Opinion

The issue

Over recent months some university student guilds and health services have reported receiving anecdotal reports of increased use of so-called 'study drugs' or cognitive enhancers by students at their institutions. Cognitive enhancers (CEs) are substances that are used in an attempt to improve intellectual ability in areas such as alertness, information processing and memory. Those that have been the focus of recent research include prescription amphetamines (e.g., Adderall, Dexedrine) anti-dementia drugs, methylphenidate (Ritalin), caffeine and racetams, a broad class of drugs comprising several stimulants. Potential CEs also include newer drugs such as modafinil, as well as herbal supplements, including ginkgo biloba and fish oil supplements containing Omega 3.

The implications

There is some evidence that university students who use CEs tend to perceive them as effective, but whether CEs are effective at improving cognition in healthy individuals is unclear. Evidence of their effectiveness in laboratory settings is extremely mixed and their effectiveness beyond laboratory settings is unknown. However, the use of any CE carries a risk of harm. Adverse side effects have been associated with all studied CEs, some of which are severe and/or permanent and for many the long term harms associated with use are unknown. Harms may also occur as a result of legal consequences of illicitly obtaining CEs online or via others' diverted prescription medications. Many of these pharmaceutical CEs are obtained online through unregulated sites selling drugs which may be counterfeit or real pharmaceuticals without a prescription. The counterfeit drugs contain ingredients which may or may not be consistent with the packet labelling. Furthermore the way these pharmaceutical CEs are used may not be consistent with the approved dosing regimens.

The research gaps

The vast majority of prevalence estimates of CE use among university students are from the US, with estimates of lifetime use ranging widely between 5.3% and 53%. Only two studies have examined CE use among Australian university students, where lifetime prevalence of CE use was estimated at 8.5% in one study and 4% in the other but these estimates are questionable, primarily because only a subset of CEs was examined. Despite these limitations, however, it is likely that the prevalence of CE use amongst Australian tertiary students is not insignificant.

New NDRI Research

NDRI is seeking funds to conduct a study to explore this relatively recent drug use phenomenon and inform potential future interventions. To this end the aims of the study are to: 

1. ascertain the prevalence and frequency of the use of these drugs by Western Australian tertiary students;
2. obtain more detail on the specific drugs being used, how they were being used and obtained;
3. investigate student attitudes surrounding them;
4. document the self-reported benefits and harms experienced by users; and
5. recommend potential interventions to prevent use and reduce the harm among those who do use these drugs.

 The proposed study has been informed by, and will be conducted in partnership with, health services and student guilds from a number of tertiary institutions in WA.