Students trying to concentrate while cramming for exams once headed for a quiet spot like the library, or played background music. If they needed to pull an all-nighter to study or finish a term paper, jolts of caffeine from coffee, soft drinks, or caffeine pills did the trick.
Parents and others who have been away from the high school and college scenes for a while may not realize that things are changing.
Students are in the forefront of a revolution in use of "brain-enhancing" drugs, developed to treat disease but increasingly used to make people perform "better than well."
For a small but growing number of college and high school students, Ritalin, Concerta, and Metadate are replacing solitude, music, and caffeine as the favored way to focus and increase concentration.
About 6 million children in the United States take Ritalin, Concerta, or similar drugs for attention deficit hyperactivity disorder (ADHD). But ADHD medicines have quietly developed a new life on campus.
Ritalin, for instance, has become one of the most abused prescription drugs.
Studies suggest that it ranks second only to alcohol as the most popular recreational drug on college campuses. Anywhere from 1.5 percent to 20 percent of college students report using Ritalin "recreationally" at least once a year. About 10 percent of high school students acknowledge using Ritalin recreationally at least once.
Students call Ritalin "the cramming drug," "Vitamin R," and "R ball." They often get it from friends or family members with Ritalin prescriptions for ADHD. When prescribed and sold through a pharmacy, the generic version of Ritalin may cost about 50 cents per tablet. When resold on campus, a single tablet can fetch $15.
Much of Ritalin's allure lies in its reputed ability to help people without ADHD maintain unusually high levels of concentration for long periods of time. Students trying to cram for exams, of course, are not the only users of nonprescribed Ritalin. Others take it so they can stay awake and party longer.
Like other prescription drugs, medications for ADHD can have dangerous side effects.
Shift workers and other adults who must stay awake and alert for long periods of time are using another drug, Provigil. Provigil was developed to treat narcolepsy, which involves excessive daytime sleepiness. But it also enables healthy people to be mentally sharp without sleeping - sometimes for more than two days.
Some antidepressants also are being used as mood enhancers by people who are not depressed.
Other brain, or "cognitive," enhancers are in the pipeline, including new drugs for Alzheimer's disease and other brain disorders. In addition to treating illness, these drugs may improve memory and learning in healthy people.
Should these drugs be available to healthy people who want to be "better than well?" Will kids who can afford brain booster pills have an unfair edge on the SATs and other tests? Will employers eventually require workers to improve their mood, concentration, or alertness with a pill?