For the avid coffee drinker bound to a monotonous desk job, there is a moment – perhaps two thirds of the way through a cup – when the unbearably tedious task at hand starts to look doable. Interesting, even. Suddenly, data entry is not something that merely pays the rent, it’s something you’re into. A caffeine-triggered surge of adrenaline and dopamine works to enhance your motivation, and the meaninglessness of it all fades as you are absorbed into your computer screen.
At least until the effect wears off. Then it’s time for another caffeine hit. Except, several thousand of those hits later, you find yourself middle-aged and struggling with a sense that you haven’t quite spent your life as you would have liked.
Unlikely as this may sound, it illustrates a reasonable possibility: drugs like caffeine can positively alter how we experience what we are doing. Taken consistently, they might help us tolerate a long-term circumstance by regularly inducing an artificial sense of interest in what we would otherwise find uninteresting. Absent such a drug-induced interest, we may find ourselves more disposed to alter the course our lives are taking.
That, at least, is the worry raised in a recent paper by Torben Kjaersgaard. His focus is on something more potent than coffee: ADHD and wakefulness disorder-drugs such as Adderall and modafinil.
There is little dispute that these can give a minor cognitive boost to individuals with these conditions, and perhaps to the sleep-deprived more generally. But their off-label use by some healthy students and professionals has also earned them the dubious title of “smart pills” – that is, the kind of enhancers that can boost your attention and memory even if you are in decent cognitive shape.
Because of that, the ethical discussion about their off-label use normally centres on cheating and coercion. Is it fair if some students use them to get better grades? Might their use by some employees coerce others to take them as well, just to keep up?
But Kjaersgaard is focused on another matter: What do we risk by using substances that enhance our enjoyment and interest in certain pursuits – say, a university major or career – which we would otherwise find meaningless and alienating? Might we end up leading deeply inauthentic lives, using pharmaceutically-induced willpower to waft through a life that otherwise means nothing to us? In other words, Kjaersgaard is concerned about the impact of these drugs on our moods and motivations, not cognition. In fact, he’s not convinced these drugs are cognitive enhancers at all.
This is because, despite repeated claims to the contrary, the evidence that these drugs enhance the cognitive abilities of off-label users is, at best, mixed. In the case of drugs like Adderall and Ritalin, a survey of over 50 experiments testing their effects on cognition among healthy, young adults found a roughly even mixture of significant and null results, with reason to believe that many other null results go unreported. In the case of modafinil, which is often held as the more potent enhancer, little evidence exists that it has any significant cognitive effect on healthy participants. In fact, two recent studies found that it slows down the response time of users in certain tasks and hinders creative thinking.
But these findings are difficult to reconcile with anecdotal reports from users who insist that, at least, something about these drugs seems to make them work harder or study better. What are we to make of these claims? It’s worth highlighting some of those anecdotal reports. Here are a few of them, collected for a study by Scott Vrecko, who looked at university student’s experiences with these drugs:
“Everything seems better, and more doable.”
“When I’m not on it I’m usually pretty relaxed about things. [. . .] When I’m on it it’s like more of a sense of urgency.”
“It just got to where I felt like if I was staring at something I just couldn’t take my eyes away from it—it made studying more interesting.”
“You start to feel such a connection to what you’re working on. It’s almost like you fall in love with it—there’s nothing else you’d rather be doing!”
Vrecko notes these and other, similar descriptions and asks just how cognitive these “cognitive” enhancers really are. If anything, these students aren’t saying that their recall or learning abilities appear improved – they just feel more driven to study. What would normally illicit procrastination now feels interesting, enjoyable, entrancing even.
These sentiments are in line with research suggesting that if these drugs have any impact at all, it’s largely subjective. For instance, a study looking at the effects of Adderall failed to find cognitive enhancement effects, but uncovered that users tended to believe their performance was enhanced compared to those given a placebo. Similarly for Modafinil, while it’s not clear that it actually improves objective performance, there’s evidence that it can induce a subjective impression of better cognitive functioning.
Taken together, it seems all we can say with any confidence about so-called smart pills is that they act on our moods and dispositions in a way that makes us feel up to the task at hand. They help us employ our otherwise standard cognitive capacities for prolonged periods and with the sort of zeal we might feel after a very strong coffee. That is, they seem to work, in part at least, by boosting our motivation.
Which brings us back to Kjaersgaard’s concern. Sometimes lacking motivation in life is symptomatic of a deeper problem: a bad career choice, a university major that does not interest you, or a lifestyle that does not suit you. In these cases, lacking motivation might signal an alienation from your life’s meaning – a sense of incongruity between your self and what you are doing with your life. Treating that alienation with a motivation enhancer, rather than re-evaluating the course of your life, seems like a bad idea.
But what about situations where our life choices are limited? In a response to Kjaersgaard, Cesar Palacios-Gonzalez and David Lawrence ask us to consider the hypothetical case of a single mother in the midst of an economic crisis who takes on an unfulfilling menial job as the only means to securing healthcare for her children. Cases like these, they argue, illustrate how it may be perfectly reasonable, or even morally obligatory, to sacrifice some aspects of our life’s meaning (e.g. work life) in order to fulfil other meaningful elements of it (e.g. family life). And in such cases, why not make the part that we have rationally and consciously sacrificed feel more enjoyable than it actually is?
It’s a valid point, though it also seems to ignore another question. In the case of the single mother (or the myriad other similar circumstances), is it justified that the only way she can secure healthcare for her children is by taking up a deeply alienating job? If it isn’t justified – that is, if her options are limited purely due to unjust socio-political forces – then motivation enhancing drugs start to look more like political complacence pills. Why strive for a better world when we can artificially induce the enjoyment of the otherwise unenjoyable – and indeed, of the unjust?
It’s the sort of spectre that permeates dystopian visions of the future, and it’s one that is very much raised by the prospect of motivation enhancing drugs.