Should we use drugs to enhance cognitive performance?
Maxine Clarke
Monday, 01 December 2008 17:40 UTC
There is a growing trend to take prescription stimulants (Adderall and Ritalin for example) in order to enhance cognitive performance – perhaps in attempt to obtain better grades or increase learning capacity. Nature has been reporting on developments in this controversial area and providing a forum for discussion. In a Commentary article published online today (_Nature doi:10.1038/456702a; 7 December 2008) Henry Greely and co-authors, who include Philip Campbell, Editor in Chief of Nature, say that society must respond to this demand. The authors call for:
- a presumption that adults should be able to use drugs for this purpose
- an evidence-based approach to evaluate the risks and benefits
- legal and ethical policies to ensure fair and equitable use
- a research programme
- broadly available information about risks and benefits
Do you agree with the authors that new methods of improving our brain function should be welcomed, to improve quality of life and extend lifespans? Will safe and effective cognitive enhancers benefit the individual and society? Or should these drugs remain illegal for these purposes?
The Nature Commentary is published online tonight (7 December) and will be in the 11 December 2008 print edition of the journal.
Previous Nature Network discussion responding to the question ‘would you boost your brain power?’
Updated 08 December 2008 08:27 UTC
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I think these drugs could really benefit our productivity in many fields but legal restrictions should always be present and further research on the potential risks is needed.
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I admire the authors taking the risk to highlight the issue. Bioethics and biotechnologies issues like “cognitive enhancement” are not going to go away. We have already had the “pleasure enhancement” revolution and not handled it well. Now there is an extensive black market of prescription pain killers, stimulants, and other drugs.
The authors seem to be suggesting a market model for the new “cognitive enhancement” similar to Viagra and other “lifestyle” drugs. This has the advantage of a legal and profitable above-ground market. The disadvantage is that the rush to legitimate market, while profitable, is likely risky, especially when long term, developmental, and multi-drug interaction risks are considered.
I do agree with the authors that the topic will not disappear, and needs to be confronted. I do not pretend to know what policies are best.
I do suspect that biotechnology will be giving us the option of many more “enhancing” drugs and technologies, lifespan being the most troublesome and divisive.
The markets for these are likely to be large, profitable, and socially disruptive, regardless of whether they are above or below ground.
Do we really need a cognitive pharmaceutical arms race? Does corporate, national, and personal professional competition need the same level of competition as pro sports (legal or illegal)? Like others arms races, the parties can negotiate a verifiable truce and decide to avoid…
As a scientist I do not relish my peers or younger colleagues taking such drugs for the extra edge in career success. I do not relish getting “confidential” advice from a tenure review committee member that next time I should try taking a daily dose of “X”.
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So we hav not yet tinkered enough with our planet to cause global warming and tons of toxic everywhere, now we would like to start tinkering with our brains… If a person is metally competent as suggested by the article in “mentally competent adults should be able to engage in cognitive enhancement using drugs,” why does that person need to enhance his cognition???
If we start treating healthy people with cognitive enhancements, what are we going to use to treat those who really need such enhancement?
Where will the line be between the mentally ill and the healthy?
Who will be admitted to graduate schools? Those who could afford the most drugs or those who are actually gifted?
I think this is probably the silliest idea I have yet heard being suggested by some otherwise really smart people…
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Damit, I need a cup of coffee before I even start to think about this question.
Oh, and nice to see you’ve cleared this out of the way before Henry’s 21st.
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I for one, believe that if they can be taken safely, they should be allowed. Why not?
This is not about finding a satisfying and rich life is about going beyond what we’re capable of today.
Inequalities and such will always exist. These drugs may widen the gap for the moment but, once they’re off-patent, the gap will close.
It’s just an academic discussion, anyway. The drugs and the market for them are here, the only choice to make is whether to keep them in the open, or drive them underground so giving them up to criminals.
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Of the points made in the article, I agree with the need for:
- an evidence-based approach to evaluate the risks and benefits
- a research programme
- broadly available information about risks and benefits
..because: yes, they’re here and not going away. At least let’s have good information on them.
I don’t think I agree with the statement
- adults should be able to use drugs for this purpose.
My main question here is: why? What’s wrong with leaving your good old brain to do its thing without enhancement? By the way: would the authors extend this to any kind of (currently illegal) drug?
- legal and ethical policies to ensure fair and equitable use.
I’d like to hear any suggestions on how this should be done. Drug screening before exams? Regularly during college attendance? Give those who can’t afford the drugs the cash to afford them? Make everyone take them (clearly, the first point rules out the opposite scenario of ‘nobody uses them’)? Just wondering.
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Just wondering – have I missed the free on-line week? I can’t seem to read all of it without paying $18
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I would be very worried about the Law of Unforeseen Consequences with the use of these largely untrialled drugs (see previous NN discussion flagged in Maxine’s original post). The majority of mind
expandingaltering drugs discovered by humanity in nature pharmucopia have side effects of one form or another. I would be very wary of using any of the current family of available drugs on a long term basis.In which case the call for evidence based research in the Nature piece will have not inconsiderabkle ethical issues. These would presumably need to be both double blind and long term.
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How should people approach the prospect of cognition enhancing drugs? In the same way that porcupines contemplate sex – with great care and circumspection.
As one commentator has said, the drugs are here, so rather than fume with moral outrage, we should think of practical ways to approach the issue. However, two thoughts occur to me immediately [ only two? Is that all? You need better meds – Ed].
The first is that one mucks around with one’s brain at one’s peril. The effects on the world around you can be have greater consequences than one might imagine. Recently, I have been having problems getting the dosage right on some antidepressants I’m currently taking. These problems have caused dramatic mood swings that have had an impact on my colleagues, as well as extreme fatigue. And yet, all the time, I have the ear of a sympathetic and knowledgeable physician who can advise me, and the drugs I am taking have a long history of use, experiment, test and so on – products of the evidence-based approach that the authors advocate.
Just imagine – the self-medication of various cognitive enhancers might have all sorts of effects that might have an impact on one’s personal and professional relationships. How does one adjust dosage? By medical advice or peer pressure? And all this is quite apart from the presence, or not, of long-term side-effects. Perhaps some of these drugs are addicitive. Perhaps, in ten years time, they will
- produce disabling psychotic episodes in which the user is impelled to kill random passers-by;
- cause the user to drop dead;
- cause the user’s head to explode;
- suffuse the user with an insatiable desire to eat live human flesh;
[ Yes, those meds are definitely doing your head in – Ed]
The second thought concerns fashion, and, more fundamentally, changing attitudes towards behaviour and drugs.
In the UK these days, little boys who in my day would be regarded as ‘cheeky’ or ‘naughty’ are viewed as having a medical consition, ADHD, that requires special resources and treatment. Gee Minor, aged 10, she of the Unicycling Girrafes, would once upon a time be labelled as a geek, but now she has Asperger’s Syndrome. Practically every second kid in my local school is regarded as having some kind of ‘special need’ of this sort. Autistic-spectrum disorders used to be rare – now they are as common as page-3 models in reality TV shows. What’s going on? Is some kind of brain-plague affecting our offspring?
Not at all. What I think is going on is this – as education systems find it harder to cope with the resources allocated to them, their notions of what is ‘normal’ shrink, so that outliers – children once simply regarded as tearaways or geeks – are now rated as ‘abnormal’ and thus demanding of extra funding, without which the system says it cannot cope, whereas once it had.
In the end, it all cmes down to money, which Iain M. Banks (in one of his Culture novels,) tells us is ‘a crude form of rationing’.
I am not sure what the above ramble has to do with performance-enhancing drugs, but one idea is that if they were to become commonplace, people without them would be regarded as slowcoaches – the normal becomes the subnormal. And what with the many unknowns relating to the side-effects of their chronic use, the course becomes potentially very dangerous indeed.
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All drugs have side effects – and sometimes they can be lethal – as I unfortunately know rather too well with a member of my family.
When we are young we believe ourselves to be invulnerable – we tend to take risks with our bodies and think things like drugs cannot touch us, but they do and the effect may not be immediately obvious.
From what I can read it seems to me that the people taking these drugs are vulnerable because they are young and we should protect them. They need to know that there will, undoubtably, be risks associated with taking these drugs, and also – another point – will taking them make them, in the long run any happier?
I don’t think I would feel very happy with myself knowing that I had succeeded just because I was on drugs if the people around me had not. It would make me feel uneasy, where would I go from here – would it mean that I would have to be on them indefinitely to live up to other people’s expectations of me?
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