Pill wars: debate heats up over 'brain booster' drugs.
Adults are taking stimulants like Ritalin and Adderall, normally used to treat serious medical conditions, to boost their concentration and job performance. Critics ask: Is it making Americans too dependent on their medicine cabinets?
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What troubles Dr. Volkow is how the commentary dismissed the dangers of these drugs, equating taking them with drinking coffee, "which is, to say the least, an irresponsible way to present it and an inaccurate one," she says.Skip to next paragraph
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In March, Volkow published a small preliminary study showing that taking modafinil might be addictive in humans, increasing the levels of dopamine, a neurotransmitter that plays a major role in addiction.
Nearly everyone talking about brain-boosting drugs agrees that they ought to be both safe and effective before being widely used. But some worry about other problems they present. Would workers, for example, feel coerced to use enhancement drugs in order to win promotions or even simply to keep their jobs?
"For example, what if hospitals started to demand that medical residents dose up on methylphenidate, a drug used to improve concentration, as a prerequisite for employment?" asks Jacob Appel in an article last year in the Journal of Medical Ethics called "When the boss turns pusher." Or what if fast-food chains insisted that employees take antidepressants to keep them calm and upbeat when confronted by dissatisfied customers?
Employers may face a dilemma. "Denying some individuals the opportunity to enhance in this way clearly undermines their right to do with their bodies as they choose," he says. "However, to permit some to engage in these enhancements may lead to an inevitable race to the bottom – or top – in which employers and market forces pressure more and more American workers to place their brains at the disposal of their bosses."
More broadly, some worry that as more brain-enhancing drugs come on the market in the next 10 to 15 years, countries may battle for "neuro competitive advantage" in the workforce. If you're a 58-year-old person living in Boston who's competing with a 25-year-old in Mumbai, for instance, you might be tempted to use the drugs – whether or not they're legal in the US, notes Zach Lynch, executive director of the Neurotechnology Industry Organization, a trade group.
Moreover, even if they are illegal, or regulated, enforcing those controls would be difficult. "Living in a global economy, I think it's going to be very hard to regulate the use of these [drugs] in the future, if they're safe and effective," Mr. Lynch says.
Brain-boosting drugs are already being considered for another workplace – the military. The Defense Advanced Research Projects Agency is working on "all kinds of drugs to make you stronger, to make you eat less," says Dr. Annas. "They want soldiers to function for up to five days without sleep. That would certainly require drugs. Whether that would have any long-term consequences, I don't think anybody knows yet."
A drug called donepezil, developed to treat Alzheimer's disease, has been shown to modestly increase memory in healthy people. It may become a Viagra-like hit with baby boomers worried about cognitive decline. Work is also under way to use drugs or other methods to selectively erase memories, something that could be used to ease post-traumatic stress among soldiers returning from war, allowing them to forget what they did on the battlefield. Annas sees problems here. "I think we want to have remorse about killing," he says.