Up to three times a week, Jack, an 18-year-old college student, takes modafinil, a prescription medication used to treat excessive sleepiness (and keep fighter pilots and astronauts awake for up to 40 consecutive hours). It’s also perceived to be something of a “limitless pill,” taken readily by C-suite executives to boost their performance. But he swallows the small, pasty pills for another purpose: Doing homework.
Without modafinil, Jack is like many college students — unenthusiastic about spending another afternoon in the library. When it’s coursing through his system, though, he’s more than happy to bust out a week’s worth of assignments, even if it’s Friday afternoon.
Jack compares the effects to a “strong energy drink,” which about summarizes the science: Modafinil appears to work by stimulating energizing hormones like serotonin, norepinephrine and dopamine. On average, its alertness-enhancing effects last for an impressive 11 and a half hours, only two hours less than amphetamine, depending on how much you take (many users pop one 200-milligram pill per day). For these reasons, it’s earned the reputation of being a “smart drug.”
For Jack, it was love at first pill. “It was the most productive day I’ve ever had,” he tells me. He completed a 12-page research paper, an assignment that would normally take him at least three days of work, in just a single afternoon. Now, he uses modafinil whenever he needs a boost of motivation, whether that be for studying or working out. “It just makes me enjoy life,” he explains.
Mind you, Jack doesn’t have a prescription for modafinil, so what he’s doing is technically illegal — modafinil is a Schedule IV controlled substance, defined as having a “low potential for abuse and low risk of dependence,” under U.S. law, meaning you need a doctor’s prescription to legally obtain it. Jack, however, takes another route: “I bought it online from an Indian pharmacy,” he says. There are many such online pharmacies, where one can purchase 200-milligram modafinil for around $2 per pill. But because these businesses fly under-the-radar, there have been cases where the drugs sold by them aren’t what they seem. For instance, some users have reported that the modafinil they bought online produces no effects whatsoever.
Despite the inherent risks that come with buying an unregulated drug online, Jack isn’t a special case. On Twitter, neuroscientist Andrew Huberman recently asserted that five to 10 percent of college students are using modafinil or armodafinil, a similar wakefulness medication, and a study of modafinil users published in June found that 47 percent take it without a prescription.
Admittedly, Huberman’s research was informal at best — he claims to have gathered his numbers from students and a fellow colleague. He also happens to promote a number of unregulated, under-researched supplements, including tongkat ali and fadogia agrestis. But while Huberman’s numbers may seem sensational, Rachel Teodorini, a lecturer at London South Bank University who’s researched the off-prescription use of modafinil, confirms to me that they’re somewhere in the ballpark. A survey of students at her university revealed that 6.6 percent have used modafinil, and 78 percent of users in her research accessed the drug through online vendors.
Even Jack admits that modafinil seems to be increasingly popular among his classmates to help them tackle their immense workloads. But it goes well beyond just modafinil: He adds that many are using off-prescription Vyvanse, Ritalin and Adderall, all of which appear to have more severe side effects than modafinil, especially when used without the guidance of a doctor. (Obviously, when prescribed, these drugs have helped many who suffer from neurodevelopmental disorders like ADHD.) Nearly one in six college students say they’ve used at least one such stimulant, and 79 percent of them got it from a friend.
Of course, modafinil is used outside of colleges, too. Bob, a 31-year-old New Yorker who runs a debt-collection business, has been taking it for some time now. He’s been managing his opiate addiction with methadone, which makes him groggy, so he needed something to help him through 10-hour workdays and weekends full of social responsibilities. “If I had to go to a family party on Saturday, I’d feel like my entire weekend was ruined, then I’d go back to work on Monday completely miserable and burnt out,” he tells me.
In a desperate attempt to improve his capacity for everything, Bob purchased adrafinil, a modafinil-like drug, on eBay. “It noticeably improved my energy and ambition,” he says. (As an aside, modafinil has also been successfully used to treat addiction.)
When Bob told his psychiatrist about his success on adrafinil, she prescribed him modafinil, and ever since, he’s been buying it from an online discount pharmacy called Blink Health, where he can get a month’s supply for only $30. It initially gave him headaches and nausea, which are common side effects, but that quickly dissipated, leaving him happier overall. “It’s made life just a little bit easier,” he tells me.
It’s stories like these that make you wonder, is modafinil really a problem, as Huberman suggested in his tweet?
That depends how you look at it. From a physical standpoint, Teodorini says that “modafinil is generally well-tolerated.” There are virtually zero known cases of overdose that involve modafinil alone (though, as always, combining it with other drugs could pose problems). Likewise, one study concluded that “modafinil overdoses were generally mild.” There have been instances where a person takes modafinil, then develops Stevens-Johnson syndrome, a life-threatening skin reaction, but that’s extremely rare. Nonetheless, we still need more long-term studies to nail down just how safe modafinil really is.
Moreover, there’s no scientific evidence that people develop a tolerance to modafinil (although, users often debate that), and it doesn’t seem to impair sleep quality when taken in the morning, meaning you can still get a good night’s sleep after a modafinil-enhanced day of productivity.
Modafinil isn’t for everyone, though: Some people develop the same nausea and headaches that Bob described, plus anxiety and nervousness that doesn’t go away until they quit. Furthermore, the absence of long-term studies does pose some major concerns. In particular, a few professionals have suggested that prolonged use of modafinil could result in sleep disorders, memory problems and cognitive decline, but we just don’t know for sure yet.
From a psychological point-of-view, modafinil poses a few more concerns. For one, it has the potential to be addictive. “If I was using it in college, I’d imagine that I’d never want to go without it,” Bob says. However, Teodorini emphasizes that it’s certainly not as addictive or harmful as an amphetamine, as Huberman implied in his tweet. The DEA even admitted that “modafinil has a low potential for abuse” in their 1999 ruling on its scheduling, and while modafinil is a Schedule IV controlled substance, Vyvanse, Adderall and Ritalin are all Schedule II, meaning the DEA acknowledges their potential for abuse is higher.
Secondly, people who self-medicate with modafinil may neglect more formal treatment that would otherwise benefit them, like therapy or another prescription from an actual doctor. “Reported modafinil users perceived themselves as having problems with inattention and procrastination,” Teodorini explains, touching on data from one of her studies.
Interestingly, in performing these studies, it’s become clear to Teodorini that the typical modafinil user is a North American or English male, who’s college educated, employed and in their mid-to-late 20s. This is true of Vyvanse, Adderall and Ritalin, too: Several studies show that men, particularly white guys in fraternities, use these drugs without a prescription more than women do. In fact, men are more likely to use almost all types of drugs than women are.
There are some well-researched reasons for this imbalance: Men are more likely to take risks, women face more stigmas when doing drugs and guys just generally have more access to them (hence why white dudes in fraternities, who are well-connected and have money, are so likely to use “smart drugs” without a prescription).
But there’s more to it, obviously. Are these young men also turning to modafinil because they refuse professional help to deal with their stress? Is professional help too expensive? Are we putting too much pressure on guys to work hard and achieve? Is a baseline human who doesn’t use modafinil no longer motivated enough to manage college, work and all the other hardships that life brings?
In other words, if there’s a problem, it’s probably not modafinil itself — it’s the strenuous situations people are currently in that encourage the use of performance-enhancing drugs without a prescription. And many users are more than willing to face a future of unknown risks if these “smart drugs” help them through the present.