Neuroanthropology

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The New Performance Enhancing Drugs

Posted by dlende on June 4, 2009

Enhanced Brain
By Andrew Hessert, Andrew Medvecz, Jimmy Miller, Jacquelyn Richard

Barry Bonds elevated his game to the next level with “the clear” and “the cream”, shattering legendary records in the process. Are scientists, students, and other academics about to do the same?

While stars such as Barry Bonds and Jason Giambi continue to defend themselves against their alleged use of performance-enhancing drugs, a new debate over the use of a different kind of performance-enhancing drug has begun to rage in the scientific world.
Barry Bonds Pumped Up
Cognitive enhancers like Adderall and Ritalin have commonly been used as a treatment for behavioral disorders such as Attention Deficit/Hyperactivity Disorder. However, these drugs are now becoming popular “performance enhancing” substances for healthy individuals trying to gain a competitive edge by boosting their overall cognitive function.

Henry Greely, a Stanford Law Professor, advocates for unrestricted availability of these drugs, claiming the enhancers will level the “cognitive playing field” and spark a new era of increased innovation. But Greely and other advocates fail to recognize the severe personal and societal consequences that such availability would generate, looking instead to a pharmaceutical solution that would, in the end, cause more problems than it would solve.

How They Work

Ritalin and Adderall have been on the market since the 1960s to treat conditions like ADD and ADHD (Center for Substance Abuse Research, 2005). While the specific mechanisms of these disorders have yet to be fully elucidated, cognitive enhancers have been successful in controlling or mitigating symptoms in patients. Ritalin (methylphenidate) and Adderall (dextroamphetamine) both inhibit dopamine reuptake, allowing dopamine signals to remain active for longer periods of time (Jones, Joseph, Barak, Caron, & Wightman, 1999). Provigil (modafinil), an alternative to the potentially addictive dopaminergic drugs, operates in similar fashion, but instead blocks reuptake of the neurotransmitter norepinephrine.

Adderall BrainThe increased neurotransmitter activity induced by these drugs stimulates many areas of the brain (see right), including the prefrontal cortex, which is responsible for a person’s ability to focus and strive toward a specific goal. This stimulation theoretically counters fragmented synaptic signaling in the brain, one suspected cause of ADD and ADHD.

While these drugs increase focus and concentration for people with attention disorders, they can also increase prefrontal cortex stimulation among people without such disorders (Devilbiss & Berridge, 2008). The increased ability to focus and concentrate on specific tasks is clearly of great social utility. These benefits, however, are not without negative consequences; numerous side effects including hallucinations, headaches, nausea, and depression have been documented.

How They Are Being Used

A growing number of healthy Americans are using cognitive enhancers in an attempt to gain a mental edge in our competitive society. The popularity of these drugs is rapidly increasing in many areas of society and has become particularly prevalent among corporate executives, academics, and college students.

An article in the January issue of TIME Magazine describes a high-level executive who uses Adderall to “continue the lightning pace and constant multitasking his job requires” (Szalavitz, 2009). Since receiving the prescription from his doctor, he says he has been better able to maintain his high level of performance, a development he attributes to his use of cognitive enhancing drugs.

The TIME article also addresses the rising use on college campuses (Szalavitz, 2009). Studies have found that 7% of college students have used a cognitive-enhancing drug for non-medical purposes, and on some campuses up to 25% of students have used enhancers to aid studying. Unsurprisingly, usage rates are higher at prestigious institutions, where students feel the need to keep pace in an overly-competitive academic atmosphere. Taking a cognitive enhancer the night before a final can help you focus for an extra hour or two, and many students believe that hour may mean the difference between an A and a B.

Improving academic achievement, however, is a complex issue—popping pills may not be the cure all for low grades. Studies have shown the association between sleep and learning; shorting on sleep to study may still lead to lower grades even with cognitive enhancers (Curcio et. al, 2006).

Among the scientists polled in a Nature study conducted in 2008, nearly 20% reported having used cognitive enhancing drugs for non-medical purposes (Maher, 2008). The most popular motivation was the desire to increase concentration, with other reasons including increasing focus, counteracting jet lag, and other miscellaneous responses. Interestingly, over half of the respondents reported experiencing negative side effects yet still continued taking the drugs.

Arguments FOR Use with the General Population

Stanford Law Professor Henry Greely is a leading proponent for making cognitive enhancers available to the general population. In his hotly-debated article in Nature, he argues that research into the benefits of the use of cognitive enhancers among the healthy population should be explored. Greely claims that the term “enhancement” has been marred by its comparison to athletics, saying “better-working brains produce things of more lasting value than longer home runs” (Greely, 2008).

In one of his main points, Greely argues that using a cognitive enhancer is analogous to any other practice intended to improve mental function, such as sleep, nutrition, and exercise. Just as these practices provide cognitive enhancement, so would the use of drugs like Adderall, Ritalin, and Provigil. These drugs have the potential to be very beneficial, and “we should welcome new methods of improving our brain function,” says Greely.

Greely further contends that cognitive enhancers may potentially “level the playing field,” allowing disadvantaged students to overcome educational gaps. Take the example of standardized tests like the SAT, which many colleges like Notre Dame use in evaluating applicants. These tests have been shown to be statistically biased against African Americans, Hispanics and other ethnic minorities (Freedle, 2008). It is possible that the use of cognitive enhancers could help them overcome this bias, promoting greater acceptance rates of minorities at prestigious universities. Used in this way, the drugs would be elevated beyond the individual desire to gain a competitive edge, and be employed as a tool to remove educational barriers, a significant cause of socioeconomic inequality.

Research focusing on the use of cognitive enhancers by healthy individuals is sparse. Greely recommends that studies in the area of cognitive enhancement be developed in order to build a knowledge base concerning usage patterns, benefits, and associated risks of these drugs. These studies could then be employed in developing an informed legal policy aimed at preventing coercion and mitigating the potential for abuse.

In a recent New Yorker article entitled Brain Gain, Margaret Talbot presents a more moderate defense for the legalization of cognitive enhancers. Talbot compares the use of cognitive enhancers to elective cosmetic surgery—both are personal choices, with inherent risks and benefits, designed to enhance particular attributes.

While not as far reaching as Greely’s assertions, Talbot’s arguments against a ban on cognitive enhancers focus on practicalities; cognitive enhancers are already in wide circulation and are being used responsibly among academic and business professionals. While cognitive enhancer use may not be ideal, Talbot argues that people should be allowed, after being informed of the risks and benefits, to make their own decisions about enhancement of their minds and bodies.

Argument AGAINST Use with the General Population

Homer's BrainWhile many support Greely and Talbot’s positions, they are not without opposition. Our arguments against popular use of cognitive enhancers stem from ethical, medical, and social concerns. We believe that promotion of cognitive enhancers in the manner described by Greely is irresponsible and neglects the more fundamental issues at the root of the problems he addresses. Talbot, while more moderate than Greely, still fails to consider the social and cultural consequences of widespread usage.

Among the many troubling aspects of cognitive enhancers are the potential negative side effects. Little is known about the long term effects of these drugs, and many of the documented short term side effects would likely affect healthy users as much as those with disorders. Imagine getting a headache from taking Provigil when you are trying to prepare for an exam the next day. In this case, the drug you are using to improve your cognitive ability is ultimately hindering it.

More serious side effects such as depression and insomnia, while not fully understood, can cause severe harm to someone who would not have otherwise developed these conditions. The striking recent instance (April 22) of a young boy hanging himself while taking ADHD meds and other incidents like it raise significant questions about the safety of these drugs, especially among people for whom the drug is a luxury and not a necessity.

Also, because Ritalin and Adderall act on the mesolimbic dopamine system, the pathway commonly associated with addictive substances such as cocaine, users run the risk of developing a dependency or becoming addicted (Volkow, Fowler, & Logan, 2009). Addiction is a high price to pay for using a drug that provides limited benefits.

Of further concern is the likely inevitable consequence that widespread use of cognitive enhancers would lead to intense social pressure and even forms of coercion. It is already clear that some executives feel these substances are necessary to remain competitive. More students at competitive universities would likely be pressured to use these drugs when they see other users getting better marks. General availability of cognitive enhancers in our society could easily make these drugs a necessary component for success rather than an optional boost.

Furthermore, the disparity that Greely proposes would be overcome by cognitive enhancers may instead be exacerbated. The financial means that are required to obtain these substances restricts their availability to those who can afford them. Look back at the earlier example of ethnic minorities using cognitive enhancers to improve SAT scores. Traditionally these minority groups are also economically disadvantaged and would lack the means necessary to acquire these drugs.

The real benefactors from widespread availability would be the rich, who already perform better on standardized tests. Promoting the use of cognitive enhancers would likely serve to widen the already significant divide between socioeconomic groups. Reducing the disparity within a population cannot be accomplished by using cognitive enhancers; the drugs would only reinforce the present socioeconomic barriers.

Talbot, on the other hand, places too much emphasis on personal freedom as a justification for legalization, glossing over the social and cultural implications sure to follow from widespread usage. Within her own article she recounts the story of a poker millionaire who made his fortune with the help of cognitive enhancers. His use of these substances was an isolated personal choice but had social consequences as well, allowing him to gain an unfair competitive advantage over the other players.

Justifying cognitive enhancement in the academic and business worlds on the basis of individual freedom ignores the social consequences of unfair neurological advantages in the extremely competitive context of these cultures. Cognitive enhancer legalization cannot be framed in a purely individual context; legalization will have widespread social consequences.

Conclusion

Greely and others are right in asserting that the debate over cognitive enhancers is not entirely analogous to baseball’s steroid scandal. Cognitive enhancers do provide significant long term mental benefits and arguably some social benefits. However, as we have argued, these benefits are outweighed by the physical side effects and social ramifications that such use would entail.

Moreover, any suggestion that these drugs could level the playing field fails to account for the complexities inherent in such problems. Issues like educational disparity and social pressure to boost achievement demonstrate these complexities and are fundamentally socioeconomic and cultural problems. Throwing drugs at these issues will not bring resolution. Rather a cultural- and sociological-based approach is best suited for this task. While we recognize the benefits of these cognitive enhancers, their use should be restricted to the treatment of cognitive disorders.

Bibliography

Center for Substance Abuse Research. (2005, May 2). Ritalin. Retrieved April 10, 2009, from http://www.cesar.umd.edu/cesar/drugs/ritalin.asp

Curcio, G., Ferrara, M., & De Gennaro, L. (2006). Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews , 323-337.

Devilbiss, D. M., & Berridge, C. W. (2008). Cognition-Enhancing Doses of Methylphenidate Preferentially Prefrontal Cortex Neuronal Responsiveness. Biological Psychiatry , 626-635.

Freedle, R. O. (2008). Correcting the SAT’s Ethnic and Social Class Bias: A Method for Reestimating SAT Scores. Harvard Educational Review , 1-43.

Greely, H. (2008). Towards responsible use of cognitiveenhancing. Nature , 702-705.

Jones, S. R., Joseph, J. D., Barak, L. S., Caron, M. G., & Wightman, R. M. (1999). Dopamine Neuronal Transport Kinetics and Effects of Dopamine. Nournal of Neurochemistry , 2406-2414.

Maher, B. (2008). Poll Results: Look Who’s Doping. Nature , 674-675.

Szalavitz, M. (2009, January 6). Popping Smart Pills: The Case for Cognitive Enhancement. Time.

Tansey, B. (2008, December 8). Experts urge wider use of brain-boosting drugs. San Francisco Chronicle.

Volkow, N. D., Fowler, J. S., & Logan, J. (2009). Effects of Modafinil on Dopamine and Dopamine Transporters in the Male Human Brain: Clinical Implications. Journal of the American Medical Association , 1148-1154.

16 Responses to “The New Performance Enhancing Drugs”

  1. noname said

    Nice article , I have to comment on one thing that those drugs are going to be used and people well be forced to use them like athlete are coerced to use them ,there is now stopping it so unless we want another war on drugs I argue to we should let it to be used publicly the harm well be less than is it were banned ,it like alcoholic in some ways .

  2. [...] The New Performance Enhancing Drugs [...]

  3. Julian Morrison said

    Unfair advantage? Life is not a game! Nor for that matter is life zero-sum. Enhancers provide absolute, not just relative improvement.

    • Brandon Johnson said

      As twisted as it is, a lot of people view life as a game that they can win by being successful. i disagree however

  4. messer said

    A lot of politically correct language mixed with real scientific observations. How can be so sure that “tests have been shown to be statistically biased against African Americans, Hispanics and other ethnic minorities”? No, it can show, that there is a correlation between the species and the IQ. Asians have statistically highest IQ, Blacks have lowest scores.

  5. Brian said

    While I agree with your arguments in this article, I must object to the worthless image you’ve included of the brain “with Adderall” and “without Adderall”. Besides the fact that “Increased Activity” only makes sense in regards to some baseline (so why is it present on both brain images?), what circumstances surrounded the measurement in those two images? Was it a snapshot of one particular instant or some average of activation over time? What task was the person (or persons) performing? The wash of red on the left-side image of the brain serves only to recall the silly “This is your brain on drugs” ad.

    I think the text of the article itself was excellent, but the use of this image only detracted from your important message. I know the authors must be intelligent, and hopefully in the future you will include pictures that only enhance the overall quality of the article.

  6. Josh said

    “The real benefactors from widespread availability would be the rich, who already perform better on standardized tests.”

    1. Sandra Scarr, after conducting the Minnesota Transracial Adoption Study:

    “Within the range of ‘humane environments,’variations in family socioeconomic characteristics and in child-rearing practices have little or no effect on IQ measured in adolescence.” P. 476

    “There is simply no good evidence that social environmental factors have a large effect on IQ, particularly in adolescence and beyond, except in cases of extreme environmental deprivation.” P. 476

    By adulthood, all of the IQ correlation between biologically related persons is genetic. P. 178 Phenotypic g closely reflects the genetic g, but bears hardly any resemblance to the (shared) environmental g. P. 187

    2. From that study the black children adopted by white families matured to have IQs that are consistent with their biological peers; Asian children adopted by white families mature to have IQs that are consistent with their biological peers and which are higher than their adoptive parents.

  7. Josh said

    Also, consider the twin studies discussed here on Gene Expression.

    “despite their lower performance, which is genuine, multiple lines of evidence point to African-Americans valuing academics nearly as much as white Americans, if not equally so (for instance spending just as much time on homework. A number of lines of evidence are discussed by Ludwig and Cook in The Black-White Test Score Gap, which you can read here). But an even more profound revelation that causes doubt about cultural explanations is that behavioral genetic experiments show us that home and parental environments don’t seem to matter at all. As fantastic as it may be, at least three big studies now show us that unrelated children raised in the same household, as well as parents and their adoptive children, differ in IQ as much as any two strangers randomly picked from the general population. There are IQ similarities in biological families, but we find that once genes are accounted for, there is no residual left to explain.

    So there are many good reasons to doubt cultural explanations a priori, but a more direct test is available. One possible way to control for distinct ethnic values is simply to raise the children of higher or lower scoring racial backgrounds in another ethnocultural environment of purportedly different values. If ethnic differences are caused by ethnically different parents, as asserted by gene-disparaging psychologists such as Richard Nisbett, then such a test should settle the issue. The transracial adoption data we have so far doesn’t appear to support Nisbett.

    One longitudinal study, the only one of its kind, of black children raised in white homes, showed that by highschool these adoptees scored no differently on IQ tests than African-Americans raised by their biological parents. Meanwhile three studies of Asians [1] raised in white families showed higher than average test scores. A problem with these latter three papers of Asian adoptees is that they didn’t use control samples of white adoptees. Did the Asian children just score higher because adoptees in general score higher?

    Contrary to “culture” theory, the ethnic academic gaps are almost identical for transracially adopted children, and to the extent they are different they go in the opposite direction predicted by culture theory. The gap between whites and Asians fluctuated from 19 to .09 in the NAEP data while the gap in the adoption data is from 1/3 to 3 times larger. This is consistent with the Sue and Okazaki paper above which showed that contrary to popular anecdotes, the values that lead to higher academic grades are actually found more often in white homes. In other words Asian-Americans perform highly despite their Asian home cultural environment not because of it. And though the sample is meager, I find it interesting that the gap between the black and white adopted children was virtually identical (within just 4-6 points) to the gap between whites and blacks in the general population, just like in the Scarr adoption study.

    http://www.gnxp.com/MT2/archives/004064.html

  8. dlende said

    Josh, you really picked the wrong site for race baiting. It’s not good science, and it’s not good anthropology. I suggest you read some other work on site here:

    The Flynn Effect: Troubles with Intelligence #2

    How Intelligent Are Intelligence Tests?

    Neuroanthropology and Race – Getting It Straight

    You should also look at the science in a more balanced way. Let me draw from a recent review on genetics and intelligence by Deary et al (pdf). Noting that the majority of genetic studies do not actively account for relevant environmental variations, the paper moves on to discuss heritability (h2) and shared environment (c2). Here is the relevant quote: “This sample [from the National Collaborative Perinatal Project] has a high proportion of impoverished families. One useful summary is an analysis in which families were dichotomized into high and low socio-economic status (SES). For high SES families, h2 was 0.71 and c2 was 0.15. For low SES families, h2 was 0.10 and c2 was 0.58 (694).”

    Race/ethnicity is also a social category (or folk taxonomy), and thus a serious impediment when included in this type of research since it doesn’t capture the relevant variation. So here is Robert Sternberg et al. (2005), Intelligence, Race and Genetics (pdf) in American Psychologist: “They further argue that race is a social construction with no scientific definition. Thus, studies of the relationship between race and other constructs may serve social ends but cannot serve scientific ends. No gene has yet been conclusively linked to intelligence, so attempts to provide a compelling genetic link of race to intelligence are not feasible at this time. The authors also show that heritability, a behaviorgenetic concept, is inadequate in regard to providing such a link.”

    And for those interested, here is an article by Nisbett and race & intelligence (pdf).

    But honestly I’d rather the debate center on the students’ discussion of performance enhancing drugs.

  9. Josh said

    Here is the relevant quote: “This sample [from the National Collaborative Perinatal Project] has a high proportion of impoverished families.”

    The problem with this is that it is from this paper by Turkheimer E
    ‘Socioeconomic status modifies heritability of IQ in young
    children.’ Psychol Sci 2003; 14: 623–628.

    A few problems with this paper:

    1 – The study included only young children and does not make any attempt to extrapolate that all other findings of significant increases in h^2 by age 17 are in any way invalid. The effects of the shared environment vanish at around age 12.

    2 – Turkheimer began his paper by recognizing that the heritability of cognitive ability in childhood is well established.

    3 – Turkheimer made no attempt whatsoever to determine what components of SES he was measuring. There are three obvious items to consider: macro environmental, micro environmental, and genetic. All work to date indicates that the first of these can be found in children, but that it is absent in late adolescents; by late adolescence, all of the environmental component is of the second type; and that genetic intelligence is the largest determinant of SES.

    4 – Turkheimer says that the effect he observed was related to the homes in which the children were raised. This is interesting, since it relates to the adoption studies which show that after childhood there is no adult IQ correlation between biologically unrelated children who were reared together in the same home.

    5 – Turkheimer discusses in some detail that SES is not strictly an environmental variable, since it is known to be (statistically) caused by the intelligence of the parents. He points out that the models he used “cannot determine which aspect of SES is responsible for the interactions” observed.

    6. In Britain, the exact opposite of Turkheimer’s result was found in over 2,000 pairs of 4-year-old twins (N = 4,446 children), with greater heritability observed in high-risk environments.

    7. A re-analysis of the Hawaii Family Study of Cognition also found contrary results to Turkeimer’s. Nagoshi and Johnson found no reduction in the relationship between parental cognitive ability and offspring performance in families of lower as opposed to upper levels of socioeconomic status. In the 1,349 families they studied, the relationship remained the same across tests, ethnicity, and sex of offspring.

    Asbury, K., Wachs, T. D., & Plomin, R. (2005). Environmental moderators of genetic influence on verbal and nonverbal abilities in early childhood. Intelligence, 33, 643-661.

    75. Nagoshi, C. T., & Johnson, R. C. (2005). Socioeconomic status does not moderate the familiality of cognitive abilities in the Hawaii Family Study of Cognition. Journal of Biosocial Science, 37, 773-781.

  10. Josh said

    “And for those interested, here is an article by Nisbett and race & intelligence”

    Thanks for the link, here is a discussion by JP Roos in relation to inequality generally which cites that edition of Psychology, Public Policy, and Law, 11, 328-336. that edition of J. P. Rushton & Jensen, A. R (2005).

    http://www.valt.helsinki.fi/staff/jproos/inequality.htm

    Here is the reply to Nisbett, Sternberg & Aronson in that edition.

    http://www.udel.edu/educ/gottfredson/30years/Rushton-Jensen-reply-to-commentaries-on-30years.pdf

    >Race/ethnicity is also a social >category (or folk taxonomy), and >thus a serious impediment when >included in this type of research >since it doesn’t capture the >relevant variation.

    It’s a social category, but groups cluster into these recognisable groups. Also, note that in terms of classic anthropology WW Howell’s analysis of cranial measurements identified seven groups which largely correspond to the population clusters Cavalli-Sforza identified.

    In relation to more recent studies there is a discussion of the paper by Neil Risch here by Steve Hsu:

    http://infoproc.blogspot.com/2007/01/metric-on-space-of-genomes-and.html

  11. Josh said

    Dlende,

    “But honestly I’d rather the debate center on the students’ discussion of performance enhancing drugs.”

    Fair enough, I’ve never actually tried any although if I had my time over I might consider it.

    There is a fantastic article here by Johan Hari about his experiment with smart drugs & why he stopped taking them.

    http://www.johannhari.com/archive/article.php?id=1298

  12. Ashley said

    I think it may help people perform in school but what happens when they get off the drugs? I take Adderall and stop during the summers and it is hard to maintain my weight. I also developed depression from taking and so did a friend of mine. Overall my school performance did get better but everything else went downhill for me.

  13. [...] 5. The New Performance Enhancing Drugs by Andrew Hessert, Andrew Medvecz, Jimmy Miller, Jacquelyn Richard — Comprehensive student research discussing the widespread use of drugs like Ritalin and Adderall by students, executives, and others, with a discussion of advocates’ and critics’ perspectives. It’s a wide-reaching discussion of ‘cognitive enhancers’ and an excellent example of integrative theory. [...]

  14. [...] http://neuroanthropology.net/2009/06/04/the-new-performance-enhancing-drugs/ [...]

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