Friday, February 01, 2013

Enhancement Horror in Germany? Not Quite.

Pharmacology reports in its current issue the results of a survey of about 2600 German university students. The study's objective was to find out to what extent German students use cognitive-enhancing drugs. Turns out, German students find themselves in good company. A survey [doi:10.1038/452674a] of readers of Nature reported that about 20% of readers of that journal take performance enhancing drugs. German students come in at roughly that level. Compare that to office workers (5%). Makes you wonder whether the scientist readers of Nature know something that the rest of us don't know - after all, one reason for people arguing against the use of cognitive-enhancing drugs is that 'we dunno whether they actually work.' It seems those in the know are voting with their feet on this little detail. 

The survey (anonymous as it was) was cristal clear with regard to what it was that they were after. Here's their definition of brain doping, as they call it, 'Substances for brain doping are pharmaceuticals or illegal drugs that you cannot buy in a drugstore and that were not prescribed to you to treat a disease. The only reason why you use this substance is to improve cognitive performance, such as attention, alertness, and mood. Examples are stimulant drugs (amphetamines), caffeine tablets, cocaine, methylphenidate, and mephedrone.' That excluded then academia's traditional brain doping means, caffeine from the coffee maker, those revolting energy drinks and other above-the-counter stuff like that. It also excluded students who would be taking ADHD medication because of a clinical condition they were suffering from. One oddity perhaps, caffeine tables were included in their list, because they're only available in limited quantities in pharmacies in Germany, while here in Northamerica we can, of course, get em at the local 7/11. Of course, the articles also offers standard ruminations about caffein tablets being 'may be' gateway drugs. Bit like the good ol marijuana wars. Oh, did I mention that this research was partially funded by the World Anti-Doping Agency? So, naturally it's all really terrible. Really!

The survey team had a very high response rate (German students, ha!), 2834 surveys were distributed, 2569 were returned. That's a >90% rate of return. The sex distribution was roughly 60% female to 40% male. Here's what the survey unearthed with regard to illicit drug taking for the purpose of cognition enhancement. Of all students about 23% took such drugs. By field of study it looks like this:

  • Economics or law  25.0%
  • Languages or education 17.6%
  • Culture sciences 27.8%
  • Sports science 31.6%
  • Medicine, psychology,
  • or natural sciences 23.9%

By sex it looks like this:

  • Female 20.4%
  • Male 27.9%

In terms of semester distribution, it seems first semester students are the most likely takers. 

First 28.6%
Other 20.0% 

The main conclusion of the study: 'Drug prevention models need to be established.' Amen to that! - Just kidding. Presumably the same drug prevention models that have been such overwhelming failures on all other fronts are being recycled here. 

Like many other bioethicists I am - in principle - in favour of permitting students (and others) to take cognition enhancing drugs, provided certain conditions of voluntariness are met, and provided the students are informed about the known risks and benefits. However, there are drugs and drugs, of course. Some cognition enhancing medicines are addictive, others are not. I would be worried about folks taking addictive enhancing drugs, because I have some doubts about the cost-benefit ratio here. However, in case of cognition enhancing drugs that have no significant harmful side-effects and that are not addictive, it is arguably time to change regulations prohibiting the use of such drugs. Just going by the numbers cited above, it is clear that draconian measures are bound to fail, just like any drugs related prohibition has failed. It is equally clear that many medical professionals are happily prescribing cognition enhancing drugs to their 'patients', given that this is currently the only legal way of obtaining them. Assuming that their 'patients' quality of life improves as a result of their willingness to prescribe these drugs, all the - ethical - power to them. Universities also need to decide how to handle this. One would really want to see research testing whether those students who take such drugs actually perform better (I suspect they would), and whether that is a result of their drug taking. If it turned out to be the case that they had an advantage over students not taking such drugs, there would have to be institutional responses ensuring a kind of a level playing field in terms of exams, grades and such matters. 

Ps: cannot vouch for the veracity of the image used in the top left-hand corner... :).

1 comment:

  1. I could easily be persuaded not to care much if a few highly-paid elite athletes risk their long-term health for the sake of getting an incremental advantage (and therefore possibly an extra endorsement contract or two), but ordinary university students? When having a GPA 0.1 lower than the next gal/guy might be career-limiting? (Eg: admission to med school or grad programs). ISTM you final paragraph is right: there has to be some way of ensuring a level playing field. Humans will take stupid risks for perceived advantage.

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