Last month researchers at the universities of Oxford and Harvard published a comprehensive review of a drug called Modafinil. Originally developed in France to treat sleeping disorders, Modafinil is now better know as a cognitive neuroenhancer or a smart drug. The basic idea behind such drugs is that they can give normal cognitive functions, such as memory and attention, a bit of a boost. It’s these neuroenhancing aspects of Modafinil that the Oxford-Harvard review focused on. The question essentially being asked was: does Modafinil make healthy people smarter, and is it safe? The answer was, yes and yes. This finding has societal implications. Are we about to start sanctioning academic doping?
The off-label use and misuse of smart drugs, such as Modafinil, is already widespread, particularly within the hallowed halls of academia. A recent study undertaken at King’s College London reported that about 10 per cent of students had used a smart drug at least once. Similarly, in a reader poll undertaken by the popular science journal, Nature, 1 in 5 of the 1,400 respondents said they had used off-label smart drugs, such as Modafinil and Ritalin (used to treat ADHD) at least once. The genius, so to speak, is already out of the bottle.
Sanctioning the use of smart drugs however, raises all kinds of ethical questions. This is brave new territory as it is not even clear how you might go about licensing the use of such substances for purely non-medical, non-therapeutic neuroenhancement. Perhaps college professors could write the prescriptions, and at last get to feel like “real” doctors. More seriously though, what would this mean for students who wanted to stay drug free? Would those who chose to “just say no” to performance enhancing substances quickly rethink their decision once even the class clown started getting better grades than them?
Consider the push of tough love, and the persuasive pull of parent power. In the past, children were routinely cajoled into taking cod liver oil. Fish oil doesn’t have a great taste, and before the oil came in capsule form children would vehemently object to their daily dose. “But fish oil is good for your brain,” parents would counter argue, “don’t you want to be clever?”
So what about 21st-century parents? Might we soon hear children being coaxed into taking their cognitive neuroenhancers: “Take your Modafinil or there’s no football for you this weekend, young man.”
It’s not only students who would be affected by the widespread acceptance of smart drugs. We often talk about lifelong learning, and many jobs in the information age require that we constantly update our knowledge. If you had a hard-to-diagnose and potentially life-threatening illness, which physician would you want handling your case: the doctor, wide-eyed and wired on Modafinil, or his sleepy looking counterpart?
These new drugs could be considered first generation neuroenhancers. It’s hard to know what’s around the corner, but if we develop a legitimate market for smart drugs then the obvious direction of travel would be to develop chemical agents with more powerful and longer-lasting neuroenhancing effects. But how much is too much, and can a person be too smart? A related issue is access. If the drugs were prohibitively expensive then certain individuals, perhaps whole populations, would be shut out and further disadvantaged.
It is easy to demonise something that is already known as a “drug”. Drugs are often associated with sickness or criminality, neither of which is a particularly positive association. But caffeine is a drug, and it too can be considered a cognitive neuroenhancer.
The Muslim world had a long debate about the status of coffee – it was, at certain times in history, prohibited. Just as society once debated the legitimacy of coffee (caffeine), the time has now come to debate the use of pharmacological cognitive neuroenhancers. Smart drugs: yes or no?
Dr Justin Thomas is an associate professor of psychology at Zayed University
On Twitter: @DrJustinThomas
