By Joel Garreau
Washington Post Staff Writer, June 11, 2006
Compared with the kind of drug users who get police attention, "This is an entirely different population of people -- from the unmotivated to the super-motivated," Restak says. These "drug users may be at the top of the class, instead of the ones hanging around the corners."
Smart-pill use generally doesn't show up in campus health center reports, he says, because "This is not the kind of stuff that you would overdose on" easily. Amphetamines are associated with addiction and bodily damage, but in use by ambitious students, "if you go a little over you get wired up but it wears off in a couple of hours. And modafinil has a pretty good safety record." Finally, smart-pill use is a relatively recent development that has not yet achieved widespread attention, much less study, although Restak expects that to change.
"We're going to see it not only in schools, but in businesses, especially where mental endurance matters." Restak can easily imagine a boss saying, " 'You've been here 14 hours; could you do another six?' It's a very competitive world out there, and this gives people an edge."
That's why even small surveys conducted by students themselves are suggestive. For a senior project this semester, Christopher Salantrie conducted a random survey of 150 University of Delaware students at the university's Morris Library and Trabant Student Center.
"With rising competition for admissions and classes becoming harder and harder by the day, a hypothesis was made that at least half of students at the university have at one point used/experienced such 'smart drugs,' " Salantrie writes in his report. He found his hunch easy to confirm.
"What was a surprise, though, was the alarming rate of senior business majors who have used" the drugs, he writes. Almost 90 percent reported at least occasional use of "smart pills" at crunch times such as final exams, including Adderall, Ritalin, Strattera and others. Of those, three-quarters did not have a legitimate prescription, obtaining the pills from friends. "We were shocked," Salantrie writes. He says that in his report, he was "attempting to bring to light the secondary market for Adderall" specifically because "most of the university is not aware" of its extent, he says.
When you start asking questions about smart pills, the answers you get divide sharply into two groups.
When you ask the grown-ups -- deans, crisis counselors, health counselors -- they tell you they don't know too much about the subject, but they don't think it is much of a problem at their institutions.
"I'm not sure of the size and scope," says Jonathan Kandell, a psychologist and assistant director at the University of Maryland Counseling Center. "I have heard about it. But I don't get a sense it's a major thing that they come to the center about."
When you ask the students, they look at you like you're from the planet Zircon. They ask why you weren't on this story three years ago. Even if some of these drugs are amphetamines, it's medicine parents give to 8-year-olds, they say. It's brand-name stuff, in precise dosages. How bad can it be? Sure, there are problems with weight loss, sleep loss, jitters and throwing up, they say. But other unintended consequences are not what you might expect. Universities now sport some of the cleanest apartments in the history of undergraduate education. Says one student who asked for anonymity because she has been an off-prescription user of these drugs: "You've done all your work, but you're still focused. So you start with the bathroom, and then move on to the kitchen . . . ."
Warning: Side Effects
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In the name of altering mood, energy and thinking patterns, we have been marinating
our brains in chemicals for a very long time.
Caffeine is as old as coffee in Arabia, tea in China, and chocolate in the
New World. Alcohol, coca leaves, tobacco and peyote go way back.
Even psychopharmaceuticals have been around for generations. Amphetamines -- which are the active ingredient in Adderall and Ritalin -- were first synthesized in Germany in 1887. Students have been using them for generations, in the form of Benzedrine and Dexedrine.
Beta blockers have been the dirty little secret of classical musicians since the 1970s. Originally prescribed to treat high blood pressure, they became the "steroids of the symphony" when it became clear Inderal controlled stage fright. As long ago as 1987, a study of the 51 largest orchestras in the United States found one in four musicians using them to improve their live performances, with 70 percent of those getting their pills illicitly.
What's new is the range, scope, quantity and quality of substances, old and new, aimed at boosting our brains -- as well as the increase in what's in the pipeline. Current psychopharmaceuticals represent only the beginning of cognitive enhancers aimed at improving attention, reasoning, planning and even social skills.
The memory compounds being raced to market by four U.S. companies are initially aimed at the severely impaired, such as early-stage Alzheimer's patients. But researchers expect the market for memory drugs to rapidly extend into the aging population we think of as normal, such as the more than 70 million baby boomers who are tired of forgetting what they meant to buy at the shopping mall and then realizing they've forgotten where they parked their cars, too. Or students who think such drugs could gain them hundreds of points on their SATs.
In research now underway, one such substance, ampakines, boosts the activity of glutamate, a key neurotransmitter that makes it easier to learn and encode memory. How useful they might be in a French or law exam.
But there are side effects with every drug. Strattera -- the ADHD medicine that is not a stimulant and may be taken for weeks before it shows an effect -- comes with a warning that it can result in fatal liver failure. The FDA warns it also may increase thoughts of suicide in young people. For a while last year, Canada pulled a form of Adderall from its markets as a result of sudden unexplained deaths in children with cardiac abnormalities. Modafinil can decrease the effectiveness of birth control. All of these drugs come with a raft of side-effect warnings.
Nonetheless, pharmaceutical companies are racing to bring to market new drugs aimed at fundamentally altering our attitudes toward having a healthy brain. The idea is less to treat a specific disease than it is to, in the words of the old Army recruiting commercial, "Be all that you can be."
Of Mice and Men
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Is this what smart has come to in the early 21st century? Is Ken Jennings,
the "Jeopardy" phenom, our model of smart? Do SATs and grade-point
averages measure all of what it means to be intelligent? If so, these drugs
have a potent future. But definitions of intelligence may change -- already,
some colleges have stopped requiring SAT scores from applicants.
Howard Gardner of Harvard is the godfather of the idea that smart is more than what IQ tests test. In his seminal 1983 book, "Frames of Mind: The Theory of Multiple Intelligences," and later works, he laid out a then-novel model of cognition that included many other kinds of sagacity.
"I feel that what we call 'intelligence' is almost always 'scholastic skill' -- what it takes to do well on a certain kind of short-answer instrument in a certain kind of Western school," he writes in an e-mail. "Other uses of intellect -- musical competence, facility in the use of one's hands, understanding of other people, sensitivity to distinctions in the natural world, alertness to one's own and others' emotional states etc. -- are not included in our definitions of intelligence, though I think that they should be. Unless performances in these other domains were directly tapped, we'd have no idea of whether 'performance enhancing pills' affect these other forms of intelligence as well."
Eric R. Kandel is shocked by the idea that powerful elixirs like the ones he is developing might rapidly trickle down to ambitious college kids. He shared the 2000 Nobel Prize in medicine for his research on the physiological basis of memory storage in neurons. He also founded Memory Pharmaceuticals.
"That's awful! Why should they be taking drugs? They should just study! I think this is absurd. What's so terrible about having a 3.9? The idea that character and functioning and intelligence is to be judged by a small difference on an exam -- that's absurd. This is just like Barry Bonds and steroids. Exactly what you want to discourage. These kids are very sensitive. Their brains are still developing. Who knows what might happen. I went to Harvard. I like Harvard. It ain't worth it."
The mind amplifiers he's working on, he insists, could have major effects on lots of needy people -- those with mental retardation or Down syndrome, or those with memory loss from depression or Alzheimer's or cancer chemotherapy or schizophrenia. "There are lots of populations out there that really, really need help," he says.
Kandel is hugely enthusiastic about taking a memory that has slipped and bringing it back up to reasonable. His compounds are terrific in aging mice, he says.
But ambitious college kids?
Why take the risk?
In normal mice, he says, his stuff improves memory -- only by 20 percent
to 50 percent.