Brain-boosting drugs OK for healthy adults, says Greely

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Henry Greely, the Deane F. and Kate Edelman Johnson Professor in Law at Stanford University, says that cognitive-enhancing drugs shouldn't be off-limits to otherwise healthy adults hoping to boost brain power.

As scientists and pharmaceutical companies continue developing drugs to treat brain diseases, there’s a chance those pills will have some benefit to healthy minds. They might increase alertness, focus concentration or improve memory.

And just because they originally may have been intended for patients with dementia, sleeping disorders or some other mental malady, the so-called cognitive-enhancing drugs shouldn’t automatically be off-limits to otherwise healthy adults who just want to boost their brain power, says Henry Greely, the Deane F. and Kate Edelman Johnson Professor in Law at Stanford University.

In a commentary published this week in the journal Nature, Greely and colleagues from six other institutions argue that cognitive enhancement is not necessarily a bad thing.

The scholars write that cognitive-enhancing drugs “should be viewed in the same general category as education, good health habits, and information technology—ways that our uniquely innovative species tries to improve itself.”

Greely and his fellow authors recognize that some of the drugs—like Ritalin, an attention deficit disorder medication—are becoming more popular on campus black markets among students looking for a mental edge. The authors, however, do not promote widespread use of the pills that would ignore health risks, create pressure for their use in schools and the workplace or lead to scenarios in which their use would give someone an unfair competitive edge.

Rather, they propose several ways to shape guidelines for fair and responsible use of the drugs.

“To the extent that these brain-enhancing drugs become more of a reality, we’ll have no choice but to try to figure out what to do about how they’re used,” Greely said in an interview.

Greely said he has no financial stake in the sale or development of any brain-enhancing drugs.

The authors’ first idea is to create a research program that would collect information about the usage, benefits and risks of the drugs.

“Good policy is based on good information, and there is currently much we do not know about the short- and long-term benefits and risks of the cognitive-enhancement drugs currently being used, and about who is using them and why,” they write.

The group also wants doctors, educators and regulators to have input in developing policies that address the use of the drugs by healthy people. Physicians and teachers also should help to increase public understanding of the drugs and their risks, benefits and alternatives.

In their role as “gatekeepers to medications,” doctors should consider the ethics in prescribing the drugs, and should be consulted on how their benefits could be maximized while protecting patient health, Greely and his colleagues say. Other professional groups—like teachers and human resource officers—should also have a say because they’re responsible for fostering and evaluating cognitive performance and helping people improve that performance. But educators and bosses need to refrain from pressuring anyone to take the drugs.

“From assembly line workers to surgeons, many different kinds of employee(s) may benefit from enhancement and want to access it, yet they may also need protection from the pressure to enhance,” the article says.

The authors also see room for “careful and limited legislative action.”

“Fundamentally new laws or regulatory agencies are not needed,” they say. Rather, existing drug laws possibly should be modified to “avoid making felons out of those who seek to use safe cognitive enhancements.”

Unlike illegal steroid use in sports, which have well-documented negative side effects and do not promise anything beyond the playing field, brain-enhancing drugs hold the potential for increased work productivity and better quality of life.

“If you have people working smarter, we like to think that the world can be a better place,” Greely said. “Sports will always be a zero-sum game. With brain enhancement, that’s not so.”