Steroids for the brain

12/15/2008

SHOULD healthy adults be allowed to take brain-enhancing drugs to improve their performance at work or school?

That question, posed by a group of scientists online in the journal Nature and answered with a qualified "yes," raises health-related and ethical red flags but ought not to be dismissed out of hand.

It is well known that drugs normally prescribed for children with hyperactivity and attention deficit disorders and older adults suffering from Alzheimer's and other memory problems can improve the brain function of healthy adults as well. Indeed, many people already illegally use these drugs to improve concentration or mental sharpness. In a 2001 study, about 4 percent of college students surveyed admitted having used prescription stimulants illegally during the previous year. At some colleges, the number was as high as 25 percent.

So, why shouldn't people who are in good health and can afford the drugs be allowed to legally improve their productivity or performance? Isn't that what millions already are doing when they take caffeine-laced drinks such as Jolt and Red Bull?

But are these drugs merely the pharmaceutical equivalent of a double-espresso, or are there hidden, long-term dangers even for healthy people who take medications that can result in reduced appetite, irritability, depression, increased blood pressure, difficulty sleeping, and changes in blood glucose? There is no data one way or the other on this question, but reasonable caution suggests that people shouldn't take potentially dangerous drugs when there is no medical necessity.

Then there are the ethical concerns.

The seven co-authors of the study, including researchers from Harvard, Stanford, and other prestigious universities, say that healthy, competent adults pharmacologically improving the way their brains work is a positive development. They make the attractive case that taking Adderoll to do better at work or school is no more morally repugnant than stoking up on caffeine or hiring a tutor.

But wouldn't students who can't afford to "cognitively enhance" their brains be put at an unfair disadvantage when competing for college grades or taking exams that go a long way toward determining what law school or medical school they'll attend or who their first after-college job will be with?

Would employers constantly on the lookout for ways to improve productivity pressure workers to take brain-enhancing drugs? Could willingness to take drugs at the workplace become a condition for advancement, or even retention? Isn't it likely that abuse of these drugs would increase rapidly if they became easier to obtain? Do we really want airline pilots, surgeons, and long-haul truckers, among others, to do their jobs on mind-altering medications?

These are serious questions, as the researchers themselves acknowledged. Until the answers to both the medical and ethical are sorted out, "brain doping" is one genie better left in the bottle.