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The Case for Performance-Enhancing Drugs

The Olympics saw only one doping (and one pot!) bust. Opposition to chemical boosting remains high, but the inevitable trend will end in an embrace—oddly, led by "smart drugs."

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The questions become even thornier when we consider drugs that might, say, vaccinate against addiction or aggression or envy. Would our kids lose some of their free will if we vaccinated them so that smoking would never bring pleasure and cocaine would carry no kick? If we had an anti-violence drug, would we even use it for fear that it would neutralize our animal flight-or-fight response enabling chemically unenhanced enemies to take advantage of us?

The ability to regulate ourselves with drugs produces multiple conundrums because altering the defaults on the way we make choices inevitably changes who we are. This is why addiction itself is so frightening: although we’re already limited in controlling “what we want to want,” addiction insidiously places one desire above all others. But if a drug allowed us to choose what we want to be passionate about, how would we even know what that should be?

Existing “smart drugs” like Ritalin and amphetamines are marred both by their addiction potential and by the fact that their effects aren’t especially large and only enhance certain types of learning. Indeed, some research suggests that they actually impair the performance of those who are most intelligent, working best on B and C students, not those already getting As.

Oddly, the same drug may help people with ADHD less likely to yield to unwise impulses, while making those who are addicted to it more likely to make ill-advised choices. Both phenomena seem to reflect the idea that there’s a “sweet spot” in the brain’s dopamine system: run it too low and attention and memory may be impaired, but elevating it too high also causes problems.

But if effective drugs are developed that fight the ordinary cognitive decline that can come with aging—not just frank disease states like Alzheimer’s— they may well improve intelligence generally and it would be nearly impossible to prevent “off label” enhancement use. Indeed, we’re already far more lenient with drugs we see as productivity tools than we are with those we see as offering unearned pleasure. While some doctors will freely admit to prescribing Ritalin, Provigil and amphetamines to buoy up busy executives, they would be targeted for prosecution if they confessed prescribing Valium or opioids for mere relaxation.

The idea of cognitive enhancement allows us to consider drug policy issues afresh and to examine the often hidden-values questions in arguments that are framed as being simply about risks. We tolerate far greater risks in the quest for knowledge and what we view as personal growth than we do in the quest for pleasure. This is why dangerous expeditions like mountain climbing that are far riskier than most drugs are not seen as simply selfish indulgences. It’s also why many people see psychedelic drugs as being wrongly classed among drugs thought simply as "meaningless" pleasures.

Pharma will not shy away from cognitive enhancers if it can market them as fighting aging—and if we allow plastic surgery, it becomes bizarre to ban improving the mind as well. The chemicals that can change us may be sitting on lab shelves right now: those of us who know both the highs and the lows of pharmaceutical experience need to think hard about how the world can best deal with them to maximize the benefits and minimize the unintended negative consequences.

Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).