Drugs to make you cleverer are in the test-tube. Good
THIS drug is peddled on every street corner in America, and is found in every country in the world. It is psychoactive, a stimulant and addictive. Users say that it increases alertness and focus, and reduces fatigue. But the high does not last and addicts must keep consuming it in increasing quantities.
Put this way, sipping coffee sounds more like an abomination than the world’s most accepted form of drug abuse. But centuries of familiarity have put people at their ease. In the coming years science is likely to create many novel drugs that boost memory, concentration and planning. These may well be less harmful than coffee—and will almost certainly be more useful. But will people treat them with as much tolerance?
The new cognition-enhancing drugs are designed to treat debilitating diseases such as Alzheimer’s, attention-deficit disorder and schizophrenia. But because they act deep in neural pathways of the brain, some of them are bound also to enhance people’s power to think and learn (see article). Such drugs will inevitably be used by healthy people too. That is the lesson from medicines such as Ritalin (methylphenidate) and Provigil (modafinil), which are now widely used “off label” to boost performance, as Nature has found. When the British journal asked its scientifically aware readers earlier this year, one in five of those who answered said they had used such drugs non-medically, to help them concentrate or learn.
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.
Some worry about the unfair advantage and peer pressure that comes from these drugs. However, millions suffer from untreated but mild memory loss. Is it fair to deny them help? If the shy or the scatterbrained take cognitive enhancers, it is not obvious whether this is levelling their playing field or giving them an unfair advantage. Is it “natural” to prop up the ageing body with a nip and a tuck, but to restrict help for the aging mind to brain-training on the Nintendo?
Punishing the off-label use of cognitive enhancers may also be unfair to those who find these drugs medically useful in unexpected ways. Schizophrenics, it has recently been found, are likely to be heavy smokers because nicotine is good for their condition. Genetic variations between people are associated with different levels of working memory. People using Provigil or Ritalin may eventually be found to have a legitimate but previously unknown need for the drug.
There will always be risks, but no more than for other medicines. Remember that the new drugs will have passed clinical trials because they are treatments for a disease, even if they have not been licensed as cognitive enhancers. There will be a lot of habitual off-label takers, more people than in the trials, so the regulators need to monitor them for side-effects—especially in children. But detailed and accessible information about the side-effects of drugs is to everyone’s advantage.
With any compound, the task is to minimise harm while maximising the freedom to choose. It may even be that, like Viagra, society largely welcomes the arrival of a chemical that does, far better, what omega-3s, ginseng, vitamins and all the other quackery have failed to do. Unless of course, you want to outlaw double espressos too.