Drugs for mental enhancement

2008-04-15

in Economics, Geek stuff, Politics, Science

Rusty bridge and steam pipes

A recent informal survey, conducted by Nature, suggests that large numbers of scientists are ‘doping’ with drugs that enhance their wakefulness and concentration. While the old joke holds that “a mathematician is a device for converting coffee into theorems,” drugs of choice have expanded to include Modafinil (Provigil) and Methylphenidate (Ritalin).

One in five respondents said they had used drugs for non-medical reasons to stimulate their focus, concentration or memory…

For those who choose to use, methylphenidate was the most popular: 62% of users reported taking it. 44% reported taking modafinil, and 15% said they had taken beta blockers such as propanolol, revealing an overlap between drugs. 80 respondents specified other drugs that they were taking. The most common of these was adderall, an amphetamine similar to methylphenidate.

I do not find this surprising. At a conference once, I met a young woman who pays her tuition by selling drugs usually prescribed for attention deficit disorder to fellow students at her Ivy League school.

It is not clear what kind of response is justified in the face of such anecdotal evidence. It is not obvious, prima facie, that the use of drugs is an inappropriate way to improve one’s mental function or academic output. People use all sorts of mechanisms – from physical activities to dietary modifications – to try to achieve the same end. Prescription drugs are thoroughly vetted for safety, though it is also fair to say that people self-prescribing are likely to make mistakes in terms of dosages and interactions with other substances. People make all kinds of sacrifices for success and it isn’t clear why it is obviously inappropriate for them to run the risks associated with altering their biochemistry. Given the degree to which success is related to self-esteem and contentedness, as well as the degree to which perceptions of failure associate with depression, it could arguably be better for one’s mental health to use whatever aids to success are available.

One legitimate concern is about a spiral effect. If honour roll students and leading researchers start becoming dependent on drugs to improve their focus, it might become difficult for anyone not doping to keep up. That could lead to situations in which people feel strongly pressured to do drugs as well. Of course, that strong pressure already exists in competitive academic environments. Still, there is reason to be especially wary when it is combined with psychoactive chemicals.

The questions suggested by the survey cannot be adequately addressed in a short blog post, but it does seem likely that they will be the subject of greater amounts of attention in the future. The competitive nature of the world, and the need to achieve things ever more rapidly, ensures that a market will exist for products that help people cope with both of those things. As with other unauthorized uses of drugs, the policies adopted by governments will affect things like price, availability, safety, and access to information and advice. Getting the balance right will be tricky.

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{ 25 comments… read them below or add one }

Litty April 15, 2008 at 8:41 am

It’s about time those flying spacecraft started adopting the methods of the freight trucking industry.

Anon April 15, 2008 at 9:59 am

People who need drugs to get their brains working are so pathetic… now where’s my venti dark roast?

Also: DEA Chief: Winners Occasionally Use Drugs

Kerrie April 15, 2008 at 10:41 am

I would rather see adults make the choice to take Ritalin than push it on helpless kids. The normal prescription use of these drugs is the real crime.

AnonotherAnon April 15, 2008 at 11:06 am

I will admit that all the talk about how productive Ritalin makes you has made me want to try it. That said, I am unwilling to buy it from some random website, and I am not sure how to scam a doctor into giving me some.

As for Modafinil, it sounds just amazing.

. April 15, 2008 at 11:12 am

Desperate parents,dangerous drugs
Parents of hyperactive children face a dreadful dilemma
Apr 20th 2006

BRITAIN: Education
Behave, or else
The state used to neglect badly behaved children. Now it gives them drugs and substitute parenting

Supercharging the brain
Sep 16th 2004
From The Economist print edition
Biotechnology: New drugs promise to improve memory and sharpen mental response. Who should be allowed to take them?

“While there are those who scoff at the idea of using a brain-boosting drug, Arthur Caplan, a bioethicist at the University of Pennsylvania in Philadelphia, does not think it would be particularly new, or inherently wrong, to do so. “It’s human nature to find things to improve ourselves,” he says. Indeed, for thousands of years, people have chewed, brewed or smoked substances in the hopes of boosting their mental abilities as well as their stamina. Since coffee first became popular in the Arab world during the 16th century, the drink has become a widely and cheaply available cognitive enhancer. The average American coffee drinker sips more than three cups a day (and may also consume caffeine-laced soft drinks).

Prescription drugs, though never intended for widespread use, have followed suit. Ritalin, for example, is used by some college students to increase their ability to study for long hours. Not surprisingly, some worry about the use of such drugs to gain an unfair advantage. Modafinil has already surfaced in doping scandals. Kelli White, an American sprinter who took first place in the 100-metre and 200-metre competitions at last year’s World Championships in Paris, later tested positive for the drug. Initially she insisted that it had been prescribed to treat narcolepsy, but subsequently admitted to using other banned substances as well. As a result, she was forced to return the medals she won last year and, along with a handful of other American athletes, was barred from competitions for two years.”

The ethics of brain science
Open your mind
May 23rd 2002
From The Economist print edition
Genetics may yet threaten privacy, kill autonomy, make society homogeneous and gut the concept of human nature. But neuroscience could do all of these things first

“Another argument is that drugs for the brain are simply one more step down a road taken by orthodontics, face lifts, Viagra and other medical extras. That may be so. But it could be a step in seven-league boots, for pharmaceutical companies are only just beginning to mine the spectrum of psychological ailments that flesh is heir to. Drugs to combat shyness, forgetfulness, sleepiness and stress are now in or close to clinical trials, not to mention better versions of drugs that have already swept society—what Arthur Caplan, a bioethicist at the University of Pennsylvania, calls “super-Prozacs”.”

. April 15, 2008 at 11:14 am

“Just as with genetics, however, the spectre that most terrifies many of those who fear the advance of neurotechnology is that it will one day be capable of “enhancing” human beings. Some worry that this may blunt the differences between individuals, turning society into one homogeneous mass. Others see the opposite risk—a Gattacesque division between the privileged and the unenhanced.”

Harmony April 15, 2008 at 1:59 pm

It was a survey conducted by and published in Nature, not Science. I guess the first thing to realize is, as you pointed out, it was an informal, self-reporting survey. So accuracy is suspect. Second, is one in five a large number? Meaning, is it much different from the rest of the population, which may not be taking those particular kinds of drugs, but are probably taking some kind of drugs? Legal or otherwise? In fact, I wonder what percentage of the population is entirely drug-free?!

Emily April 15, 2008 at 2:26 pm

The Ubyssey also reported on the rise of the drugs used at UBC: http://ubyssey.bc.ca/2006/12/05/students-taking-drugs/

It’s not acceptable for Olympic athletes to use drugs to enhance performance for obvious reasons, so I’m not sure why it would be acceptable for our best students to use drugs to enhance performance, leaving students who work harder in the dust.

If the norm becomes taking the drugs, it leaves ‘clean’ students at an immediate disadvantage. I think if we start depending on altering your biochemistry just to keep up in school, we’ve really lost the point of education all together.

(The point not being to cram as much information as possible into as short a time as possible and then forget, but to learn in a way that informs our decisions better for a lifetime.)

Milan April 15, 2008 at 2:30 pm

Harmony,

It was a survey conducted by and published in Nature, not Science.

Thanks for pointing this out. I have fixed the text above.

I guess the first thing to realize is, as you pointed out, it was an informal, self-reporting survey. So accuracy is suspect.

Very true. That said, whether the number was 5% or 40%, it would raise the same general questions.

Second, is one in five a large number? Meaning, is it much different from the rest of the population, which may not be taking those particular kinds of drugs, but are probably taking some kind of drugs? Legal or otherwise? In fact, I wonder what percentage of the population is entirely drug-free?!

That would be interesting to know, but there does seem to be something special about taking drugs to increase your productivity, rather than for the sake of enjoyment. Directly comparing recreational use with mental ‘doping’ is likely to be misleading.

Milan April 15, 2008 at 2:33 pm

Emily,

I disagree to some extent about drugs and atheletes. It is not obvious why we allow them to use all sorts of (potentially dangerous) non-drug enhancements, but draw the line at certain chemicals.

I think if we start depending on altering your biochemistry just to keep up in school, we’ve really lost the point of education all together.

We alter our biochemistry constantly and for all sorts of reasons. We feel hungry and eat a cookie, feel tired and drink a coffee. While side effects are definitely a concern, I don’t see how talking Ritalin for concentration is fundamentally different in kind. A Ritalin-boosted education may be richer, more effective, and more valuable over the course of one’s life.

Milan April 15, 2008 at 2:39 pm

Malcolm Gladwell has written some interesting stuff on drugs and sports:

Drugstore Athlete
September 10, 2001

The War on Drugs

War on Drugs, con’t

“Similarly, it is perfectly legal for an athlete to get painkillers after an injury, so he can continue playing (and, I would point out, risk further injury.) It is not legal for that athlete to take Human Growth Hormone, in order to speed his recovery from that same injury. Again, why? What is the distinction? Why is it okay to play hurt but not okay to try and not play hurt? There may be a perfectly valid reason here as well. But don’t we need to spell out what it is?”

Game of Shadows

Francis April 15, 2008 at 6:29 pm

You can buy Modafinil from this site, no questions asked:

http://www.antiaging-systems.com/

It is really expensive, though: $149.99 for 30 pills.

A better option is Adrafinil, a prodrug version of the same thing: $39.99 each for 40 pills.

http://www.antiaging-systems.com/iasstore/acatalog/adrafinil.html

Kerrie April 15, 2008 at 7:06 pm

I can’t imagine that a drug like Ritalin would enrich someone’s education, except in extremely limited circumstances. It makes you better at performing repetitive and monotonous tasks.

Milan, I share your ‘well why not’ approach as well as your concerns, but Emily is right to point out the difference between learning and achievement. Ritalin could enhance “performance” but it does not enhance creativity, lateral thinking-skills, problem-solving or synthesizing information. The rise of such drugs is a sad indicator of what passes for education. That said, I would still rather see of-age adults making a personal choice to take it than see it shoved down the throats of kids.

Sarah April 15, 2008 at 7:23 pm

I rather agree with Emily – there is something concerning about a culture in which academic success might be defined more by a willingness to self-medicate in search of a ‘quick fix’ rather than to study, especially if the drugs concerned are risky, expensive, illegal or incompatible with other medication (ie. not everyone can use them, so some are disadvantaged). I think coffee is rather a different case insofar as it is cheap, legal, very few people are allergic to it (or otherwise medically unable to drink coffee) and as such is available to almost everybody (plus caffeine overall is consumed by yet more people). My concern is about unfairly advantaging / disadvantaging students relative to their peers, and the worrying implications of a culture in which pill-popping is viewed as the solution to one’s problems.

Kerrie April 16, 2008 at 12:50 am

For that matter, even caffeine is not exactly a sign of a healthy, thriving culture of learning. The wider issue here that has not directly been addressed is students developing *real* mental and emotional health problems as a result of being in a high-stress environment. Excess caffeine intake is not healthy either.

Now, I don’t think that universities should be solely held accountable for student’s mental health, of course students must take personal responsibility too. Sometimes it’s even part of “university culture” to demonstrate how very hard you are suffering for your work, a culture where studying “hard” is more respected than studying “smart”.

However I’m sure any one of us-especially the ones with A or A+ averages- has had a moment at university where they thought “I could be learning so much if I didn’t have to cram all this shit in my head for the next midterm all the time”. I just feel like it doesn’t have to be like that-that it should be possible to receive a high quality education, and to perform to a high standard, without abusing our mental and physical health.

A lower-stress education system would also have the benefit of encouraging optimal lifestyle habits that make more productive workers after uni. No one at the office looks up to you if you brag about getting 4 hours sleep and drinking five coffees that morning, you’re actually a detriment to the company if you don’t take care of yourself.

This whole discussion raises very profound questions about the point of education. I don’t have answers to all of those questions. However I feel very strongly that education should be considered a sustainable, lifelong habit, and not a bunch of crap crammed into four years of our lives.

Milan April 16, 2008 at 9:48 am

Kerrie,

People have told me that taking drugs like Ritalin or Adderall very substantially increases their reading comprehension and later recollection of the materials. Similarly, there is no reason to think that drugs only improve one’s ability to perform “repetitive and monotonous tasks.” Look at the legions of artists who have coloured histories with all sorts of substances.

None of this is to advocate drugs, exactly. I am just saying that there is good reason to think the benefits are non-illusory (so are the harms, naturally).

Sarah,

Interesting issues of fairness do arise here, but it isn’t clear where the balance lies. Why are those who are naturally better at concentrating more justified in that property than those who acquire it artificially? It seems like the initial distribution of characteristics is even more arbitrary and unfair than those based on later choices.

Kerrie,

There is definitely an arms race mentality in universities but, as with an arms race, it is very hard to break out of. If I can convince everyone else to sit back and relax – while I continue studying at my previous level of intensity – I do better relative to them while doing no more work.

Kerrie April 16, 2008 at 11:15 am

Yeah, so fine. Let the adults make abusive choices for themselves. Like alcohol and smoking, there are lots of stupid decisions that adults can legally make. But that doesn’t mean our society should actively encourage those choices, nor should we force them on kids as many do with Ritalin.

Sarah April 16, 2008 at 11:21 pm

Milan, in short, the reason I think “natural” distribution of characteristrics regarding concentration etc is less unfair is because it does not mirror existing socio-economic inequities, as would be the case if an ability to pay or relative lack of fear of legal sanction were the defining characteristics (this might also be the case with ill-health, much of which continues to be caused by socio-economic inequality). As such, a random or near-random distribution of natural advantage and disadvantage is much less unfair than a distribution which reflects & exaggerates inequalities of race, class, gender etc. Compounding the very high degree of existing inequality in regard to higher education strikes me as inexcusable.

Dan | thesamovar April 17, 2008 at 9:05 pm

In principle, performance modifying drugs are not a problem. There are some difficulties in practice though, for example if there are side-effects (and there usually are). Heavy competition for the top jobs combined with the multiplying effect of these drugs on performance makes it more likely that people will take them, and hence more likely that they’ll suffer from the side effects. In principle, it’s fine for adults to make decisions which hurt themselves, but if society evolves to the point where the decision is certain failure in your career, or high risk to your health, then there’s a problem.

There’s also a more subtle problem which is that ‘performance’ usually corresponds to some technocratic measure which may not correlate with what is actually important. This isn’t the fault of the drugs per se, but their effect is to multiply the severity of the problem. Success in exams tests ability to succeed in exams, not ability to come up with creative new ideas, or whatever. Success in science is largely about the number of publications and the impact factor of the journals they’re published in. This is a dubious measure of success, but because it is the measure of success, people work towards it.

In conclusion: the problem is not the drugs per se, it’s the incentive structures our society offers people, and these drugs can exacerbate problems surrounding these. It would be better to address these social problems, especially as history tends to show that it’s difficult if not impossible to suppress a technology once it’s been invented.

. April 29, 2008 at 1:26 pm

CNS Drug Reviews
Vol. 5, No. 3, pp. 193.212
© 1999 Neva Press, Branford, Connecticut

Adrafinil: A Novel Vigilance Promoting Agent
Norton W. Milgram, Heather Callahan, and Christina Siwak
Division of Life Sciences, University of Toronto at Scarborough,
Toronto, Ontario, Canada

. April 29, 2008 at 1:32 pm

“As one indication
of the safety level of modafinil in humans, Bastuji and Jouvet (2) described a
subject who unsuccessfully attempted to commit suicide by taking 45 tablets of modafinil
(a quantity 15 times greater than a normal high dose). Bastuji and Jouvet (2) also found
that the long-term use (³ 3 years) of modafinil did not result in harmful side effects, peripheral
side effects or disturb nocturnal sleep. Patients treated with modafinil for at least 3
years did not develop tolerance or dependence.”

. May 29, 2008 at 11:53 am

Medicine
Smart drugs

May 22nd 2008
From The Economist print edition
Drugs to make you cleverer are in the test-tube. Good

“For many, drug is a four-letter word. Unapproved use is at best worrying and unfair, and at worst dangerous and immoral. Such thinking leads to strict controls or even prohibition and criminalisation. In Britain, for instance, Ritalin is a class B drug. Yet strict controls would be both futile and wrong.

Futile, because if people really want medicines, they can easily get hold of them. Nature’s drug users procured their stashes from prescriptions from doctors or over the internet. As anyone with an e-mail address knows, the difficulty is not scarcity, but keeping the offers for Viagra, real or fake, at bay.

And wrong because such drugs promise to do a lot of good. Many people already use Provigil to cope with night-shift work, jet lag and lack of sleep, and suffer few side-effects. Others use beta-blockers to overcome the anxiety and stress of performance. Scientists use off-label drugs to increase their focus. If that helps them unravel the mysteries of the universe, so much the better. If chemical assistance can help increase the useful human lifespan, the benefits could be huge. “

. July 17, 2008 at 1:23 pm

Night of the Living Meds
The U.S. military’s sleep-reduction program.
By William Saletan
Posted Wednesday, July 16, 2008, at 8:01 AM ET

. July 17, 2008 at 1:25 pm

“The study concluded that caffeine “significantly improved visual vigilance, choice reaction time, repeated acquisition, self-reported fatigue and sleepiness.”

But caffeine was only the beginning. “The US military … has a long-standing effort in tracking and evaluating popular supplements,” says the report. “To date, 86 proposed ergogenic and cognitive aids have been evaluated.” These apparently include “amphetamines and modafinil,” which “are known to be effective for combating the effects of sleep deficit.” But the hot target now is a class of chemicals called ampakines. “

. June 7, 2009 at 11:07 pm

The New Yorker on the underground world of “neuroenhancing” drugs.
Posted by Mark Frauenfelder, April 21, 2009 8:41 AM

“Cephalon, the Provigil manufacturer, has publicly downplayed the idea that the drug can be used as a smart pill. In 2007, the company’s founder and C.E.O., Frank Baldino, Jr., told a reporter from the trade journal Pharmaceutical Executive, “I think if you’re tired, Provigil will keep you awake. If you’re not tired, it’s not going to do anything.” But Baldino may have been overly modest. Only a few studies have been done of Provigil’s effects on healthy, non-sleep-deprived volunteers, but those studies suggest that Provigil does provide an edge, at least for some kinds of challenges. In 2002, researchers at Cambridge University gave sixty healthy young male volunteers a battery of standard cognitive tests. One group received modafinil; the other got a placebo. The modafinil group performed better on several tasks, such as the “digit span” test, in which subjects are asked to repeat increasingly longer strings of numbers forward, then backward. They also did better in recognizing repeated visual patterns and on a spatial-planning challenge known as the Tower of London task. (It’s not nearly as fun as it sounds.) Writing in the journal Psychopharmacology, the study’s authors said the results suggested that “modafinil offers significant potential as a cognitive enhancer.”

Brain Gain: The underground world of “neuroenhancing” drugs

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