Wish I knew what the editors of Nature were smoking!

Oh, wait, I do. Kind of.
As I write this, the ScienceBlogs.com home page “buzz” concerns this editorial in Nature, one of the world’s pre-eminent science journals. Here, a septet of scholarly voices combine to rally behind “brain doping” (apparently a cutting-edge way of saying “taking speed”) as a means of achieving “cognitive enhancement” (or, more formally, “getting high”).
The thrust of the argument the writers make is that the responsible use of stimulant drugs like modanifil (Provigil), methylphenidate (Ritalin) and Adderall (amphetamine and dextroamphetamine) can lead to enhanced cognitive function and thus (careful of this “if A then B,” because I don’t really see it as categorically valid) a better, more productive life. It’s a little strange; these people are taking an old idea and making an old argument in its favor, but because the argument is in Nature and supplemented by more psychopharmacology than you’d see at, say, a NORML convention, people are apt to treat it as novel.


Anyway, my first thoughts when I started reading the article were, not unexpectedly, of sports doping, presently an illegal practice in almost every arena. Most of the authors’ favored drugs are banned by the international governing bodies of practically all major sports as well as pro leagues stateside, since stimulants confer a physical advantage to complement the mental one (or vice versa, depending on whether you want strength or smarts to be merely a side effect). In any event, I expected to learn that the authors are ethical proponents of sports doping to the same extent they are of brain doping, because they essentially argue for both throughout the article but using different words. For example:

Many of the medications used to treat psychiatric and neurological conditions also improve the performance of the healthy.

Very easily becomes

Many of the medications used to treat renal or wasting conditions also improve the performance of the healthy miler or linebacker.

In discussing whether brain doping could be interpreted as “cheating,” the authors write:

In the context of sports, pharmacological performance enhancement is indeed cheating. But, of course, it is cheating because it is against the rules. Any good set of rules would need to distinguish today’s allowed cognitive enhancements, from private tutors to double espressos, from the newer methods, if they are to be banned.

So it’s not yet clear whether they would be happy to see rules against performance-enhancing drugs abolished wholesale. The argument is more nuanced than I make it seem; a lot of sports drugs are downright deadly if used to excess, more so, in all likelihood, than anything the authors would propose stuffing into someone’s forebrain. But later in the pitch, there’s this:

Whether the cognitive enhancement is substantially unfair may depend on its availability, and on the nature of its effects. Does it actually improve learning or does it just temporarily boost exam performance? In the latter case it would prevent a valid measure of the competency of the examinee and would therefore be unfair. But if it were to enhance long-term learning, we may be more willing to accept enhancement. After all, unlike athletic competitions, in many cases cognitive enhancements are not zero-sum games. Cognitive enhancement, unlike enhancement for sports competitions, could lead to substantive improvements in the world.

I’m not sure what is meant here by “zero-sum game.” An athlete who dopes and doesn’t get caught over the arc of his or her career might make millions of dollars more than he or she would have if clean. But this windfall does not have to occur at the expense of other athletes in the same sport. many of whom are also benefiting financially from doping. Better, stronger athletes who are threats to set world records put people in the stands, and the sport itself is literally enriched. Zero-sum?
If, on the other hand, all that the authors are claiming is that sports results are less important than the overall functioning of a society, well, that is not something I needed to crack open Nature to learn.
What I found interesting while halfway through the article, in light of the sum of the authors’ proposals, was their continual emphasis on brain doping being suitable only for those with healthy brains. If those judged not to have such brains cannot partake, I thought, then they will be deprived of the cognitive advantages the authors believe the healthy will develop through responsible use, and the gap between the two groups will widen. Perhaps, I mused, the authors vigorously favor the supervised use of brain doping agents in those with less-than-healthy brains?
Sure enough, this base was covered, as were others tangential to it. And in fact, I’m adding nothing here other than my own biases and a disproportionate interest in sports doping. Just read the article. This is clearly not something that was pulled out of someone’s kiester a few weeks ago–a daunting amount of thought, so much of it concerning ethics, was poured into generating this call to action. I don’t yet have an opinion, but I think that the responsible use of marijuana by people with healthy brains ought to be permitted if this stimulant shit gains traction and legitimacy. I mean, come on. Even if I don’t smoke myself, continuing to keep weed illegal in light of the outrageous number of…OK, old argument. But this new material only empowers it.
On he whole I enjoyed reading this piece and the ideas therein are going to generate some noise for sure. I even got a serious chuckle out of some of the content. Like this:

With rates of ADHD in the range of 4-7% among US college students using DSM criteria4, and stimulant medication the standard therapy, there are plenty of these drugs on campus to divert to enhancement use.

Notice they don’t say, “plenty of these drugs on campus are diverted,” but “to divert,” as if people carrying around controlled substances owing to a prescription are a fertile and even necessary source of “brain doping” for those lacking prescriptions. Mine those ADHDers! (I think this might be a subtle American English-British English transmogrification.)
It’s unapologetic better-living-through-chemistry through and through, and to their credit, the authors do not waver.

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  1. #1 by MattK on December 11, 2008 - 12:00 am

    Specifically about the sports analogy: the point of sport is competition. The point of science, for example, is generating knowledge and competition is a byproduct. I think that the analogy would work better if we compared “brain doping” among chess players or jeopardy contestants to regular old doping in athletic competition. At least that is my first thought.
    Anyway, I don’t really like the idea in general but I can’t articulate exactly why at this time. I’m just not sure whether there is anything that we can do about it.

  2. #2 by Muse142 on December 11, 2008 - 12:02 am

    I’m still not sure what I think about cognitive enhancers (aka speed). I really liked reading your analysis though.
    Will have to actually read the paper and then get back to ya!

  3. #3 by jrshipley on December 11, 2008 - 12:16 am

    The merely puritanical appeals are completely unpersuasive on this, as on all ethical issues surrounding scientific life enhancement. I’m not, in fact, even moved in the least by appeals to competitive fairness in the case of athletics. I am moved by safety issues, but assessing safety risks is an empirical matter. On specifically ethical considerations I am most moved, both with respect to life enhancing drugs and life enhancing genetics, by access issues. The notion of a privileged class of enhanced humans is just simply repugnant. My sense of the competition among human societies throughout history is that if one does not pursue an available technology then another will. For that reason, I think prohibitionist policies on life enhancement technologies are not viable. The best course, therefore, is to connect as often as possible the funding of research with the absolute right of access to life enhancing biotech.

  4. #4 by John on December 11, 2008 - 12:48 am

    Sports will eventually have to give in on the performance enhancement side. At some point average people will be enhanced enough that the “pure” athletes will seem unskilled and no one will watch. By then it will seem as controversial as whether or not athletes should be allowed to wear contact lenses.
    Personally I’m still reluctant to try any of this mind enhancement stuff, for fear that it will catch up with me the way steroids catch up with athletes.

  5. #5 by fullerenedream on December 11, 2008 - 2:35 am

    I’m not sure what is meant here by “zero-sum game.”
    If some people take cognitive enhancements, it can be a benefit to them without necessarily being a disadvantage to others who don’t take enhancements.
    That’s because if someone working on things that benefit all of us (doctors, scientists, you name it) takes enhancements, that enhancement benefits all of us too. They win, we win. Hence it is not a zero-sum game.

  6. #6 by Bob O'H on December 11, 2008 - 3:56 am

    …concerns this editorial in Nature, …

    That isn’t an editorial: it’s a Commentary. I’ve no idea how much the editors of nature agree with what was written, I suspect they published this to try and start a discussion.
    There are, though, some editors who are definitely smoking something strange.

  7. #7 by Bob O'H on December 11, 2008 - 3:56 am

    …concerns this editorial in Nature, …

    That isn’t an editorial: it’s a Commentary. I’ve no idea how much the editors of nature agree with what was written, I suspect they published this to try and start a discussion.
    There are, though, some editors who are definitely smoking something strange.

  8. #8 by Bob O'H on December 11, 2008 - 3:56 am

    …concerns this editorial in Nature, …

    That isn’t an editorial: it’s a Commentary. I’ve no idea how much the editors of nature agree with what was written, I suspect they published this to try and start a discussion.
    There are, though, some editors who are definitely smoking something strange.

  9. #9 by Dunc on December 11, 2008 - 5:41 am

    I’ve taken shitloads of amphetamines in the past. I really wouldn’t describe the experience as enhancing my cognitive abilities…
    As for sports doping… How was it Frankie Boyle put it on “Mock The Week”? Something like “I don’t want to watch someone shave a hundredth of a second off the world record – I was to see Carl Lewis with the heart of a cheetah and the legs of a kangaroo.”

  10. #10 by Warren on December 11, 2008 - 2:06 pm

    I envision the authors as being a group of scrawny nerdy types who constantly got the shit kicked out of them by jocks when they were in high school. Meanwhile the stoners, who saw it all happen, didn’t do anything to prevent it; they just laughed.
    Hence, today, it’s only the intelligent, superior beings who are entitled to “enhancement”; the smelly, stupid jocks can all go to hell long with the stoners and their “unhealthy” brains.
    While I don’t believe that’s a conscious intent of the article, it really does seem a bit snobbish to me.

  11. #11 by BikeMonkey on December 11, 2008 - 2:24 pm

    Nature is really, really enthused by this brain doping stuff. It’s been going on for over a year…
    http://drugmonkey.wordpress.com/2007/12/19/performance-doping-in-academia-take-2/
    http://drugmonkey.wordpress.com/2007/11/14/doping-is-a-okay-according-to-nature/
    I’m with kemibe, the analogies to sports doping are stronger than Nature would like to think. And this “greater good” stuff leads down some very slippery slopes….what else might we justify in the pursuit of “cures”?

  12. #12 by northstar_student on December 13, 2008 - 9:07 am

    A number of people (mostly men) take steroids but don’t compete against anyone else in sports. Their goal is usually to look good/muscular or to have more intense workouts. They’re really not harming anyone because they’re not competing against anyone, except maybe for mates. It doesn’t affect my career or grades in school at all.
    Yet, they are breaking the law, pretty much the same way the law is broken when a student without a prescription takes an ADHD drug.
    Thank goodness, I went to college during the 1980’s before this situation occurred.
    I consider tests and exams to be competitive events that usually have _more_ impact on students’ future incomes and careers than athletics will. In other words, 100% of college students must take exams, but maybe only 20%-40% or so choose to participate in athletics. Exams are usually mandatory in college; athletics are voluntary.
    Athletics have cut-and-dry rules, but they are usually _less_ important to students’ futures than academics. (unless a student is looking to be recruited by the NFL or the like).
    If I were sitting in an exam room for an important test and I knew the person next to me was taken a Controlled Substance that had the effect of raising his/her test score in competition with me, I would have the same response that a natural athlete has when he learns that someone on the opposing team is taking steroids. I would seek stricter control over the already-illegal “cognitive enhancement” substances. Or, I might be tempted to also “juice,” but I would do so with a great deal of trepidation because it’s committing a felony.
    I see the point that the _Nature_ writers (including the editor) are making. However, if these academic performance enhancers are legalized for use by members of the healthy population, by the same logic, steroids should be allowed for average gym rats, with the only prohibitions being in sports organizations, the Olympics etc.
    Interestingly, the same journal published an editorial during the Olympics that questioned the accuracy of anti-doping tests. While not as radical as the recent commentary, it suggests that anti-doping tests in athletics may not be working as intended.
    The sports where doping is culturally accepted are niche sports that usually are viewed as pure entertainment rather than serious athletic competitions i.e. professional wrestling and bodybuilding.
    If the use of these stimulants becomes too rampant around academia (largely as a result of competition), there may be a danger of a sort of “academic freak show” culture where the public knows that the scientists and students are “geared up” and may discredit their research results the way that Barry Bonds’ home runs are questioned.

  13. #13 by Kevin Beck on December 13, 2008 - 12:15 pm

    Maybe Nature should stick to topics in which they don’t have to take into account psychosocial ramifications, because they’ve kind of been sucking at that.
    “[A]nti-doping authorities have not adequately defined and publicized how they arrived at the criteria used to determine whether or not a test result is positive. The ability of an anti-doping test to detect a banned substance in an athlete is calibrated in part by testing a small number of volunteers taking the substance in question. But Berry says that individual labs need to verify these detection limits in larger groups that include known dopers and non-dopers under blinded conditions that mimic what happens during competition.”
    I understand the functional difference between a volunteer doped with substance X and a “known doper,” but whoever wrote this hasn’t a clue. For a score of reasons not worth delving into here, you would never in a million years get athletes to submit to such a thing. They are not rats. And I’m not sure the reward this gained is necessary to ensure accurate testing.
    “Nature believes that accepting ‘legal limits’ of specific metabolites without such rigorous verification goes against the foundational standards of modern science, and results in an arbitrary test for which the rate of false positives and false negatives can never be known. By leaving these rates unknown, and by not publishing and opening to broader scientific scrutiny the methods by which testing labs engage in study, it is Nature’s view that the anti-doping authorities have fostered a sporting culture of suspicion, secrecy and fear.”
    It is the view of the Chimp Refuge that Nature needs to understand why the means by which these tests are developed must necessarily be kept a secret in advance of major competitions such as the Olympics, lets athletes’ handlers and druggists quickly learn ways to beat them. This is wy labs are forthcoming as you please after the fact, never before.
    I’m afraid the editors are a little naive on this one.

  14. #14 by SDC on December 14, 2008 - 9:57 pm

    Coupla thoughts:
    The ‘zero-sum game’:
    True, we ALL benefit from cool new scientific discoveries. Competition for University positions, research money, etc, is fierce, though. The limits make it like a zero sum game in that the ‘doper’ (I feel like an old guy on a 1960’s news show typing that) can claim positions, money, etc, at the non-dopers expense, which is an academic version of the ‘Timmy in high-school saw his football dreams slipping away, so he was willing to do anything to stop that, including abusing steroids.
    The ‘healthy brains’:
    This one was around in the early days of Prozac. Personality changes were observed which proved to often be beneficial, so people thought, hmm, what if we give this stuff to people who aren’t suicidally depressed, too? So perhaps that’s what’s going on here.
    Also I’m reminded of the book ‘The Man who only Loved Numbers’. Erdos apparently dipped into the stimulants to ‘keep his brain open’, so to speak, but was worried that when the book about him was published it would send the wrong message to ‘epsilons’ (little kids) if it mentioned his use of enhancements.
    If I’d known about/had access to such things when I was in grad school would I have made use of them? Possibly. I got some joy out of solving problems, why not boost the joy a bit?

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