The cleverness pill.
Scientists are proposing we consider using more 'cognitive enhancers'. If you could pop a pill to raise your IQ, would you?
Be all that you can be. Humankind has the unique characteristic of striving to free us from the shackles of nature, and enhancing ourselves to be fitter, happier, more productive. How many of you are reading this with glasses on? Who has been for a run today? Who drinks coffee in the morning? All of these things have demonstrable positive effects on our ability to perform normal tasks.
In the modern age, chemicals that can improve your physical characteristics have been around – and regulated – for years. Recently, a new class of drug has emerged that can improve your mental abilities. In the science journal Nature this week a team of scientists is proposing that society need to actively consider the use of these so-called cognitive enhancers. Modafinil (sold as Provigil), Ritalin, Adderall and others are now being used regularly by healthy people, often illegally, to boost memory, alertness, and concentration and to wipe out tiredness.
The mechanisms by which modafinil works is well enough understood that it is approved for use by the Food and Drug Administration in the US, but only under prescription for specific conditions (including narcolepsy, sleep apnoea and shift work sleep disorder). Off-label use anecdotally results in the removal of the need for sleep. Ritalin – the trade name for methylphenidate – and Adderall are standard treatments for Attention-Deficit Hyperactivity Disorder. According to surveys, all three are increasingly being traded illegally, particularly on university campuses, as enhancers of memory and focus. That phrase, "be all that you can be", was the US army slogan for many years. In recent years in the US, where servicemen can be legally made to take drugs if required, soldiers have been given modafinil to improve alertness.
Cognitive enhancers have all emerged from research into treating neurological disorders. Drug development focuses on illness, rather than healthy individuals. Nevertheless, there's a rich history of spin-off drug discoveries. In 1996 when doctors were testing a treatment for angina for pharmaceutical behemoth Pfizer, a very obvious side-effect was that male patients were sporting pronounced erections. The drug wasn't very effective for angina, but the multi-billion dollar Viagra industry was thus born. Similarly, self-testing chemist Albert Hoffman was looking for medically useful molecules from a fungus when he noticed that everything had gone a bit weird. He had inadvertently invented LSD. While it was used for a while as a psychiatric drug, its widespread recreational use as a hallucinogen resulted in acid being banned under a United Nations convention.
Little is known about the effects that cognitive enhancers could have on healthy users. The corrective action a drug can have on an illness may not relate to the effect it might have in a healthy individual. Surveys indicate the side-effects are minimal, but that's a far cry from a clinical trial. But let's set aside the medical issues, and also the legal barriers to recreational use, which could result in incarceration under current laws. What about the moral and ethical problems?
As usage of these drugs is relatively common in educational establishments, it is important to consider the plasticity of the developing brain. Short-term effects may produce better exam results, but in the still-developing brain of school-age students, we have no idea of the consequences of taking cognitive enhancing drugs.
Following on from that, there is the issue of access. If only some students have access to drugs that make you smarter, that is potentially unfair. But is it any worse than a classroom in which only a proportion can afford private tuition?
Then there's the issue of liberty. Without preventative regulation, unscrupulous schools could require their students to take cognitive enhancers to boost results, as in the US army. Coercion should be viewed as an infringement of human rights.
Genetic modification has allowed us to radically improve the speed and efficiency of something we have been doing for 10,000 years, namely farming. Billions of research dollars have been ploughed into that field. But the results are still uncertain, and it remains a highly contentious issue. Similarly, drug discovery has opened the door to radically improve a defining trait of humankind: the desire to improve ourselves. We're facing a serious and complex emerging problem, and without addressing it directly in an evidence-based way, we may sleepwalk – albeit bright-eyed – into an uncontrollable mess.
Unlike with GM foods, popular usage of cognitive enhancing drugs is already well ahead of science and governance. It is vitally important that we catch up, particularly because the benefits for individuals and society could be enormous. If you could pop a pill and raise your IQ by a couple of points, why wouldn't you do it?
# Adam Rutherford
# December 12, 2008