Answer honestly: Are you as mentally sharp without your morning cup o’ Joe? If not, you’re one of the millions who use the chemical 1,3,7-trimethylxanthine—better known as caffeine—to give a little boost to your brain function.
But what if the chemical in question wasn’t available at every corner café in a steaming mug, but instead was a prescription drug being misused to give healthy (but tired) students and workers a competitive edge?
Data from various surveys suggest that’s exactly what is taking place today on college campuses and in workplaces, says Jesse Ballenger, associate professor of Science, Technology and Society Bioethics at Penn State.
A growing number of people are turning to drugs that boost attention and memory, such as Adderall and Ritalin, designed to treat Attention Deficit Hyperactivity Disorder (ADHD). Says Ballenger, “Anecdotally, many of my students claim to have witnessed their peers using some kind of drugs to help with attention and performance, and to know of students diagnosed with ADHD who are selling off prescription drugs like Adderall to classmates.”
How widespread is this problem? Surveys on college campuses suggest that as many as 20 percent of college students have experimented with these prescription stimulants, primarily amphetamines dubbed “smart pills” or “study buddies.” A study by Columbia University’s National Center on Addiction and Substance Abuse found that the number of teens abusing prescription medications tripled from 1992 to 2003, while in the general population such abuse had doubled.
“I think it’s interesting to ask what the ongoing controversy over smart drugs says about American society,” remarks Ballenger. “This is only the latest round in a series of similar controversies about medical enhancements that stretch back at least to the use of tranquilizers in the 1950s. They were thought to make it easier for shy or uptight people to fit in socially, thus conferring an unfair social advantage over those not using them.”
Citing the work of bioethicist Carl Elliott, Ballenger points out that our fascination with medical enhancements tends to follow a predictable course. “First, a particular enhancement—in today’s case, so-called smart pills—seems to improve some aspect of human functioning,” he explains. “Then there is a boom in its use, followed by widespread public handwringing about whether its use constitutes cheating or somehow undermines the moral character of society, followed next by calls for a return to traditional values of self-reliance.”
Over time, adds Ballenger, enthusiasm for the enhancement wanes “when it seems not to provide as revolutionary a change in human functioning as originally claimed, and public attention moves on to newer, purportedly more powerful and more revolutionary forms of medical enhancement.” The cycle then begins again.
In the case of “academic doping,” the popularity of neuro-enhancing drugs may be a reflection of “intense social expectations about intellectual performance and productivity,” Ballenger notes. In an increasingly competitive environment, the pressure is on to “present a more attractive and valuable self to the world.”
The trouble is, using medical technology to build a sense of self “blurs the boundary between the self and the technology,” argues Ballenger. What’s more, buying and selling prescription drugs are felony crimes that violate most campus codes of conduct, and using them creates serious health risks, including psychological and physical dependency.
In light of the substantial risks, why are some neuroethicists calling for greater acceptance of psycho-stimulants? Stanford professor Henry Greely and colleagues published an editorial in Nature calling for “responsible use of cognitive enhancing drugs by the healthy,” and arguing that “Society must respond to the growing demand for cognitive enhancement. That response must start by rejecting the idea that ‘enhancement’ is a dirty word.”
Ballenger sees it differently. “The problem is less whether we embrace the use of cognitive enhancements, or reject their use,” he says emphatically. “Rather, the problem is an uncritical acceptance of an arbitrary standard of intellectual performance and productivity as constituting the measure of a person’s moral worth. Our most important challenges as individuals and as a society are moral. They will not be solved by a modest boost of cognitive ability or productivity, but by attaining something more like wisdom.” And while attention or memory may be temporarily boosted with a drug, “wisdom will not come in the form of a pill.”
Melissa Beattie-Moss, Research Penn State