Class A Drug: Affluent Israeli Highschoolers Are Taking Ritalin Without Doing Their Homework

A Haaretz investigative report shows that the benefits of the drug are far from clear, especially when taken without proper supervision.

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A week before R.’s matriculation exams, her mother, A., found herself rushing around the city in an attempt to find a physician who would give her a prescription for Ritalin. ‏(Haaretz is in possession of the full names of all those mentioned in the article.‏)

R., a senior in one of the best high schools in the city where the family lives, was in a panic. She couldn’t cope with the mountains of material for the exams and needed medicinal help urgently, she said.

A. took up the challenge. “What can you do?” she says now. “Here’s a kid who’s having a hard time, an outstanding student who is being done in by stress. I saw how badly she was suffering and had to help her.” Nevertheless, a wavering in her voice hints at uncertainty that she had done the right thing.

R. only began to take Ritalin in the 12th grade. For years she was a top student and had coped with her schoolwork. In her senior year, though, the pressure grew. She blames the system.

“The only thing the school wants is for us to excel,” she says. “Of the 30 students in my class, 26 take pills. I was one of the last. Mom insisted that I do it with prescriptions. Some of the kids just take from others who have a prescription,” she adds. The last remark takes her parents, who are with her, by surprise.

Ritalin is considered an efficient medication in terms of its effectiveness in helping sufferers from ADD ‏(attention deficit disorder‏) and ADHD ‏(attention deficit hyperactivity disorder‏). It is administered to adults and children in order to quiet their inner noise, enabling them to pay attention, take part in classes and study like “normal” people − though “normal” is different from one person to another.

“Ritalin is given only to children, adolescents and adults who have been diagnosed with ADHD,” the Health Ministry tells Haaretz, in reply to questions about the scale of the drug’s use. However, experts who were quoted in a Wall Street Journal article on the subject this month stated that 15 to 20 percent of those who take medications ‏(Ritalin, Adderall and others‏) for attention deficit disorders in the United States do so without prescriptions. There are no statistical estimates of the phenomenon for Israel, but it’s clear that it is quite easy to obtain Ritalin without going to a doctor − from fellow students in universities, colleges and high schools, in addition to the professionals.

R.’s parents are well-off, as are the families of her school friends. The health maintenance organizations do not provide information about the geographical dispersion or socioeconomic status of those who take the medications. Off the record, however, a source at one of the HMOs admitted that a correlation exists between the consumption of the medications in general and economic ability. A large drugstore chain told us explicitly that Ritalin use is far higher in the center of the country.

Socioeconomic profile

According to Prof. Avinoam Reches, a neurologist who is also the chairman of the ethics committee of the Israel Medical Association, “Ritalin has a high socioeconomic profile, and its use in [affluent] north Tel Aviv as compared to [less affluent] south Tel Aviv approaches a multiple of ten.” That comes as no surprise to T., whose son, N., will enter the 12th grade in a Ra’anana high school next fall. “Many of the students in N.’s class take pills, and he also often wanted to take them,” she says. “But his father, who is a physician, made it clear that he is unwilling for him to use the pills. People aren’t aware of the side effects of the drugs.”

N. feels that his parents’ decision is blocking his path to success. He and other high school students we spoke to are convinced that pill-popping represents the optimal way to scholastic achievements, and that an unfair gap exists between those who use Ritalin and those who are denied its advantages.

The students complain of excessive schoolwork, crushing pressure from the system and home to excel, and serious concentration problems. N.’s mother agrees with her son in one respect: “It turned out that everyone in his class, with just one exception, was diagnosed with learning problems, and therefore they were given more time in exams,” she says. “I took him for a diagnosis and now he gets extra time like the others. So at least he was freed of the psychological pressure of having to finish the exam before everyone else.”

Though no official confirmation exists for the data, the fact cannot be ignored that well-off parents are able to shorten the waiting period for ADHD diagnosis, and to spend thousands of shekels on private doctors to achieve that end. A mother from north Tel Aviv − both of whose sons were diagnosed with
attention deficit disorders − insisted that this was a lengthy process and that no parent would “organize” pills for his child just so he would get better grades in school. But a short conversation with one of her sons, who has just completed the 11th grade, confirms that this is a widespread phenomenon. He tells us that almost 30 of the 40 pupils in his class pop pills, though “only 15 of them really suffer from ADHD.

“Getting pills is no problem,” he adds. “Whoever wants them gets them, and anyway it’s also easy to be diagnosed with some sort of problem.”

His description is seconded by D., from Ra’anana, the mother of two high school students. “I was shocked last year, when the older one − who was in the 11th grade − asked us to help him obtain Ritalin,” D. said. “’But you have no problems in school, so why do you need the capsules?’ I asked him. He replied, ‘Everyone takes them.’ My instinct was to say, ‘And if everyone were to jump off the roof?’ But after I called a few parents from the class, I realized that it really was commonplace − that many students take Ritalin, especially during exam

D. said that last year she refused to help her son get the medication, but that a few months ago, when he was studying for matriculation exams, she relented. “The struggle had become ridiculous,” she recalls. “Even without my help he was able to get Ritalin − from a classmate who has a prescription. What could I do? On top of which, his marks on the exams were now relatively high − a lot higher than he had been getting all year.”

D. explains that the family doctor referred her son to a private clinic that specializes in diagnosing attention deficit disorders. He also had blood tests and heart-function tests, and was examined by an HMO neurologist. “A process of weeks or months was necessary to get the prescription,” D. says, “and there wasn’t enough time before the exams. In the end I took him privately to see a psychiatrist who had diagnosed some of his classmates. After a short visit, he provided the diagnosis and the prescription.

“I'm certain he doesn’t have any sort of attention disorder, but I wanted the process to be done through me and transparently, rather than have him take some unknown medication he got from a friend or buy it illegally.” This year her younger son, who will be entering the 10th grade, also asked for her help. “I preferred to cooperate. I didn’t want him doing it secretly, behind my back, so I took him to the psychiatrist, too,” D. said.

The phenomenon is not confined to high school. In Israel − in contrast to the United States − no official data are available about the number of post-high school students who take medication to improve their concentration. But anyone who has visited university and college campuses knows that the phenomenon is widespread and growing.

K., a master’s degree student, sensed that she was drowning during the exam period in the first semester. Stressed by the pressure of work, the need to memorize material and the difficulty of finding time amid taking care of the children and the tasks of daily life, she decided to try one of the pills her brother had obtained by prescription. “It was an incredible feeling,” she recalls. “In a regular situation, I felt that everything I read was slipping out of my brain, but with the pill, every letter sunk into my head.”

Even though she is aware that trading in Ritalin is a criminal offense − Ritalin is included in the Dangerous Drugs Ordinance in Israel − she does not think the use of Ritalin without a prescription falls into this category. “I was never diagnosed as having an attention deficit disorder,” she notes, “but in my opinion I have an acquired disorder.”

Hagit ‏(not her real name‏) recently completed her studies as a graphic designer. In her final year, when she had to submit a graduation project, she felt the need for chemical assistance. Pleased with the results after taking a Ritalin pill she got from a friend ‏(who had a prescription‏), she made an appointment with her family doctor to get a prescription of her own.

“My doctor told me he is not in favor of Ritalin, on principle. He gave me a prescription for only 10 pills and sent me to have a diagnosis that costs NIS 900,” Hagit recalls. “That was too expensive for me, so I just asked for some pills from friends who have a prescription. Every other student takes Ritalin, so it wasn’t hard to get hold of.”

Liquidation sale

Ritalin consumption in Israel is soaring. According to Health Ministry data, use of the drug rose by 10 to 15 percent between 2005 and 2009, but in 2010 there was a dramatic increase of 76 percent in the consumption of the active ingredient methylphenidate ‏(which is found in Ritalin, Concerta and similar drugs used in the treatment of ADHD‏). The steep rise in 2010-11 followed an authorization to prescribe a larger dosage of the medication in order to adapt it to the needs of adolescents and adults. About 55,000 people were treated in 2010, the Health Ministry says. In 2011, about 143,000 people were prescribed the medication ‏(according to reports by the HMOs about the use of medications that appear in the “basket of medicines,” referring to state-funded medical services and pharmaceutical drugs‏). These figures do not include extended-release versions, such as Concerta and Ritalin LA, which are not part of the basket and for which patients pay full price.

Depending on one’s worldview, the rising usage can be read as stemming from greater awareness, from the number of individuals being diagnosed, the ineffectuality of the education system or the spread of bad habits. The increase is confirmed by parents, teachers and students in high school and the country’s colleges and universities. Ritalin is available only by prescription and in measured quantities, but many of the pills end up on the black market.

The HMO to which the family of Y. − a high school student from Tel Aviv diagnosed with ADD − belongs, gives him a prescription for 60 pills a month, though in practice he uses only half that number. “I prefer not take them on Shabbat, holidays and during summer vacation,” he says, “and even on a daily basis I don’t always take two pills.” He sells the “leftovers” to classmates.

Y. says he charges NIS 20 per pill, but adds that in other classes and other schools, the price can go as high as NIS 50. According to Y., his classmates take Ritalin mainly during exam periods, but he has also heard of cases in which pupils crushed the medication and sniffed it like cocaine. At the time he obtained a prescription for Ritalin, he was “a mediocre-minus student with plenty of discipline problems.” Ritalin, Y. says, is a “medicine that changed my life.” He describes its effect on other students, who apparently do not suffer from ADHD, as positive, saying that they too did very well in their exams.

M., an adviser in a junior high school in the center of the country, says that in a class of 40 students “I would say that 15 to 20 percent take Ritalin. The parents are constantly talking about it and checking into it. They don’t draw a distinction between attention deficit disorders and learning disorders, which require a psycho-didactic evaluation. The parents are confused. There is a wild private market, drugs by personal import in a Tel Aviv drugstore [by prescription]. A permit from the Health Ministry is required, but you can also import independently. I know a mother who went to great lengths for her son to obtain [Ritalin] very expensively.”

Where does the pressure to be diagnosed come from? The school?

M.: “In some cases the initiative comes from the school. They see that a pupil is having a hard time concentrating for eight hours, and that this is having a direct effect on his achievements. But sometimes there's peer pressure: ‘I have ADD, I have ADD!’ There are children who find it convenient to adopt that title. In certain cases it really can engender a major change for the better. There are children who maintain a love-hate relationship with the pill. Those who turn into zombies from taking the drug will stop taking it at a certain stage.”

Brain wars

The big question about the extensive use of Ritalin and similar drugs, which sound like a cure-all for all kinds of problems, is this: Do Ritalin and Concerta really improve cognitive abilities, or is their effect more like that of a few cups of strong coffee? The drug works by increasing the amount of dopamine in the brain, thus assisting it to create “order.” There is no proof that methylphenidate, the active ingredient in Ritalin and Concerta, actually improves memory or cognitive ability. The influence lies in a sense of wakefulness that is induced, a feeling of alertness and concentration. Methylphenidate affects the central nervous system; its operation is similar to that of caffeine, only more intense, approaching the impact of amphetamines.

A study conducted in 2009 at the National Institute of Mental Health in the United States, using digital brain imaging, showed that Ritalin does in fact heighten the flow of dopamine. The researchers think that this improves the ability to concentrate and be focused, though it’s unclear whether this is the result of a greater intake of dopamine or is brought about by the increased flow of blood into the brain.

In the light of this, what is the effect on those who suffer from attention deficit disorders? According to a study conducted among 4,000 students in Quebec over an 11-year period ‏(as reported in the Wall Street Journal on July 8‏), children who received medication such as Ritalin and Adderall actually got worse grades than students with attention deficit disorders who did not take such medication. Girls who took the medication reported a higher rate of emotional problems.

A U.S. government study of 579 children with ADD, which examined the achievements of those who took medication versus those who didn’t, found that there were short-term improvements, but that the difference disappeared by the third year in which the medication was taken.

“The studies are mutually contradictory,” says Dr. Dorit Yudeshkin-Porat, a psychiatrist who treats adults, children and adolescents. “There are studies claiming that it abets concentration, while others say that people who are helped by Ritalin apparently have an undiagnosed element of disorder.”

It’s important to remember, she adds, “the placebo effect that makes those who take the medication feel an influence that stems from the psychological level, not necessarily the neurological level.” Prof. Reches also believes that “use that is not medically indicated” is largely related to the placebo element, “in which just the thought of taking medication that improves concentration makes us feel concentrated.”

Dr. Iris Manor, a psychiatrist specializing in the treatment of children and adolescents, and director of the ADHD Unit at Geha Psychiatric Hospital, Petah Tikva, is angered by the view that Ritalin is some sort of panacea. In her opinion, the result is a distorted situation that is harmful to those who genuinely need the medication, because it is perceived as a drug for the lazy. “Ritalin is an excellent medication for those who suffer from ADD, but it does not work for those who do not have that disorder,” she explained. “It improves certain functions but has an adverse effect on others, and therefore the end result is that it does not help [those who don’t need it].”

According to Dr. Manor, “A web of superstitions has been created about Ritalin, but that is not so if one looks at the subject from a purely scientific angle. We need to shatter the conception about these substances. The medication deserves our respect. As with every aspect of medicine, you should not begin Ritalin treatment without undergoing a systematic diagnosis, and only by an expert physician.” She notes that even those who need Ritalin will not always benefit from it: it has no effect on about 15 percent of those who are diagnosed with ADHD.

According to studies conducted by the neuroscientist Prof. Martha Farah, from the University of Pennsylvania, neurological medication that raises the dopamine level is of less help to people who possess naturally high intellectual ability. The amount of dopamine in the brain is a product of natural ability. People who have trouble in school tend naturally to have less dopamine, or their dopamine level decreases relatively quickly. As a result, they will show a greater improvement by taking substances that affect the dopamine level than people who have naturally higher dopamine levels to begin with, and as such possess greater ability to internalize and remember material.

However, a contradictory view is given by Prof. Judith Aharon-Peretz, the director of the Cognitive Neurology Unit at Rambam Medical Center, Haifa. “Some people have a minor disorder that might even be useful to them, because of their speed of thought,” she notes, “whereas in others the disorder causes functional disability. There is a broad spectrum of attention deficit disorders, so the medications can be of greater or lesser help, according to the disorder’s location on the spectrum.”

So Ritalin helps everyone?

Aharon-Peretz: “Ritalin is not an antibiotic but a medication that improves the ability to learn, and it can also help people who have not been diagnosed. But it is important to bear in mind its dangers. Parents and high school students are not aware of these.

“We have already encountered cases of students − including medical students − who took a high dosage and ended up losing consciousness and going into spasms. Many people think that if it helps, then the more the better, and take life-threatening dosages.”

Modified behavior

In fact, the medication can be hazardous even without a too-large dose. If there is one thing that everyone agrees on, it is that Ritalin causes side effects. Among those listed by Yudeshkin-Porat, some are merely bothersome: reduced appetite, headaches, dryness in the mouth, stomachaches, sleep disturbances and a feeling of despondency. However, others are more serious, such as anxiety and irregular heartbeat.

“Responsible physicians who prescribe Ritalin will generally demand a heart-function check to find out whether a prior problem exists and to monitor the situation,” Yudeshkin-Porat says. Studies conducted in universities around the world, including Yale, have shown that raising the level of dopamine in the brain over time causes an increased flow of blood to the brain, which can cause permanent damage in the prefrontal cortex. The irony is that this region of the brain is responsible for thought, so damage is caused precisely to long-term memory and to problem-solving ability.

High school student R. developed a series of side effects, as her mother recalls: “R. became aggressive. She said things I had never heard her say before, like ‘Get out of my face!’ One day I came home and she had just come out of the shower and she started to talk. She talked for an hour and a half nonstop, like a real mania attack. Another time I asked her, ‘Have you eaten?’ She replied with a rebuke, ‘Mom, how could I eat, I took Ritalin!’”

R. laughs at the memory and adds that she actually liked having a diminished appetite. “I am glad I took Ritalin,” she admits. “I had reached a state in which even those close to me didn’t believe I would get a matriculation certificate. As soon as I started to take Ritalin, there was an improvement. I could concentrate for hours. The side effect of depression was there, but it was short. On the other hand, the joy at the exam results is great and lasting.”

If high school students make light of the side effects, adults find themselves weighing whether to take the medication − though, of the ones we interviewed, most decided to stay with it. Hagit, the graphic designer, experienced side effects of despondency, lack of appetite, extreme mood swings and even a danger of addiction. “People think that because it’s a medication it’s not addictive,” she says, “but actually it’s similar to cocaine. I know people who can’t function without it.” She does not rule out taking the medication again in the future, for projects that require prolonged concentration.

Prof. Reches, too, underscores the fact that Ritalin is not a candy but a medicine that exacts a price. “When you take Ritalin unnecessarily and without medical supervision, there is a danger of using the wrong dosage or of using it in combination with other medications,” he says. “In addition, there are serious phenomena, such as depression or a major emotional ‘fall’ after usage. You cannot squeeze superfluous energies from the body without paying for it.”

Yael, a graphic designer from Tel Aviv, suffered for years from undiagnosed ADD. “I lived with it, finished high school and got a degree with it. A degree in graphic design is ideal for people like me, because it is work of the sort that I can actually concentrate on. There is something about people who suffer from ADD but are undiagnosed, which allows them to compensate for and bypass those difficulties.”

Four years ago, as the owner of her own studio and mother of two children, she decided that she needed help. “It was like getting glasses after a prolonged vision problem,” she recalls. “I didn’t understand how I had gone through childhood like that. All the external stimuli − telephones, music, light, people going through the studio − were silenced. Like magic.”

But the side effects came quickly: a higher pulse rate, lack of appetite, serious dryness in the mouth and deep weariness after using Ritalin. “My feeling is that the body pays for so many hours of concentration. It’s not something that comes naturally to me,” she observes. At the height of the medication’s influence, Yael says she finds it difficult to speak and sometimes lapses into stuttering. “It is hurting my social relations somewhat,” she admits. “People call and I tell them I can’t talk because I am on Ritalin. On days when I have to make a presentation to a client, I will take the Ritalin afterward.”

Will you let your children take Ritalin?

“No. I think that the price you pay for a very good level of concentration is too high for a child to be able to cope with. The feeling is really one of being drugged. I will look for a private framework that will suit my child − and that won’t be easy, because I'm a single parent − but I will not drug him.”

But you said that for you it was like getting a pair of glasses.

“True, but if I had been given those glasses in the fourth grade, I would be a different person today. I would have had different marks, but it is too strong a tool. On the other hand, I don’t really know − I have no real experience in being a focused, relaxed person.”

Cosmetic neurology

Given its unproven effectiveness, dangerous side effects and personality changes, should the use of Ritalin be restricted only to those suffering from the most serious levels of attention deficit disorder? According to Prof. Reches, its use by people who have not been diagnosed with ADHD should not be completely ruled out.

Reches has also issued a position paper on the subject for the IMA’s ethics committee. “The discussion about Ritalin and similar medications is in part theoretical-philosophical, and has to do with the function of medicine,” he notes. “Is the function of medicine only to prevent diseases and treat them, or should it also improve an individual’s quality of life, as that individual perceives it?”

Reches finds a parallel between aesthetic medicine − cosmetic surgery − and the use of Ritalin to improve cognitive abilities. In both cases it is a choice without medical indication, and in both cases the patient/user needs to be aware of the side effects.

One way or the other, Reches believes it is essential for the process to be medically supervised − just as no one would choose to undergo a nose job with just the help of a generous classmate. Ritalin, too, needs to be prescribed by a physician and be taken under medical care. “When it comes to sports, as we know, a change or upgrading of the maximum human performance is prohibited,” Reches says. “It cost Lance Armstrong seven [Tour de France] titles. But what about the cognitive side? When I was in high school, kids who had money bought a slide rule instead of logarithmic tables. These days, people who take private lessons are also breaking the absolute equality of schooling. On the margins, it’s clear − there is already inbuilt inequality in intellectual abilities, and also in the means that need to be mobilized to improve those abilities. The question is whether we, as physicians, need to concern ourselves with those ethical and philosophical issues.”

The analogy Reches draws between the use of Ritalin and similar medications and cosmetic surgery is not new. It is widely used and has already spawned a new term to conceptualize the phenomenon: cosmetic neurology. The term was coined by Prof. Anjan Chatterjee, a neurologist from the University of Pennsylvania. He maintains that the two cases − cosmetic surgery to change one’s appearance, and taking medication to heighten concentration and thinking − resemble each other. In both cases, people are trying to improve themselves with the use of medical aids that were developed for other purposes. Chatterjee told The New Yorker that the use of these substances will become as accepted as the use of cosmetic surgery.

According to neuropsychologist Dr. Tali Fischer from the Cognitive Neurology Unit at Rambam Medical Center, “The phenomenon of Ritalin use by healthy people raises a philosophical question concerning a clash between two elements: on the one hand, a person’s right to improve himself; and on the other, the physician’s responsibility to safeguard the patient. There is no unequivocal answer, and different physicians will prescribe Ritalin to different people, because there is no definitive indication. When someone is sick, things are clear, but here we have an open question.”

In the view of Dr. Yudeshkin-Porat, the present preoccupation with Ritalin recalls the question of the psychometric exams as criteria for university admission. “It used to be that people took the exams without preparation, but gradually preparatory courses came into being and now no one would dare take the exam without such a course,” she says. “The same discussion is underway among high school students: If everyone is taking it, why shouldn’t I also take it? The problem is that, unlike preparatory courses, Ritalin has serious side effects.”

The present generation, particularly adolescents and children, is constantly subject to attention and concentration disorders. Accordingly, some will argue that this generation requires Ritalin as a steady diet.

In fact, this form of disorder is built into modern life. The extensive culture of screens, working on different subjects simultaneously − which is part of almost every field − the rapid shifting from Facebook to email to news sites and so on: all this requires parallel attention. The phenomenon is well known; in fact, it’s likely that while reading this article, you started to tap your foot nervously, checked your email from time to time and possibly also looked at a newly posted Facebook status.

Perils of multitasking

Back in 2008, the journalist and writer Nicholas Carr published his formative article, “Is Google Making Us Stupid?” ‏(in The Atlantic magazine‏). He argued that our thought was becoming superficial and we were finding it difficult to internalize information and concentrate for lengthy periods.

At that time, Carr drew mainly on hunches and an analysis of the changes he felt occurring in his brain. In his subsequent book “The Shallows: What the Internet is Doing to Our Brains,” Carr draws on significant data and demonstrates by means of contemporary research what has been happening to the human brain in recent years.

According to Carr, the way we use the Internet and the effect of the multiplicity of screens has made it difficult for people to distinguish between important and trivial information. Multitasking is making it difficult for us to concentrate on one activity for any length of time. These are all symptoms of ADHD. The effect is far greater on the present generation of children − those born into this brave new technological world.

One of the studies that Carr quotes was done by nGenera, a U.S.-based consultancy firm. In 2008, the company published a study which, on the basis of interviews with 600 teenagers, examined the influence of the Internet on the brains of young people who grew up in this technological reality. When young people see a written text, they scan the page quickly and do not read it either from side to side or from bottom to top. For their brain, the experience of computer reading continues when the text appears on a printed page.

The quick scan impedes their ability to focus on the important content, and in many cases they miss information completely ‏(because of the superficiality of their reading‏). Carr believes that even though our brain possesses an impressive capacity to adapt itself to changing needs, it is compelled to leave certain abilities behind − such as the ability to focus on one thing at length.

The unease created by the need to perform multiple tasks also affects the internalization of information and its storage in the brain. The brain needs quiet, sleep and tranquillity in order to collect the information in a way that will render it accessible in the future. The unease that results from the use of multiple screens affects the quality of sleep, not to mention the quality of information storage.

The new Ritalin

So what will be the next substance that will try to enhance our neurological functioning? Probably the most natural candidate is Modafinil, a drug that promotes wakefulness and which has been shown in research studies to improve brain functioning and learning ability far more saliently than Ritalin. It sharpens the memory and accelerates cognitive abilities. It helps overcome sleep deficit and keeps the user alert, though after a time the problem of sleep loss affects learning.

Modafinil was originally developed as a medication to treat narcolepsy, a sleep disorder. Like Ritalin, Modafinil augments the amount of dopamine in the brain, thereby enhancing wakefulness. Unlike Ritalin, though, it is a more “pleasant” experience for users and does not produce phenomena such as anxiety and disquiet after use. Its utilization to internalize information is considered more effective than that of Ritalin. However, its primary danger lies in the fact that it is far more addictive than Ritalin.

Until the next star of the attention deficit medication world arrives, though, Ritalin will likely to continue to be number one. Maya, a student in a creative field at the Technion − Israel Institute of Technology, Haifa, is taking Ritalin in an effort to avoid the irritation she feels when she is given boring assignments. “Sometimes I am not sure whether it’s the chemical effect or whether it’s the very fact of taking the pill that helps psychologically,” she says.

“In any case, it enables me to sit still and gives me the feeling that there is an auxiliary force at work, that more brain cells are mobilizing for the task. I don't take Ritalin when my creativity is being put to the test or when I have to speak in front of an audience − only for things that I don’t have the energy to do,” Maya concludes.

Yael, who decided she would never give the medication to her children, offered a completely different answer when it comes to adults: “I recommend that everyone try it. This stage, between the age of 30 and I-don’t-know-when, is impossible. I have two small children, I have a life, I run a business, and I live in a country where the level of stimulation is insane. Ritalin is a solution that currently has no rivals.”

A quick study

The increasing use of Ritalin is a phenomenon that is occupying American universities. The extensive research being conducted about the use of the medications we know as Ritalin, Concerta or Adderall has led them to be dubbed “study drugs” or “smart drugs.”

In 2011, the U.S. Department of Health and Human Services estimated that 5 percent of Americans in the 18-25 age bracket were using the substances illegally. According to a study whose results were published in the online community Her Company ‏(on the Huffington Post website‏), the number of illegal users is more than the percentage that use cocaine and LSD combined.

A survey conducted for the University of Michigan Hospital found that one of every 10 children aged 13-17 admitted to using learning drugs to improve their scholastic achievements. By comparison, only one of every 100 parents thought their children were using the medications.

Child taking pill.Credit: Getty Images
A school class.Credit: Reuters
Prof. Avinoam Reches.Credit: Tomer Appelbaum
Ritalin.Credit: Tomer Appelbaum
Nicholas Carr. Hunches.Credit: Sander Duivestein
Dr. Dorit Yudeshkin-Porat.Credit: Tomer Appelbaum
Dr. Tali FischerCredit: Tomer Appelbaum

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