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Doping is a no-no in sports, but there's no rule against it in the classroom or on the job—and that's the way it should stay, doctors and ethicists write in a new commentary urging the safe use of medicines normally prescribed for patients with attention disorders but increasingly used off-label by healthy folks seeking an edge.

"We call for a presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs," the authors write in this week's Nature. "Cognitive-enhancing drugs seem morally equivalent to other, more familiar enhancements" like a good night's sleep, exercise and a healthy diet, they say.

In people with attention deficit-hyperactivity disorder (ADHD), stimulants including Adderall and Ritalin improve attention, memory and control of disinhibitions. But the drugs' effect on the catecholamine system, which regulates stress hormones, benefits everyone, as many a soldier and student have found. Soldiers are offered stimulants to keep them alert, the commentary notes, and students down coffee or caffeine-rich Red Bull to stay awake and cram; almost 7 percent of U.S. college students have popped stimulants to focus their studying. A new drug prescribed to people with sleep disorders that cause fatigue, Provigil, sometimes is used to conquer jet lag. Even musicians sometimes use the heart drugs beta blockers to combat stage fright.

Stimulants can cause heart irregularities, dizziness, nervousness and restlessness. Critics argue that the use of stimulants for cognitive enhancement in people who are healthy amounts to cheating, and some imply that the commentary amounts to unjustified endorsement of lifestyle drugs. "It's a nice puff piece for selling medications for people who don't have an illness of any kind," Leigh Turner of the University of Minnesota Center for Bioethics told the Associated Press.

But so long as they're safe and people — especially kids — aren’t forced to take them, the drugs should be allowed, according to the new commentary.
 
"All new technologies are at first resisted, even the typewriter," co-author Michael Gazzaniga tells Technology Today. "There is somehow a sense one is cheating the system. Well, so is chemotherapy. When all of these new technologies are used in moderation and the right social context, they are a good.

"Most of these drugs are used in spurts when huge mental demands are called for. They are not for everyday mental routines," he added. "Having said that, I think it is a fair concern to make sure people don't become dependent on them as a way of life. Working above one's pay grade in the end has tremendous costs."

Image by iStockphoto/Tomaz Levstek

11 Comments

1. 1. torchstar 03:34 PM 12/8/08

   Amen! Better living through Chemistry. After all, who has the right to judge as "cheating" any action resulting in brilliant thoughts and action of a person's intellectual endeavor ultimately expanding knowledge!

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2. 2. quantum_flux 03:36 PM 12/8/08

   I have ADHD and I'm grossed out by this article. It has "drug company bribed SA" written all over it. Why not just re-legalize cocaine in order to get more Sigmand Freuds into the population, or pot in order to get more Ray Charles? The thing that needs to be considered is whether there are secondary effects from 'doping' (and there are, I can tell you from experience). Some of those 'dope' aka stimulent drugs that respectable doctors prescribe are dangerous, very dangerous! Imagine heartburn and burping up chlorine gasses from the HCl content in them, and that's just the non-biochemical effects. Natural remedies (such as sugar, coffee, and caffienated tea) are a much safer option.

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3. 3. quintby 03:43 PM 12/8/08

   
   Those who think they can avoid serious risk by using Provigil ( modafinil ) instead of Adderall or Dexedrine (dextro amphetamine ) should think again. Provigil was originally regarded by the FDA as so safe that it was designated as a Class IV drug when approved in 1998. Then in 2006, Provigil manufacturer Cephalon Inc. sought FDA permission to sell it to treat ADHD ( ADD or attention deficit disorder ) re-naming Provigil " Sparlon ". This time the FDA committee came to a much different conclusion about the safety of Provigil. The FDA committee determined, among other things, that a horrific skin disease known as Stevens Johnson Syndrome occurred far more often in users of Provigil than it did among those who had never taken Provigil. You could say that Stevens Johnson Syndrome, known also as SJS, is to skin what flesh-eating virus is to flesh. A type of hypersensitivity reaction which usually stems from the use of drugs, SJS usually takes hold of its victims early on in a patient's use of the causative medication, almost always at dosage levels well within FDA prescribed limits. If you were to happen to walk into the hospital room of an SJS victim who had suffered a hypersensitivity reaction to Provigil, you would almost surely conclude that you were looking at a critically-injured burn victim. And you would be very nearly right. SJS victims often present at the hospital with extensive burn-type skin damage, sometimes over 50% or more of a victim's exterior skin, and frequently to the level of third degree burns. In fact, victims of SJS are most often treated in hospital burn units, where one is available This is done not only because burn unit nurses have the skills necessary to treat SJS victims properly, but also because ICU nurses who are highly skilled themselves are often not emotionally equipped to deal with the appearance of SJS patients -- the burns from SJS may come from within but they act like and have the appearance of burns from the outside by sustained exposure to fire. Although by no means the only dangerous side effect found by the FDA committee to have occurred to Provigil users, the possibility of so many patients risking so deadly a reaction for a drug solely to treat a serious but non-life-threatening disorder such as ADHD was a principal reason that the FDA committee rejected Cephalon's proposal to vastly increase numbers the population of users for its "safe" highly-profitable drug, Provigil. Touted as a 'slam dunk' for approval, Cephalon's stock prices plunged at news of the FDA denial
   

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4. 4. alphachapmtl 03:51 PM 12/8/08

   In 100 year, I'll be dead. And so will you. In the meantime, please let me abuse myself anyway I want. I'm not telling you how to live your life, don't tell me how to live mine. Live and let live, then we die.

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5. 5. Professor Plum 05:17 PM 12/8/08

   this kinda scares the crap out of me, its only going to take so long until stuff like this is the status quo and if you choose not to take these kinds of drugs youll be on a "lower plane" than the drug enhanced average joe. i really hope it dosent have to come to that...

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6. 6. Illumidigerati 06:44 PM 12/8/08

   This won't be the case at all. These stimulants will never be OTC-legal because they do in fact enhance one's mental state, make one more focused and productive and the gov't doesn't want those kind of people walking the streets! They want sheep. I have taken enough off label Adderall to confirm this. There is a definite mental change, which 9 of 10 times becomes euphoria and a need to produce; a need to get up and do something. I've come home after work in the wee hours of the morning to find my friend and neighbor at the time hanging out of his 2nd floor apt. cleaning the windows. It does help, and it does enhance those that don't need the help, but by no means will it be found next to Advil at gas stations in any recent year, if ever, just as pot(which was treated like LSD in the 70's), cocaine(which was found in Coca Cola), extacy(which was used for couples therapy in the 80's), and heroin(which...well, there's nothing good about that drug) will never be found on the open, legal market.
   
   Some things are better left underground...

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7. 7. MichaelLanthier 06:50 PM 12/8/08

   There's a very interesting (and short) survey on this topic currently being run by the University of British Columbia:
   
   www.yourviews.ubc.ca/neuroethics.

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8. 8. surfgal 11:51 AM 12/9/08

   "This commentary ignores recent studies that show Ritalin to be ineffective in performance enhancement over a three year period and harmful to growth and development in children, yet somehow these drugs are now considered the magic bullet for adults? It should raise alarm bells," states Steve Bordley, President of TrekDesk, a treadmill desk manufacturer. "None of these medications can make the claim that they boost memory and cognitive abilities, increase the amount of small blood vessels in the brain as much as 43%, or reduce the incidence of stroke, dementia or Alzheimer's over the long term. But a daily walking regimen accomplishes this without any potential risks and a long list of additional health benefits as well. You hear very little about this because no one makes any money telling you walking is the answer."
   
   Categorizing these drugs as "smart drugs" seems to be both an oxymoron and a brilliant marketing ploy, exploiting American's drive to be at the top of their game.

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9. 9. ZenaV 02:36 AM 12/10/08

   My GOD! They are finally getting some commonsense!! U hpyocrites up there STFU! I'm so sick of people ragging on other people about their personal choices. Did ur mothers raise you in a cave by the hair of the head??? She sure didn't teach you no manners or considerations for others. Maybe you're just jealous of other people. Makes you unhappy if someone else is. You DO know that is a sin don't you? And if youre a non-believer, it just UNCIVIL! Get a life boys. And grow up. I'm starting a manners school. Would you like to apply? I'll give u guys a discount. If YOU can be taught manners, ANYONE can! LOL!

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10. 10. ZenaV 02:41 AM 12/10/08

    ALL drugs should be legalized. WE ARE NOT CHILDREN that people like you can decide what we can and cannot decide when making personal life choices. You want to make everything illegal so you can oppress, suppress, and DEPrESS! Not to mention rip people off. Stop it!

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11. 11. BoundlessPotential 11:35 AM 3/27/09

    All drugs affect consciousness in some way. Unlike cocaine or marijuana or alcohol, these drugs enhance consciousness and allow people to live a more fulfilling life. Healthy people use cars to move faster, so why shouldn't they be allowed to use these stimulants to think faster and with more focus? Just because some people are born with certain disadvantages doesn't mean we should restrict the rights of everyone else.

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