimberly R Urban
- Department of General Anesthesia, Division of Stress Neurobiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Wen-Jun Gao
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA, United States
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Vagwala MK, Bicquelet A, Didziokaite G, Coomber R, Corrigan O, Singh I. Towards a Moral Ecology of Pharmacological Cognitive Enhancement in British Universities. NEUROETHICS-NETH 2017; 10:389-403. [PMID: 28890739 PMCID: PMC5569139 DOI: 10.1007/s12152-017-9336-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 06/02/2017] [Indexed: 11/30/2022]
Abstract
Few empirical studies in the UK have examined the complex social patterns and values behind quantitative estimates of the prevalence of pharmacological cognitive enhancement (PCE). We conducted a qualitative investigation of the social dynamics and moral attitudes that shape PCE practices among university students in two major metropolitan areas in the UK. Our thematic analysis of eight focus groups (n = 66) suggests a moral ecology that operates within the social infrastructure of the university. We find that PCE resilience among UK university students is mediated by normative and cultural judgments disfavoring competitiveness and prescription drug taking. PCE risk can be augmented by social factors such as soft peer pressure and normalization of enhancement within social and institutional networks. We suggest that moral ecological dynamics should be viewed as key mechanisms of PCE risk and resilience in universities. Effective PCE governance within universities should therefore attend to developing further understanding of the moral ecologies of PCE.
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Affiliation(s)
- Meghana Kasturi Vagwala
- Trinity College of Arts and Sciences, Duke University, P.O. Box 95790, Duke University West Campus, Durham, NC 27708 USA
| | - Aude Bicquelet
- NatCen Social Research, 35 Northampton Square, London, EC1V 0AX UK
| | - Gabija Didziokaite
- Department of Social Sciences, Loughborough University, Brockington Building, Margaret Keay Rd, Loughborough, LE11 3TU UK
| | - Ross Coomber
- Griffith Criminology Institute, Mt Gravatt Campus, M10_4.02N, Brisbane, QLD 4122 Australia
| | - Oonagh Corrigan
- University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ UK
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre, University of Oxford, Warneford Ln, Oxford, OX3 7JX UK
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