Human Nature: Science, Technology, and Life.

Shrink Drugs

If you put your kid on ADHD drugs, what will you have to show for it three years later?

Maybe just a smaller kid.

Shankar Vedantam outlines the unpleasant findings in the Washington Post:

New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months. The study also indicated that long-term use of the drugs can stunt children's growth.

In the early stages of the project, known as the Multimodal Treatment Study of Children With ADHD, the drugs looked good. But as years went by, the benefits faded, and the only remaining effect was, in relative terms, physical shrinkage:

In August 2007, the MTA researchers reported the first follow-up data, which by then no longer showed differences in behavior between children who were medicated and those who were not. But the data did show that children who took the drugs for 36 months were about an inch shorter and six pounds lighter than those who did not.

Here's the report published by the study's supervisors in 2007:

The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size.
Conclusions: Stimulant-naive school-age children with Combined type attention-deficit/hyperactivity disorder ... show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.

Without evidence of growth rebound. You lose two centimeters of expected growth—more than three-quarters of an inch—and you don't get them back. That's nowhere close to the two feet of height you can withhold from a prepubescent girl through estrogen therapy. But it's just as permanent.

And how did the study's funder, the National Institute of Mental Health, spin the bad news? Vedantam tweaks the Institute for its truth-stretching headline—"Improvement Following ADHD Treatment Sustained in Most Children"—and for euphemistically reporting that kids who weren't drugged "grew somewhat larger."

This study won't settle the debate over ADHD drugs. But it should sober anyone who thinks that medicating the mind won't affect the body—or that the effects can be erased.

Doping and Deficits

Would you like to take performance-enhancing drugs to boost your pro sports career? Are the drugs banned as a form of cheating? No problem. Just find a doctor willing to certify that you have a "deficit" of the performance factor in question.

That's what seems to be happening in Major League Baseball.

More here.

White-Collar Steroids

Are people in your office using performance-enhancing drugs?

I'm not talking about steroids. I'm talking about brain enhancers, such as Ritalin for concentration and Provigil for sleep reduction. Two months ago, I wrote about a Nature survey in which 20 percent of a self-selected sample of scientists, academics, and journalists admitted using such drugs "for non-medical reasons to improve my concentration, focus and memory." In absolute terms, it's hard to argue against these neuroenhancers. But in relative terms, freedom of enhancement can become coercive. If your officemates are outworking you by popping pills, can you afford not to join them?

We know this is a problem in sports. Has it become a problem in the white-collar workplace? Neil Munro examines this question in a recent issue of National Journal. The answer seems to be: We don't yet know, but signs point to trouble ahead.

Munro goes through what little we know. First, there's the non-random Nature poll. Then there's a survey at one college in which one of every six students admitted to taking prescription drugs as a study aid. Munro also cites the recent doubling of adult prescriptions for Adderall and Ritalin, implying that the increase is too big and fast to be purely therapeutic. But the really interesting comment comes from Zack Lynch, the executive director of the Neurotechnology Industry Organization:

If you're GE Capital and you have offices in 154 financial centers around the planet, and these [brain-drug] tools are available in Dubai, and your workers there are trading more effectively, 5 to 10 percent better—they'll have a neuro-competitive advantage over workers where these tools are not legalized.

Neuro-competitive advantage. There's the leverage point for pushing brain boosters into the workplace. The good news is, these pills might make you more productive. The bad news is, if you don't take them, some guy in Dubai will, and he'll eat your job. Lynch flatly tells Munro that if the United States restricts performance-enhancing office drugs, "companies will shift their work offshore."

I don't want to make this scenario sound like it'll be here tomorrow. The brain is notoriously finicky, so there are a lot of obstacles and side effects to work out. But the same is true of performance-enhancing drugs in sports, and that hasn't stopped them from becoming a coercive presence.

Munro points out that neuroenhancement is a big emerging market and that one firm has already been caught exploiting it:

Cephalon, a large biopharmaceutical company, agreed to pay a $425 million settlement to the federal government last year after the firm's sales force was accused of marketing its Provigil anti-sleep drug for purposes other than those for which it has been approved. Provigil was approved for treating narcolepsy, but it was used as a stimulant by some of the scientists who responded to the Nature poll.

Next time you're chatting with your colleagues around the water cooler, ask what they're taking with their water.