After breaking his leg and piling on 50lbs, John Smith took Vyvanse to suppress his ap¬petite. This was on the advice of a medical-student friend who had lost a “near-miraculous” 20lbs despite no change to his lifestyle. Vyvanse did the trick: Mr Smith swiftly shed the excess weight.

在摔断一条腿、还增重50磅后，约翰•史密斯(John Smith)开始服用Vyvanse药物以减小胃口。这是一位学医的朋友的建议，这位朋友在没有改变生活方式的情况下近乎奇迹般地减重20磅。Vyvanse很管用：史密斯快速甩掉了多余的体重。

However, he also noticed that when he used Vyvanse, a prescription¹ drug to treat binge-eating and attention deficit² hyperactivity disorder³ (ADHD) in children and adults, he could “hyper-focus” on his work. Now the 30-year-old (who chose a pseudonym⁴ when interviewed for this article) “pops a small dose” every time he needs to power through his work as an analyst⁵ for an investment group in the US.

然而，他还注意到，在他服用Vyvanse期间，他可以“精神高度集中”于自己的工作。Vyvanse是一种处方药，用于治疗暴食症以及儿童和成人的注意力缺失过动症（ADHD，俗称多动症）。30岁的史密斯（在为这篇文章接受采访时他选择用假名）在美国一家投资机构担任分析师，如今，每次需要全神贯注地投入工作时，他就会“吞下小剂量”的Vyvanse。

Vyvanse lets him shut off the world, put his head down and dive into numbers. “I feel a desire to track down the answers. It creates an obsessive⁶ compulsive desire for me to check off my work as completed — and completed well.”

Vyvanse让他与世界隔绝，静下心来徜徉于数字的汪洋大海。“我感觉到一种找到答案的渴望。它让我产生了一种带有强迫性的愿望，要确定我的工作已做完，而且完成得非常出色。”

He does not have a prescription for the drug but buys it by the pill from a friend who does. Mr Smith has also sold pills to friends who feel the need for help to concentrate or work long hours. This is never for profit, he is keen to point out, and often puts him out of pocket. “I’m not a professional drug dealer,” he says. “I simply help out friends when they request it.”

他没有这种药的处方，而是从一位有处方的朋友那里一粒一粒的购买。史密斯还把药卖给需要集中注意力或长时间工作的朋友。他急切地指出，这么做从来不是为了盈利，事实上他经常赔钱。“我不是一个职业的毒品贩子，”他表示，“我只是在朋友们提出请求时帮助他们。”

Such stories do not surprise Michael Sinclair, apsychologist based in the City of London. He is used to seeing a steady trickle⁷ of younger clients who report taking drugs such as Vyvanse or Adderall that are prescribed for ADHD, or Modafinil, which is used to treat narcolepsy, in an attempt to help people concentrate or work for longer periods. “People are buying it off each other and on the internet.”

这种故事并没有让在伦敦金融城工作的心理学家迈克尔•辛克莱博士(Dr Michael Sinclair)感到意外。他已习惯于看到较年轻的客户跟他说，他们在服用治疗多动症的Vyvanse或阿得拉(Adderall)，或者治疗嗜睡症的莫达非尼(Modafinil)等处方药，目的是帮助他们集中注意力或工作更长时间。“人们正向熟人购买，或者从网上买。”

Patrick Curtis, a former banking⁸ analyst and founder⁹ ofWall Street Oasis¹⁰, a networking and career site for those working in finance, observes a generational shift in the use of drugs. There is a move from alcohol and cocaine¹¹ to so-called “performance-enhancing drugs” among younger Wall Street workers. “The demands of the job have increased and the drugs of choice have evolved as a result,” he says. He believes the pressures and competition are harder for this generation. “Students 20 years ago barely even knew what investment banking was in their freshman¹² and sophomore¹³ years. Today, they know how to build leveraged¹⁴ buyouts, run a discounted cash flow and explain complex derivatives¹⁵.”

前银行业分析师、面向金融业人士的社交和职介网站Wall Street Oasis创始人帕特里克•柯蒂斯(Patrick Curtis)观察到，药物的使用出现了代际变化。较为年轻的华尔街员工正从酒精和可卡因转向所谓的“提高绩效的药物”。“工作要求提高，他们的首选药物也随之变化，”他表示。他认为，对于这一代人而言，压力和竞争更难应对。“20年前，大一和大二的学生们根本不懂投行业务是怎么回事。如今，他们知道如何策划杠杆收购、计算出贴现现金流，还能解释复杂衍生品。”

One technology sector¹⁶ worker, who prefers to remain anonymous¹⁷, took Adderall to help him get through his high-school exams. “When you have 36 hours’ worth of exams in the space of three weeks there simply isn’t a way to get prepared for everything ahead of time. Adderall, whether [its effect] is physiological¹⁸ or psychological, helps you get through that.”

一位希望匿名的科技行业员工曾借助阿得拉通过高中考试。“如果你要在3周时间内参加共计36小时的考试，你根本没有办法提前准备好一切。不管（它的效果）是生理上的还是心理上的，阿得拉会帮你度过难关。”

A downside was that it would sometimes make him focus on the wrong thing: “You start reading on a certain subject, not related to your course, and you keep reading and researching it because you’re interested in it.”

一个缺点是，有时这种药物会让他把注意力投向错误的对象：“你开始阅读某个主题，与你的功课无关，你会一直读，一直研究，因为你对它感兴趣。”

The numbers of people who use such drugs for productivity reasons rather than medical ones is hard to gauge¹⁹. One report in the US estimated 34 per cent of college students had used ADHD medication primarily in periods of high academic stress. Others have suggested the figure is lower. Researchers at King’s College London and the London School of Economics found that 9 per cent of surveyed students had used Modafinil, Adderall or Ritalin at least once. Moda¬finil is approved for helping²⁰ shift workers stay alert in the US. But as a 2012 re¬p¬ort, called “Human enhancement and the future of work”, pointed²¹ out, “the definition of shift work could encompass²² many different work patterns”.

很难计算有多少人服用这种药是为了提高学习或工作效率，而不是为了治病。美国的一份报告估计，34%的大学生曾服用过治疗多动症的药物，主要是在学习压力大的时候服用。其他人提出，这个数字应该更低。伦敦大学国王学院(King’s College London)和伦敦经济学院(LSE)的研究人员发现，9%的受访学生至少曾服用过莫达非尼、阿得拉或利他林(Ritalin)一次。莫达非尼在美国被批准用于帮助轮班工作者保持清醒。但正如2012年一篇题为“人类增强与工作的未来”(Human enhancement and the future of work)的报告所指出的，“轮班工作的定义可能会包括很多不同的工作模式”。

Johann Hari, a former Independent journalist who left the newspaper after admitting plagiarism²³ and then wrote a book about the war on drugs, recently told of his use of the anti-narcolepsy drug Provigil. “You can do even more work, and be constantly processing information, and sleep only four hours a night.” He believes he became addicted²⁴. The long-term effects of such drugs on healthy minds is yet to be determined²⁵.

独立报》(Independent)前记者约翰•哈里(Johann Hari)最近讲述了他服用抗嗜睡药物Provigil的经历；在承认剽窃后，他离开了该报，后来撰写了一本有关禁毒战争的书。“你甚至可以做更多工作，不断处理信息，而每晚只睡4小时。”他相信自己上瘾了。目前还不确定这些药物对健康心理的长期影响。

Michael Craig is a consultant²⁶ psychiatrist²⁷ at the London-based Nightingale and Maudsley hospitals and works with adults with ADHD. He has encountered patients with no medical need demanding pills. One mother of a teenager preparing to study in the US was particularly aggressive in her demands for a prescription. “She felt that it wasn’t a level playing field if her child was not using them.”

迈克尔•克雷格(Michael Craig)是在伦敦的南丁格尔医院和莫斯里医院执业的精神科顾问医师，与患有多动症的成人打交道。他遇到过没有医疗需要但要求开这些药的患者。一位十几岁孩子的母亲准备让孩子去美国读书，她的开药要求尤为咄咄逼人。“她觉得，如果自己的孩子不服用这些药的话，他将面临一个不平等的竞争环境。”

Many of his patients are misdiagnosing themselves, believing their inability to focus for long stretches is a physiological defect. ADHD is unusual in that “people want to have it”, says Dr Craig. “You don’t get that with bipolar or schizophrenia — people will ask for their money back in a private clinic or complain if it’s in the public sector if you don’t diagnose them with adult ADHD.”

他的很多患者对自己误诊了，他们认为自己无法长时间集中注意力是一种生理缺陷。克雷格表示，ADHD的不寻常之处在于，“人们迫不及待地想患上它。躁狂抑郁性精神病或精神分裂症就不是这样。如果你没有对他们作出成人多动症诊断的话，私人诊所的病人就会要求退钱，公共部门医院的病人就会投诉。”

This resonates with Dr Sinclair who fears that people are trying to use drugs to “eliminate the worst aspects of themselves”. Those who come through his door tend to be perfectionists “who fear failure”. He is concerned that people are not allowing themselves to feel tired or down. “Actually, it’s OK to feel low”.

身为心理学家的辛克莱博士同意这点，他担心人们正试图利用药物“消除自身最糟糕的部分”。那些找他咨询的人往往是“害怕失败”的完美主义者。他担心，人们不允许自己感觉疲劳或情绪低落。“实际上，感觉状况不佳是正常的”。

John Harris, a bioethics professor at the University of Manchester, is more sanguine²⁸. He is broadly in favour of technology and drugs that improve performance. “If everyone’s working all hours the pressure is on.” Just as people use coffee and alcohol, so prescription drugs might be a rational response to pressure, he feels. “We should operate on the pressure not the drugs.”

曼彻斯特大学(University of Manchester)生物伦理学教授约翰•哈里斯(John Harris)则比较放松。他基本上支持那些提高绩效的技术和药物。“如果所有人都通宵达旦，压力就产生了。”他觉得，就像人们喝咖啡和饮酒一样，处方药可能是人们应对压力的一种理智反应。“我们应该对压力下刀，而非药物。”

Ben Willmott, head of public policy at CIPD, a UK human resources body, agrees that the pressure must be tackled. “The best way for employers to reduce the risk of employees using this type of drug is to ensure that line managers are trained effectively, working hours are appropriate and that people are not put under excessive and prolonged pressure.”

英国人力资源组织特许人事与发展协会(CIPD)公共政策主管本•威尔莫特(Ben Willmott)认为，必须解决压力问题。“雇主减少员工服用这类药物的风险的最佳方法，就是确保直线经理接受有效培训，工作时间适当，而且员工没有处于长期、过大的压力之下。”

As for the pseudonymous Mr Smith, he shrugs²⁹ off the notion that he is under too much pressure. “Honestly? I love my job and wish I could do even more work.”

至于使用假名的史密斯，他对自己受到太大压力的说法不以为然。“诚实地说？我热爱我的工作，我甚至希望能多干点。”