University

11/11/2009

"Smart pills" have stupid problems

An avalanche starts with a single pebble, and scientists are now warning us that they’re seeing the next social avalanche begin:  the age of neuro-enhancers … pills to make us smarter … is here.

You see it in large numbers of college students taking the stimulant Adderall to do better on term papers.  You see it in pilots and doctors and taxi drivers who work long shifts taking Ritalin to help them concentrate.  You see it in the promise of new drugs that will even further enhance “mental performance.” 

An informal poll conducted last year by the journal Nature found that one in five readers of that scientific publication had taken drugs off-label to improve “their focus, concentration, or memory” – and a third said they would likely give “smart drugs” to their kids if they learned that other parents were doing so.

Call it neuro-enhancement, call it “cosmetic neurology,” call it drug addiction – but in the future, we’re warned, if you’re not popping pills to make you smarter, then you’ll be left behind.

“For the moment, people looking for that particular quick fix have a limited choice of meds,” writes Margaret Talbot in a fascinating look at the future of pharmaceutical neuro-enhancement in the London Guardian.  “But given the amount of money and research hours being spent on developing drugs to treat cognitive decline, Provigil and Adderall are likely to be joined by a bigger pharmacopoeia.”

But what does it mean to get “smarter” from a pill?  Intelligence is so hard to measure even in the most controlled of circumstances … when we talk about “brain boosting” drugs, what’s actually getting boosted? 

Stanley Krippner, for one, says that feeling smarter doesn’t always fit the facts.

“Years ago, I was on a television show with the actor Tony Randall,” he remembers. “During a commercial break he told me about his psychotherapy sessions and how his psychiatrist revealed that he had discovered amphetamines, claiming that he could get twice as much work done after taking his daily ‘dose.’ However, the psychiatrist began confusing patients and suffered memory impairment, and eventually committed suicide. At that point Randall stopped psychotherapy, concluding that it had served its purpose.”

It was a clear case, Krippner says, of a “brain enhancing” drug not leading to very smart decisions.  “This is an example of how Americans tend to ‘medicalize’ activities looking for a ‘quick fix,’” he says.  “But often the idea of the quick fix bears very little relationship to the reality we find.”

Talbot is inclined to agree.  In her article, she notes that it appears to be concentration that is enhanced … while creativity and complex decision making appears to suffer.  No students she interviewed said they did great work while on neuro-enhancers … only that they could do more of the adequate work. 

It may be that “smart” drugs aren’t actually improving intelligence as we generally understand it at all:  evidence so far suggests they don’t improve our ability to have new insights, or to connect disparate ideas, make long term plans, or think through implications.  They do allow us to spend more time at our jobs (or students at their desks) doing drudge work.  Being “on task” in a limited sense isn’t the same as being “smart” at all.  And if there’s confusion about that, Talbot thinks, it has more to do with our culture than with the drugs.

“It's not the mind-expanding 1960s any more,” she writes:

“Every era, it seems, has its own defining drug. Neuroenhancers are perfectly suited to the anxiety of white-collar competition in a floundering economy. And they have a synergistic relationship with our multiplying digital technologies: the more gadgets we own, the more distracted we become and the more we need help in order to focus. The experience that neuroenhancement offers is not, for the most part, about opening the doors of perception, or about breaking the bonds of the self, or about experiencing a surge of genius. It's about squeezing out an extra few hours to finish those sales figures when you'd really rather collapse into bed; getting a B instead of a B-minus on the final exam in a lecture class where you spent half your time texting; cramming for the GREs (postgraduate entrance exams) at night, because the information-industry job you got after college turned out to be deadening. Neuroenhancers don't offer freedom. Rather, they facilitate a pinched, unromantic, grindingly efficient form of productivity.”

For those who want to actually enhance their creativity or “intelligence” as we more commonly understand it, Ruth Richards, an MD and PhD who teaches in Saybrook’s Creativity Studies program, has some other ideas.

“Whenever possible, the best strategy is to retain and fine tune the equipment we’ve got,” she says.  “Meditation, for example, is a mental discipline that can lead to permanent improvements in concentration, awareness, originality, and much more, all at the same time, without added dosing to keep it going.”

 Krippner agrees wholeheartedly. 

“There are many ways that one can enhance one's neural system that do not involve risks, such as mindfulness meditation, exercise (jogging, swimming, walking), martial arts (including tai chi and qigong), a healthy diet, and cognitive tasks (ranging from crossword puzzles to computerized ‘mind games’).”

However smart you are, it seems, inspiration really is 99% perspiration after all. 

 

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