Adderall, Legalize It

Interesting thought...

If drugs can safely give your brain a boost, why not take them? And if you don't want to, why stop others?

In an era when attention-disorder drugs are regularly — and illegally — being used for off-label purposes by people seeking a better grade or year-end job review, these are timely ethical questions.

The latest answer comes from Nature, where seven prominent ethicists and neuroscientists recently published a paper entitled, "Towards a responsible use of cognitive-enhancing drugs by the healthy."

In short: Legalize 'em.

"Mentally competent adults," they write, "should be able to engage in cognitive enhancement using drugs."

Roughly seven percent of all college students, and up to 20 percent of scientists, have already used Ritalin or Adderall — originally intended to treat attention-deficit disorders — to improve their mental performance.

Some people argue that chemical cognition-enhancement is a form of cheating. Others say that it's unnatural. The Nature authors counter these charges: Brain boosters are only cheating, they say, if prohibited by the rules — which need not be the case. As for the drugs being unnatural, the authors argue, they're no more unnatural than medicine, education and housing.

In many ways, the arguments are compelling. Nobody rejects pasteurized milk or dental anesthesia or central heating because it's unnatural. And whether a brain is altered by drugs, education or healthy eating, it's being altered at the same neurobiological level. Making moral distinctions between them is arbitrary.

But if a few people use cognition-enhancing drugs, might everyone else be forced to follow, whether they want to or not?

If enough people improve their performance, then improvement becomes the status quo. Brain-boosting drug use could become a basic job requirement.

Ritalin and Adderall, now ubiquitous as academic pick-me-ups, are merely the first generation of brain boosters. Next up is Provigil, a "wakefulness promoting agent" that lets people go for days without sleep, and improves memory to boot. More powerful drugs will follow.

As the Nature authors write, "cognitive enhancements affect the most complex and important human organ and the risk of unintended side effects is therefore both high and consequential." But even if their safety could be assured, what happens when workers are expected to be capable of marathon bouts of high-functioning sleeplessness?

Most people I know already work 50 hours a week and struggle to find time for friends, family and the demands of life. None wish to become fully robotic in order to keep their jobs. So I posed the question to Michael Gazzaniga, a University of California, Santa Barbara, psychobiologist and Nature article co-author.

"It is possible to do all of that now with existing drugs," he said. "One has to set their goals and know when to tell their boss to get lost!"

Which is not, perhaps, the most practical career advice these days. And Penn State neuroethicist Martha Farah, another of the paper's authors, was a bit less sanguine.

"First the early adopters use the enhancements to get an edge. Then, as more people adopt them, those who don't, feel they must just to stay competitive with what is, in effect, a new higher standard," she said.

Citing the now-normal stresses produced by expectations of round-the-clock worker availability and inhuman powers of multitasking, Farah said, "There is definitely a risk of this dynamic repeating itself with cognition-enhancing drugs."

But people are already using them, she said. Some version of this scenario is inevitable — and the solution, she said, isn't to simply say that cognition enhancement is bad.

Instead we should develop better drugs, understand why people use them, promote alternatives and create sensible policies that minimize their harm.

As Gazzaniga also pointed out, "People might stop research on drugs that may well help memory loss in the elderly" — or cognition problems in the young — "because of concerns over misuse or abuse."

This would certainly be unfortunate collateral damage in the 21st century theater of the War on Drugs — and the question of brain enhancement needs to be seen in the context of this costly and destructive war. As Schedule II substances, Ritalin and Adderall are legally equivalent in the United States to opium or cocaine.

"These laws," write the Nature authors, "should be adjusted to avoid making felons out of those who seek to use safe cognitive enhancements."

After all, according to the law's letter, seven percent of college students and 20 percent of scientists should have done jail time — this journalist, too.

By Brandon Keim

Towards responsible use of cognitive-enhancing drugs by the healthy