America's love affair with legal amphetamine: Column When will we be able to just say no?

Lawrence Diller | USATODAY

I've decided to create a new psychiatric disorder. Why not? Drug companies do it all the time.

Shire, which makes Adderall, won approval recently from the Food and Drug Administration to market its amphetamine drug, Vyvanse, for the treatment of BED. You haven't heard of it? Neither had many people, until Shire funded studies to get the binge eating disorder into the DSM-5 — America's official psychiatric bible of common life dilemmas translated into mental disorders. My disorder is called achievement anxiety disorder (AAD), and it explains the increasing reports of prescription amphetamine misuse most often in the form of Adderall abuse.

Just what is achievement anxiety disorder? Like all psychiatric conditions, there are no blood tests or brain scans to make the diagnosis. But you can see it all around us — frantic people working ever harder to achieve a certain level of material satisfaction and security. Because of our country's declining position as a global economic empire, along with a widening gap between the 1% and everyone else, Americans must now work harder and make more money just to maintain the same standard of living our country enjoyed 40 years ago. And while the U.S. has produced astounding successes and accomplishments, that history has left many Americans doubting their own abilities, striving to do more and turning to drugs to cope.

A once-personal struggle for self-acceptance and success has turned into contagious angst about a collective failure to live up to our dreams. Today's Millennial generation is the first group of Americans since World War II who will not live as well as their parents did. Our young adults who are turning to Adderall are the stark casualties of this broken cultural norm that makes happiness impossible to achieve.

Adderall is not a new drug. Amphetamine (legal and illegal) has been around since 1929 and has repeatedly found its way into the mainstream culture over the years for use in treating depression, asthma, neurasthenia, narcolepsy, weight control and now attention deficit hyperactivity disorder, ADHD — or ADD (without hyperactivity). Doctors invoke ADD as the most current reason to prescribe a chemical that, in the short term, makes anyone who takes it, child or adult, more alert, more methodical and more likely to complete tasks that are boring or difficult. There is no evidence in either children or adults that taking Adderall has long-term benefits.

Rampant Adderal use is a clear sign of our nation's epidemic of ADD or AAD — you decide. According to Drug Enforcement Administration records, in 2013 American manufacturers of prescription stimulant drugs produced 191,723 kilograms, or 211 tons, of legal speed. This translates to more than two dozen 20 mg Adderall pills for every man, woman and child in this country. AAD may be a particularly American condition. Our country makes up less than 4.5% of the world's population but produces 70% of its legal amphetamines.

Our epidemic of ADHD/ADD is the official reason for our love affair with legal amphetamine,but experts estimate that nearly a third of the stimulants prescribed in our country is diverted for illegal misuse (without a doctor's prescription). Any college student can tell you how easy it is to obtain Adderall during exam time. Knowledgeable Web surfers go to the "dark side" of the Internet and find sites such as the Silk Road, where Adderall is openly sold and traded.

However, we can't just blame drug companies and drug dealers for our love affair with Adderall. In any epidemic , one must not only examine the qualities of the virus but also consider the qualities of the host. AAD is part of our national character. Horatio Alger, George Babbitt, Jay Gatsby and Gordon Gekko are authors and fictional characters who chronicle how fundamental AAD is to the American ethos, though, as far as I know,none of them used Adderall.

Our relentless pursuit of material acquisition is our unofficial state religion. Nothing short of some natural or social catastrophe is likely to change our values soon. But at some point, our use of Adderall for AAD is certain to peak and then crash. It's a historical inevitability, with at least three waves of doctor-prescribed amphetamine abuse in our country's past. The last was in the 1970s, when many dieting women became addicted via their physicians' prescriptions. Doctors were sued, lost their licenses, and the practice stopped.

This time is different. There are mega Fortune 500 companies making $9 billion a year by selling legal speed and stimulants. Their power and influence over government regulatory agencies such as the FDA and DEA make it unlikely that the use of Adderall will decrease any time soon. Unfortunately, many more young adults will become addicted, and some will die before America says no (again) to Adderall.

Lawrence Diller, M.D. practices behavioral pediatrics in Walnut Creek, Calif. His latest book is Remembering Ritalin.

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