The illicit use of stimulants for cognitive enhancement is significantly higher than non-medical use of prescription stimulants among pupils and students. Stimulant use is determined by gender, school type, and school marks. The potential risks associated with stimulant use require early awareness and intervention strategies.

The use of coffee and caffeinated drinks for CE was found to be widespread in the surveyed population. Although the use of caffeine tablets was found to be smaller than the above-mentioned means, it still indicates a relatively high disposition for using tablets for purposes of CE.

Background:The goal of this pilot study was to assess attitudes toward cognitive enhancement (CE) in users and nonusers of prescription or illicit stimulants for CE. Methods: Self-rating questionnaires were used to assess general attitudes toward CE in a sample of 1,035 high school students and 512 undergraduate university students in Germany. Attitudes were also assessed in a subgroup of 49 users of prescription and/or illicit stimulants and compared to the remaining group of nonusers. Results: When asked about the conditions under which participants would consider the use of substances for CE, more than 80% of participants answered that such substances must not lead to long-term damage or addiction if they were to consider using them, while 95% (more often females than males) thought that currently available substances would lead to addiction. Only 16% would not use cognitive enhancers under any condition. A minority of participants (more males than females) stated that students with low academic performance (26%), pilots (21.6%), or physicians (18.9%) should be allowed to use cognitive enhancers; 50.4% would support the use among the cognitively impaired elderly. Compared to nonusers, users were significantly more likely to (1) believe that it was fair for others to use cognitive enhancers, (2) allow the use in students with lower academic performance, and (3) use cognitive enhancers if others did. Reported substance use was associated with higher achievement motivation and with a stronger external locus of control. Conclusions: The disposition to use cognitive enhancers among high school and university students in Germany is high, if substances are safe. However, fear of addiction and doubts about fairness lead most participants to abstain from stimulant use for CE.

Larger epidemiological studies are needed to elucidate the risk of misuse and addiction in subjects using stimulants for PN.