Smart Drugs: Should ‘Mental Wealth’ Be Promoted?

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Cognitive enhancement (i.e. augmenting and improving brain functions like memory or concentration) has been an area of interest to humans for centuries. Classroom education, physical exercise and adequate sleep/nutrition are all well-established means to improve your mental faculties. In the last few decades, attention has been given to pharmacological cognition-enhancers; these drugs are officially referred to as nootropics.

The U.S. military has used amphetamine-derived nootropics since WW2 in their fighter pilots, to improve battle readiness and flight performance. More recently, various classes of nootropics are used to treat neurological disorders like ADHD and narcolepsy. Drug names like Ritalin, Adderall and Methylphenidate are well-known in this field.

Within the last decade, there is growing evidence that healthy individuals (especially university students) are using these medications for non-medical purposes, without a prescription. In the context of rising tuition fees and often-toxic levels of professional competition, the fact that some students are taking these drugs to ‘enhance’ their study sessions and ‘improve’ their exam performance is not surprising. However, numerous issues have been raised on this practice. Firstly, these drugs are often obtained without a prescription from unlicensed suppliers over the Internet; this means that the contents and safety of the final product cannot be confirmed. Secondly, since nootropics are typically used only for people with mental disorders, the long-term effects and risks of these drugs when used in mentally-healthy (neuro-typical) people, have not been extensively tested. The ethical concerns are also significant; some view the use of ‘smart drugs’ in students as ‘cheating’ and often compare it to doping in competitive sports. Others see the possible ‘diversion’ of medical resources away from patients with genuine cognitive dysfunction as morally wrong. Laws to regulate the use of nootropics are almost nonexistent, as this practice has only surfaced in the last few years, and the fact that these drugs are already legal to use for patients.

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The effectiveness of nootropics to improve mental functioning in patients with cognitive disabilities (e.g. ADHD) is unquestioned, however the same cannot be said when taken by healthy people. Numerous studies have pointed to a cognitive ‘baseline’ that smart drugs act from, where people on the lower end of the spectrum (with lower IQ and/or neurological dysfunction) will see the greatest benefit, while individuals with healthy brains hit a ‘ceiling’ in the level of cognitive enhancement they can get out of the drugs. The data is extremely conflicted; some studies see a modest improvement in cognition in neuro-typical people, others see no change or even a negative effect from such drugs. Some researchers point out that the drugs may just act on alternative elements that precede improved cognition, such as motivation or focus, while other say that learning and memory cannot be ‘quantified’ as these standardised tests aim to do, arguing that our understanding of all the processes of learning and memory in humans is too limited to make any solid conclusions on the effects of so-called smart drugs.

College and uni students taking smart drugs may be unaware of their questionable efficacy, and so inflated expectations on the effectiveness of the drugs may exceed their actual effects, possibly even leading to an enhanced placebo effect. A lack of discussion about unrealistic expectations and the actual risks of taking nootropics without a prescription can result in more harm to individuals using for the first time.

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On whether a student is ‘cheating’ when they take nootropics, their euphemistic labelling as ‘extra help’ or ‘study drugs’ is often used to justify the practice. Smart drugs are seen in these cases as just another ‘tool’ to help revision and with university life in general, much like a cup of coffee or purchasing a gym membership. They also point out the fact that nootropics are not perfect; as one student recalled, ‘you can take Ritalin and still procrastinate‘. Nonetheless, detractors worry that ‘traditional values’ of hard work and fair play as part of academic integrity could be jeopardised if success comes at the end of a pill. Other arguments against smart drugs state that access to these medications could largely be dependent on wealth, with lower-income or disadvantaged students missing out on cognitive enhancement based on their means, and so may have to resort to crime to obtain the drugs. A counter-argument would be that this inequality is already widespread and accepted in society; academic success is already more likely for students who can pay for independent tutors or a private school education.

A ‘diversion’ and subsequent shortage of prescription medications for mentally-impaired patients is another pressing concern; indeed, neuro-typical people comprise 90% of all Modafinil takers, and so some fear that patients may be at risk, especially around university exam seasons. Again, as smart drugs are a relatively recent phenomenon, there is not much evidence yet to suggest that genuine patients are detrimented by students taking nootropics. Concerns over this practice of ‘cosmetic neuro-pharmacology’ arguably unfounded, as one ethicist pointed out:

Large sums of money are spent on cosmetic [plastic]surgery without any concerns about distributative justice or deployment of physicians. To suggest that neurocognitive medication should not be available because everyone could not afford them is preposterous

Neuroscientists’ opinions are as conflicted as the data on smart drugs; their usage in academia is just as prevalent as in students, with many professionals taking them to deal with jetlag and to remain productive. While some argue the capacity of smart drugs to improve quality of life through enhanced performance and negating shortcomings of nature, others cite the danger of ‘promoting’ drug use in healthy people. All scientists agree that the available research on smart drugs is severely lacking, and so it can be argued that any further discussion should be done in conjunction with more long-term, large population studies to give a more accurate risk assessment of smart drugs. In the meantime, improving mental health through traditional means like exercise and good nutrition should always be the preferred option over artificial drugs.

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Deputy Sci/Tech Editor | Sub-editor 2019/20 | 3rd year Neuroscience student, i.e. drugs, brains and 100% pain

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