好英语网美国高中流行“聪明药”
He steered into the high school parking lot, clicked off the ignition and scanned the scraps of his recent weeks. Crinkled chip bags on the dashboard. Soda cups at his feet. And on the passenger seat, a rumpled SAT practice book whose owner had been told since fourth grade he was headed to the Ivy League. Pencils up in 20 minutes.
他把车开进高中停车场，熄火，扫了几眼最近几周的学习笔记。仪表盘上是皱成一团的薯片包装。脚底下是乱扔的可乐纸杯。副驾驶座上，放着一本快翻烂了的SAT（美国大学入学考试——译注）练习册。从上四年级时起，这本书的主人就被下了指示，他将来的目标是常春藤名校。还有20分钟考试开始。
The boy exhaled. Before opening the car door, he recalled recently, he twisted open a capsule of orange powder and arranged it in a neat line on the armrest. He leaned over, closed one nostril and snorted it.
这男孩长出一口气。他回忆道，打开车门前，他拧开一粒胶囊，把里面的橙红色粉末倒在车门把手上，排成齐齐整整的一条线。他俯下身，按住一个鼻孔，然后，吸气。
多迪·斯卡拉在听上九年级的儿子乔纳森形容说，班上有些同学滥用兴奋剂时叹道：“现在我还得为兴奋剂担心吗？这是真的吗？他们不该要用到这种手段以达成进入理想中大学的目的。”
Throughout the parking lot, he said, eight of his friends did the same thing.
他说，就在这个停车场里的某处，他的八个朋友正做着同样的事。
The drug was not cocaine or heroin, but Adderall, an amphetamine prescribed for attention deficit hyperactivity disorder that the boy said he and his friends routinely shared to study late into the night, focus during tests and ultimately get the grades worthy of their prestigious high school in an affluent suburb of New York City. The drug did more than just jolt them awake for the 8 a.m. SAT; it gave them a tunnel focus tailor-made for the marathon of tests long known to make or break college applications.
他吸入的药粉不是可卡因或海洛因，而是Adderall，一种用于治疗注意力缺乏多动症(ADHD)的处方药，其主要成分为安非他明。男孩说，他和他的朋友需要“开夜车”用功或是考试时提高注意力时会定期分享这种药物，从而取得配得上他们所在的这所纽约富人区名校声誉的优异成绩。这种药物不仅能让他们清醒异常地面对早上八点的SAT考试，还能给他们一种非同一般的专注力，应对这一系列马拉松式的长考，SAT考试成绩一直以来并看作是申请大学的敲门砖。
“Everyone in school either has a prescription or has a friend who does,” the boy said.
这个男孩说：“学校里的每个人，要么自己有处方，要么认识能拿到处方的朋友。”
At high schools across the United States, pressure over grades and competition for college admissions are encouraging students to abuse prescription stimulants, according to interviews with students, parents and doctors. Pills that have been a staple in some college and graduate school circles are going from rare to routine in many academically competitive high schools, where teenagers say they get them from friends, buy them from student dealers or fake symptoms to their parents and doctors to get prescriptions.
根据采访学生、家长和医生得来的信息，在全美国的高中里，追求高分、竞争大学录取通知书而产生的压力正在诱使学生们走上滥用处方兴奋剂的道路。在某些大学和研究生院中已经司空见惯的兴奋剂，如今在一些学业竞争激烈的高中里也开始由罕见变寻常。这些十几岁的少年说，他们要么从朋友那里获得药物，要么从学生药贩子那里花钱购买，再不然就在家长和医生面前伪装症状，骗取处方。
Of the more than 200 students, school officials, parents and others contacted for this article, about 40 agreed to share their experiences. Most students spoke on the condition that they be identified by only a first or middle name, or not at all, out of concern for their college prospects or their school systems’ reputations — and their own.
本文写作过程中联系到了200余名学生、校方人士、家长及其他有关人士，其中约有40人愿意分享他们的个人经历。大多数学生开口表态的前提条件是只能使用他们的部分名字或是完全匿名。他们担心未来申请大学会因此受到影响，或是出于对其中学声誉及自身名誉的考虑。
“It’s throughout all the private schools here,” said DeAnsin Parker, a New York psychologist who treats many adolescents from affluent neighborhoods like the Upper East Side. “It’s not as if there is one school where this is the culture. This is the culture.”
“这边的所有私立中学都这样，”纽约执业心理医生德安辛·帕克(DeAnsin Parker)说。他诊治过许多家住上东区这种富庶中产阶级街区的青少年。“这不是某一所学校的校园文化。这本身就是一种校园文化。”
Observed Gary Boggs, a special agent for the Drug Enforcement Administration, “We’re seeing it all across the United States.”
美国禁毒署(Drug Enforcement Administration)特工加里·博格斯(Gary Boggs)评论道，“这种现象遍及全美。”
The D.E.A. lists prescription stimulants like Adderall and Vyvanse (amphetamines) and Ritalin and Focalin (methylphenidates) as Class 2 controlled substances — the same as cocaine and morphine — because they rank among the most addictive substances that have a medical use. (By comparison, the long-abused anti-anxiety drug Valium is in the lower Class 4.) So they carry high legal risks, too, as few teenagers appreciate that merely giving a friend an Adderall or Vyvanse pill is the same as selling it and can be prosecuted as a felony.
美国禁毒署将Adderall、Vyvanse、利他林(Ritalin)和Focalin这类处方兴奋剂列为二类受管制物质——等同于可卡因和吗啡——因为它们均属于成瘾性最强的药用物质。（相较而言，很久以来便被经常滥用的抗抑郁药物安定[Valium]仅属于等级较低的四类受管制物质）因此，这些药丸也伴随着很高的法律风险。没有几个青年人知道，不过是给朋友一粒Adderall或Vyvanse，性质上就等同于贩卖受管制药物，可以被以重罪起诉。
While these medicines tend to calm people with A.D.H.D., those without the disorder find that just one pill can jolt them with the energy and focus to push through all-night homework binges and stay awake during exams afterward. “It’s like it does your work for you,” said William, a recent graduate of the Birch Wathen Lenox School on the Upper East Side of Manhattan.
尽管这些药物通常会使ADHD患者平静下来，非患者却发现，一粒药丸就可以让他们聚精会神，整晚开夜车做功课之后，还能在考试的时候保持清醒。“就好像它帮你把功课都做了一样，”威廉说。他最近刚刚从曼哈顿上东区的伯奇·沃森·伦诺克斯中学（Birch Wathen Lenox School，纽约一所著名精英中学）毕业。
But abuse of prescription stimulants can lead to depression and mood swings (from sleep deprivation), heart irregularities and acute exhaustion or psychosis during withdrawal, doctors say. Little is known about the long-term effects of abuse of stimulants among the young. Drug counselors say that for some teenagers, the pills eventually become an entry to the abuse of painkillers and sleep aids.
但是，医生指出，滥用处方兴奋剂也会导致抑郁和情绪不稳（因缺乏睡眠而引起）、心律不齐和停药期间的急性衰竭反应和精神失常等。关于青少年时期滥用兴奋剂的长期效果尚所知甚少。药物滥用咨询师表示，对于某些青少年，这些药丸最终会诱使他们走上滥用镇痛剂和安眠药之路。
“Once you break the seal on using pills, or any of that stuff, it’s not scary anymore — especially when you’re getting A’s,” said the boy who snorted Adderall in the parking lot. He spoke from the couch of his drug counselor, detailing how he later became addicted to the painkiller Percocet and eventually heroin.
“一旦你初尝禁果，开始服用药丸或是这一类的东西，这事就变得不再可怕了——尤其是你还能拿到好成绩，”那个在停车场吸入Adderall的男孩说。说这话的时候他正坐在药物滥用咨询师的沙发上，一一列举他后来如何逐渐对镇痛剂Percocet上瘾，最后又迷上了海洛因。
Paul L. Hokemeyer, a family therapist at Caron Treatment Centers in Manhattan, said: “Children have prefrontal cortexes that are not fully developed, and we’re changing the chemistry of the brain. That’s what these drugs do. It’s one thing if you have a real deficiency — the medicine is really important to those people — but not if your deficiency is not getting into Brown.”
曼哈顿卡伦治疗中心的一名家庭治疗师保罗·L·霍克迈尔(Paul L. Hokemeyer)说，“儿童的大脑前额叶皮层仍未充分发育，我们需要改变患儿大脑的化学成分。这些药物的作用机制正是如此。你真的欠缺某种东西是一回事——药物对于那些人来说真的很重要——但如果你所欠缺的是考不上布朗大学的话，那就是另外一回事了。”
The number of prescriptions for A.D.H.D. medications dispensed for young people ages 10 to 19 has risen 26 percent since 2007, to almost 21 million yearly, according to IMS Health, a health care information company — a number that experts estimate corresponds to more than two million individuals. But there is no reliable research on how many high school students take stimulants as a study aid. Doctors and teenagers from more than 15 schools across the nation with high academic standards estimated that the portion of students who do so ranges from 15 percent to 40 percent.
根据艾美仕市场研究公司（IMS Health，一家专业提供医药健康信息的公司）的数据，从2007年开始，开给美国10到19岁青少年的ADHD药物处方量增长了26%，目前已达每年2100万份处方之多。据专家估计，这相当于200多万名个体服药患者。但目前还没有可靠数据表明，到底有多少高中生在为了准备考试而服用兴奋剂。据医生和就读于全美国15所以成绩优异而著称的中学的学生估测，这么做的学生约占学生总数的15%到40%。
“They’re the A students, sometimes the B students, who are trying to get good grades,” said one senior at Lower Merion High School in Ardmore, a Philadelphia suburb, who said he makes hundreds of dollars a week selling prescription drugs, usually priced at $5 to $20 per pill, to classmates as young as freshmen. “They’re the quote-unquote good kids, basically.”
“他们都是拿A的那种好学生，有时候也有想要提高成绩的B级生，”费城阿德摩尔区劳尔梅里恩高中(Lower Merion High School)的一名高四学生（美国的小学学制为五年，高中学制为四年，9年级为高一，依此类推——译注）说。他说，光靠把处方药以每粒5到20美元的价格卖给同学，他每周可以赚上几百美元。他的主顾甚至包括高一新生。“基本上，他们是那种‘好孩子’。”
The trend was driven home last month to Nan Radulovic, a social worker in Santa Monica, Calif. Within a few days, she said, an 11th grader, a ninth grader and an eighth grader asked for prescriptions for Adderall solely for better grades. From one girl, she recalled, it was not quite a request.
上个月，加州圣莫妮卡的一名社工娜恩·拉杜洛维奇(Nan Radulovic)深切地感受到了这一潮流。她说，几天之内，就有一个11年级学生、一个9年级学生和一个8年级学生（分别相当于高三、高一和初三——译注）分别跟她索要Adderall的处方，目的仅仅是为了提高成绩。她回忆道，在其中一个女孩那里，可能根本都算不上要。
“If you don’t give me the prescription,” Ms. Radulovic said the girl told her, “I’ll just get it from kids at school.”
“如果你不给我处方，”拉杜洛维奇女士转述那个女孩的话说，“我就从学校里别的孩子那儿去弄。”
Keeping Everyone Happy
皆大欢喜
Madeleine surveyed her schedule of five Advanced Placement classes, field hockey and several other extracurricular activities and knew she could not handle it all. The first physics test of the year — inclines, friction, drag — loomed ominously over her college prospects. A star senior at her Roman Catholic school in Bethesda, Md., Madeleine knew a friend whose grades had gone from B’s to A’s after being prescribed Ritalin, so she asked her for a pill.
玛德莱娜(Madeleine)研究了一下自己的课表：5门爱普课程（美国中学生上大学前所修的能够获得大学学分的高级课程——译注）、曲棍球，还有另外几门课外活动。她知道，自己肯定没法应付。学年第一次物理学测验——斜面、摩擦、阻力——仿佛预示着她的大学申请之路。玛德莱娜当时在马里兰州贝塞斯达一所罗马天主教学校里读高四，是学校里的运动明星。她认识一个朋友，拿到利他林处方后成绩从B上升到A。于是，玛德莱娜跟她要了一粒药丸。
She got a 95. Thereafter, Madeleine recalled, she got Adderall and Vyvanse capsules the rest of the year from various classmates — not in exchange for money, she said, but for tutoring them in calculus or proofreading their English papers.
她考了95分。玛德莱娜回忆说，那之后，她在这一学年中从多个班上同学手上搞到Adderall和Vyvanse胶囊——用来交换的不是钱，而是辅导他们微积分，或是校对他们的英语作文。
“Can I get a drink of water?” Madeleine said she would ask the teacher in one class, before excusing herself and heading to the water fountain. Making sure no one was watching, she would remove a 40-milligram Vyvanse capsule from her purse and swallow it. After 30 minutes, the buzz began, she said: laser focus, instant recall and the fortitude to crush any test in her path.
“我能喝口水吗？”玛德莱娜说，课堂上，她会这样跟老师请假，然后走向饮水器。确保没有人在看着她之后，玛德莱娜从随身小包里拿出一粒40毫克的Vyvanse服下。30分钟后，劲头就上来了。据她形容，注意力会像激光一样精准，记忆中的东西立即出现在眼前，而且信心十足，简直可以冲破考试中遇到的任何障碍。
“People would have never looked at me and thought I used drugs like that — I wasn’t that kid,” said Madeleine, who has just completed her freshman year at an Ivy League college and continues to use stimulants occasionally. “It wasn’t that hard of a decision. Do I want only four hours of sleep and be a mess, and then underperform on the test and then in field hockey? Or make the teachers happy and the coach happy and get good grades, get into a good college and make my parents happy?”
“人们不会盯上我，觉得我会滥用药物——我不是那种孩子，”玛德莱娜说。她刚刚在一所常春藤名校完成大一的学业。她仍偶尔使用兴奋剂。“这不是一个艰难的决定。到底是每天只睡四个小时，搞到一团糟，然后考试成绩和曲棍球比赛都表现不好，还是让老师开心，教练开心，拿好成绩，进好大学，让我的父母也开心？我想要哪一种结果？”
Madeleine estimated that one-third of her classmates at her small school, most of whom she knew well, used stimulants without a prescription to boost their scholastic performance. Many students across the United States made similar estimates for their schools, all of them emphasizing that the drugs were used not to get high, but mostly by conscientious students to work harder and meet ever-rising academic expectations.
玛德莱娜估计，在她所在的那所中学，班上同学约有1/3使用兴奋剂以提高学习成绩。玛德莱娜熟悉他们中的绝大多数。他们都没有处方。全美范围内，许多学生就各自所在学校的情况做出类似推测。所有人都强调说，服用药物不是为了体验神魂颠倒的感觉。使用者主要是一些刻苦用功的学生，为了满足日益提高的升学期待而不得不出此下策。
These estimates can be neither confirmed nor refuted because little data captures this specific type of drug misuse. A respected annual survey financed by the National Institute on Drug Abuse, “Monitoring the Future,” reports that abuse of prescription amphetamines by 10th and 12th graders nationally has actually dipped from the 1990s and is remaining relatively steady at about 10 percent.
因为几乎没有专门针对此种药物滥用状况的数据，这些预测既无法被肯定也无法被否认。美国国家药物滥用研究所(National Institute on Drug Abuse)出资进行的一项相关年度调查《监测未来》(Monitoring the Future)指出，全美范围内，10年级生和12年级生滥用处方安非他明的比例从上世纪90年代起实际上有所下降，目前相对稳定地保持在10%左右。
However, some experts note that the survey does not focus on the demographic where they believe such abuse is rising steadily — students at high-pressure high schools — and also that many teenagers barely know that what they often call “study drugs” are in fact illegal amphetamines.
然而，一些专家注意到，该项调查并未特别关注在竞争压力巨大的高中就读的那些学生。专家认为，在这一人群中，药物滥用状况正稳定增加。此外，许多青少年并不知道，他们经常提到的“学习药丸”实际上是非法的安非他明。
“Isn’t it just like a vitamin?” asked one high school junior from Eastchester, a suburb of New York.
“那不是跟维生素差不多吗？”一名纽约伊斯特切斯特的高三学生问道。
Liz Jorgensen, a licensed addiction specialist who runs Insight Counseling in Ridgefield, Conn., said her small center had treated “at least 50 or 60” high school students from southern Connecticut this school year alone who had abused prescription stimulants for academics. Ms. Jorgensen said some of those teenagers landed in rehab directly from the stimulants or, more often, grew comfortable with prescription drugs in general and began abusing prescription painkillers like OxyContin.
利兹·乔根森(Liz Jorgensen)是一位治疗药物成瘾的执业专科医生，在康涅狄格州里奇菲尔德经营一家名为“省悟咨询”(Insight Counseling)的戒毒辅导中心。据她声称，这家小中心光是本学年便收治了“少说也有50到60个”来自康涅狄格州南部的高中生。他们都曾出于提高成绩目的而滥用处方兴奋剂。乔根森女士表示，一些青少年单纯是因为滥用兴奋剂而进入戒毒中心，但更常见的是另外一种——习惯了一般的处方药之后，开始滥用奥施康定(OxyContin)这样的处方镇痛剂。
A spokesman for Shire, which manufactures Vyvanse and Adderall’s extended-release capsules, said studies had shown no link between prescribed use of those drugs and later abuse.
沙尔制药(Shire)的发言人说，研究显示，依照处方服用药物与未来的药物滥用并无联系。该公司是Vyvanse和Adderall缓释胶囊的制造商。
Dr. Jeff Jonas, Shire’s senior vice president for research and development, said that the company was greatly concerned about the misuse of its stimulants but that the rate was very small. “I’m not aware of any systematic data that suggests there’s a widespread problem,” he said. “You can always find people who testify that it happens.”
沙尔制药的资深研发副总裁杰夫·乔纳斯(Jeff Jonas)博士表示，该公司对于不正当使用该公司制造的兴奋剂的问题极为关注，但这种事情发生的概率很低。“就我所知，没有系统性数据表明这是一个广泛存在的问题，”他说，“你永远都能找到声称某种事确实发生过的人。”
Students who sell prescription stimulants to their classmates focus on their burdens and insecurities. One girl who sells to fellow students at Long Beach High School on Long Island said: “These kids would get in trouble if they don’t do well in school. When people take tests, it’s immediately, ‘Who am I getting Adderall from?’ They’re always looking for it.”
向同学贩卖处方兴奋剂的学生关注的是他们课业负担和不安全感问题。一个把药丸卖给她在长岛高中(Long Beach High School)的同学的女孩说，“如果在学校里成绩不好，那些孩子就会有大麻烦。只要一考试，人们马上会问：‘谁能帮我搞来Adderall？’他们总是有需求。”
Every school identified in this article was contacted regarding statements by its students and stimulant abuse in general. Those that responded generally said that they were concerned about some teenagers turning to these drugs, but that their numbers were far smaller than the students said.
我们联系了这篇文章里点名道姓的每一所学校，告知他们，有该校学生声称校园中普遍存在兴奋剂滥用。那些回复通常表示，校方对于一些青少年使用药物的问题十分关注，但这些人的总数远比学生们声称得为少。
David Weiss, superintendent of Long Beach Public Schools, said the survey his district used to gauge student drug use asked about only prescription medications in general, not stimulants specifically.
长滩公校联盟(Long Beach Public Schools)总教务长大卫·韦斯(David Weiss)指出，他所管辖学区用来估计学生药物使用状况的调查仅询问总体上的处方药使用状况，而不会特别针对兴奋剂提问。
“It has not been a surface issue for us — we’re much more conscious of alcohol or other drug use,” Mr. Weiss said in a telephone interview. “We haven’t had word that it’s a widespread issue.”
“对我们来说，这个问题还没有特别突出——我们更关心酗酒或其他药物滥用问题，”韦斯在电话采访中表示：“迄今为止，据我们所知，这还不是一个普遍问题。”
Douglas Young, a spokesman for the Lower Merion School District outside Philadelphia, said prescription stimulant abuse was covered in various student-wellness initiatives as well as in the 10th-grade health curriculum. Mr. Young expressed frustration that many parents seemed oblivious to the problem.
费城劳尔梅里恩学区的发言人道格拉斯·杨(Douglas Young)表示，许多针对学生身心健康的活动项目及10年级的卫生课程中都涉及了处方兴奋剂滥用问题。众多家长对这一问题的不闻不问令杨深感失望。
“It’s time for a serious wake-up call,” Mr. Young said. “Straight A’s and high SAT scores look great on paper, but they aren’t reflective measures of a student’s health and well-being. We need to better understand the pressures and temptations, and ultimately we need to embrace new definitions of student success. For many families and communities, that’s simply not happening.”
“严肃讨论这件事的时间到了，”道格拉斯·杨指出：“每科都拿A，SAT考试高分，那些虽然看上去很美，但却不能真正反映一个学生的身心健康状况。我们需要更好地理解压力与诱惑，说到底，我们需要重新定义学生的成功。对于许多家庭和社区，这还是没影儿的事。”
Fooling the Doctors
骗过医生
During an interview in March, the dealer at Lower Merion High reached into his pocket and pulled out the container for his daily stash of the prescription stimulants Concerta and Focalin: a hollowed-out bullet. Unlike his other products — marijuana and heroin, which come from higher-level dealers — his amphetamines came from a more trusted, and trusting, source, he said.
在3月份的一次采访中，一位劳尔梅里恩高中(Lower Merion High)的毒贩把手伸进口袋，掏出装着他每天用于交易的Concerta和Focalin的容器——一个空子弹壳。和他其他的交易品——大麻和海洛因——不同，这些安非他明不是来自上线的毒贩，而是他口中一个更可靠的地方。
“I lie to my psychiatrist — I expressed feelings I didn’t really have, knowing the consequences of it,” he said, standing in a park a few miles from the high school. “I tell the doctor, ‘I find myself very distracted, and I feel this really deep pain inside, like I’m anxious all the time,’ or something like that.”
“我对我的精神病医生说谎——说一些我实际上没有的感觉，明知道接下来的会是什么，”站在离高中几英里外的公园里，他说道：“我跟医生说，‘我觉得自己总是走神儿，内心十分痛苦，整天处于焦虑之中’，诸如此类。”
He coughed out a chuckle and added proudly, “Generally, if you keep playing the angsty-teen role, you’ll get something good.”
他咯咯笑出声来，骄傲地补充道，“一般来说，如果你一直扮演一个忧郁少年的角色，总会捞到点儿好处的。”
Christine, a junior sitting nearby, said she followed the well-known lines to get her drugs directly and legally, a script for scripts. “I’m not able to focus on schoolwork,” she said in a mockingly anxious voice. “I’m constantly looking out the window.” Although she often uses the drugs herself, snorting them for a faster and more intense effect, she said she preferred to save them for when her customers crave them most.
坐在附近的一名高三学生克里斯蒂娜(Christine)说，她靠着众所周知的一些台词直截了当、合理合法地拿到药物——剧本变处方。“我没办法专心做作业，”她故意装出忧心忡忡的口气说，“我忍不住一直想往窗户外头瞄。”尽管她的药往往是自己使用——鼻吸而非口服，从而更快见效，劲头更大——她也会留下一些，卖给更需要这些药物的客户。
“Right before everybody took the PSATs, a bunch of kids went to the bathroom to snort their Addies,” she said.
“PSAT考试（SAT预考——译注）前，总会有一伙学生跑到厕所，吸食他们的宝贝兴奋剂。”她说。
This is one of the more vexing problems with stimulants in high schools, experts said — the drugs enter the schools via students who get them legally, if not legitimately.
专家指出，这是高中校园兴奋剂滥用中最让人伤脑筋的问题之一——不管是不是真的患有ADHD，一些学生总能合法拿到药物，再经由其手流入校园。
Older A.D.H.D. drugs required low doses every few hours, and schools, not wanting students to carry the drugs themselves, had the school nurse hold and dispense the pills. Newer long-lasting versions like Adderall XR and Vyvanse allow parents to give children a single dose in the morning, often unaware that the pills can go down a pants pocket as easily as the throat. Some students said they took their pills only during the week and gave their weekend pills to friends.
上一代的ADHD药物需要每隔几小时就服药一次，每次剂量较低。学校通常不让学生自己携带药物，于是委托校园护士保管并分发药丸。新一代长效药AdderallXR和Vyvanse仅需每天早上服用一次。家长们让孩子吃药时，通常并不知道，这些药丸并没有被咽下喉咙，而是藏到了裤子口袋里。一些学生说，他们只在周一到周五服药，周末的药丸留给朋友们。
The mother of one high school freshman in Westchester County said she would open the kitchen cabinet every morning and watch her son take his prescribed dose of Ritalin. She noticed one day that the capsule was strangely airy and held it up to the light. It was empty.
一名家住威斯特彻斯特郡的母亲说，每天早上，她都会打开厨房的柜门，眼看着上高中一年级的儿子服下医生开给他的利他林。有一天，她注意到，胶囊感觉轻飘飘的，很奇怪。于是她将药丸对准亮光。里面是空的。
“There were a few times we were short in the month, and I couldn’t understand why,” recalled the woman, whose son was in eighth grade at the time. “It never dawned on me until I found those empty capsules, and then I started discovering the little packets of powder. He was selling it to other kids.”
“有几次一个月没到，药就吃光了，我还不明白是怎么回事，”这个女人回忆道。当时，她儿子还在上8年级。“直到发现那些空胶囊，我才意识到不对劲。之后，我开始发现小包的药粉。他在把药卖给其他孩子。”
A number of teenagers interviewed laughed at the ease with which they got some doctors to write prescriptions for A.D.H.D. The disorder’s definition requires inattentiveness, hyperactivity or impulse control to present “clinically significant impairment” in at least two settings (school and home, for example), according to the Centers for Disease Control and Prevention. Crucially, some of this impairment must have been in evidence by age 7; a proper diagnosis for a teenager claiming to have A.D.H.D., several doctors said, requires interviewing parents, teachers and others to confirm that the problems existed long before.
一些接受采访的青少年取笑那些轻易就被他们骗过、开出ADHD药物处方的医生。美国疾病控制与预防中心的网站指出，ADHD的确诊需要在两个以上的场合下（例如学校和家中）出现“临床上显著的”注意力缺失、多动或冲动控制症状。更关键的是，这些受损症状必须到7岁时仍很明显。一些医生指出，要对一个声称患有ADHD的青少年做出适当诊断，至少需要与家长、老师和其他人面谈，以确定问题长久以来一直存在。
Many youngsters with prescriptions said their doctors merely listened to their stories and took out their prescription pads. Dr. Hilda R. Roque, a primary-care physician in West New York, N.J., said she never prescribed A.D.H.D. medicine but knew many doctors who did. She said many parents could push as hard for prescriptions as their children did, telling her: “My child is not doing well in school. I understand there are meds he can take to make him smarter.”
许多手握处方的年轻人说，他们的医生只不过听了他们讲述的故事，就掏出了处方笺。新泽西州西纽约市的家庭医生希尔达·R·罗克(Hilda R. Roque)表示，她本人从未开过ADHD处方，但知道一些医生这么干过。她说，许多家长和孩子一样急于得到处方。他们对她说，“我的孩子在学校里表现不佳。我知道有种药物吃下去就能让他变聪明。”
“To get a prescription for Adderall was the Golden Ticket — it really was,” said William, the recent graduate of Birch Wathen in Manhattan.
“能拿到Adderall的处方就跟中了终身大奖（Golden Ticket，源自小说《查理与巧克力工厂》，抽中者可获参观全宇宙最著名的糖果厂并终生享受无限量免费糖果供应——译注）一样——真的。”刚刚毕业于曼哈顿伯奇·沃森·伦诺克斯中学的威廉说。
A high school senior in Connecticut who has used his friend’s Adderall for school said: “These are academic steroids. But usually, parents don’t get the steroids for you.”
一位康涅狄格州的高四学生曾经服用过朋友的Adderall。他说，“这些药丸就是学术世界的类固醇。但通常，家长们不会帮你去获取类固醇。”
As with the steroids taken by athletes, the downside of prescription stimulants appears after they provide the desired short-term competitive benefits. This was the case with a recent graduate of McLean High School in Virginia, one of the top public schools in the Washington area.
与运动员们服用的类固醇一样，在提供了期待中的短期竞争优势之后，处方兴奋剂的负面效果才会体现出来。刚从弗吉尼亚麦克莱恩高中毕业的一名学生的经历便是如此。该所高中是华盛顿地区最好的公立中学之一。
Late in his sophomore year, the boy wanted some help to raise his B average — far from what top colleges expected, especially from a McLean student. So he told his psychologist what she needed to hear for a diagnosis of A.D.H.D. — even gazing out the window during the appointment for effect — and was soon getting 30 pills of Adderall every month, 10 milligrams each. They worked. He focused late into the night studying, concentrated better during exams and got an A-minus average for his junior year.
高二下半学期，这个男孩希望提高一下自己平均为B的成绩——这离顶级名校的录取标准差得很远，况且他又是麦克莱恩高中的学生。于是他对自己的心理医生说了一堆足以让后者做出ADHD诊断的话——为了效果逼真，他甚至在就诊时一直双眼放空，凝视窗外——随即得到每个月30粒剂量为10毫克的Adderall的处方。这些药丸很管用。他可以开夜车到很晚仍保持注意力，考试时精神也更集中。高三时，他拿到了A-的平均成绩。
“I wanted to do everything I could to get into the quote-unquote right school,” he recalled recently.
“就算不惜一切代价，我也要考进那种所谓‘正确的大学’，”他最近回忆道。
As senior year began, when another round of SATs and one last set of good grades could put him over the top, the boy said he still had trouble concentrating. The doctor prescribed 30 milligrams a day. When college applications hit, he bought extra pills for $5 apiece from a girl in French class who had fooled her psychiatrist, too, and began taking several on some days.
进入高中最后一年，他迎来又一轮SAT测试，这是他最后一次凭着好成绩名列前茅的机会。男孩说，他仍旧难以集中精力。医生把每日处方剂量提高到30毫克。大学申请开始时，他以每粒5美元的价格从一位法语班女同学手上又多买了一些。那个女同学也是通过欺骗自己的精神病医生的方式获得的药物。他开始在某些日子里多次服药。
The boy said that as his A-minus average continued through senior year, no one suspected that “a kid who went to Bible camp” and had so improved his grades could be abusing drugs. By the time he was accepted and had enrolled at a good but not great college, he was up to 300 milligrams a day — constantly taking more to stave off the inevitable crash.
男孩说，最后一学年，他的总平均成绩一直保持着A-，没人怀疑“一个参加圣经夏令营的孩子”会用滥用药物的方式提高成绩。到他被一所排名不错但算不上最好的大学接收入学时，他每天服用的剂量已高达300毫克——剂量需要不断增加，以尽量延缓终将到来的崩溃。
One night, after he had taken about 400 milligrams, his heart started beating wildly. He began hallucinating and then convulsing. He was rushed to the emergency room and wound up spending seven months at a drug rehabilitation center.
一天晚上，服下400毫克药物后，他的心脏开始狂跳。他开始出现幻觉，随后全身抽搐。他被紧急送往急诊室。这件事以他在一家戒毒康复中心度过7个月而告终。
To his surprise, two of 20 fellow patients there had also landed in rehab solely from abusing stimulants in high school.
令他大吃一惊的是，那里的20个病人中，就有两个人是因为在高中滥用兴奋剂而被送进戒毒康复中心的。
“No one seems to think that it’s a real thing — adults on the outside looking in,” the boy said. “The other kids in rehab thought we weren’t addicts because Adderall wasn’t a real drug. It’s so underestimated.”
“没人把这事儿当真——外面那些成年人不过是蜻蜓点水地来看一眼，”男孩说，“康复中心里的其它年轻人觉得我们不是瘾君子，因为Adderall算不上正牌毒品。它被严重低估了。”
‘No Way You’d Notice’
“你不会注意到”
The Sklar family lives near the top of a daunting hill in Ardsley, a comfortable suburb north of New York City. Ardsley High School sends dozens of graduates every year to Ivy League-caliber colleges. When students there use Facebook, they all know that its founder, Mark Zuckerberg, once walked the same halls.
纽约北部的阿兹利是一个舒适的中产阶级街区。一座庄严肃穆的小山近顶处，斯卡拉(Sklar)一家就住在那里。阿兹利高中每年向常春藤名校输送数十名毕业生。当那里的学生使用Facebook网站时，他们都知道，该网站的创始人马克·扎克伯格(Mark Zuckerberg)曾和他们走在同一栋教学楼中。
At their kitchen table after school last month, Dodi Sklar listened as her ninth-grade son, Jonathan, described how some classmates already abused stimulants — long before SATs and college applications. An accomplished student who said he would never join them, Jonathan described the ease with which he could.
上个月，学校放学后，多迪·斯卡拉(Dodi Sklar)在厨房操作台旁和上9年级的儿子乔纳森(Jonathan)聊天。乔纳森说起，班上已经有同学在服用兴奋剂——SAT考试和大学申请可还是老远的事呢。乔纳森成绩很好，他说他永远不会加入那一行列。但他表示，如果他想的话，简直可以不费吹灰之力。
“There’s no way you’d notice — that’s why so many kids are doing it,” he told his mother. “I could say I’m going for a run, call someone I know who does it, get some pills from them, take them, come home and work. Just do it. You’d be just glad that I was studying hard.”
“你根本不会注意到——这就是为什么那么多学生都这么干的原因，”他跟妈妈说，“我可以说，我想出去跑个步， 然后给我认识的某个卖兴奋剂的人打个电话，从他们那儿拿到药丸，吃下去，回家，做功课。就是这样。你一样会因为我用功学习而感到高兴。”
His mother sighed. “As a parent you worry about driving, you worry about drinking, you worry about all kinds of health and mental issues, social issues,” she said. “Now I have to worry about this, too? Really? This shouldn’t be what they need to do to get where they want to.”
他的母亲叹息道，“身为父母，你不仅要担心孩子开快车，酗酒，担心所有的生理健康、心理健康和社交问题，”她说，“现在我还得为兴奋剂担心吗？这是真的吗？他们不该要用到这种手段以达成进入理想中大学的目的。”
Asked if the improper use of stimulants was cheating, students were split. Some considered that the extra studying hours and the heightened focus during exams amounted to an unfair advantage. Many countered that the drugs “don’t give you the answers” and defended their use as a personal choice for test preparation, akin to tutoring.
当被问及不正当的服用兴奋剂是否构成作弊时，学生们分成了两派。一些人认为，额外的学习时间和考试时被药物提高的注意力形同于不公平的竞争优势。一些人则反驳说，药物“不会给你答案”。他们认为，为了准备考试而服用药物是一种个人选择，类似于请私人教师辅导功课。
One consensus was clear: users were becoming more common, they said, and some students who would rather not take the drugs would be compelled to join them because of the competition over class rank and colleges’ interest.
有一件事已经成为共识：使用药物的人越来越常见，为了争夺班级排名和大学录取通知书，一些不想服药的学生可能会被迫加入这一行列。
A current law student in Manhattan, who said he dealt Adderall regularly while at his high school in Sarasota, Fla., said that insecurity was a main part of his sales pitch: that those students “would feel at a huge disadvantage,” he said.
一位目前在曼哈顿就读法学院的学生高中时代经常从事Adderall药物交易。曾在佛罗里达萨拉索塔某高中就读的他表示，不安全感是他的主要卖点之一：那些不吃药的学生“会觉得自己吃了大亏”。
William, the recent Birch Wathen graduate, said prescription stimulants became a point of contention when a girl with otherwise middling grades suddenly improved her SAT score.
最近刚刚从伯奇·沃森·伦诺克斯中学毕业的威廉说，当一位本来成绩平平的女生突然SAT分数显著提高后，兴奋剂处方药开始成为话题的焦点。
“There was an uproar among kids — some people were really proud of her, and some kids were really jealous and mad,” he recalled. “I don’t remember if she had a prescription, but she definitely took more than was prescribed. People would say, ‘You’re so smart,’ and she’d say, ‘It wasn’t all me.’ ”
“学生们吵成一团——有些人真心为她骄傲，另外一些人则嫉妒得发疯，”他回忆说，“我不记得她到底是不是真的有医生的处方，但她实际服用的剂量绝对要比处方量大得多。人们会说，‘你可真聪明，’然后她回答道，‘这不全是我的功劳。’”
One sophomore at Harvard-Westlake School in Studio City, Calif., is unsure what his future holds. Enrolled at one of the top high schools on the West Coast, he said he tried a friend’s Adderall this semester but disliked the sensation of his heart beating rapidly for hours. He vowed never to do it again.
一名加州哈佛-西湖中学(Harvard-Westlake School)的二年级学生对自己的前景并不明朗。被这所西海岸最顶级的高中录取后，他这学期试服了一位朋友的Adderall，但并不喜欢几个小时内心脏一直狂跳的感觉。他发誓再也不碰这种药物了。
But as he watches upperclassmen regularly abuse stimulants as they compete for top college slots, he is not quite sure.
但当看到高年级学生在争夺顶级大学录取通知书的过程中经常服用兴奋剂之后，他现在不那么肯定了。
“Junior and senior year is a whole new ballgame,” the boy said. “I promised myself I wouldn’t take it, but that can easily, easily change. I can be convinced.”
“高三和高四的情形完全不同，”男孩说，“我向自己保证不会去碰药物，但这决定轻而易举就会被改变。我对此十分肯定。”