Research paper examining the effects of cognitive enhancements with stimulants.

1. Cognitive Enhancements with Stimulants in China
Cognitive enhancers with stimulants, otherwise known as nootropics, are synthetic or
natural substances that aim to improve various mental functions such as memory, attention,
cognition, and intelligence. China is regarded as the world’s largest nootropic drug dispensary
which makes it easy for Chinese citizens to purchase certain cognitive enhancers even without a
prescription. For example, China is the world’s largest producer of Piracetam, a nootropic that
specifically aids in enhancing memory. Chinese laws surrounding Piracetam differ from the rest
of the world in that it is an over the counter drug that can be purchased without a prescription in
most pharmacies. This may be due to the fact that there is an increased motivation to use
nootropics in China because of the high levels of pressure to excel academically. Many Chinese
students use nootropics because their ability to improve mental functions can lead to higher exam
scores. However, despite the fact certain nootropics, such a Piracetam, are readily available
throughout China, other stimulant-class drugs are subject to much stricter laws.
Two popular synthetic psychostimulants, Adderall and Ritalin, are both under strict
control in China, therefore making them largely unavailable to citizens. For example, Adderall is
not available at all in Mainland China most likely because Chinese doctors rarely diagnose
Attention Deficit Hyperactivity Disorder (ADHD) in their patients. However, Ritalin is available
in small doses, meaning prescribed Chinese citizens must get their prescription refilled each
week. Although Adderall and Ritalin can both be used as cognitive enhancers, Ritalin is most
likely more accessible because it is more commonly prescribed for weight loss instead of
ADHD. Hong Kong is one exception to this in that doctors are more likely to diagnose and treat

2. ADHD with Ritalin in their patients. In addition, high levels of academic pressure have increased
the demand for Ritalin among students who wish to use it as a study aid.
Another stimulant nootropic, Modafinil, differs slightly from Adderall and Ritalin in that
it is mostly prescribed in individuals with sleep conditions because it mainly promotes
wakefulness. However, as a result it can also improve other cognitive functions such as alertness
and attention. Modafinil cannot usually be found in pharmacies throughout major Chinese cities;
however, unlike Adderall, some Chinese citizens with a valid prescription are able to obtain it
from physicians in hospitals.
The lack of availability among these drugs in China may be due to the negative stigma
surrounding mental disabilities. For example, one study found that, “Chinese Americans and
Europeans are more likely to seek help than Hong Kong and Mainland Chinese” (Zheng &
Zheng, 2015) in regards to mental disorders. Furthermore, Chinese teachers are more likely to
attribute ADHD symptoms to factors such as poor parenting or simply a lack of effort from the
student. Both of these factors may contribute to why Chinese doctors rarely recognize ADHD,
which in turn could be why psychostimulants such as Adderall and Ritalin are scarce. In addition
to these findings, despite the fact ADHD is infrequently diagnosed, studies have found that the
level of hyperactivity among Chinese boys almost doubles that of boys living in the West.
However, this may be due to the fact that “Chinese mental health professionals have a lower
threshold for rating behavior as hyperactive than professionals in the United States” (Norvilitis &
Fang, 2015). Overall, even though hyperactivity still seems to be common in China, drugs that
help these overactive symptoms are still under strict quality controls.

3. Throughout researching this topic, one special circumstance I found is that China’s laws
surrounding stimulant drugs are much stricter than the laws in the United States. Although the
United States requires prescriptions to obtain smart drugs such as Adderall and Ritalin, I found
these drugs are highly unavailable throughout China even for those with prescriptions. For
example, I read many accounts of students studying abroad in China who had to receive special
permission to obtain three months of their Adderall prescription at one time because it would not
be available for refills. I found this somewhat confusing because China is regarded as one of the
largest dispensaries for nootropics in the world; however, popular Western drugs are basically
nonexistent there. Furthermore, I expected these drugs to be readily available because of China’s
high academic reputation; nonetheless, ADHD is viewed much differently in the United States,
which may contribute to why these drugs are subject to more lenient control.

4. References
Norvilitis, J. M., & Fang, P. (2005). Perceptions of ADHD in China and the United States: A
Preliminary Study. ​Journal of Attention Disorders, 9​(2), 413-424.
doi:10.1177/1087054705281123
Zheng, Y., & Zheng, X. (2015). Current state and recent developments of child psychiatry in
China. ​Child and Adolescent Psychiatry and Mental Health, 9​(1).
doi:10.1186/s13034-015-0040-0