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How Smart are Smart Pills? The Problem of Adderall January 1, 2013
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Douglas Cassel M.D. About the Author
Douglas Cassel M.D.


Alea iacta est
(Latin: "The die has been cast") is a Latin phrase attributed to Julius Caesar on January 10, 49 BC as he led his army across the River Rubicon in Northern Italy.
Adderall is a amphetamine-like drug commonly used to treat attention deficit disorder. As anyone with teenagers already knows, Adderall can also boost alertness, fight off fatigue, and boost test scores. This off-label use has led to a robust illegal resale market on high school and college campuses. The widespread “abuse” of Adderall raises many dilemmas for both our modern society and healthcare system.
In addition to curing disease, medicine can now make us stronger, smarter and better looking. Steroids can help major league players hit 70 home runs, or keep a pitcher working into his 40's. Adderall can add points to an SAT score, help someone achieve the grades needed to get a job, or keep a tired resident physician from making a potentially fatal error. For many individuals, these benefits outweigh the potential side effects. We must realize that the use of these substances is fundamentally different from other types of drug “abuse”. Athletes or students are not taking the illicit drug in an attempt to get high or feel good, but rather to obtain a goal which is widely valued and highly rewarded by our society.
In addition to curing diseases, pharmacology is now developing many more molecules that can make our minds and bodies work better. Who will decide whether such research will be funded, or even allowed? What side effects can be tolerated in the quest for improved performance? Does fairness require drug testing prior to standardized tests, or bestowing grades? Will health insurance cover “smart pills” or memory implants for everyone? How much will people be willing to pay to buy better GMAT scores, a better tennis serve, or another year of being able to drive? People may be created equal, but now might be able to buy much more equality.
These questions can no longer be deferred. The pharmacological Rubicon has already been crossed, and major changes are coming.

Doug Cassel MD
Doug Cassel was an interventional Radiologist for 25 years, serving as the Head of Interventional Radiology at Hoag Memorial Hospital in Newport Beach, CA. Doug was Chairman of the Board of Healthcare Management Partners, a revenue cycle management company specializing in Radiology, and presently is a Board Member of Zotec, a national revenue cycle management and software company specializing in Radiology, Anesthesia, and Pathology groups for both hospital and outpatient centers. He also serves on the board of Vericle, a software and office automation company. He is a graduate of Yale, Harvard, and Stanford. Find this and other blog postings at:

The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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Anonymous on 03 Jan 2013 at 9:11 am

Do not fool yourself, there is no difference between your description of "use" and "abuse" of these drugs. It is all abuse. By taking these types of drugs, people are trying to achieve selfish goals which are ego driven and are equivalent to "getting high" just somewhat delayed.

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