Medications for the Healthy

Is medically unnecessary neural enhancement (via medication) justifiable?

In an article about multi-tasking and distraction (as related to blackberries, twittering, facebook, google, etc), Sam Anderson comments on the loss of productivity and notes that:

“A quintessentially Western solution to the attention problem—one that neatly circumvents the issue of willpower—is to simply dope our brains into focus. We’ve done so, over the centuries, with substances ranging from tea to tobacco to NoDoz to Benzedrine, and these days the tradition seems to be approaching some kind of zenith with the rise of neuroenhancers: drugs designed to treat ADHD (Ritalin, Adderall), Alzheimer’s (Aricept), and narcolepsy (Provigil) that can produce, in healthy people, superhuman states of attention. (…)”

The idea that perhaps it wouldn’t be such a big deal if people started taking such drugs to boost their concentration is problematic. Those who are prescribed the medication (those under discussion in the article are for people with ADHD, Alzheimers, and narcolepsy) are treating an under (or over) performance in one area of their brain which prevents them from attaining normal cognitive function; if everyone started enhancing perfectly normal attention patterns, the norm would change.

Even the term ‘neuroenhancer’, which, by the way, I cannot find in online medical dictionaries, is a little misleading, as its components imply that the drugs enhance brain function, when, naturally, they enhance bits of brain function – possibly (probably) at the expense of other bits.

Drugs like Adderall are described as psychostimulants, like caffeine and cocaine. Ritalin is essentially speed.

Beyond the alteration of how one defines ‘normal function’, there are, of course, the side effects. Adderall can, among other things, cause headaches, nausea, and vomiting, and acts as an appetite suppressant (much like caffeine only for a much longer time). Drugs for Alzheimers can do much the same thing, along with causing (!) confusion, vomiting, and hives. And the narcolepsy stuff is much the same again, with a potential for addiction and, unsurprisingly, may also cause insomnia, which might be great for finishing that grad paper, but might also suck for your mood and long-term health.

Add to all that the idea that, perhaps, ADHD is over-diagnosed and the ‘hyperactive’ behavior is a function of children being trapped indoors or playing a load of video games or generally responding to a more ‘stimulating’ world, and the treatment of it may simply be a way of changing the child to fit the education system rather than the other way around, and the problem, to me, seems to be the attitude towards a broadly defined idea of work, requiring a systematic overhaul, rather than turbo charging the brain as one might a car’s engine.

Popping a pill is not the same as getting regular exercise (increasing blood flow and oxygen to the brain thereby improving function overall) or changing your diet, as an overall lifestyle change will affect the body as a system rather than chemically altering one particular part.

Those who decide to take pills to compensate for a lack of planning (why did you leave that paper to the last minute?) or to make it a little bit easier to focus at work with all those Twitters happening, shift the responsibility, and possibly endanger their health in the process. Sure, this is their problem, but if one looks at, say, corporate culture, or the structure of schooling, aren’t these demanding a level of focus or performance that can’t generally be achieved without some assistance? Shouldn’t our work environments reflect a balance of human ability?

It is difficult to say outright that people shouldn’t take drugs to enhance focus – are we going to ban caffeine? Red bull? If a surgeon is more adept on speed, should we begrudge the patients that superior performance?

But then again, surely we can agree that there is a spectrum of ‘enhancement’, that coffee is a mild stimulant, that the surgeon should be able to do his job without a boost. To justify and accept casual and regular usage of psychostimulants and the like would be to allow that the increasing demands of work and life are worth it. That the pace of life should be faster, and that to take a little something to keep up is a small price to pay for progress. Real progress would be organizing work around our whole life, not allowing the marketplace to dictate what portion of life the individual gets to retain, or how fast their brain needs to work.

To advance technologically should not involve disrespecting our own limitations.

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