Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Do people abuse study drugs like amphetamine and modafinil a lot in medical school? People used to use these drugs a lot in my undergrad, without prescriptions, to gain an advantage on exams. Personally, I think it's hugely unfair unless you have a legitimate medical need (though, let's be real, ADD is hugely overdiagnosed in America)...So, what do you think? How common is it at your school, and how do you feel about it?
 
Last edited:

theseeker4

PGY 3
7+ Year Member
Apr 20, 2011
3,502
758
Suburban Detroit, MI
Status
Resident [Any Field]
Do people abuse study drugs like amphetamine and modafinil a lot in medical school? People used to use these drugs a lot in my undergrad, without prescriptions, to gain an advantage on exam. Personally, I think it's hugely unfair unless you have a legitimate medical need (though, let's be real, ADD is hugely overdiagnosed in America)...So, what do you think? How common is it at your school, and how do you feel about it?
Happens quite a bit, nothing you can really do bout it, so either get through med school without using them (which I did) or jump on the train and find a dr willing to perscribe them to you. Either way, stop worrying about other people when you should be focused on your own performance, and definitely don't fall into the trap of pretending other people's unfair advantages are holding you back.
 

Syncrohnize

PGY-1
7+ Year Member
Dec 28, 2010
2,866
2,836
Status
Resident [Any Field]
...
 

Petypet

10+ Year Member
Sep 28, 2009
781
692
Ohio
Status
Attending Physician
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
so you're telling me if i snorted adderall i would've gotten a 270 step 1, shoot....
The cognition enhancing effects of amphetamine are well-known. It obviously won't turn an idiot into a genius, but it is undeniably an advantage. Are you seriously denying the massive amount of research proving the performance enhancing effects of amphetamine?
 
Jun 22, 2015
521
713
Im pretty sure you don't retain much long term when you learn on a 48h stimulant bender.

Also... if you are using them that usually means you didn't study consistently in advance and are operating with a much lower baseline level of knowledge and won't reach the same breadth or depth of knowledge a long term studier does.
 

Mr Roboto

5+ Year Member
Jul 31, 2013
1,009
1,583
A galaxy far, far away...
Status
Medical Student
The cognition enhancing effects of amphetamine are well-known. It obviously won't turn an idiot into a genius, but it is undeniably an advantage. Are you seriously denying the massive amount of research proving the performance enhancing effects of amphetamine?
Links to papers demonstrating amphetamines increase intelligence, please.
 

Crayola227

The Oncoming Storm
5+ Year Member
Oct 22, 2013
15,963
17,797
All of Time & Space
  • Like
Reactions: JustaDO

Rekt

2+ Year Member
May 29, 2015
1,530
3,348
Status
Resident [Any Field]
Mostly just huge groups of foreign kids at my school, mostly the middle easterners.
 
  • Like
Reactions: witzelsucht
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Links to papers demonstrating amphetamines increase intelligence, please.
I never said they make you more intelligent. They just provide a temporary enhancement of cognition. Cognition is not synonymous with intelligence.

Mostly just huge groups of foreign kids at my school, mostly the middle easterners.
How's that feel going?
 

Petypet

10+ Year Member
Sep 28, 2009
781
692
Ohio
Status
Attending Physician

TheStallion16

2+ Year Member
Dec 26, 2014
242
217
Status
Medical Student
Adderall has been proven to increase focus and energy, but studies have actually shown it has no effect on test performance. Any cognitive improvements have been shown to be very mild and varies depending on the person. So it really isn't that big of an "unfair advantage" if at all. It tends not to really help people that much who don't actually need it.
 

mw18

5+ Year Member
Jan 7, 2014
890
959
Status
Medical Student
I don't know if anyone else is using anything to help them. I know I don't. I know that some med schools are competitive, but if they are finding a way to learn more then I'm not gonna cry about it. It's their health. Maybe it will make them better doctors.

Edit: quick submit by accident.
 
  • Like
Reactions: Crayola227

Sleman

5+ Year Member
Feb 28, 2013
5
0
Status
Medical Student
Honestly, who cares!

I don't know anyone doing drugs for tests, I think it's an individual behavior.
 
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
? Those feet kind of creep me out, I think it's the nail polish
You lack the nuanced eye of a foot aficionado. I've been "studying" the female foot for years, and I can assure you those are some Grade A feet. Black polish is top tier pedicure color btw.
 

sloop

2+ Year Member
May 12, 2015
1,065
1,717
Status
Resident [Any Field]
I have ADD (diagnosed as a kid) and take a prescription psychostimulant. That said, who cares?

I don't think anybody is obligated to sacrifice realizing their full potential for the sake of some abstract feeling that stimulant use is unfair.

What if disabled people thought it was unfair that we could walk around so freely? Should we all strap weights to ourselves to even the score?
 
  • Like
Reactions: Doc2028
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
I have ADD (diagnosed as a kid) and take a prescription psychostimulant. That said, who cares?

I don't think anybody is obligated to sacrifice realizing their full potential for the sake of some abstract feeling that stimulant use is unfair.

What if disabled people thought it was unfair that we could walk around so freely? Should we all strap weights to ourselves to even the score?
It's not unfair if you have a legitimate medical need for it. It is unfair if you have normal neurochemistry. You know how some people get extra time on exams if they have a learning disability? It would be like pretending to have that just so you could get extra time on an exam. Totally not cool.
 

sloop

2+ Year Member
May 12, 2015
1,065
1,717
Status
Resident [Any Field]
It's not unfair if you have a legitimate medical need for it. It is unfair if you have normal neurochemistry. You know how some people get extra time on exams if they have a learning disability? It would be like pretending to have that just so you could get extra time on an exam. Totally not cool.
I don't think these are the same thing. One is avoiding the usual structural constraints of the test while the other is doing something that allows you to operate better within the same constraints of the test.

In any case, one way I've explained this in the past is the following: would you rather fly in the airplane piloted by the person who is "cognitively enhanced" or the one piloted by the person who has eschewed cognitive enhancers because they're "unfair"?
 
  • Like
Reactions: Mr Roboto
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
I don't think these are the same thing. One is avoiding the usual structural constraints of the test while the other is doing something that allows you to operate better within the same constraints of the test.

In any case, one way I've explained this in the past is the following: would you rather fly in the airplane piloted by the person who is "cognitively enhanced" or the one piloted by the person who has eschewed cognitive enhancers because they're "unfair"?
Yeah, but the principle of it is unethical if you think about the actual reason WHY people consider it unfair. Let me explain. Let's assume there are two candidate competing for a single surgical residency spot. Applicant A has a greater natural aptitude and would outperform Applicant B if they were both unmedicated. But Applicant B takes illegal Adderall and boosts his academic performance to where he is now performing at or above the level of Applicant A. This may result in Applicant B getting the spot instead of Applicant A, which would be unfair since Applicant A would have innately made a better doctor due to his superior aptitude. The only valid counterargument to this would be if Applicant B continued to take Adderall for the rest of his life to compensate for his relative lack of innate capability. The moment he stops artificially enhancing himself, he has committed an unethical act because he has robbed the medical community of an asset i.e. he was responsible for Applicant A not making it into the specialty and thus not contributing his natural talent to it.

The point is that we want the most capable people getting the jobs, not people who are only capable when they're abusing drugs.
 

Donald Kimball

Yale thing?
7+ Year Member
Aug 2, 2012
310
226
Status
Resident [Any Field]
Yeah, but the principle of it is unethical if you think about the actual reason WHY people consider it unfair. Let me explain. Let's assume there are two candidate competing for a single surgical residency spot. Applicant A has a greater natural aptitude and would outperform Applicant B if they were both unmedicated. But Applicant B takes illegal Adderall and boosts his academic performance to where he is now performing at or above the level of Applicant A. This may result in Applicant B getting the spot instead of Applicant A, which would be unfair since Applicant A would have innately made a better doctor due to his superior aptitude. The only valid counterargument to this would be if Applicant B continued to take Adderall for the rest of his life to compensate for his relative lack of innate capability. The moment he stops artificially enhancing himself, he has committed an unethical act because he has robbed the medical community of an asset i.e. he was responsible for Applicant A not making it into the specialty and thus not contributing his natural talent to it.

The point is that we want the most capable people getting the jobs, not people who are only capable when they're abusing drugs.
Does this argument still hold when applicant A is competing against applicant C who abuses caffeine?
 
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Does this argument still hold when applicant A is competing against applicant C who abuses caffeine?
Eh. Caffeine is not a scheduled narcotic. It's like comparing whey protein powder to anabolic steroids in terms of bodybuilding. It is totally accepted, legal, and even expected for anyone to drink whey protein, but roidz are considered unfair. Speed is not even in the same league as caffeine imo.
 

sloop

2+ Year Member
May 12, 2015
1,065
1,717
Status
Resident [Any Field]
Yeah, but the principle of it is unethical if you think about the actual reason WHY people consider it unfair. Let me explain. Let's assume there are two candidate competing for a single surgical residency spot. Applicant A has a greater natural aptitude and would outperform Applicant B if they were both unmedicated. But Applicant B takes illegal Adderall and boosts his academic performance to where he is now performing at or above the level of Applicant A. This may result in Applicant B getting the spot instead of Applicant A, which would be unfair since Applicant A would have innately made a better doctor due to his superior aptitude. The only valid counterargument to this would be if Applicant B continued to take Adderall for the rest of his life to compensate for his relative lack of innate capability. The moment he stops artificially enhancing himself, he has committed an unethical act because he has robbed the medical community of an asset i.e. he was responsible for Applicant A not making it into the specialty and thus not contributing his natural talent to it.

The point is that we want the most capable people getting the jobs, not people who are only capable when they're abusing drugs.
Dude, what does fair even mean in this situation? Is it fair that some people are born smarter than other people? If yes, then why is it not equally fair for people to even the score by compensating for something that was not in their control by using cognitive enhancers? If not, then isn't any pretension of fairness already out the window?
 

Mr Roboto

5+ Year Member
Jul 31, 2013
1,009
1,583
A galaxy far, far away...
Status
Medical Student
Eh. Caffeine is not a scheduled narcotic. It's like comparing whey protein powder to anabolic steroids in terms of bodybuilding. It is totally accepted, legal, and even expected for anyone to drink whey protein, but roidz are considered unfair. Speed is not even in the same league as caffeine imo.
Amphetamine salts isn't a "scheduled narcotic," either. Give it a rest man.
 
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Amphetamine salts isn't a "scheduled narcotic," either. Give it a rest man.
Uhhh...It's classified as a Schedule II narcotic under the Controlled Substances Act, you goddamn junkie. Legally, it's just one step under drugs like heroin, cocaine, and methamphetamine. Stop spouting bull****.
 

Taddy Mason

30 Helens agree
2+ Year Member
Dec 23, 2015
845
1,639
The Seaward
Status
Resident [Any Field]
Uhhh...It's classified as a Schedule II narcotic under the Controlled Substances Act, you goddamn junkie. Legally, it's just one step under drugs like heroin, cocaine, and methamphetamine. Stop spouting bull****.
Coke and meth are also schedule II substances...
 

Mr Roboto

5+ Year Member
Jul 31, 2013
1,009
1,583
A galaxy far, far away...
Status
Medical Student
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Coke and meth are also schedule II substances...
That just further proves my point. Adderall is on the same level as meth and cocaine, and people like @Mr Roboto pretend it's the same as Flintstones vitamin. It's literally speed, and it's disgusting that future doctors would be abusing it. If you can't hack the curriculum on your own, maybe you don't deserve to be here in the first place (with the exception of people who have a LEGITIMATE diagnosis of ADD). And for the record, I think it's bull**** when people get diagnosed with ADD in med school...They wouldn't have made it to med school in the first place if they really had ADD. They're just lazy and want a boost. Pathetic.
 

Taddy Mason

30 Helens agree
2+ Year Member
Dec 23, 2015
845
1,639
The Seaward
Status
Resident [Any Field]
That just further proves my point. Adderall is on the same level as meth and cocaine, and people like @Mr Roboto pretend it's the same as Flintstones vitamin. It's literally speed, and it's disgusting that future doctors would be abusing it. If you can't hack the curriculum on your own, maybe you don't deserve to be here in the first place (with the exception of people who have a LEGITIMATE diagnosis of ADD).
They're Schedule II because they have a legitimate medical use.

And for the record, I think it's bull**** when people get diagnosed with ADD in med school...They wouldn't have made it to med school in the first place if they really had ADD. They're just lazy and want a boost. Pathetic.
I know several people who were Dx with ADD in grad school and med school. Its not laziness, some people are able remain highly functional and deal with their Sx while being largely unaware of having attention problems until they hit a breaking point (e.g., the demands of med school) where their Sx start to have a significantly negative impact their lives. Also, if a physician is really that suspect that a person is drug seeking and doesn't have ADD they can always refer the patient to a psychologist for testing.
 
  • Like
Reactions: Mr Roboto
Sep 16, 2014
125
56
A professor at a medical school my friend goes to went over ways in class on how to potentiate/maximize amphetamines with a little wink. They applied renal and neural physiology, named specific transporter proteins, etc. Hey, if it makes you be a better person with no side effects, whatever.
 
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Also, if a physician is really that suspect that a person is drug seeking and doesn't have ADD they can always refer the patient to a psychologist for testing.
That can be easily faked. It's not like a blood test. When it comes to mental diseases, all you have to go by is the patients' behavior and HPI. Consider the PHQ9. Anyone could go in and get prescribed antidepressants just by filling out a maximum score on the questionnaire...same thing for ADD. All it takes is saying that you can't focus and then pretending like you can't focus if they test you.

A lot of lazy people would get their speed taken away if we had a biochemical test for ADD.
 

The Knife & Gun Club

MS - 4
2+ Year Member
Nov 6, 2015
2,350
4,522
Hollywood Upstairs Medical College
Status
Medical Student
Uhhh...It's classified as a Schedule II narcotic under the Controlled Substances Act, you goddamn junkie. Legally, it's just one step under drugs like heroin, cocaine, and methamphetamine. Stop spouting bull****.
Also I'm pretty sure Modafinil is like a schedule 3 or something since it doesn't have a significant risk of addiction.

That said I don't think those drugs are as helpful as you think. I've taken pretty much every prescribable psychostimulant under the sun (all through legal, physician prescribed channels), and never saw a significant increase in academic abilities.

It made it more pleasant to stay up late and focus on super boring school stuff, but the actual academic yield is remarkably low. Amphetamine derivatives certainly don't improve intelligence and in many people actively reduce academic potential IMO.

That's why after having access to Modafinil, vyvanse, adderall, etc, I decided I learn better without any of them. So I wouldn't openly assume everyone who's taking them is actually benefiting...they may just like being "high" while they study.
 
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
Also I'm pretty sure Modafinil is like a schedule 3 or something since it doesn't have a significant risk of addiction.

That said I don't think those drugs are as helpful as you think. I've taken pretty much every prescribable psychostimulant under the sun (all through legal, physician prescribed channels), and never saw a significant increase in academic abilities.

It made it more pleasant to stay up late and focus on super boring school stuff, but the actual academic yield is remarkably low. Amphetamine derivatives certainly don't improve intelligence and in many people actively reduce academic potential IMO.

That's why after having access to Modafinil, vyvanse, adderall, etc, I decided I learn better without any of them. So I wouldn't openly assume everyone who's taking them is actually benefiting...they may just like being "high" while they study.
By the way, how was Modafinil? I was reading a paper recently that made it seem like Adderall 2.0. Obviously you didn't find any of them too useful academically, but in general how did you find that Modafinil compared to the amphetamines? I'm just curious since it's a relatively new drug which is being used 0ff-label for ADD (only officially approved for narcolepsy and shift work sleep disorder).
 

Taddy Mason

30 Helens agree
2+ Year Member
Dec 23, 2015
845
1,639
The Seaward
Status
Resident [Any Field]
That can be easily faked. It's not like a blood test. When it comes to mental diseases, all you have to go by is the patients' behavior and HPI. Consider the PHQ9. Anyone could go in and get prescribed antidepressants just by filling out a maximum score on the questionnaire...same thing for ADD. All it takes is saying that you can't focus and then pretending like you can't focus if they test you.

A lot of lazy people would get their speed taken away if we had a biochemical test for ADD.
You clearly know nothing about Dx-ing or psychometric testing for ADD.
 
Last edited:

The Knife & Gun Club

MS - 4
2+ Year Member
Nov 6, 2015
2,350
4,522
Hollywood Upstairs Medical College
Status
Medical Student
By the way, how was Modafinil? I was reading a paper recently that made it seem like Adderall 2.0. Obviously you didn't find any of them too useful academically, but in general how did you find that Modafinil compared to the amphetamines? I'm just curious since it's a relatively new drug which is being used 0ff-label for ADD (only officially approved for narcolepsy and shift work sleep disorder).
I hated the side effects of traditional ADHD medication. So modafinil is nice in that it doesn't cause the loss of appetite, mood destabilization, etc.

But it's just not particularly useful in treating ADHD.
 

Donald Kimball

Yale thing?
7+ Year Member
Aug 2, 2012
310
226
Status
Resident [Any Field]
Eh. Caffeine is not a scheduled narcotic. It's like comparing whey protein powder to anabolic steroids in terms of bodybuilding. It is totally accepted, legal, and even expected for anyone to drink whey protein, but roidz are considered unfair. Speed is not even in the same league as caffeine imo.
So, let me get this straight: your addictive performance drug of choice is GOOD because it's legal or unscheduled, but someone else's addictive performance drug of choice is BAD because it's illegal or scheduled?
 
  • Like
Reactions: Mr Roboto
OP
Foot Fetish

Foot Fetish

2+ Year Member
Jun 4, 2016
682
1,360
Status
Medical Student
So, let me get this straight: your addictive performance drug of choice is GOOD because it's legal or unscheduled, but someone else's addictive performance drug of choice is BAD because it's illegal or scheduled?
Yeah, typically we outlaw things that are bad. That's sort of the point of laws.
 

Taddy Mason

30 Helens agree
2+ Year Member
Dec 23, 2015
845
1,639
The Seaward
Status
Resident [Any Field]
Yeah, typically we outlaw things that are bad. That's sort of the point of laws.
Ah, so that's why booze and tobacco are legal and marijuana is illegal.
 

Donald Kimball

Yale thing?
7+ Year Member
Aug 2, 2012
310
226
Status
Resident [Any Field]
Yeah, typically we outlaw things that are bad. That's sort of the point of laws.
One time, alcohol was illegal. And then it wasn't. So, by your reasoning, it was bad, and then it was good, despite nothing about the substance changing in the interim. Just because society deems using caffeine "good," doesn't make it inherently different from using amphetamines, which society deems "bad." Alcohol and cigarette smoking are legal (and GOOD by your logic), but LSD is not. How many lives have the former claimed vs the latter?

At the end of the day, people use performance enhancing substances, techniques, etc. It's silly to equivocate that one is morally better or worse than another, more or less fair than another, or cheating vs not, when they all boil down to the same thing. In fact, if it's so easy to get diagnosed with ADHD and receive stimulants, then how could it be unfair? Surely that's more fair than being born as a white male in the upper class, living care free of medical or economic concerns, receiving an excellent private school education, going on to an Ivy League undergrad and medical school, and becoming a neurosurgeon, right?
 

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,613
65,288
4th Dimension
That can be easily faked. It's not like a blood test. When it comes to mental diseases, all you have to go by is the patients' behavior and HPI. Consider the PHQ9. Anyone could go in and get prescribed antidepressants just by filling out a maximum score on the questionnaire...same thing for ADD. All it takes is saying that you can't focus and then pretending like you can't focus if they test you.

A lot of lazy people would get their speed taken away if we had a biochemical test for ADD.
There's a lot of aversion to giving people ADHD meds after a certain age. You have to pass a really thorough series of psychometric tests, have proven cognitive difficulties in school, etc.

Plenty of people get pills off of those with a legitimate script though, but that's something that goes all the way back to high school. I'd bet if you ran a hair test on most med school classes, only about 50% would pass between all of the drugs that are out there. I don't use any drugs of any sort myself, aside from benadryl to sleep, and don't really care if others do, but I'm just sayin' it as a matter of fact- many of these kids are doing the same stuff other people their age are doing, plus a little amphetamines on the side.
 

sloop

2+ Year Member
May 12, 2015
1,065
1,717
Status
Resident [Any Field]
That can be easily faked. It's not like a blood test. When it comes to mental diseases, all you have to go by is the patients' behavior and HPI. Consider the PHQ9. Anyone could go in and get prescribed antidepressants just by filling out a maximum score on the questionnaire...same thing for ADD. All it takes is saying that you can't focus and then pretending like you can't focus if they test you.

A lot of lazy people would get their speed taken away if we had a biochemical test for ADD.
I had an EEG, MRI, several psychometric testing sessions with a clinical psychologist and a neuropsychologist (including IQ tests, tests of visuospatial reasoning, etc.), multiple questionnaires filled out by different teachers and several years of attempts with one-on-one occupational therapy and behavioral modification. I then failed Straterra treatment (well, I am told it helped a little but nowhere near enough), before I finally got prescribed Ritalin.

I get that my experience might be slightly more intense than most, but still . . . It wasn't like "Wahh! I can't concentrate!" "Okay, here's Ritalin."
 
  • Like
Reactions: Walter Lance

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,613
65,288
4th Dimension
Yeah, typically we outlaw things that are bad. That's sort of the point of laws.
That drugs are "bad" is a largely subjective assessment. Objectively, can we state that all of the illegal drugs out there are bad? Many are simply deemed "not having any medical or therapeutic use," but since when is something not being useful worth making it illegal?

Drugs being illegal largely goes back to Christian ideals of sobriety that had roots in the Old Testament. There isn't some objective basis for determining that mind-altered states are bad, and in many cultures and religions throughout history, such experiences have been considered divine rather than a societal ill. That drugs are illegal is therefore more a historical curiosity, a vestigial remnant of laws based upon the founding religion of our forefathers.