Wednesday, April 28, 2010

Stop! Panic Time!

DISCLAIMER: I wrote this originally on April 28th , but didn't get a chance to edit and post it prior to finals, as I'm sure you know how it goes. After all, the LOST series finale was last weekend, and all 6 seasons are not going to watch themselves in between tests. Enjoy.

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Ah, it's the most wonderful time of year for law students. It is the time of year that the temperature finally reaches levels of tolerability, and glossy-eye law students emerge from their textbook-induced hibernation to once again look upon the beauties of nature. Birds chirp and flowers bloom as the poor kids straighten their backs to meet the sweet smell of spring. Now no longer bound to the harsh attendance requirements of their employment law classes, these students pour into nature for the first time in months, soaking in the sun and enjoying the freedom that only finals season offers.

Bullshit.

One could say that Spring Break was the calm before the storm, because some students started studying for finals over a month ago. However, for most, finals season began when class ended just a few days ago. Most law students haven't seen the sun in days, if not weeks. They hole up in window-less rooms to ensure a complete casino environment where the student cannot know what the time of day is. Students will send their pets home to their mothers because their study schedule guarantees neglect. I, personally, have never studied more that 3 days for a law school test, but several students have dedicated weeks to the study of a single subject that they hope to be able to regurgitate in a single 3-hour, knuckle-warping gauntlet.

But the preparation is only one side of the coin. Law school is not just a intellectual exercise, it is a psychological tour de force. We have discussed The Panic previously. The Panic is the contagious stress-inducing phenomenon that permeates law school buildings and affecting the hapless students inside. The Panic has certainly taken a beachhead at my fair institution, and it has already brought many to their knees in teary breakdowns of Dave Chappelle proportions.

This is not a post about The Panic. This is a different kind of post. The Panic just happens to be going on, and I think it's hilarious. Instead, I would like to talk about healthcare. I present you the effects of two drugs. Pharmaceutical #1 and Pharmaceutical #2. I have listed the effects of both drugs below.

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Pharmaceutical #1

Physical effects

Anorexia, hyperactivity, dilated pupils, blood shot eyes, flushing, restlessness, dry mouth, bruxism, headache, tachycardia, bradycardia, tachypnea, hypertension, hypotension, fever, diaphoresis, diarrhea, constipation, blurred vision, aphasia, dizziness, twitching, insomnia, numbness, palpitations, arrhythmias, tremors, dry and/or itchy skin, acne, pallor, convulsions, and in rare cases (or in cases of abuse) coma, stroke, heart attack and death.

Psychological effects

Euphoria, anxiety, increased or decreased libido, alertness, concentration, energy, self-esteem, self-confidence, sociability, irritability, aggression, psychosomatic disorders, psychomotor agitation, hubris, excessive feelings of power and invincibility, repetitive and obsessive behaviors, paranoia, and with chronic and/or high doses, amphetamine psychosis can occur. The long term effects on the neural development of children have not been established.

Withdrawal effects

Mental fatigue, mental depression and an increased appetite. Symptoms may last for days with occasional use and weeks or months with chronic use, with severity dependent on the length of time and the amount taken. Withdrawal symptoms may also include anxiety, agitation, excessive sleep, vivid or lucid dreams (deep REM sleep), suicidal thoughts and psychosis.

Pharmaceutical #2

Short-Term effects

Alertness, feelings of well-being and euphoria, energy and motor activity, feelings of competence and sexuality. Athletic performance may be enhanced. Anxiety, paranoia and restlessness are also frequent. Occasional use does not typically lead to severe or even minor physical or social problems.

Long-Term effects

With excessive dosage, tremors, convulsions and increased body temperature are observed. With excessive or prolonged use, the drug can cause itching, tachycardia, hallucinations, and paranoid delusions. Overdoses cause tachyarrhythmias and a marked elevation of blood pressure. These can be life-threatening, especially if the user has existing cardiac problems.

Chronic intake causes brain cells to adapt functionally to strong imbalances of transmitter levels in order to compensate extremes. The experience of insatiable hunger, aches, insomnia/oversleeping, lethargy, and persistent runny nose are often described as very unpleasant. Depression with suicidal ideation may develop in very heavy users. All these effects contribute a rise in tolerance thus requiring a larger dosage to achieve the same effect. May also greatly increase this risk of developing rare autoimmune or connective tissue diseases such as lupus, Goodpasture's disease, vasculitis, glomerulonephritis, Stevens-Johnson syndrome and other diseases. It can also cause a wide array of kidney diseases and renal failure. Abuse doubles both the risks of hemorrhagic and ischemic strokes, as well as increases the risk of other infarctions, such as myocardial infarction.

Dependency effects

Dependence (or addiction) is psychological dependency on its regular use. Dependency may result in physiological damage, lethargy, psychosis, depression, and fatal overdose.

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If you have not guessed it so far, Pharmaceutical #1 is dextroamphetamine, the active ingredient in drugs like Adderall. Pharmaceutical #2 is recreational-grade benzoylmethylecgonine, otherwise known as cocaine.

I'm no pharmacist, but those look a hell of a lot alike. Considering that I have seen people on both, personal experience suggests that they are not too different. However, one is perfectly allowable in a law school setting while the other will forever prevent your passing a Character and Fitness Committee.

First, it may be important for us to go over the history of ADD and its treatment. "Hyperactivity" has been observed as early as 1793. Up until the 1960s, ADHD was only linked to identifiable brain injuries, not hereditary or environmental factors. However, “attention deficit disorder” did not exist as a diagnosable disease until the DSM-III, published in 1980. The active chemicals in what became to be known as Ritalin were originally discovered in 1944. In the 1960s, stimulants were first used in treating ADHD. Hardly over a decade later, ADD existed as its own independent psychological disorder.

Now, before we jump to conclusions about the disease that didn't exist until the cure could be sold to the victims, let's see how many people suffer from the disease. Psychologists estimate that between 3% and 5% of the United States populace has some form of ADHD. However, surveys report that between 5% and 35% of college age students self-reported taking study aids such as Ritalin and Adderall. Even one study found that 43% of American boys exhibited 3 of the 9 criteria for ADD under the DSM-IV. To give you an idea of how insignificant that statistic is, 16% of those very same boys will have blue eyes (not a criteria for ADD under the DSM-IV). One needs 6 of the 9 symptoms to be diagnosed with ADD. Therefore, it is more likely that you have exhibited enough symptoms worthy of being diagnosed of ADD while reading this article, than it is that you have blue eyes.

But you may be asking yourself, "But Godfather, why should I care about these peo… ooo! shiny object!” The answer is important in law school setting.

Under the Americans with Disabilities Act, educational facilities taking federal dollars must make accommodations for Americans with disabilities. ADD is a recognized disability under the ADA, which means that these students are often "accommodated" to the tune of 1.5x testing time. Because many law finals are three hours, this can be 4.5 hours, or as much as five total hours of testing, covering the same questions and the same material as other people in the class. Additionally, no consideration is given should be students also be prescribed coping prescriptions. For example, if a student is diagnosed with ADD and reports it to the school, there is no secondary check to see if they are actually taking Ritalin or Adderall. What this means is that students are given one opportunity to level the playing field, while also receiving another opportunity to tilt it in their favor. Many students are notorious for spending five hours, cracked out on Adderall, pounding out every last detail where the ultimate winner is the one who threw out the most information on their final.

But it doesn't stop there. Some students hoard their prescriptions. For the 18 weeks between finals, students will simply “save up” their precious supply of mind-enhancing drugs. After saving up the stash, students will take double, and sometimes even triple, the recommended dose for weeks on end. They will sleep precious few hours, choosing instead to hunch over desks, scanning over pages of information.

This is neither healthy, nor fair. These "disabled" are given more than enough opportunities to abuse their situation. Their behavior is no different than that of a cocaine addict. Without their precious drug, these people cannot function. However, during their binges, they will sustain themselves for literally a month on average of three hours of sleep per night. Once finals are over, the inevitable withdrawal set in, replaced by a steady stream of alcohol.

The practice of law is not law school. Tests do not occur twice a year. Instead, testing occurs on a daily basis. Reaction and cognition are necessary constantly, not for month-long benders. Yet, people are surprised to hear that law has high incidents of substance abuse.

It is because it starts in law school. The high stress environment lends itself to encouraging other outlets. Alcohol is the most common one. However, with the prevalence of study aids such as Ritalin and Adderall, the need for, and the inability to, ink out one last bit of productivity from a day that isn't getting any longer will only encourage more abuse. Adderall is an amphetamine. It is a Schedule-II drug. So is cocaine. One prevents your bar passage, but the other nearly guarantees it. Think about it.

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