Smartening Up
Luci Gutiérrez
Published:
March 9, 2008
Yet an era of doping may be
looming in academia, and it has ignited a debate about policy and ethics that
in some ways echoes the national controversy over performance enhancement
accusations against elite athletes like Barry Bonds and Roger Clemens.
In
a recent commentary in the journal Nature, two Cambridge University
researchers reported that about a dozen of their colleagues had admitted to
regular use of prescription drugs like Adderall, a
stimulant, and Provigil, which promotes wakefulness,
to improve their academic performance. The former is approved to treat
attention deficit disorder, the latter narcolepsy,
and both are considered more effective, and more widely available, than the
drugs circulating in dorms a generation ago.
Letters
flooded the journal, and an online debate immediately bubbled up. The journal
has been conducting its own, more rigorous survey, and so far at least 20 respondents
have said that they used the drugs for nonmedical
purposes, according to Philip Campbell, the journal’s editor in chief. The
debate has also caught fire on the Web site of The Chronicle of Higher
Education, where academics and students are sniping at one another.
But
is prescription tweaking to perform on exams, or prepare presentations and
grants, really the same as injecting hormones to chase down a home run record,
or win the Tour de France?
Some
argue that such use could be worse, given the potentially deep impact on
society. And the behavior of academics in particular, as intellectual leaders,
could serve as an example to others.
In
his book “Our Posthuman Future: Consequences of the
Biotechnology Revolution,” Francis Fukuyama
raises the broader issue of performance enhancement: “The original purpose of
medicine is to heal the sick, not turn healthy people into gods.” He and others
point out that increased use of such drugs could raise the standard of what is
considered “normal” performance and widen the gap between those who have access
to the medications and those who don’t — and even erode the relationship
between struggle and the building of character.
“Even
though stimulants and other cognitive enhancers are intended for legitimate
clinical use, history predicts that greater availability will lead to an
increase in diversion, misuse and abuse,” wrote Dr. Nora Volkow,
director of the National Institute on Drug Abuse, and James Swanson of the
But
others insist that the ethics are not so clear, and that academic performance
is different in important ways from baseball, or cycling.
“I
think the analogy with sports doping is really misleading, because in sports
it’s all about competition, only about who’s the best runner or home run
hitter,” said Martha Farah, director of the Center for Cognitive Neuroscience
at the University of
Pennsylvania. “In academics, whether you’re a student or a researcher,
there is an element of competition, but it’s secondary. The main purpose is to try
to learn things, to get experience, to write papers, to do experiments. So in
that case if you can do it better because you’ve got some drug on board, that would on the face of things seem like a plus.”
She
and other midcareer scientists interviewed said that,
as far as they knew, very few of their colleagues used brain-boosting drugs
regularly. Many have used Provigil for jet lag, or
even to stay vertical for late events. But most agreed that the next generation
of scientists, now in graduate school and college, were more likely to use the
drugs as study aids and bring along those habits as they moved up the ladder.
Surveys
of college students have found that from 4 percent to 16 percent say they have
used stimulants or other prescription drugs to improve their academic
performance — usually getting the pills from other students.
“Suppose
you’re preparing for the SAT, or going for a job interview — in those
situations where you have to perform on that day, these drugs will be very
attractive,” said Dr. Barbara Sahakian of
Jeffrey
White, a graduate student in cell biology who has attended several
institutions, said that those numbers sounded about right. “You can usually
tell who’s using them because they can be angry, testy, hyperfocused,
they don’t want to be bothered,” he said.
Mr.
White said he did not use the drugs himself, considering them an artificial
shortcut that could set people up for problems later on. “What happens if
you’re in a fast-paced surgical situation and they’re not available?” he asked.
“Will you be able to function at the same level?”
Yet
such objections — and philosophical concerns — can vaporize when students and
junior faculty members face other questions: What happens if I don’t make the
cut? What if I’m derailed by a bad test score, or a mangled chemistry course?
One
person who posted anonymously on the Chronicle of Higher Education Web site
said that a daily regimen of three 20-milligram doses of Adderall
transformed his career: “I’m not talking about being able to work longer hours
without sleep (although that helps),” the posting said. “I’m talking about
being able to take on twice the responsibility, work twice as fast, write more
effectively, manage better, be more attentive, devise
better and more creative strategies.”
Dr.
Anjan Chatterjee, an
associate professor of neurology at the University of Pennsylvania who foresaw
this debate in a 2004 paper, argues that the history of cosmetic
surgery — scorned initially as vain and unnatural but now mainstream as
a form of self-improvement — is a guide to predicting the trajectory of
cosmetic neurology, as he calls it.
“We
worship at the altar of progress, and to the demigod of choice,” Dr. Chatterjee said. “Both are very strong undercurrents in the
culture and the way this is likely to be framed is: ‘Look, we want smart people
to be as productive as possible to make everybody’s lives better. We want
people performing at the max, and if that means using these medicines, then
great, then we should be free to choose what we want as long as we’re not
harming someone.’ I’m not taking that position, but we have this
winner-take-all culture and that is the way it is likely to go.”
People
already use legal performance enhancers, he said, from high-octane cafe Americanos to the beta-blockers taken by musicians to ease
stage fright, to antidepressants
to improve mood. “So the question with all of these things is,
Is this enhancement, or a matter of removing the cloud over our better selves?”
he said.
The
public backlash against brain-enhancement, if it comes, may hit home only after
the practice becomes mainstream, Dr. Chatterjee
suggested. “You can imagine a scenario in the future, when you’re applying for
a job, and the employer says, ‘Sure, you’ve got the talent for this, but we
require you to take Adderall.’ Now, maybe you do
start to care about the ethical implications.”