The Pharmaceutical Journal
Vol 275 No 7371 p494
15 October 2005

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Through caverns measureless to man more
Abuse of stimulants by college students is commonplace more
Distinguishing between the laws of life and the laws of death more

Through caverns measureless to man

Recently (PJ, 21 May, p622) I referred to certain engravings discovered in a narrow cavern called Aveline's Hole, in Burrington Combe in the Mendips, and suggested that similar inscriptions were probably present in cave sites in Cheddar Gorge.

Now I read in the September/ October issue of Current Archaeology that, indeed, some abstract engravings believed to date from Mesolithic times have been discovered in the cavern known as the Long Hole, which is situated above the celebrated Gough’s Cave in Cheddar.

The Long Hole is an opening of elliptical shape, barely wide enough to permit human access. It penetrates some 250m into the hillside. On the western wall of a small chamber 70m inside the cavern, just as the end wall rises abruptly 5m to block further ingress, have been found three separate engravings. All are abstract and rectilinear, comprising roughly parallel lines in two or three groupings and apparently scored with stone tools. Their degree of patination indicates a great age.

Unlike Aveline’s Hole, which remained sealed from the early Mesolithic period until penetrated by explorers in 1797, the Long Hole has been visited from time to time since the Roman occupation at least. Some of the graffiti there can be dated to 1668. Excavations in the 1960s showed considerable disturbance of local deposits.

No materials attributable to the Palaeolithic period have been reported from the cave finds, although an abundance of such remains has been discovered in Gough’s Cave beneath the cavern in question. Moreover, the style and condition of the Long Hole graffiti suggest a Meolithic origin.

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Abuse of stimulants by college students is commonplace

In the New England Journal of Medicine for 15 September, Richard Kadison, a mental health expert from Harvard University, discusses some of the problems that arise when college students try to increase their academic achievements with the assistance of stimulants or antidepressants.

Drug abuse of this kind is widespread in colleges and universities in the US, writes Dr Kadison. Students turn to drugs because they are overwhelmed by the demands of their studies and perhaps believe that they are suffering from attention deficit hyperactivity disorder (ADHD).

Prescribing for college students has been greatly influenced by the advent of selective serotonin reuptake inhibitors and stimulants designed to treat ADHD but illegal, or inappropriate, use has been made of these drugs by students who imagine that they will increase achievement during study and examinations. They think of such drugs as safe, expecting them to increase performance with small risk to health.

There is a challenge for physicians to determine which patients have a real need for psychotropic medication. Depression appears not infrequently during late adolescence. Students with diagnosed ADHD are three times as likely as their peers to abuse other substances, including alcohol, in an effort to ameliorate their attention problems or their depression.

Stimulants have been taken to improve concentration, mental focus and alertness. Students may take them in order to stay up later and study harder when a test is looming. Some may crush a tablet and inhale the powder, or occasionally inject it into a vein, to achieve a rapid and intense effect.

Antidepressants and stimulants have different therapeutic and side effects. SSRIs improve mood, social functioning, sleep and concentration, but may produce nausea, headache and sleep disturbances. Common side effects of stimulants include sleep problems, nervousness, abdominal pain, anorexia and irritability.

Although college students, and sometimes their families, may request these drugs to improve performance, other may avoid them in fear of developing a dependence. Education regarding medication from a primary care physician is therefore desirable.

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Distinguishing between the laws of life and the laws of death

John Ruskin commented in 1862: “Government and co-operation are in all things the laws of life; anarchy and competition the laws of death.” This strikes me as a sensible distinction. But we seem in these enlightened days to have strayed far from co-operation and entered the jungle of competition.

Our daily lives are shadowed by our efforts to gain a few steps on our contemporaries, and to gain a position among our peers in which we can boast of our superiority, whether in the smartness of our latest clothes or car, the richness of our diet, our holidays abroad, or the magnificence of our bank account.

In our leisure activities we compete in a desperate manner. Games are no longer fun to play for their own sake; they must include winning at any cost. Second place is not acceptable. Sport is serious. To help us shine we take drugs or muscle-building supplements, and hope not to be detected if our success brings us under suspicion of cheating.

In both our educational and leisure moments we talk glibly of a strange construction known as “league tables”, in which our prowess or that of our institution is compared with that of our fellow students. Yet we all possess personal attributes that are not necessarily the same as those of our friends and neighbours, and there is no good reason why we should submit to being placed on a list and be looked down upon because we are different when it comes to mathematics, languages, musical talent or ability to paint a cow in a field. To judge an academic institution by the individual capabilities of its inmates is frankly absurd and unfair.

Much the same objection can be made against the craze for breaking records in any activity. It does not worry me if I cannot knock one minute off the time taken by my neighbour to ride his bicycle from A to B. Nor do I feel a great urge to reach mountain peaks that other explorers have found unachievable. There are so many other goals awaiting me, nearer home, though they may bring me no fame to achieve.

Finally, is a certain contentment good for the soul and better than a perpetual urge to do more and more? As William Henry Davies wrote, “What is this life, if, full of care, / We have no time to stand and stare?”

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