Is test-doping cheating?

Yes. It reduces the validity of the test, and puts test-takers at risk of developing substance abuse.

My email inbox has been full of arguments about my post calling the practice of taking stimulants to improve one’s scores on the SAT and LSAT (and presumably the MCAT and GMAT) “dishonest” and likening it to doping in sports competition. The objections fell into two categories: some asking why doping was cheating, and others arguing that “life isn’t a sporting event” and that the category therefore wasn’t applicable.

Second things first: No, life isn’t a sporting event. But test-taking is part of a competitive process where the (astonishingly valuable) prizes are the small number of places at the top colleges and professional schools. (Arguably, where you go to college, within the range likely to be relevant here, matters more socially than it does professionally. But where you go to law school or business school matters enormously. Moreover, with more and more places using scholarship awards to compete for top students, there are immediate financial advantages to scoring better than your competitors.)

In any competitive process, an advantage for one competitor is a disadvantage for others. So the question is what counts as an “unfair” advantage. The answer isn’t obvious.

In general, though, we expect people to obey the law. Breaking the law for competitive advantage seems to me to fit pretty squarely into the category of cheating.

But why, one might ask, should there be such a law? Using a stimulant once or a few times isn’t harmful. If some students want to obtain a competitive edge by studying, others by popping Ritalin, and still others by catching a good night’s sleep before the test, why shouldn’t the rules allow any or all of those strategies?

The simple answer is that the tests are supposed to measure aptitute for learning, and more generally aptitude for performing intellectually demanding tasks. That’s why the schools value the results. So the test results ought, ideally, to reflect something about the normal performance of the test-takers. Taking stimulants is a self-limiting process; you’re not creating mental energy out of nowhere, but merely borrowing it fairly stiff rates of interest. People can’t be stimulated all the time. So unstimulated performance is a better measure of average performance than is stimulated performance.

Finding the potential law student (for example) who responds most postively to psychostimulants, or tolerates the greatest dose of stimulant without becoming manic or compulsive, or who is most adept at figuring out what dose of stimulant will produce optimal performance on the LSAT, doesn’t have much to do with finding the potential law student most likely to have a good career in law school and as a lawyer. Therefore, the rules of the LSAT should forbid drug-taking as a test adjunct, as the criminal law already does.

If drug-assisted test-taking were legal, and if (as seems likely) the drugs can produce big gains for many students, then every student who really wants to compete will have to do the work of figuring out whether stimulents help him or her, which stimulant is optimal, and how much to use. Some of them are likely to find the stimulant experience rewarding, or discover that they work much better stimulated than not. All of those people will be at risk of developing stimulant abuse or dependency, which is a really bad risk to be at. Lots of methamphetamine addicts started out taking the drug to work, not to party. (I know one guy whose mind will never be the same after the methamphetamine habit he developed while using meth to write his Ph.D. thesis about drug abuse.)

To sum up: Allowing stimulant use in the context of competitive test-taking means, virtually, requiring it of those who want to win the competition. And requiring stimulant use is likely to have some bad results in the future lives of test-takers, in addition to reducing the validity of the tests as predictors of academic and professional performance. Since taking stimulants to boost test scores is illegal, and since making it legal would have bad results, I think it’s fair to call taking stimulants for that purpose “cheating,” and I’m disappointed that today’s test-takers by and large either don’t agree or don’t care. (Two emails informed me that test-doping is now very widespread and barely covert.)

In this respect, test-doping differs from the use of drugs producing long-acting cognitive enhancement. If I can make myself lastingly smarter or less forgetful by taking a pill, that’s no different from an employer’s point of view than if I can do the same thing with good eating or reading habits. The problem there is that the first generation of drugs is likely to have side-effects, and certain to have an unknown long-run side-effect profile. But once again taking those drugs is going to become virtually mandatory for those who are playing the winner-take-all games in the professions and in academia.

There’s probably not much we can do about that.

Even the test-doping problem may be virtually intractable. With millions of prescriptions out there, the milder stimulants are easy to get. ETS and its competitors could start requiring chemical tests, as the sports authorities do, but they’re going to confront the fact that some students have legitimate prescriptions for stimulants to treat ADHD or nacolepsy. Moreover, since the ADHD diagnosis is particularly hard to specify, it won’t be hard for aggressive and well-connected students to find a physician willing to write a prescription in time for the LSAT. The Americans with Disabilities Act would (or at least I hope it would) make it impossible for the test companies to put asterisks next to the test scores of students with prescriptions.

One option would be to take the time pressure off the tests, which would substantially — though not by any means completely — eliminate the stimulant advantage. Another would be for the schools to mount their own tests (perhaps on line), as a supplement to the uniform tests, reducing the gains to be made from doping for a single test that covers all schools.

I don’t have a clear idea about what to do. I am, however, pretty clear that there is a problem.

Cannabinoids and memory

Cannabinoids interfere with short term, ummmm…., now what was that word … whatever. Sometimes that’s good. Especially if you’re a birdbrain.

Smoking pot interferes with short-term memory. That’s the source of about half of marijuana-related humor (the other half being about the munchies).

In the 1980s, Raphael Mechoulam and his colleagues found that the brain makes its own cannabinoids (which they dubbed “anandamides,” from the Sanskrit word for “bliss”), and a set of neurons with anandamide receptor sites. That explains why pot-smoking is psychoactive. Still unexplained is the biological function of the anandamide system; presumably, the ability to get stoned wasn’t a survival advantage.

Even before anandamide ligand-receptor system was discovere, some people — notably Andrew Weil — had claimed that pot-smoking might have an offsetting benefit in enhancing creative imagination. As might be expected, the relevant studies, which might yield politically incorrect results, mostly haven’t been done.

A new study suggests that memory interference and creativity enhancement might be different results of a single underlying process. Memory, it seems, can interfere with imagination.

In the new study, birds were shown a worm in a wormhole. Then the lights were turned off and back on, and the birds were allowed to search for the worm. Birds given a drug that blocks the actions of the brain’s endogenous cannabinoids performed better on the task of finding the worm where it had been before, suggesting that the cannabinoid system worsened performance on short-term memory tasks.

That left the puzzle as to why the system was there in the first place. But a second experiment suggested an answer to that puzzle. If the location of the worm was changed while the lights were out, the cannabinoid-blocked birds stubbornly insisted on finding the worm where it used to be, while those with normal cannabinoid function were much quicker to try alternative locations.

You might say that the cannabinoid-enabled birds flip-flopped, while the cannabinoid-blocked birds stayed the course.

The paper (DeVoogd, T.J., et al., “Cannabinoid Inhibition Improves Memory in Food-storing Birds.” Proceedings of the Royal Society: Biological Sciences (Vol. 271, No. 1552, Oct. 7, 2004) doesn’t seem to be up yet on the Royal Society website. Cornell has posted a well-written press release, though.

Drug enforcement, drug prices, and drug abuse

The current rules for determining sentences in drug cases serve the wrong goal.

I just finished a four-day seminar with a group of federal judges at which we discussed drug abuse control policy. (That’s why postings here have been light.)

As part of my preparation, I had Kenna Ackley, my research assistant, pull together some numbers. Between 1980 and 2004, the number of drug dealers in state and federal prison is up more than twelvefold, from 24,000 to 325,000. Most of that increase is cocaine dealers.

Over that same period. the retail price of cocaine is down about 80% in constant dollars, from $535 a gram equivalent in 1980 to $105 today.

Those numbers convince me of something I wouldn’t have believed: that, under U.S. conditions, no practicable level of drug law enforcement can raise the prices of mass-market drugs. (Prohibition itself, along with enough enforcement to avoid having the law become a dead letter, does influence drug prices: pharmaceutical-grade cocaine costs your dentist between $5 and $10 a gram.)

If that’s right, then the right measure of the effectiveness of drug law enforcement isn’t the costs it imposes on the illicit markets, but its effect on the side-effects that result from the operation of those markets: violence, corruption, neighborhood disruption, seduction of minors into illicit activity, and (if significant) financial contribution to terrorist operations against the U.S.

The current structure of sentences for drug offenses, which is based largely on the drug involved and the quantity dealt, is more or less appropriate to a supply-reduction enforcement strategy. It makes no sense in a world where we’re trying to reduce market side-effects instead.

Reviving ADAM

Can the most cost-effective drug data collection program be saved? Does anyone care?

Today was the first day of a two-day meeting organized jointly by the National Institute of Justice and the drug czar’s office on how to revive, in some form, the Arrestee Drug Abuse Monitoring (ADAM) program, killed at the beginning of this year.

It’s a discouraging process. Everyone agrees that collecting drug data from arrestees was a great idea, but no one is sure where the money is going to come from to do it. Eight million dollars a year is peanuts in a $40 billion federal drug budget, but the National Institute of Justice is a tiny agency, and last year its budget got butchered on the Hill, leaving it with only $6 million for its entire social science research program.

No one quite knows why the two Justice Appropriations subcommittees are so hostile to NIJ in general and ADAM in particular; the idea that the anti-science bias of the Administration has rubbed off on its co-partisans on the Hill — “A crusade doesn’t need a roadmap” — is of course merely speculative.

My belief, not universally shared at the meeting, is that collecting information about arrestees is a great idea, but shouldn’t be restricted to their drug-related behavior. Whatever sort of social dislocation or personal dysfunction you want to study, it comes through the nation’s lockups. If ADAM started collecting data on homelessness, infectious disease (and in particular sexually transmitted disease), informal labor markets, etc., it could not only do more good in the world but also have a chance of tapping into larger budgets than the pittance NIJ gets: those of the National Institutes of Health and the Centers for Disease Control and Prevention, for example. It’s even possible some foundation money might be found. But from a bureaucratic perspective, sharing cost always means sharing control, and sharing control is scary.

So the whole thing is pretty discouraging. But as today’s meeting dragged drearily on, I kept hearing a voice whispering, “Help is on the way!”

Vaccines against drug abuse (NOT!)

A really bad idea about how to use a really promising technology.

What if someone who would like to quit smoking cigarettes or crack but finds it hard to do so could get an injection that would keep the molecules of the drug in question from getting from his bloodstream to his brain? If he took the drug, he would get little or no psychological effect from it; the behavior, like all unrewarded behaviors, would extinguish fairly quicly.

If such a treatment existed, some forms of drug dependency would suddenly become curable rather than merely treatable. (Here’s the fairly optimistic National Academy report on the topic, which includes my chapter on benefits and costs.)

The technology seems to be within reach; a nicotine therapy is well along in human trials, and a cocaine therapy shows promise, though it has yet to be subjected to the double-blind acid test. (Alcohol is a no-go for technical reasons, and there are so many opiates and opioids out there that there might not be much use in making one or two of them unusable by a given patient; the new treatments are molecule-specific.)

The idea is either to teach the body’s immune system to respond to the drug molecules as if they were pathogens (by making antibodies to them), or to make the antibodies in a factory and then inject them directly into the patient.

Since this is the same principle by which vaccination against infectious disease works, it seems natural to call the proposed therapies “vaccines.” But calling them vaccines would be profoundly misleading, since vaccines are used prophylactically, to prevent disease, while the new anti-drug treatments would be used therapeutically, to treat already established cases of drug abuse (or, perhaps, as secondary prevention in individuals — especially adolescents — who had started to use an abusable drug but not yet become diagnosably drug-abusing or dependent).

As a policy proposal, mass preventive immunization against the abuse of some drug just doesn’t pass the giggle test. The useful life of a treatment is likely to be three months or so, though it could be repeated. Each treatment is likely to cost hundreds of dollars, which is tiny compared to the cost of active cocaine addiction and small compared to the cost of active tobacco addiction but huge compared to the risk faced by a randomly-selected child of becoming dependent on any one drug within a three-month window.

That’s why those working on these new treatments prefer to call them “immunotherapies” rather than “vaccines”: to keep anyone from thinking that we can prevent cocaine abuse the way we prevent polio.

Apparently, it didn’t work. The Independent reports that the British government is seriously studying the idea of mass immunization.

There are three possibilities here: (1) The Independent has gotten the story entirely wrong; (2) Someone in Her Majesty’s Government has been smoking something; or (3) The story is satire. The fact that the primary person quoted is “Professor Nutt” argues for #3, but #2 still seems like the most likely interpretation. Sigh.

It just goes to show that, just when you thought you had a foolproof idea, someone comes along and invents a higher-performance fool.

Against J.S. Mill

Is there a defensible principle of autonomy that ought to rule out paternalistic legislation regardless of the facts? I doubt it.

Ignoring the context (quite interesting in its own terms), I’d like to reflect on a sentence from a post by Eugene Volokh:

Talk of autonomy and freedom of choice isn’t fully apt (and perhaps isn’t apt at all) when we’re dealing with people who lack the mental capacity to fully comprehend the nature and consequences of their choice.

Right. But of course none of us has the mental capacity to fully comprehend the nature and consequences of our choices.

Adults are closer to being able to do so than children, and normally competent adults than developmentally disabled adults, and those without severe mental disorders than those with severe mental disorders. But we’re all more or less feeling our way in the dark, trying to see by the (inadequate) light of our own reason, moving under the (largely random) impulse of our appetites and aversions, and listening to the (unreliable) voice of tradition to warn us of pitfalls.

So the argument for freedom and autonomy can’t be that a normal healthy adult human fully comprehends the consequences of his or her own actions. Rather, it has to be that a normal healthy adult human, in many cases, understands those consequences well enough so that any limitation on his or her choices (made by other imperfect humans through imperfect institutional mechanisms) is more likely to worsen outcomes than to improve them, especially when the value of learning from one’s own mistakes is factored in.

In the case of a child, or an adult with profound developmental disabilities, it will often be the case that even imperfectly administered interference will lead to better outcomes than full autonomy, partly because the people deciding on the interference will, in general, have better judgment than the person whose autonomy is being interfered with. That will less often be true in the case of a normal healthy adult.

But it won’t (if you’ll pardon my grammar) never be true. Offer a random sample of normal healthy American adults free access to cocaine, and (I claim) the benefit enjoyed by those who sample it, find that they like it, but never lose control of their cocaine-taking will be swamped by the loss incurred by the minority who sample it, find that they like it, and become addicted. That is true in part because people systematically underestimate the risks of losing control over their own behavior; putting a sign next to the cocaine machine warning of the dangers of addiction won’t cure the problem. So (I claim) we can improve the welfare of potential cocaine-takers by denying people the choice of taking cocaine (or, rather, denying them the choice of taking it legally).

Now perhaps that claim is false, or perhaps the damage from cocaine prohibition is high enough to swamp its benefits. I don’t think so, but those are a quasi-empirical questions. (Empirical because they concern partly matters of fact rather than purely questions of analysis or value, but only quasi-empirical because the relevant measurements cannot, in fact, be made.)

But since normal healthy adults lack the mental capacity to fully comprehend the nature and consequences of the choice to take cocaine (which involves taking the risk of becoming addicted to cocaine) the argument that drug prohibitions and other consumer-protection regulations ought to be ruled out because they violate a valid principle of freedom and autonomy cannot be sustained.

[See “Liberalism and Vice Control,” Journal of Policy Analysis and Management, Vol. 6, No. 2, Winter 1987. (Sorry, no link. If you’re curious, I can send an offprint.)]

What killed ADAM?

Why the most cost-effective element of the national drug data collection effort was the one we just stopped doing.

Some time ago, I complained in this space about the cancellation of the Arrestee Drug Abuse Monitoring program. Partly as a result, a respectable glossy magazine with a scientifically sophisticated readership asked me for a brief essay on the topic.

Here’s the draft. Comments solitcited. Warning: the piece lacks the spontaneous sparkle of my best blogging.

Preventing drinking by problem drinkers

Phil Leitzel on ankle bracelets to restrain dangerous drinkers.

Some time ago I offered some thoughts in this space about how to take the bottle away from dangerous drunks: from people who, under the influence, drive or commit assaults.

Jim Leitzel at Vice Squad reports on an alternative approach: an ankle bracelet that allows continuous remote monitoring of alcohol consumption by measuring the alcohol that transpires through the pores. Expensive ($12/day) but worth it in many cases. Presumably the price would come down in mass application.

Drugs and Violence in El Salvador

Report on my field trip to El Salvador, with a speech and a paper on reducing drug-related violence.

When not engaged in blogging, I sometimes teach, and do actual policy analysis. I just visited El Salvador for the second time (courtesy of the United Nations Devlopment Program’s Sociedad sin Violencia project to talk to officials and citizens there about how to modify drug policy to reduce the violence incident to drug trafficking and drug (especially alcohol) consumption.

It turns out that El Salvador has a big gang problem (apparently imported from Los Angeles). That I hadn’t known before my travels, so it’s not reflected in what I wrote. I’m hoping to go back this summer with a team including David Kennedy to plan an initiative to reduce gang violence, on the model of Boston’s Project Cease-Fire.

In the meantime, though, I thought I might as well show you what I’d been up to. Perhaps readers who know more of Salvadoran conditions than I do can provide some useful advice.

Controlling Drug-related Violence (Speech text from 2002

Reducing the Contribution of the Drug Problem to Violence in El Salvador (Report from 2004)