Monday, May 4, 2009

Beyond caffeine and No-Doz

Cosmetic surgery for your brain?

Several months ago we blogged about neuroplasticity, the ability of the human brain to grow new cells. Today the subject is neuroenhancement, the use of drugs such as Adderall, Ritalin, Provagil and other so-called “smart drugs” to improve brain functions.

In a long and fascinating article in the April 27 issue of The New Yorker, Margaret Talbot wrote that more and more college students are taking neuroenhancing drugs to become higher-functioning for exams, writing papers and doing research. They are often getting them from friends with prescriptions.

This “off label” use of stimulants for nonmedical purposes was reported in various studies to have been practiced by 4.1 percent of American undergraduates overall, as many as 25 percent at one school, and 35 percent at another. In addition, some graduates are using them after college to improve their performance on the job.

“If we eventually decide that neuroenhancers work, and are basically safe, will we one day enforce their use?” Talbot asks. “Lawmakers might compel certain workers – emergency room doctors, air-traffic controllers – to take them. (Indeed, the Air Force already makes modafinil [the generic name for Provagil] available to pilots for long flights.”

The question arises, would such drugs be useful, and safe, for staving off dementia and cognitive impairment in older people? The jury is still out – in fact, the jury has scarcely been seated. There haven’t been extensive studies of this possibility, and those that have been done are inconclusive, according to Talbot’s article.

What about the ethical aspects of neuroenhancer use? One user, a researcher at a defense-oriented think tank in northern Virginia, said, “We should have a fair degree of liberty to do with our bodies and minds as we see fit, so long as it doesn’t impinge on the basic rights, liberty and safety of others. Why would you want an upper limit on the intellectual capabilities of a human being? And, if you have a very nationalist viewpoint, why wouldn’t you want our country to have the advantage over other countries, particularly in what some people call a knowledge-based economy?”

Anjan Chatterjee, a neurologist at the University of Pennsylvania and a researcher specializing in the ethical implications of “smart drug” use, coined the term “cosmetic neurology” to describe the practice. He told Talbot he thinks it will eventually become as acceptable as cosmetic surgery.

“It makes no sense to ban the use of neuroenhancers,” Talbot writes. “Too many people are already taking them, and the users tend to be educated and privileged people who proceed with just enough caution to avoid getting into trouble… Neuroenhancers are perfectly suited for the anxiety of white-collar competition in a floundering economy. And they have a synergistic relationship with our multiplying digital technologies: the more gadgets we own, the more distracted we become, and the more we need help in order to focus.”

Today a lot of people – too many – need neuroenhancement help to focus not on the job, but on looking for a job.

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