Take Your Pills

Take Your Pills is a new documentary by Alison Klayman about non-therapeutic stimulant drug (ab)use. A description of the documentary on Alison’s web site is here and a link to the trailer is here. I just finished watching it, and so I thought I’d share some of my initial reflections.

Its focus is mainly on Adderall, though there’s also some mention of Ritalin, and one or two mentions of modafinil. There’s also a short segment of the documentary that looks at one of the plethora of commercial “nootropic” products coming onto the market. Personally, I’d have cut that segment – because that’s the only commercial non-prescription product discussed, to me that segment just felt like an advertorial – and also it seemed to be completely uncritical about whether what’s being sold by that company is snake oil.

For anyone who’s working on the topic of cognitive enhancement, or colloquially “smart drugs”, I think it’s a good documentary to watch. It does have various limitations, such as the one I just mentioned above, its focus on pharmaceutical methods to the exclusion of other methods, and also its rather restricted focus on students and only a minor look at its use in the workplace. But despite all that I did really appreciate that Alison made this documentary, and that she touched on at least some of the pertinent social issues. In this last regard, the comments by Anjan Chatterjee and Martha Farah were really helpful, though I wish there had been way more of that.

As far as a program designed for public consumption, though, I seriously worry that it isn’t anywhere near sufficiently critical. Here’s just one example to demonstrate what I mean. I transcribed some of the dialogue from a discussion with a student (somewhere in the last 10 minutes of the program) who has been using Adderall to help her get better grades. (For the sake of argument, let’s set aside doubts about whether Adderall actually helped her get those better grades, which is an important empirical issue.) Reflect on how this woman reasons:

Did you get your grades back already?
I got one grade back from the exam I took this morning at 10. And I got an A!
The stress really doesn’t ever leave entirely.
But I’m excited once I, like, graduate to not, like,… to be able to leave that at work.
I have a pretty good feeling that this will be the end of my relationship with Adderall.
Hopefully in the adult world I won’t… I’ll manage my time well enough that there won’t be a time when I need to take prescription drugs to, like, get my work done.
So hopefully it’s the end, I… I mean, I don’t know where I’ll be, but when I picture myself I don’t picture myself taking Adderall.

My take on her reasoning here goes something like this: Now that I’ve got my better grades, I can get that job I really wanted, and I can finally ditch Adderall. But why think that? If she needed Adderall to get that job in the first place, then what got her that job are skills she possesses when she uses Adderall. And by accepting that job she signs up for a job that will require the skills she has when she uses Adderall, and if she stops taking Adderall then she is likely to find herself struggling to meet that job’s demands. Where I fear that will eventually lead her is back into reliance on Adderall. (I don’t actually think she’s necessarily contemplating landing her dream job in the above transcript. However I don’t think that’s a problem for my purpose here since all I’m using this for is to demonstrate the structure of her reasoning. And the structure of her reasoning, I fear, will be equally flawed regardless of the competitive context to which it is applied.)

To be clear, my point isn’t that we should fear using Adderall. Maybe we should, or maybe we shouldn’t — that’s a much deeper issue that would require a much longer discussion. Rather, my point is just that if this person hopes she’ll finally be able to stop using Adderall, then I think there’s a dangerous blind spot in her reasoning. Or so it appears to me, anyway. I offer this as one example of the kind of critical reflection that I would have loved to see in this documentary, but alas there is not very much of it there.

Another more general concern I have about this documentary is that its rather enthusiastic portrayal (or at least that’s the mood I felt watching it — more enthusiasm than caution or, preferably, even-handedness) and lack of critical reflection on the deeply important social and cultural problems in Take Your Meds, is likely to stimulate (yes, pun totally intended) yet more interest in stimulant (ab)use among its audience. And yet more people developing an interest in using stimulants in this manner is not, in my view, a good thing. Should you watch it, though? Yes, absolutely. But please just keep in mind my reservations about the regrettable relative lack of a deeper critical perspective on the social and cultural factors.

That’s enough for now. I’m sure I’ll include a version of this blog post in the book I’m writing with my colleague Dr Emma A. Jane entitled “Outsmarted”, which we hope to have finished some time in the second half of 2018. Stay tuned. Oh, and if you’ve read to the end of this post then note that there’s also an interesting discussion of this documentary here.