ABSTRACTTHE MORAL LIFE OF ADDERALL: HEALTH, EMPOWERMENT, AND RESPONSIBILITY IN THE ERA OF PHARMACEUTICALIZATIONByTazin Karim DanielsMy dissertation is an ethnographic exploration of how pharmaceutical morality is challenged, negotiated, and reconstructed across the social life of prescription stimulants. It is situated within the modern American university, where students are experimenting with drugs such as Adderall and Vyvanse in an attempt to improve academic performances. Sanctioned for the treatment of Attention Deficit/Hyperactivity Disorder (ADHD), these powerful medications require a doctor’s prescription to access legally. However, studies indicate that they are commonly circulated among peers, leading to proscribed consumption rates of up to 43% in some college populations. Existing research focuses primarily on the motivations of the illicit user and describes their pharmaceutical choices according to neoliberal logics. I build on this work by also considering the moral logics that students rely on to rationalize their controversial behaviors. Moreover, I examine how these logics are translated and absorbed as they filter through the economic, medical, and academic landscapes that circumscribe the user experience. This includes questions of safety, fairness, legality, and efficacy posed by pharmaceutical advertisers, heath service providers, and drug dealers – many of whom contribute to definitions of “responsible” stimulant use in the university setting. Data for this project was based on ethnographic fieldwork conducted from 2012 to 2014 at a large public institution, which I refer to as “American State University.” It is centered around semi-structured interviews and participant observations with 45 undergraduates, aimed at explicating the the complex set of values and concerns that are associated with Adderall in the college environment. I interacted with these individuals over 12 to 24 months in various capacities as they avoided, procured, distributed and consumed stimulants in public and private settings. To provide context for these student-centered experiences, I also conducted a critical discourse analysis of select direct-to-consumer (DTC) pharmaceutical marketing campaigns and interacted with medical and educational professionals on and around campus. In combination, these methods provided key insights into how discourses around responsible stimulant use were constructed and diffused by these various actors during their interactions with students. My findings suggest that engagements with prescription stimulants have become a fundamental part of how numerous students construct themselves and are constructed by others as healthy, empowered, and responsible individuals. In particular, the flexibility of Adderall as a medication, enhancement, and recreational drug allowed both users and providers to mold its symbolic meaning into a form that would complement or enhance their moral sense of self. However, my data illustrates how flexibility can lead to instability as students struggled to make sense of the social and chemical implications they experienced during circulation and consumption. I argue that this instability triggered what Zigon (2007) describes as “moments of moral breakdown” which were based in concerns over medical non-compliance, malingering, social stigma, drug dealing, academic dishonesty, and addiction. My multi-methodological approach allowed me to document the strategies informants developed to preclude and respond to these moments of moral breakdown, and the multiple functions of Adderall within these rationales. As a result, my research provides ethnographic evidence to better understand how students manage the double-edged flexibility/instability of prescription stimulant use in order to operate unreflectively in an increasingly pharmaceuticalized environment.
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