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Common use of drugs to improve the mind poses ethical challenge
Alok Jha, science correspondent Thursday July 14, 2005 The Guardian
Can't remember phone numbers, worried about an upcoming exam or desperately want to give up smoking? In future, the answer will be simple: just pop a pill. The idea that an array of easily available and addiction-free drugs could be used to improve memory or increase intelligence is the stuff of science fiction dystopia - in Brave New World, Aldous Huxley created a whole planet under the spell of a pleasure drug called Soma.
But a new report by leading scientists in the fields of psychology and neuroscience argues that, very soon, there really will be a pill for every ill. "It is possible that [advances] could usher in a new era of drug use without addiction," said the report by Foresight, the government's science-based thinktank.
"In a world that is increasingly non-stop and competitive, the individual's use of such substances may move from the fringe to the norm."
However, the report said the widespread adoption of new brain-enhancing drugs was not without risks and would raise "significant ethical, social and practical issues."
Drugs that work on the brain are already common - many people can hardly begin their days without the mind-sharpening effects of caffeine or nicotine.
Launching the report yesterday, the government's chief scientific adviser, Sir David King, said that brain-enhancing drugs developed to treat diseases such as Alzheimer's were likely to find increased use among healthy people looking to improve their perception, memory, planning or judgment.
Ritalin, prescribed to children with attention deficit hyperactivity disorder, is sometimes used by healthy people to enhance their mental performance. Modafinil, a drug developed to treat narcolepsy, has been shown to reduce impulsiveness and help people focus on problems.
"It improves working memory - your ability to remember telephone numbers - it gives you an extra digit or two," said Trevor Robbins, an experimental psychologist at Cambridge University and an author of the Foresight report.
"It also improves your planning when you're doing complex, chess-like problems. It makes you more reflective about a problem: you take a bit longer but you get it right."
Modafinil has already been used by the US military to keep soldiers awake and alert and some scientists are considering its usefulness in helping shift workers deal with erratic working hours. It has also been tested for cocaine users. "It produces some of the subjective effects of cocaine without the chronic dependence," said Prof Robbins. Other drugs are being touted as "vaccinations" against substances such as nicotine, alcohol and cocaine. The treatment would work by causing the immune system to produce antibodies against the drug being abused - these antibodies would render the drug impotent when taken and prevent it from having any effect on the brain.
"How [the vaccinations are] used depends on clinical judgments," said Prof Robbins. "Informed consent is important."
But he cautioned against any plan to pre-vaccinate people against narcotics. "One would be very careful indeed about trying to sign one's children up for such treatment," he said. "That, to me, sounds reprehensible."
In the long term, drugs that can delete painful memories could also be used routinely. "We are now looking 20-25 years ahead," said Prof Robbins. "Very basic science is showing that it is possible to call up a memory, knock it on the head and produce selective amnesia."
That has obvious uses for people suffering from post-traumatic stress disorder, but there is also the tantalising possibility that it could be used to treat harmful addictions.
"Drug addiction can be understood very much as an aberrant learning process," said Prof Robbins.
"Many of these drugs hijack the learning processes of the brain and produce aberrant habits, which dominate behaviour.
"Clearly the possibility exists that you can call up a drugrelated memory and produce amnesia for it, thus removing craving for that particular drug."
As drug research improves, the harmful effects of today's recreational drugs could even be engineered out.
"It may be that one could design out the harmful effects of existing drugs," said Professor Gerry Stimson of Imperial College. "So, alcohol analogues, drugs which produce similar effects to alcohol without some of the side-effects."
Society must decide how to use the new drugs, the scientists said.
For example, if drugs to improve exam performance become widespread, schoolchildren might find themselves being tested for drugs before exams, they suggested.
"It's a new twist on drug-testing," said Prof Stimson. "Is it a fair advantage or an unfair advantage?"
On the menu: range of treatments
? Ritalin (methylphenidate) is used by a small number of students in an attempt to improve exam results and by business people to improve performance in the boardroom
? D-amphetamine also improves memory but only for people of a certain genetic make-up
? Rimonabant is used as an antidote to the intoxicant effects of cannabis and a treatment for heroin relapse. But it is sometimes also used to enhance the high produced by these drugs by reducing their side-effects
? Naltrexone is already used to treat chronic alcoholism and narcotic abuse. It works by blocking the pleasure receptors that are normally activated in the brain when people use the drugs
? Propranolol, a beta-blocker, is used to treat high blood pressure, angina, and abnormal heart rhythms. It is also used sometimes by snooker players to calm their nerves
? Modafinil, a stimulant developed to treat narcolepsy, has been used by soldiers to improve memory and judgment. It is also used in treatment of cocaine addiction