“The good-grade pill”

The New York Times reports on the widespread use of prescription stimulants as study aids among students competing to get into top colleges. These kids aren’t partying: they’re working. And unlike the false impression of improved performance that alcohol gives, the improved performance from the amphetamine-type stimulants is perfectly genuine. But that doesn’t mean the kids – and the adults who do the same thing anren’t getting hurt.

Using stimulants doesn’t create energy; it just borrows it, at a ruinous rate of interest. Sometimes – in military settings, for one obvious example – the short-term gains cover the longer-term costs. But it’s a tricky business, and of course one long-term effect of stimulant abuse is impaired judgment, especially about drug-taking.

It’s a pure case of the Schelling “hockey helmet” problem: what Robert Frank calls a “smart-for-one-dumb-for-all” situation. The number of spots at Swarthmore doesn’t go up; all the students can do is jockey for position. They’d be better off, as a group, if no one was using, but any individual who doesn’t use finds himself at a competitive disadvantage. And of course the rat race continues thoughout a career in any of the professions, the stakes rising with increasing income inequality.

The problem will only get more complex as pharmaceutical technology develops. The current stimulants are sometimes called “steroids for the brain,” but the analogy isn’t precise; the anabolic steroids build lasting strength rather than merely boosting immediate performance. But scientists are working right now on genuine cognitive enhancers: drugs that will stimulate the growth of brain cells. The advantage they confer will be genuine, but it would be insanely optimistic to imagine that messing with brain chemistry won’t have bad side-effects, or that all of those side-effects, over many years of use, will be detected in routine clinical trials lasting a few months.

The use of amphetamine-type stimulants by those who don’t have attention-deficit disorders (or the much less common narcolepsy) is almost certainly a bad deal socially. That’s much less obvious about the use of true cognitive enhancers, once they have been developed; there might be not much social benefit in improving the IQs of all our litigators – after all, someone is going to win the case, and someone is going to lose it, no matter how smart the lawyers are – but improving the IQs of all of our scientists (or policy analysts, for that matter) might pay big dividends.

One thing, however, is clear: our existing ways of thinking about “drug abuse” and dealing with it through lawmaking, enforcement, and persuasion, have very little relevance to the problems posed by the stimulants and the cognitive enhancers. Their abuse is not like the abuse of recreational drugs; the risks and the motivations of the users are different. Neither enforcement and prevention messages is likely to do much good, but the smart-for-one-dumb-for-all structure of the problem makes a laisser-faire clearly inappropriate.

So it would be a mistake to treat this an an opportunity to open one more front in the drug wars, and an equal mistake to simply allow unrestricted competitive use of stimulants. As Lincoln said about the Civil War, “As our case is new, so we must think anew, and act anew. We must disenthrall ourselves.”

Right now, I don’t see much disenthrallment on the horizon.

Comments

  1. kathleen says

    One window into a “cognitively enhanced” future would be an examination of the motivation of those choosing the “enhancement”–what is their intent? In most cases, it would simply be to outcompete the rest of us, hardly a virtue-based motivation. The outcome would probably follow accordingly, as the “enhanced” would develop new methods to move our money into their pockets.

    If we can’t adequately define IQ, how can we define its enhancement? Would it be a global enhancement of spatial, analytical, creative, and moral capabilities? Or would it be limited to one narrow aspect of IQ? Do we want to enhance the analytical abilities without a concomitant heightening of integrity? Would the enhancement of one ability come at the expense of another? After all, the cranial vault is a defined space with no room for any additional brain matter, and any neuronal growth could only occur at the expense of other brain matter.

    Who will make the choices of what to use and on whom? Who does the cost/benefit analysis, and on what will it be based? How can unmeasurable results be observed, such as a decrease in creativity that might go hand-in-hand with an increase in spatial skills?

    Should parents have the right to modify their offspring to the parent’s vision of “improved”? Or does every human have the autonomy to be free of such manipulations by others?

    In spite of there being more questions than answers about this enterprise, it does seem likely that humanity will blunder forth blindly into a world of such “enhanced” beings only to discover copious unintended and unfortunate side-effects, and that the motivation for doing this will be for all the wrong reasons. Nothing makes me more glad that I won’t live forever, because the whole idea is odious–the epitome of hubris–and one that I’d rather not live to experience.

    • Ken Rhodes says

      Kathleen, I was always fortunate to be able to do well enough, irrespective of the performance of my “competitors.” Additionally, I was fortunate to have parents who urged me, not to “beat my competitors,” but rather to “do my best.” Given that my motivation was to “do my best” and thus to “achieve more,” I see no difference in my methods and/or my results compared to if my motivation had been to “beat my competitors.”

      I think the negative aspect of “competition as a motivator” is misplaced, unless it drives us to do things that attempt beat our competitors by sabatoging them, rather than simply elevating ourselves.

      • kathleen says

        By “outcompete” I meant that those using cognitive enhancers would be doing so specifically to gain a competitive advantage over others. This is profoundly different than simply “competing” by doing your best while using your own talents and efforts.

        There are already plenty of non-pharmaceutical methods of increasing one’s competitive edge–two examples would be to hire special tutors or to pay for others to write your term papers. My position is that use of a pharmaceutical “enhancer” is more akin to the second, and thus would be a form of cheating. Cheating is, after all, merely one way that people seek to gain an edge over their competitors.

        Not all competition is worthy of acclaim, and it is this kind of corrupt competition to which I was referring.

        • says

          So, would taking coffee, as SamChevre related below, be kosher? The acute state of one’s mood, alertness, focus isn’t under one’s control and is subject to modulation, probably by both autonomic and cognitive feedback processes. Should one’s performance be held willingly hostage to these neural whimsy?

  2. Maynard Handley says

    “It’s a pure case of the Schelling “hockey helmet” problem: what Robert Frank calls a “smart-for-one-dumb-for-all” situation. ”
    “Neither enforcement and prevention messages is likely to do much good, but the smart-for-one-dumb-for-all structure of the problem makes a laisser-faire clearly inappropriate.”

    cf Houses in the Hamptons, or preschool at “I’m Rich Montessori”, or skyboxes at the Jets’ stadium…

    Those with the money and power in this country have refused to understood the nature of the social interactions they are in for 30+ years — what makes you think they are going to wise up now? And I don’t see “but now it’s MY kid at risk” as having much affect; that line of reasoning hasn’t worked before, either in the sports context or in the wealth context.

    Beyond that, we have the additional confounding effect of Big Pharma, happy to rush in, confuse the issue, and blatantly lie. After all this stuff’s supposedly safer than Benzedrine or Seconal, and Big Pharma had no problem telling us all the wonderful effects of those drugs. So I suspect we’re not going to see this play out as a war on drugs scenario, more like an SSRI-type scenario. You take the stuff, it helps you for a while, then your brain adjusts to the increased levels —but now, even though you aren’t running any faster than before, you can’t easily go back to living without the stuff.
    (One could argue that it doesn’t HAVE to be that way, that a permanent boost is theoretically possible. But one suspects that if such a painless permanent boost is possible, given the very rough dicking around we are performing — increase this neurotransmitter, decrease that one — evolution would have stumbled upon it without that much difficulty. Compare CPUs. There was a time when, yes, you could just improve the performance of a CPU across every dimension without tradeoffs. But we can hardly do that now, and we have maybe three more generations of decreasing transistor size before we can’t do it at all — if you want higher clock speed, it WILL require a better cooling system. So are brains like an 80286, far far from the possibility frontier; or are they like an Ivy Bridge i7 and damn close to the possibility frontier for their technology?)

    • Dave says

      Longtime lurker here, but I have to jump on “I’m Rich Montessori”: While it’s true that Montessori schools most commonly operate as private schools, and are therefore more available to families who can afford tuition, I’d offer several caveats. First, Montessorians as a whole are a pretty idealistic bunch, and tuition tends to run above Catholic and below other private schools. Second, Montessori is expanding into the public sector, and several outstanding examples exist, in Hartford, Milwaukie, Kansas City, and Denver, to name a few. Finally, Montessorians generally are pretty holistically focused, away from test-scores and narrowly defined achievement. “Education for the whole child” being one of the mantras.

  3. KLG says

    So, “Flowers for Algernon” really was a cautionary tale. I wonder, do middle schoolers still read the story?

    • prognostication says

      They did 15 years ago, and the stimulants to take tests problem was already in full force by the time I was in college. I never did it; I come from a family with a history of heart problems and didn’t want to tempt fate, among other reasons, but I certainly knew a lot of people who did.

  4. sd says

    Ugh – a nasty problem on the horizon (and to a certain extent here today) and one that there aren’t clear tools to solve.

    If it were possible to test for the use of cognitive-enhancing drugs (I’m no pharmocologist, but I suspect the answer is “no”), then one could contemplate a testing protocol (either at the time of college admissions or randomly during school with significant consequences for abuse). But that’s not an especially satisfying solution and, as I say, I suspect not technically feasible anyway.

    This is also a classic case of an issue on which our deeply partisan political culture is likely to screw us. If sensible solutions develop on the political left, then the political right is likely to say “see – the commies over there want to stamp out all human achievement so that everyone is equally miserable.” If sensible solutions develop on the political right, the the political left is likely to say “see – those facists over there want to keep everyone stupid so that they can continue pushing their anti-intellectual agenda.”

    • Brett Bellmore says

      Isn’t it bad enough that drugs which might enhance human physical performance are being held back to help sports be ‘fair’, now you want to do the same to any drug that might enhance mental performance, too?

      Here’s an idea: If somebody isn’t actually attacking somebody else, assaulting them, or defrauding them, leave them the heck alone.

      • says

        Yeah.

        The problem is that the starting mindset is wrong- that ingesting substances in your body is something that is completey dependent on the graces of the government.

        The correct starting point is ingesting substances is a personal freedom. Deciding what you want to eat, what pleasures you want to pursue, or how productive you want your brain to be are personal decisions. Regulation is fine where a compelling case can be made for restrictions on freedom, but not otherwise.

  5. says

    A smart pill in a willfully ignorant country would just be a nocebo…

    We live in a nation in which 50% of the population believes in young-earth creationism. That means 50% of the population can’t participate in a conversation about microbes *evolving* antibiotic resistance, or a host of other cutting edge themes in science. Tell them 3-5% of their genome comes from the Neanderthals? You might as well try to convince them that Venus is extra warm because of greenhouse gases and that maybe we could someday warm Mars with some of the same…

    Would a smart pill change any of this? I think not. Everyone saw the recent data where the *most educated* Republicans were the most anti-science. The supposition is that they used their smarts to bolster their biases by attacking science. Did anybody see the Iowa Republican planks? In particular:

    Plank 9.2, “…claims of human-caused global warming are based on fraudulent, inaccurate information… a plan to take our freedoms and liberties away.”

    I think a paste from the Wikipedia’s entry on Lysenkoism is utterly apt:

    (Lysenkosim is) …derived from the centralized political control exercised over the fields of genetics and agriculture by the director of the Soviet Lenin All-Union Academy of Agricultural Sciences, Trofim Denisovich Lysenko and his followers, which began in the late 1920s and formally ended in 1964.

    So, in toto, I don’t see the smart pill making a positive difference. Just more of the same sort of trend. The Republicans will just be a hell of a lot cleverer in thwarting science and a host of other *progressive* issues. Or put another way, this nation is going down a right-wing toilet, a smart pill would probably just accelerate the flush to Social Darwinism and the day when libertarians argue that hunting other humans for food is a good thing…

    What the country needs is a wisdom pill.
    For to borrow and alter a quote: Of all the forms of genius, wisdom has the longest awkward age.

    Are there any wise people left in this country?
    And if there are, do they ever get to write weekly columns in the LA Times?
    I mean really: Jonah Goldberg is arguably smart, but he has the wisdom of a mentally-ill pitbull.
    Does anybody believe Jonah Goldberg on smart pills will be an improvement?

    (Watch this to at least the :57 second mark: http://www.youtube.com/watch?v=hxsEG9c_p30)

    • SamChevre says

      We live in a nation in which 50% of the population believes in young-earth creationism. That means 50% of the population can’t participate in a conversation about microbes *evolving* antibiotic resistance

      This is not actually true. (Substantially all creationists make a distinction between micro-evolution (observable, hence acceptably scientific) and macro-evolution (not); antibiotic resistance is in the first category.

      • says

        False categories for minds that insist on a falseness that lets them have it both ways…

        But you are correct Sam. I should have said, This ought to mean that 50% of the population can’t participate…”
        And I thought about writing that. But I couldn’t lend myself to catapulting the bullshit…

      • Maynard Handley says

        So they believe that by adding 1 to a number you can increase it, but you can’t keep adding 1 to get all the way to 1000?
        Well that makes perfect sense.

        Given that there exist observed speciation events, I find it hard to see what value these people can add anything to a conversation — they’ve clearly already decided that neither evidence (observed speciation) nor logic (accumulation of many small effects) is relevant to their world view.

    • Byomtov says

      What gives you the idea that Goldberg is smart?

      I see no signs of intelligence in his work whatsoever.

    • Dennis says

      Minor nit: Microbes evolving antibiotic resistance is scarcely cutting-edge. We were discussing that when I was an undergrad biology major decades ago. The first key papers were written by Lehninger in the 1960s or early 70s.

      • koreyel says

        Minor nit about the minor nit…

        In the April 28th – May 4th issue appears this letter (From Alasdair Cook) to the New Scientists:

        A retired vet gave me copies of the Veterinary Record, and I found this little gem from 10 January, 1948: “For some time past, there appears to have developed a diminution in the efficiency of penicillin, and it is significant that about two or three months ago, general medical practitioners were increasing the dosage by as much as 100 per cent. The British Medical Journal of November 29 directs timely attention to what it calls ‘the magnitude of this unwelcome change’, and discusses the possible causes hereof.” That was just four years after penicillin became available to civilians in the UK.

        What’s cutting edge is not whether microbes evolve resistance per se, but rather we should ban antibiotics in livestock feed because of that fact.
        Cutting edge it that little has been done about it for 30 years, except deferment of a decision because overtly “more research” needs to be done.

        This woman’s blog is must reading for that:

        http://www.wired.com/wiredscience/superbug

  6. SamChevre says

    I’ve come as close as legally possible to doing this, back when I was taking professional exams.

    Actuarial exams are brutal; the introductory exams when I took them were 4-hour, multiple-choice tests, with a pass rate that was generally around 40% (and getting 60% of the questions right generally guaranteed a pass). Given that dynamic, and the fact that every exam you were competing only against people who had passed enough exams to get to that point, meant that working at maximum capacity for four hours was critical to passing. And for math-and-memory intensive work, four hours is a long time to be all the way on.

    Here’s how I did it (and this was not an uncommon strategy.) I avoided caffeine and sugar entirely for a month before the exam. The morning of the exam, I brewed 8 double-shots of espresso, and mixed them with about 1/2 cup of sugar and a bit of cream. I drank 1/4 of that before driving to the exam, 1/4 when I got there, and the remaining half about 10AM. With that much stimulants running around my bloodstream and no tolerance, I could focus fully for four hours.

  7. says

    So what we’re saying is that cognitive enhancers might not be a bad thing if our society hadn’t been systematically turned into a pseudo-darwinian cockfight? As with others, I do wonder what the criteria are for measuring cognitive enhancement (I’m betting that walking out of the exam saying “this doesn’t measure anything useful” would not qualify.) This question is particularly important in light of the fact the (at least the last time I looked) tests that were supposedly the best at measuring pure “g” (philosophically the general substrate of intelligence, or, statistically speaking, the thing that correlates best among tests of different kinds of intelligence) also show the strongest Flynn Effect (in which measured “intelligence” rises by about 3 points a decade).

  8. David Isaac says

    Back around 1968-1970, I had friends in college who touted the benefits of using a then-experimental or, at least, fairly new drug (called Ritalin) in helping them study for exams. I didn’t see the attraction, and never heard any more about this drug until almost 30 years later, when trying to get help for a child with learning disabilities.

    Music, especially intense Classical music, was always my preference for cognitive enhancement.

  9. Brett Bellmore says

    “The use of amphetamine-type stimulants by those who don’t have attention-deficit disorders (or the much less common narcolepsy) is almost certainly a bad deal socially.”

    The problem is that driving their use into a black market can easily be a worse deal socially.

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