高科技"聰明藥"造就的模範員工

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.

在摔斷一條腿、還增重50磅後，約翰•史密斯(John Smith)開始服用Vyvanse藥物以減小胃口。這是一位學醫的朋友的建議，這位朋友在沒有改變生活方式的情況下近乎奇蹟般地減重20磅。Vyvanse很管用：史密斯快速甩掉了多餘的體重。

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

然而，他還注意到，在他服用Vyvanse期間，他可以“精神高度集中”於自己的工作。Vyvanse是一種處方藥，用於治療暴食症以及兒童和成人的注意力缺失過動症（ADHD，俗稱多動症）。30歲的史密斯（在爲這篇文章接受採訪時他選擇用假名）在美國一家投資機構擔任分析師，如今，每次需要全神貫注地投入工作時，他就會“吞下小劑量”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 obsessive compulsive desire for me to check off my work as completed — and completed well.”

Vyvanse讓他與世界隔絕，靜下心來徜徉於數字的汪洋大海。“我感覺到一種找到答案的渴望。它讓我產生了一種帶有強迫性的願望，要確定我的工作已做完，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.”

他沒有這種藥的處方，而是從一位有處方的朋友那裏一粒一粒的購買。史密斯還把藥賣給需要集中注意力或長時間工作的朋友。他急切地指出，這麼做從來不是爲了盈利，事實上他經常賠錢。“我不是一個職業的毒品販子，”他表示，“我只是在朋友們提出請求時幫助他們。”

Such stories do not surprise Michael Sinclair, apsychologist based in the City of London. He is used to seeing a steady trickle 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.”

這種故事並沒有讓在倫敦金融城工作的心理學家邁克爾•辛克萊博士(Dr Michael Sinclair)感到意外。他已習慣於看到較年輕的客戶跟他說，他們在服用治療多動症的Vyvanse或阿得拉(Adderall)，或者治療嗜睡症的莫達非尼(Modafinil)等處方藥，目的是幫助他們集中注意力或工作更長時間。“人們正向熟人購買，或者從網上買。”

Patrick Curtis, a former banking analyst and founder ofWall Street Oasis, 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 cocaine 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 freshman and sophomore years. Today, they know how to build leveraged buyouts, run a discounted cash flow and explain complex derivatives.”

前銀行業分析師、面向金融業人士的社交和職介網站Wall Street Oasis創始人帕特里克•柯蒂斯(Patrick Curtis)觀察到，藥物的使用出現了代際變化。較爲年輕的華爾街員工正從酒精和可卡因轉向所謂的“提高績效的藥物”。“工作要求提高，他們的首選藥物也隨之變化，”他表示。他認爲，對於這一代人而言，壓力和競爭更難應對。“20年前，大一和大二的學生們根本不懂投行業務是怎麼回事。如今，他們知道如何策劃槓桿收購、計算出貼現現金流，還能解釋複雜衍生品。”

One technology sector worker, who prefers to remain anonymous, 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 physiological or psychological, helps you get through that.”

一位希望匿名的科技行業員工曾藉助阿得拉通過高中考試。“如果你要在3周時間內參加共計36小時的考試，你根本沒有辦法提前準備好一切。不管（它的效果）是生理上的還是心理上的，阿得拉會幫你度過難關。”

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.”

一個缺點是，有時這種藥物會讓他把注意力投向錯誤的對象：“你開始閱讀某個主題，與你的功課無關，你會一直讀，一直研究，因爲你對它感興趣。”

The numbers of people who use such drugs for productivity reasons rather than medical ones is hard to gauge. 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 helping shift workers stay alert in the US. But as a 2012 re¬p¬ort, called “Human enhancement and the future of work”, pointed out, “the definition of shift work could encompass many different work patterns”.

很難計算有多少人服用這種藥是爲了提高學習或工作效率，而不是爲了治病。美國的一份報告估計，34%的大學生曾服用過治療多動症的藥物，主要是在學習壓力大的時候服用。其他人提出，這個數字應該更低。倫敦大學國王學院(King’s College London)和倫敦經濟學院(LSE)的研究人員發現，9%的受訪學生至少曾服用過莫達非尼、阿得拉或利他林(Ritalin)一次。莫達非尼在美國被批准用於幫助輪班工作者保持清醒。但正如2012年一篇題爲“人類增強與工作的未來”(Human enhancement and the future of work)的報告所指出的，“輪班工作的定義可能會包括很多不同的工作模式”。

Johann Hari, a former Independent journalist who left the newspaper after admitting plagiarism 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 addicted. The long-term effects of such drugs on healthy minds is yet to be determined.

《獨立報》(Independent)前記者約翰•哈里(Johann Hari)最近講述了他服用抗嗜睡藥物Provigil的經歷；在承認剽竊後，他離開了該報，後來撰寫了一本有關禁毒戰爭的書。“你甚至可以做更多工作，不斷處理信息，而每晚只睡4小時。”他相信自己上癮了。目前還不確定這些藥物對健康心理的長期影響。

Michael Craig is a consultant psychiatrist 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.”

邁克爾•克雷格(Michael Craig)是在倫敦的南丁格爾醫院和莫斯里醫院執業的精神科顧問醫師，與患有多動症的成人打交道。他遇到過沒有醫療需要但要求開這些藥的患者。一位十幾歲孩子的母親準備讓孩子去美國讀書，她的開藥要求尤爲咄咄逼人。“她覺得，如果自己的孩子不服用這些藥的話，他將面臨一個不平等的競爭環境。”

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.”

他的很多患者對自己誤診了，他們認爲自己無法長時間集中注意力是一種生理缺陷。克雷格表示，ADHD的不尋常之處在於，“人們迫不及待地想患上它。躁狂抑鬱性精神病或精神分裂症就不是這樣。如果你沒有對他們作出成人多動症診斷的話，私人診所的病人就會要求退錢，公共部門醫院的病人就會投訴。”

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”.

身爲心理學家的辛克萊博士同意這點，他擔心人們正試圖利用藥物“消除自身最糟糕的部分”。那些找他諮詢的人往往是“害怕失敗”的完美主義者。他擔心，人們不允許自己感覺疲勞或情緒低落。“實際上，感覺狀況不佳是正常的”。

John Harris, a bioethics professor at the University of Manchester, is more sanguine. 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.”

曼徹斯特大學(University of Manchester)生物倫理學教授約翰•哈里斯(John Harris)則比較放鬆。他基本上支持那些提高績效的技術和藥物。“如果所有人都通宵達旦，壓力就產生了。”他覺得，就像人們喝咖啡和飲酒一樣，處方藥可能是人們應對壓力的一種理智反應。“我們應該對壓力下刀，而非藥物。”

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.”

英國人力資源組織特許人事與發展協會(CIPD)公共政策主管本•威爾莫特(Ben Willmott)認爲，必須解決壓力問題。“僱主減少員工服用這類藥物的風險的最佳方法，就是確保直線經理接受有效培訓，工作時間適當，而且員工沒有處於長期、過大的壓力之下。”

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

至於使用假名的史密斯，他對自己受到太大壓力的說法不以爲然。“誠實地說？我熱愛我的工作，我甚至希望能多幹點。”