A few scattered comments, no single argument...

Performance-doping by a large percentage of students at prestigious schools has been going on for decades. Separate from the people who are wired differently and really need the chemical tuning.

Also, it seems a lot of students are on anti-depressants. (You might be, too, if you had pushy overachiever helicopter parents always pushing you. Or if the same career that paid for your affluent upbringing, including college admission advantages, came because a parent operated very selfishly in general.)

Meds seem to be a go-to solution for many affluent families.

Adderall doesn't let someone be the brightest student, but it helps them keep up with courseload, of study-heavy or lab-heavy classes -- to compete with the students who have better/more prior education/experience, better work practices, who prioritize studies over partying, or who are otherwise brighter as a student in some regard.

Of the students who didn't actually have an ADHD disability, but ended up relying on the meds anyway, they aren't bad people. They're actually generally nice and smart, like everyone else. I hope it keeps working for them, or they are able to wean off without ill effects.

One thing I really worry about is a different but related problem: a culture of cheating, most recently accelated by ChatGPT and the like. That seems to be having really bad societal effects already.

One thing I wonder about is whether some of the students on other meds, like for depression, are having too much edge of passion and creativity taken off. Although the college admissions and career prep books and coaches tell students how to give the corporate-standard performative indicators of "passion", that comes out as a very different thing, and maybe all the meds has something to do with that. (I suppose a professor who's been engaged for a few decades would have a good perspective on this.)