We all want to be the best versions of ourselves.
Many people look for ways to boost their brain power to improve performance at school, work, or in their hobbies.
New scientific discoveries have led to drugs and technologies that can enhance cognition – our ability to think, focus, learn and remember.
But is it right to use drugs just to make our brains work better than normal?
Key Facts:
- People have tried to enhance brain function with drugs for centuries, with mixed results. Cocaine and amphetamines were once praised before their risks were known.
- Use of “smart drugs” like modafinil and methylphenidate is rising among healthy people seeking a mental edge.
- Evidence for benefits is mixed, while long-term safety is unknown. Strict regulations apply to medical uses, but less oversight for healthy users.
- Enhancement blurs the line between treatment and improving those without deficits. Ethical issues include safety, fairness, coercion, and changing expectations.
Source: Brain Neurosci Adv 2019
A Long History of Brain Boosting
Seeking ways to improve our minds is an ancient human striving.
Long before science, people used herbs, tonics and other natural substances to try to think sharper and live better.
Some examples are coca leaves in South America, khat in Africa, and ma huang in China.
In the late 1800s, chemists isolated the active ingredients of such plants.
Cocaine and amphetamine were first hailed as wonder drugs that boosted energy, mood and performance.
Sigmund Freud praised cocaine as a stimulant and cure-all before its addictive potential was recognized.
Amphetamine kept weary soldiers alert in World War II before being restricted for its risks.
This cycle has repeated with new “smart drugs” touted for brain boosting until negative effects emerged.
Are we doomed to repeat this pattern again? Or has science finally developed safe ways to enhance our minds?
Pharmacological Cognitive Enhancers
Now we have a range of drugs developed to treat conditions like ADHD, sleep disorders and Alzheimer’s disease.
These affect brain pathways using chemicals like dopamine, noradrenaline and acetylcholine.
Healthy people are increasingly using these “nootropics” off-label in hopes of boosting cognition.
Most popular are stimulants like methylphenidate (Ritalin) and modafinil (Provigil). Methylphenidate is prescribed for ADHD and narcolepsy to improve focus and concentration.
Modafinil promotes wakefulness and is used for sleep disorders.
Surveys estimate that around 5% of the general population, and up to 20% of students, have used these types of drugs illicitly for neuroenhancement.
Do these smart drugs work for healthy brains? The evidence is mixed due to limited research.
Some report enhanced focus, alertness, memory and motivation.
But effects depend on factors like baseline performance and can be modest for well-rested people.
There are no studies on long-term usage, so safety remains uncertain.
Most “soft enhancers” like caffeine have mild effects for most users.
But prescription stimulants carry risks like addiction and psychosis, especially at high doses.
Drugs bought online evade quality regulations and oversight.
Modafinil appears safer so far, with lower addiction potential.
Some even microdose psychedelics like LSD, but without evidence on effects or safety.
Non-pharmacological cognitive enhancement
Pills aren’t the only path to a sharper mind. Physical exercise strongly benefits cognition and brain health.
Mental training like meditation boosts focus and memory. Apps aim to improve cognitive skills, though transfer to real-world thinking remains unproven.
Electrical brain stimulation like tDCS shows early promise for enhancement but requires more study.
A good night’s sleep, healthy diet, and an enriched environment also enhance neurological function.
Such lifestyle factors are considered normal, though their cognitive boost exceeds many drugs.
Poverty and stress impair childhood development, so socioeconomic status shapes cognition too.
From this perspective, cognition-enhancing drugs could help overcome early deprivation.
Treatment vs. Enhancement – Where Do We Draw the Line?
Most laws and ethics boards distinguish between medical treatment and enhancement of healthy people. But the line isn’t always clear.
When is a person performing at their cognitive peak, versus living below their potential? How do we define enhancement versus correcting deficiencies?
Some argue drugs just restore baseline functioning when people are sleep-deprived or stressed. But expectant use to boost performance beyond normal raises ethical concerns.
Safety looms large, especially long-term use and in vulnerable groups like youth. Efficacy is also still speculative in healthy brains. Societal impacts require thought too.
Will enhancement coerce people to achieve unrealistic standards? Widen inequities in competitive pursuits?
Change workplace expectations? Benefits like reducing errors in critical jobs must be weighed against risks of an “arms race” of enhancement.
The motivations and fairness behind gains matter – is achievement by drugs deserved, or cheating?
Does authenticity suffer if pills rather than effort provide the edge?
Medicine aims to help the unwell, not improve the well. Yet reasonable people disagree on where to draw the enhancement line.
Strict bans may also drive users to illicit means and deter research into safer innovations.
As with past enhancers, both hype and demonizing often exceed reality.
A nuanced public debate is needed, informed by science but broadened to wider perspectives.
Ongoing Research of cognitive enhancers is necessary
More rigorous research is vital to clarify the promise and pitfalls of neuroenhancement.
Scientists must develop better tests to detect cognitive changes in healthy people, and measure real-world impacts on functioning.
Long-term studies tracking efficacy and side effects are especially important.
This research should then inform evidence-based policies on safety, efficacy and ethical issues.
Neuroscientists have a responsibility to proceed cautiously and avoid hype.
Findings should be conveyed responsibly to media, regulators and the public.
But overzealous restrictions also risk deterring valuable research and driving uncontrolled usage.
A measured approach can help fulfill the promise of enhancement, while managing risks of new technologies we do not yet fully comprehend.
The desire to enhance our abilities is deeply human. But pursuit of progress and competitive advantage does not justify reckless means.
With thoughtful research and ethical debates, society can aspire to advance human potential while upholding values of autonomy, justice and human dignity.
References
- Study: Neuroethical issues in cognitive enhancement
- Authors: Anette B. Bruhl et al. (2019)
