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Cognitive Enhancement Drugs: A Social Dilemma

 Divyanshu Yaduvanshi

    Ever wondered if a pill or the use of a substance could make you smarter and you are able to cognitively function at a significantly higher rate? Although this sounds like a myth but with the growing modern medicine and resources this might seem possible in near future with limited detrimental side effects. The current psychological war with diseases pertaining to neurocognitive disorders like Alzheimer, Dementia, etc. have led to more and more research on cognitive enhancement drugs which might help the patients with these disorders but what if these drugs are used by healthy individuals to boast their cognitive performance and move higher in the socioeconomic ladder or competitive sports. The idea of cognitive enhancement has been used widely like consuming caffeine to enhance vigilance, working memory, and incidental learning or the use of nicotine for enhancing episodic memory, working memory, and attention in the short term (Hooley et al., 2021). This blogpost will be further going into the nuances of the use of cognitive enhancement drugs by healthy individuals and what implications it might have on society.

    Moyer (2016) argues that the drugs like Modafinil were originally prescribed to treat narcolepsy but have found its use in enhancing the cognitive functioning of people especially while completing difficult tasks. The author also highlighted the research conducted by University of Oxford which analyzed 24 studies within the span of 24 years and found that Modafinil strongly affects cognitive performance. One of the reviews on these studies concluded that taking the drug didn’t enhance the ability to do simple tasks like pressing a particular button after seeing a certain color but it showed more accuracy on more complex cognitive tasks i.e. mainly executive functions but also attention and learning (Moyer, 2016). On the other hand, the author commented that the drugs like Modafinil have side effects like insomnia, headache and stomachache in select users, and also suggests to be addictive.

    Simultaneously, people with neurocognitive disorders do benefit from cognitive enhancement drugs and the benefits outweigh the risks but the picture changes when taken by a healthy individual in which it might prove to be more counterintuitive than beneficial. Moyer (2016) argued that students suffering from attention-deficit/hyperactivity disorder (ADHD) largely benefitted from cognitive enhancers but it was not a longitudinal study and hence failed to account for any long-term risks or damages like addiction. Furthermore, the author argues that these cognitive enhancers prove to be more beneficial for people with low to middle IQ while they prove to be highly ineffective in older adults as highlighted by some research. One such example was the case of methylphenidate (Ritalin) which did not enhance performance among older adults while they were effective among young adults.

    Thus, cognitive enhancement drugs help not only the people with disorders like Alzheimer but also help to improve the cognition in highly functioning individuals and hence are widely used by the military like the drugs Modafinil and Donepezil improves the performance of military pilots (Mehlman, 2004). Simultaneously, Mehlman (2004) argues that these drugs prove to be effective in improving executive functions like helping in enhancing goal-oriented problem solving. Although this imposes a serious unresolved issue which is whether these cognitive enhancement drugs are ethical to use and if yes then are they restricted to particular fields or open to all. According to Chatterjee (2019) an estimated 5% - 40% of students, 9% of surgeons, 19% of economists, and 28% of poker players say they have used illegal or prescription drugs for cognitive enhancement and one of the most popular cases for this was of the mathematician Paul Erdős. 

    Hence, Chatterjee (2019) conducted an online survey open to everyone to gain the general opinion about the usage of cognitive enhancement drugs by the students for their studies, athletes for their sports performance, and employees for higher work performance. It was observed that people were more open to employees taking these drugs to improve their working performance even if they themselves would not take it. It was further evidenced that no difference was observed when the level of competition was hypothetically increased in the workplace environment suggesting competitiveness was not the factor on which participants answered the survey. One of the reasons for this as suggested by the author was that using drugs for increasing cognitive performance for school and sports was not accepted in society as they are perceived to be used for self-improvement and consider it to be unfair while an employee's performance leads to improvement for the larger society either directly or indirectly.

    One might argue that sports are to be played within a set of rules and if it is decided that cognitive enhancement drugs are to be prohibited then it is fair for each player because then everyone follows them. On the contrary, how can we prohibit these drugs outside sports like among students, employees or even military for that matter and what all implications they might have if they are used everywhere without restrictions. Even if the safety of these drugs is ensured in the near future for all, then also promoting fairness and equality will be an issue in society (Mehlman, 2004). It can further contribute to the socioeconomic divide between the poor and the rich. Some might argue a better approach would be to permit cognitive enhancements to be available on the open market for those who can afford them and to subsidise access to them for those who cannot although even if this could be achieved it would lead to over use by the higher socio-economic society as there will be no barriers to prohibit it (Mehlman, 2004).
 
    Similarly, this would also mean that consuming such drugs regularly even if one doesn’t have neurocognitive disorder might lead to other epigenetic modifications within the genes and might have some serious implications for future generations. Furthermore, the people who might be diagnosed with neurocognitive disorder might not be able to gain an equal cognitive performance with healthy individuals even after treatment since healthy individuals will also use them and become cognitively better thereby defeating the purpose of decreasing the divide between the people diagnosed with the disorder and the rest of the society. Hence, these are some of the problems that might arise in future as the growth in cognitive enhancement drugs increases with time and even if it is not permitted for the use of individuals for self-gain then that would mean that individuals like students might even be required to provide a urine test before exams as seen in the case of athletes for steroids?



References
Hooley, J. M., Butcher, J. N., & Nock, M. K. (2021). Chapter 10 Personality Disorders. In Abnormal psychology: Global edition (18th ed., pp. 351–394). essay, Pearson Education Limited. Retrieved April 8, 2022.

Moyer, M. W. (2016, March 1). A safe drug to boost brainpower. Scientific American. Retrieved April 22, 2022, from https://www.scientificamerican.com/article/a-safe-drug-to-boost-brainpower/

Mehlman, M. J. (2004). Cognition‐Enhancing drugs. The Milbank Quarterly, 82(3), 483–506. https://doi.org/10.1111/j.0887-378x.2004.00319.x

Chatterjee, A. (2019). Cognitive enhancement is okay, but wait until you graduate. Psychology Today. Retrieved April 22, 2022, from https://www.psychologytoday.com/us/blog/brain-behavior-and-beauty/201907/cognitive-enhancement-is-okay-wait-until-you-graduate


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