Should Students Be Tested for Brain-Enhancing Drugs?

Is increasing mental performance through a pill wrong?
Is enhancing your brain with a pill wrong?

If you could take a pill to make you temporarily smarter, would you? The use of brain-enhancing drugs in colleges continues to rise and a recent paper in the Journal of Medical Ethics has fueled the debate over if and how students’ use of these drugs should be controlled. Authored by Vince Cakic, Professor in the School of Psychology at the University of Sydney, the JME paper questions if doping tests could ever become a part of academic life the way they have become part of athletic life. Should we test students for brain enhancing drugs? More importantly, how do we feel about chemical enhancement of the mind and is it something that we should avoid or embrace?

In 1964, a Romanian doctor, Cornelin E Giurgea coined the term nootropics to include those substances which enhance cognitive function in some way (especially those with few side effects). Research into nootropics is typically centered on correcting abnormal levels of cognizance (as occurs with ADHD or Alzheimer’s), not brain-enhancement for its own sake. While there are literally thousands of chemicals which could be perceived to have nootropic effects, the most commonly used drugs in academic settings are methylphenidate (aka Ritalin), modafinil, dextroamphetamine (aka Adderall), and atomoxetine. Commercially, you can find nootropics offered for sale online, especially those in the racetam family such as piracetam and oxiracetam. Almost all stimulants have a nootropic effect at some level of dosage. These substances are here, and their use is spreading, but outside of prescription drugs efficacy and side effects are rarely well known. As with so many forms of technology that offer to provide a competitive edge, consumer demand has outstripped the slow process of scientific and government review.

The trouble with evaluating nootropics is that we have such trouble defining intelligence in the first place. Many drugs that seek to mitigate the effects of diseases like Alzheimer’s or Parkinson’s have nootropic effects on healthy brains. Yet in an Alzheimer’s patient an increased ability to process short term memory is much clearer than it is with a person who is taking the drug for enhancement. Is a student who takes ritalin before a test able to remember 5% more? How do you know what they would have remembered in the first place? Cognizance, like many other complicated biological factors, is easy to identify in its extremes, but hard to quantify in small increments. It is clear that the extralegal or recreational use of prescription drug nootropics can produce sensations of increased focus, energy, and creativity, but such results are not universal nor are they without risks.

Side effects for what many call nootropics are wide ranging. Many of these drugs seem to function by changing the levels of neurotransmitters, enzymes, or hormones in the brain. As a result, use can cause temporary or permanent shifts in the amount of those chemicals generated by the body. For stimulant nootropics, users run the risk of heart failure. Few nootropics have been studied for long term continuous use, raising concerns about liver and kidney disease. The most widely reported, and again difficult to quantify, side effect of nootropics is mood alteration. Some mood alteration is often part of the desired effect of these drugs, but excessive depression, thoughts of suicide, or unusual aggression can accompany chemical brain-enhancement.

With the dangers presented by nootropics, it would seem an easy choice to try to keep them out of the reach of students. Yet keeping people from taking drugs they perceive as smart-pills is easier said than done. A study in Nature found that an average of 7% (with a range up to 25%) of US college students have used a nootropic at some point in their careers. The vast majority of these cases involved illegal use of a controlled substance. A good portion of students thus seem willing to take substantial risks to achieve cognitive enhancement. It wouldn’t be easy to overcome such determination. I guess we could just make incoming freshmen read Flowers for Algernon and hope they become disillusioned with the idea of temporarily enhanced intelligence.

As the NY Times pointed out last year, many professors are themselves using nootropics to help them stay focused during important research. The phenomenon is widespread enough to have inspired a doping-crackdown hoax we discussed earlier.  It would seem hypocritical to test students without also testing scientists, teachers, quiz show hosts…the list goes on. Why should students be held to a higher standard than the professionals they are training to become?

In his paper in JME, Cakic makes comparisons between controlling drug enhancement in academia and in athletics. Competitive determination is always slightly ahead of testing capabilities. Timing the use of steroids, choosing new and unknown versions of muscle enhancements, finding ways to falsify examinations…these methods have allowed many professional athletes to ‘juice’ themselves even with rigorous doping tests. The same could easily happen if we tried to test students for brain-enhancing chemicals.

Yet even if creating effective doping tests for nootropics would be easy, that doesn’t mean they should be performed. Do we care about a ‘level-playing field’ when it comes to thinking? As Cakic again points out, there is already an alarming disparity in cognitive performance in our current system. Some of the gap is a result of socio-economic opportunities. Are private academies and the money for private tutoring sessions nootropic? We could also concern ourselves with stress levels, or expectations of performance, as these affect academic performance and can be traced to neurotransmitters, enzymes, and hormones in the brain.

For some, it’s more than just a safety issue.  There is something they find onerous about mental augmentation. Society seems to have already approved enhancements of mental performance through electronic devices. Calculators and smart phones are ubiquitous. As we learn more about neurochemistry, and build better models of the human brain, nootropics could become just as safe and understood as an iPhone. Would it be ok to take cognitive enhancers then? Remember that at some point electronic devices will become small enough to enter the body like a prescription drug. Even earlier we may see biological devices that are engineered just as much as a graphing calculator.

Whether it’s pharmacological or electromechanical, there will be a brain-enhancing device some day, or many such technologies. More people than just students will consider using them. Unlike with athletics, mental acuity doesn’t conform to the normal ideas of a competition. Getting smarter isn’t a game. Do we need rules for it? If a child is born with abnormal neurochemistry and we use nootropics or some other treatment to increase his intelligence can we then turn to an average person and deny them the same? Who is deciding what is abnormal and average in the first place?

For now, concerns with taking nootropics are as much about getting what you paid for as they are about ethics. Few retail brain-enhancers have rigorous laboratory evidence to support their claims. Prescription medications like ritalin or adderall have a fairly successful track record, but these drugs do not work for everyone in the same way, and can expose users to side effects (such as sleepiness) that could counteract their effectiveness. Simply stated I don’t think there is currently a safe, well understood, and universally effective ‘smart pill’. There are just a bunch of reasonably risky, moderately researched, and fairly effective noticeably-more-focused-pills.

Yet if I return to my original question, and assume there was such thing as a 100% reliable and powerful nootropic… honestly, I would take it. Why not? If there were reasonable side effects, and long term toxicology was well understood, then yes definitely. Every day we consume nicotine, caffeine, alcohol and many other chemicals which affect our minds and bodies, often by degrading performance. Is wanting to go the other direction so wrong? I welcome the inevitable smart pill the same way I welcome smart phones. Technology is supposed to help us achieve more with less effort. That’s the point.

*As always the opinions expressed in this post do not necessarily reflect the opinions of Singularity Hub, its owners, the author, Algernon the mouse, or anyone you have ever met before.