O' Great One,

Will cognitive enhancing drugs make me smart enough not to take cognitive enhancing drugs? Or do I need wisdom enhancing drugs? And should I call my physician if my cognitive enhancement lasts longer than four hours?

Modafinil and Provigil are actually the same thing - the first is the active ingredient in the second. Adderall is an amphetamine and is a very different drug. Aderall is used to treat depression, while one of the side effects of Provigil is depression.

As an individual naturally gifted with a high intellect I'd like to note that, contrary to the last paragraph here, I do not object to "artificial" enhancements that would allow others to better compete with me (though I might be concerned if I was forbidden to take those enhancements as well if I wished).

Peter,

I agree perhaps for a different reason. All drugs cause undesirable side effects particularly with chronic use. I need only compete, therefore, with people like you since chronic drug users will eventually not have much cognition to enhance. Ah, evolution.

Modafinil and Provigil are the same drug.

I strongly agree with Posner that people should be able to use cognitive enhancing drugs if they so wish.

The current evidence seems to suggest that these drugs improve cognition more in lower- than higher- performers.

If correct this does indeed suggest that cognitive-enhancing drugs would increase competition for the naturally-gifted cognitive elite (who, probably for this reason, seem to be the most powerful group who currently oppose cognitive enhancing drugs).

And, of course, cognitively-enhancing drugs are almost universally used - in forms such as caffeine and nicotine. For example, strong coffee at lunch time 'artificially' overcomes (for many people) the spontaneous tendency to have a siesta in the afternoon - allowing better concentration and more work to be accomplished.

A further irony is that many people who oppose (often by ridicule) the idea of smart drugs, themselves use powerful dumb drugs such as alcohol.

I strongly agree with Posner that people should be able to use cognitive enhancing drugs if they so wish.

The current evidence seems to suggest that these drugs improve cognition more in lower- than higher- performers.

If correct this does indeed suggest that cognitive-enhancing drugs would increase competition for the naturally-gifted cognitive elite (who, probably for this reason, seem to be the most powerful group who currently oppose cognitive enhancing drugs).

And, of course, cognitively-enhancing drugs are almost universally used - in forms such as caffeine and nicotine. For example, strong coffee at lunch time 'artificially' overcomes (for many people) the spontaneous tendency to have a siesta in the afternoon - allowing better concentration and more work to be accomplished.

A further irony is that many people who oppose (often by ridicule) the idea of smart drugs, themselves use powerful dumb drugs such as alcohol.

Is it ethical to try to keep our species even less intelligent than it could be?

The challenge to academics from cognitive stimulants is surely three fold:

1. Academics need to identify which aspects of cognition are stimulated.

2. Those academics concerned with selecting the best students and marking academic performance need to design their tests to minimise the marks that can be gained by using the aspects stimulated.

3. Other academics can then set about finding means to stimulate the aspects not so far stimulated.

The challenge to the phamaceutical industry is to meet demand by producing effective stimulating agents which do not pose a threat to health. That demand is likely to be huge. How many companies will want to offer stuff that is approved safe free to their staff?

The first challenge to Government is to make sure that the initial versions of the drugs carry the appropriate health warnings, and to ensure that they are not addictive. Why in the world should they do more? There is an expected net benefit to society from using these agents, while any losses are likely to fall on the private user who has made a free, informed choice.

The second challenge to Government will be to find means to ensure that poor people who could benefit from them are not denied access to the agents, and at the same time to promote the market process producing ever-safer and ever cheaper agents.

It would appear unethical for each party concerned not to try to meet these challenges. Failing to do so would damage their fellow citizens. While these agents are not freely available, there will be an ethical problem in people trying to deny them to potential competitors while using them themselves. Well- organised markets solve such problems by promoting wider availability.

Scientific studies have shown pretty much equivalent effects of modafinil (Provigil), amphetamine, and caffeine at the appropriate doses (do a search of modafinil and caffeine on PubMed). So it appears that Cephalon is doing a great job of marketing what is basically an expensive extra large cup of coffee.

Even if there really was a 'smart' pill, in the worst case scenario the patent would run out in 10-15 years, the demand would create robust competition, which would drive prices down near marginal cost of pennies per pill. And presumably, if most everyone could buy smarts, the world would be a better place. Well, maybe in theory...

I agree that it does not make such sense to ban intellect-enhancing drugs, mainly for the reason that it is not possible (even more than in the athletic case) to draw sensible demarcations between "natural" and "unnatural" enhancing. We know too little about cognitive functioning to do so.

Your words have the bulging typeface of a juicer. Come clean!

Perhaps of some relevance to the topic is this quote from B. Pascal:

"Too much and too little wine. Give him none, he cannot find truth; give him too much, the same."

At the University of Chicago Law School, which grades students according to a strict bell curve in most classes, less than one student per year graduates with Highest Honors. If it were discovered that one such student used intelligence enhancing drugs, should the Law School put an asterisk next to Highest Honors on the student's transcript? (Assume that monitoring were cost-feasible and that intelligence doping with certain drugs is more than just a "borderline" case than say coffee.)

Hmm - I'm just wondering if the Prof's essay is obliquely addressing the growing Black Market in Nootropic chemicals (Cognitive Enhancers, Smart Drugs), both real and fake, in the world's high power universities that have become so competitive that students will do anything to get a competitive advantage. As with any performance enhancing pharmacuetical one must balance the benefits against the risks and there are many.

Most users don't seem to understand that there is a naturally occuring autonomic regulatory control function that exists at the brain/mind interface. Such that, with any accelerated intellectual actions over a certain time period, there is an equal anti-intellectual action over a similiar time period. The brain/mind performs this function to establish an equilibria and balance. So what's the gain? Furthermore, science has not yet fully established or understands the correlation between the increase in I.Q. points and dosage per mg of certain nootropic chemicals. As with some drugs, there is a law of diminishing returns and in some cases, reversal. In the reversal case, instead of it being a "smart drug" it functions as a "dumb drug". But as for the "pushers", who cares, it's only profit.

Anyway, it really doesn't matter, elite organizations, like the Aristo's Club and Illuminati already are, very, very, very, selective.

I've looked into various nootropic drugs. Most of them are essentially 'speed' and the racetams (piracetam, etc.) temporarily destroyed my verbal ability. But perhaps they work better on other people. (preloading with acetylcholine is essential and I question the tendency of people using an 'attack dose' to start out, but that's another story.) As was mentioned previously, a lot of these drugs are just another form of coffee.

I'm fine with people getting ahead by whatever means possible. I just seriously question how much nootropics really do for most people aside from perhaps making them temporarily more alert. Now if there was a way to undo tolerance-formation with amphetamines, that would be interesting. It's possible, theoretically, to separate opiods from their addictive effect if they are properly designed. And vitamin C does so to some small degree naturally. So tolerance is not mandatory for all classes of drugs. But I've looked into this a bit and we don't seem to be anywhere close to making most other drug classes non-addictive or non-tolerance forming.

Until then, count me out.

p.s. I shouldn't have excluded nicotine, which is very different from speed ( an nicotinic -acetylcholinergic ) but considering how addictive that is I've avoided it like the plague.

Lysine ( an amino acid ) was sometimes helpful to me. I'm not sure if it's because it boosts my immune system or if it's because it metabolizes to acetyl-CoA providing an acetyl group for the formation of acetylcholine. But that's more a matter of nutrition at that point than drug use.

Likewise, a lot of GABA-ergic drugs can help improve sleep structure in those who are deficient.

Bacopa was mildly helpful for me personally, and most herbs that increase dreaming will enhance memory.

It'd be silly to ban substances like the latter since they are mostly therapeutic and do not, as far as I'm aware, take people outside of any normal parameters.

Balzac laid out a routine for maximizing performance enhancement from caffeine, that culminated in eating ground coffee beans, without water, on an empty stomach. He himself recognized that he was risking his health in the pursuit of art.

I would say that we should put an asterisk by Balzac's number of novels (career and single season) but I find that the official record (i.e., Wikipedia) actually chooses to be a little vague on Balzac's statistics ("almost 100" novels and plays in the Comedie Humaine).

Judge Posner's succinct take on the steroid controversy hits every point and is precisely what I've been saying for years now, largely to deaf ears. Thank you for the validation.

I've been using Adderall in reasonably high doses for many years precisely because it makes me a far better lawyer, so obviously I have no problem with people using these drugs.

But people seem to mistakenly believe that Adderall makes you smarter, in the sense that you can understand more concepts with Adderall than you otherwise could. This is not true at all. Adderall and other so-called "intelligence-enhancing drugs" simply allow you apply your intelligence in with complete and uninterrupted concentration for extended periods of time.

It's a bit like Red-Light/Green-Light, where getting to the finish line is the equivalent of fully understanding a concept. When you're applying your intelligence, you are moving forward; when you are not applying your intelligence -- that is, your mind turns to something else, even for the slightest amount of time -- you are stopped. Adderall is like a permanent green light: you never stop moving forward. Without Adderall, you would almost certainly have to stop at least once, and probably many more times. A child will get to the finish line faster with a permanent green light will than he would with a few red lights along the way, but that doesn't mean that the permanent green light enhanced his natural speed; it just allowed him to apply his natural speed without interruption.

When I'm off Adderall, I can understand everything that I understand when I'm on Adderall. Does Adderall enhance my performance? Absolutely. Does it enhance my range of legal and non-legal knowledge? Yes, because it allows me to work significantly longer hours and read significantly more. But does it enhance my intelligence? No.

As a young student these sorts of drugs sound very tempting, although I have not used them myself... yet. I don't feel that I would need them to enhance my natural intelligence, and from what I've read of modafinil in particular it doesn't seem to have such an affect. Rather I would use it to improve my attentiveness and increase my work capacity, much in the way "TV" (you must hate your parents) argues.

Another thought provoking post, thank you. Drugs are drugs. Does it matter what is making a person an addict, i.e. the motivation? Brings to mind Anna Nicole Smith (the dead sex bearing football star).

I am not against these types of drugs, but have to wonder. Does it become a crutch? Can people that use them perform adequately with out them?

Judge Posner's consequentialism is beginning to verge on nihilism.

Jeff, I can offer first-hand answers to your questions:

Does it become a crutch? Yes.

Can people that use them perform adequately with out them? No.

I take no more than I'm prescribed, but over time I've become completely dependent on Adderall for work. This was a risk that was not adequately explained to me before going on it. While I certainly don't regret going on Adderall, I would have liked to have known what I was getting myself into.

In my opinion, the inability to perform adequately without it is by far the worst side-effect. What's worse, someone who isn't ADD who starts to take Adderall regularly will eventually become clinically ADD without it. It induces your brain to produce an excess of a certain chemical that helps concentration, so when you stop taking it, your brain produces an artificially low amount of the chemical to maintain its chemical balance.

So we should not start handing these medications out to everybody just because they enhance performance. Adderall is a powerful stimulant, and going on a medication like Adderall is a decision that should not be taken lightly.

Is it ethical to try to keep our species even less intelligent than it could be?

Unfortunately it seems everyone is assuming that all drugs cause adverse side effects. While all drugs are capable of doing so, not all of them will. Adderall when taken properly (fairly small doses, 10-20mg) is perfectly safe, not physically addictive, and won't cause any harm to your body. Plus I've never heard of anyone being allergic to it.

There is simply no rational reason for not allowing people to be as focused, intelligent, and alert as possible. While nobody should be forced to take a drug, nobody should be prevented from doing so, either.

A superstar user of "intellectual performance-enhancing drugs" was
Paul Erdös.

http://www.nytimes.com/books/first/h/hoffman-man.html

Paul Hoffman writes, "Erdös first did mathematics
at the age of three, but for the last twenty-five years of his life...
he put in nineteen-hour days, keeping himself fortified with
10 to 20 milligrams of Benzedrine or Ritalin, strong espresso,
and caffeine tablets. "A mathematician," Erdös was fond of saying,
"is a machine for turning coffee into theorems."

"At five foot six, 130 pounds, Erdös had the wizened, cadaverous
look of a drug addict, but friends insist he was frail and gaunt long
before he started taking amphetamines."

"Before Erdös died, on September 20, 1996, at the age of eighty-three,
he had managed to think about more problems than any other
mathematician in history. He wrote or co-authored 1,475 academic papers,
many of them monumental, and all of them substantial. It wasn't just the quantity
of work that was impressive but the quality...." Some people think that the
modern field of concrete mathematics that is the basis for computer science
could not have been developed without his efforts.

Although he was a superstar producer it seems he was not motivated by
ordinary economic stimuli. "What little money Erdös received in stipends
or lecture fees he gave away to relatives, colleagues, students, and strangers.
He could not pass a homeless person without giving him money....In 1984 he won
the prestigious Wolf Prize, the most lucrative award in mathematics. He contributed
most of the $50,000 he received to a scholarship in Israel he established in the name
of his parents. "I kept only seven hundred and twenty dollars," Erdös said, "and I
remember someone commenting that for me even that was a lot of money to keep."
Whenever Erdös learned of a good cause--a struggling classical music radio station,
a fledgling Native American movement, a camp for wayward boys--he promptly made
a small donation." When a student borrowed $1,000 from him to go to Harvard,
and later wanted to pay it back, he suggested that the student do the same as he did.

For him competition was important, he often used money as prizes to challenge
mathematicians to solve problems he alone could not do, however his general way
of working was to show up at a mathematician's doorstep and sit down with them
for some days and work on solutions, he was a problem-solver more than a
theoretician. "With 485 co-authors, Erdös collaborated with more people than any
other mathematician in history."

He never drove himself, it is hard to imagine how his drug use could harm others.
"Like all of Erdös's friends, Graham was concerned about his drug-taking. In 1979,
Graham bet Erdös $500 that he couldn't stop taking amphetamines for a month.
Erdös accepted the challenge, and went cold turkey for thirty days. After Graham
paid up--and wrote the $500 off as a business expense--Erdös said, "You've showed me
I'm not an addict. But I didn't get any work done. I'd get up in the morning and stare at a
blank piece of paper. I'd have no ideas, just like an ordinary person. You've set mathematics
back a month." He promptly resumed taking pills, and mathematics was the better for it."

His inability to cope with everyday life was legendary. "When asked by US immigration,
as he returned after a conference in Amsterdam in 1954, what he thought of Marx, Erdös
made the ill judged reply:-

I'm not competent to judge, but no doubt he was a great man.

Erdös was not allowed back to the United States [for a number of years] but no reason was given.
The files indicate that the official reasons were not the answers Erdös gave to the above questions, but the fact
that he had corresponded with a Chinese mathematician who had subsequently returned from
the United States to China and also Erdös's 1941 FBI record."

You have to think that in today's War on Drugs he would have been arrested and deported.

I as many other people have lived through the distressing consequences of a loved one
addicted to amphetamines. Currently governments probably spend more money on trying
to shut down methamphetamine production than anything else, even though when you look
at externalities such as mortality figures, overdoses from prescription drugs such as methadone
or Xantax are many times more common.

The question of amphetamines increasing "intellectual" production needs more research.
Some military experiments seem to show that pilots can stay awake longer but maybe
not fly any better. In the case of Paul Erdos one has to remember that his genetic heritage
has been speculated as an independent factor for his productivity: he was a Jew from
Budapest just like the very famous physicists and mathematicians in the Manhattan Project
(who are not known for taking drugs). There is some research to show that in some lines
of work it is not intelligence so much as hard work that is the major factor. Maybe the
case of Bobby Fischer and the Polgar sisters provide some evidence for the effort theory,
while in the case of Soviet chess the government did support the production, but individuals
such as Botvinnik wisely also trained for other jobs and so maybe were not so successful.
In chess and math, early effort seems to be important, Erdos is rare for being able to be
productive until age 83, maybe drugs played a role in that.

Although it can be argued that Erdos' drug use was an individual choice, and therefore should
be tolerated, most likely if put to a vote most people would not want to live in such a confined
and strange way, but rather emphatically like neighbors. Certainly there is no reason to
believe that government's promoting or tolerating general use of amphetamines would lead
to social benefits such as mathematical theorems. The question is really in the case of these
superstars, and of course celebrity is a factor in assessing behavior, they are singled out
as society's role models and so the eccentric behavior that accompanies their achievements
cannot be made known, or they must be subject to the rule of law that applies to everyone else.

overdoses from Xantax? If they meant Xanax, it's practically impossible to O/D from xanax without mixing it with alcohol (and then, the o/d is really from increased alcohol effects moreso than from the benzodiazepine alzrazolam).

John2, thanks for mentioning Erdos' story. 10-20 mg of Ritalin is not a very big dose. Ritalin is ~ 1/3 as potent as Adderall. I suppose benzedrine was pushed out of the market for abuse; Jack Kerouac wrote of using it. Vyvanse, the most recent amphetamine concoction, lists (cardiac) ventricular hypertrophy and hypertension as side efects. It may be given with guanfacine, a BP lowering drug that reduces the needed dose of stimulant. A clinical example beyond that of the typical ADHD patient is that of a child who answers questions well in grade school but finds that he/she can't maintain concentration and grades as junior high or some other stage comes up. It is as if a processor for information is good but as you progress the buffer needed to retain information for processing is insufficient. So subtly even a case like Erdos may represent a kind of ADHD, the central criteria of which is "maladaptive" inattention.

One question, Is the "ADD/ADHD" diagnosis real or is it really an institutional response to trying to control behaivor? Such that, instead of trying to maintain or develop academic systems that deal with such behaivor (possiibly a naturally occuring developmental behaivor) the institutions in question find it easier to dose students with chemicals and drugs. The whole issue is much akin to the misuse of the diagnosis of schizophrenia sixty to seventy years ago and the use of prefrontal lobotomies.

There was a reason for "Recess" once. Does any one remember it?

'Recess' is kind of an interesting idea in relation to ADHD. Recess gives the kids time to go to a 'fun' state. Hopefully, they can then carry that 'fun' over to their work when they come back. It's obvious people can pay more attention when they're having 'fun,' the reward center of the brain is dopamine mediated; stimulants cause dopamine stimulation. Presumably there is some spillover of dopamnergic excitation with 'recess,' known to adults as 'the weekend.'

Everyone who is interested in this post should read the milestone paper on addiction and rationality.

http://ideas.repec.org/a/ucp/jpolec/v96y1988i4p675-700.html

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