A science blog with Eric Berger

Will our society sanction the use of drugs in our pursuit of happiness and success?


Such is the crux of the emerging field of cosmetic neurology, a term coined to describe the use of cognitive stimulants such as Provigil and Adderall for people to sleep less, focus and accomplish more.

Use of such drugs is clearly on the rise among the competitive set, and this week’s there’s a fascinating article in the New Yorker that provides a broad perspective on the increasingly popular usage of such drugs:





As the article notes there are a host of new drugs coming out that will give people a cognitive boost and drug companies seem eager to exploit this emerging marketplace.

However, it was recently shown that Provigil might be addictive and I worry that people taking such drugs aren’t spending enough time considering the consequences. In living for the moment they might be forfeiting their long-term future because we just don’t know the implications of taking these drugs at high doses for long periods of time.

Personally, I don’t see taking drugs as a solution unless it’s a vaccine or if I am desperately ill. While I’m tempted by the pharmacology enhanced ability to work 12 hours a day, and still be an attentive father and husband, I just can’t bring myself to try it.

Have you?

Categories: Medicine
Eric Berger

35 Responses

  1. Les D. says:

    I’m with you. I avoid drugs of any kind as much as I can, though I do take a statin and 81mg aspirin daily on the advice of my internist.

    There are two reasons for doubting Dr. Chatterjee’s prediction: firstly, the cost of Provigil is up to $400 per month, which is rather daunting to most people in the current economic climate; and secondly, as oil production winds down during the next decade or so I expect the pace of life will slow dramatically. The important thing in life will become your gardening ability, not staying in touch twenty-four hours a day.

  2. Sci Guy Fan says:

    How is this different than steroid use among athletes?

  3. Jim says:

    Cocaine, coffee, chocolate, uppers,

    diet pills, niacin and many others have been taken to enhance performance for decades if not centuries. These new drugs are only part of the continuum. The main difference is that these new drugs come from a factory with a marketing team while many of the old came from a living, green plant in Colombia.

  4. craig says:

    If people take drugs legal and illegal just to feel good and forget their problems, then if drugs come along that are perceived as or actually do make you better at doing something which is generally considered to have some worth, in the absence of drugs, there is little doubt even in the face of any negative longer term consequences they will take those too. I see a bright future for the FDA to ponder over making such new drugs legal and for the profits of Mexican drug lords who will be only too willing to import the ones that aren’t.

    Technology, our savior and our downfall, somehow those hunter gatherer days are looking more and more nostalgic.

  5. Hal says:

    There will be interesting times ahead. My understanding of the current state-of-the-art is that while it might help you concentrate for short periods etc., it will not make you “smarter”. They won’t make something out of nothing.

    And honestly, being smarter is not the secret of happiness. I think it’s inversely correlated; that’s why people drink.

    But where it gets interesting is dealing with the gradual loss of cognitive function that occurs with aging. People will pay a lot for a drug that forestalls mental aging.

  6. PDQPete says:

    I think the comparison of surgery to long-term drug use fails on one important point:

    When you have surgery, you have it, and it’s over, and you heal. Undesirable side effects (bleeding, sutures, pain) diminish with time and eventually go away because surgery’s a discrete event, not something that goes on and on every day.

    When taking drugs indefinitely as a maintenance regimen (rather than to cure some disorder, after which you stop), side effects go the other way: they start out insignificantly small, then become noticable, then annoying, and eventually burdensome if not life-threatening.

    Now if you’re taking a drug because you’ll die without it (as with insulin) or because your quality of life will be severely degraded without it (as with antipsychotics), it’s still a rational choice to take the drug and deal with any side effects as they arise.

    But taking drugs meant to cure serious illness because you think they’ll make your life a little easier is like gambling with your rent money: whatever you win isn’t worth the risk. And if you do it long enough, eventually you’ll lose* (Phen-Phen, anybody?)

    *Yes, I know that’s not how statistics work. But it is how toxicity works.

  7. ntangle says:

    These new drugs don’t sound like much of a leap beyond the mood-altering and mood-stabilizing drugs that are already over-prescribed. And certainly not a leap beyond illegal recreational drugs, other than adding some new legitimacy.

    No doubt that this new family of drugs will do well. But, I won’t do them.

  8. KLT says:

    that is very unsettling. I had read a story like this about programmers who work in Silicon Valley who were taking Provigil to stay awake, but I just assumed they were getting it some other way.

    Because how can Drs write Rx’s for controlled substances to people who aren’t diagnosed with a serious medical condition that warrants them? I have to take Provigil myself, but I’ve also had 3 sleep studies done, plus ongoing supervision from neurologists who specialize in sleep disorders like Narcolepsy.

    Its especially scary that any Dr would write a Rx for Adderall since that one is much more dangerous…I had to stop taking it because my blood pressure got so high and I was getting the worst chest pains & heart palpitations from it that I seriously thought I was going to have a heart attack!

  9. Rorschach says:

    There is also some clinical and laboratory evidence that things learned while under the influence of these “cognitive enhancers” are dependent on the continued use of those drugs for retention/recall. so in other words once you start down this road, you have to keep taking the drug to maintain what you’ve learned.

    This cannot bode well….

  10. Corey says:

    I will not attempt these until the effects are far better understood, and demonstrated to be net long-term positive, and demonstrated to have an effect that compliments my current advantages over my peers.

    What does this mean?

    a) Long-term memory is not the same as short-term, and is not formed the same way. A deep practical understanding of a difficult subject that endures after the exam is not formed by cramming or spectacular concentration for 24 hours before the exam. It’s formed by long-term steady use and also by deep sleep where the memories can be written permanently and integrated with a larger body of knowledge. No drug demonstrates this today. My peers who can ‘cram better’ with a drug gain little to no advantage over me, since I don’t cram. I just do a lot of homework all semester long and routinely score two sigma above the mean.

    b) Sleep is a critical component to performance, along with long-term memory as I said above. Drugs that make you ‘feel’ like you are not tired are not the same as drugs that legitimately remove the need for sleep. Part of my exceptional performance on science exams is a solid 8 hours of sleep the night before. Rested, with lots of time for memory formation, my computational ability at the time of the exam is exceptional. It’s less about recall and more about having the mental agility to construct a meaningful answer. No drug can yet replace that night of sleep.

    c) It has been my experience as a computer professional that those who work ‘harder’ and more hours are seldom as good as those that work smarter. It’s a cliche but a major drive to my own creativity in computers has always been a desire to find a way to complete a task in a shorter time so I can go home to my family. A drug that gives me a routine 12 hour workday with less sleep so I have time left for my family would DULL my edge, not improve it. A company full of people working even longer days trying to look busy or push more paper around is still going to get killed by an innovator that is more creative and attempting to do things a different way to save time to market.

    Since I haven’t heard of a drug that makes you more creative, I’ll stick with caffeine in the morning and alcohol with my wife in the evening, thanks.

  11. ttyler5 says:


    For thousands of years, drug-bent cognition has had deep psychotic side effects.

    Why would anyone expect a different result now?

  12. Rorschach says:

    I forsee legions of people who’s brains have been burned to a crisp and are in a permanent pit of depression that no SSRI will ever be able to touch. These drugs work on the same neural pathways as crystal meth. All we need to do is look at the result of long term crystal meth use and project forward.

  13. someone who posts here says:

    I know someone with a script to the Provigil, and sometime last year, he and I had a discussion about it. While I can’t condone taking someone else’s “meds”, I confess that he gave me one and I took it.

    I now know what the fuss is about. Folks, it’s speed. A controlled time dose mind you, but it’s speed all the same. The stuff works like a magic charm. As such, it’s probably quite bad for you. Nothing that works like speed can be good for you in the long run, except of course, caffiene. :)

    Since my flirtation with the drug was temporary, I can’t testify to any long term usage. I would be embarrassed to ask my family doctor to prescribe me any, but I can see how others might not feel so reticent.

  14. Richard says:

    The other expert quoted in this article, Martha Farah, who is a psychologist at Penn and the director of its Center for Cognitive Neuroscience



    There’s not a lot of advantage to be gained, competing with India, Japan, and China in the “anxious”, “efficiency-obsessed”, or overworked categories. Neuro-enhanced or not.

  15. Katie says:

    I know of folks popping Adderall to help cram for tests and “focus” more in the academic world. I personally do not agree with the practice, especially when they were not perscribed it in the first place. I do think it’s cheating … But to be phiolosophical, is there EVER a level playing field in life? I haven’t seen it to be so.

  16. GeneL says:

    Same old, same old. People want equal results, since they are not satisfied with equal opportunity. Money, sports, sex, power, etc. Take a pill, get equal results whether it’s deserved or not. Sad.

  17. Joshua says:

    The real question is, will government?

  18. KLT says:

    For anyone with kids or grandkids that may be concerned about this, I would recommend glancing over this article if you get a chance…which about half way down the page goes into the topic of kids & Rx drugs.

    What about “Safe” Drugs?

    -Also I just realized our recent Awake mag cover series specifically addressed the topics of Rx misuse/abuse and stressed out students.

    (I don’t think they’ve added the print version to the site yet) but the audio downloads of the whole mag are available HERE

    (in the box underneath where you can select the language, there’s a scroll down menu of issues from the past few months you can choose. The Rx one is the May 2009 and the ‘stressed out students’ is the April 2009 Awake)

  19. Old Gringo Stan says:

    I am proud of my turtle brain. It took me 8 years of distance education to become an engineer. I do not work well in groups of fast talking young engineers.

    My thought is that I excell in detail design of power systems and control systems working alone. I don’t mind taking a problem home for the weekend to solve at my leisure.

    Methodical perserverance has been my forte. However, I always like to have a real brain available to consult with when I hit a barrier.

    Frenzied psychobable is the absolute worst way to design or problem solve.

    Anyone know where I can find a job in or near Houston ? Ok, I’m 73 but I refuse to retire. I’m unemployed :) Oh, I prefer to wait till summer fishing is over to go back to work.

  20. Gary Packwood says:


    I have no desire to become one more statistic of unintended consequences.

    One needs only look at Michael Jackson’s face to understand unintended consequences.

    I’ll work with my physician just like I always

    have and listen and read.

    Probably read more from the SciGuy in the future now that I have found this great place.

  21. ld says:

    What Corey said rings true, I believe – for myself and my gifted computer scientist son. I’ve seen what he’s referring to, firsthand, at work – (the harder workers don’t do as well as the smarter); complete, restful sleep is so nourishing and totally improves my cognitive function. Napping is a sport at our house. Why would anyone give up that mental processing time? My best ideas come from REM sleep.

  22. jonathan says:

    using advances in scientific medicine to increase my cognitive function? not for me!

    the last thing this world needs is smarter people.

    i’d rather indulge my alarmist tendencies with idle speculation on the internet.

  23. Charles Hixon says:

    In answer to your headline question: yes, if the pharmaceutical companies have their way with Washington and find profit in it. The old tobacco lobbysts are probably already working for the pill makers. Washington will ultimately attach a sin tax to the pills and they will compete for market share with illicit substances – things pharmaceuticals cannot claim as their$.

  24. Great Scott! says:

    Yoga will produce the same effects. It takes discipline and time to achieve though. Of course, it also provides many other benefits.



  25. ttyler5 says:


    Great comment above, here it is again for those who may have missed it:

    While you didn’t go there with it, in fact you have have outlined a possible prima facie case for prohibiting students from using the drugs to cram for entrance exams and finals.

    If it could be shown that the drugs merely enhance short-term memory, and that any part of the knowledge gained from using the drugs will dissipate when the drugs wear off or soon thereafter

    — then of course a test score enhanced by such methods would constitute a fraud.

  26. Vernon Williams says:

    As for such supposedly mind enhancing drugs, I think the more relevant question is not should they be used, but will they, to which I fear the answer is probably yes.

    For myself, I wouldn’t touch them for fear of as yet undetermined side effects. Plus, what rational person wants to turn themselves into a constant type A personality? Sounds like a recipe for total burn out.

    Corey, as a long time computer programmer, I have to totally agree with you about working smarter, not harder. Even when there is a time crunch, just jumping into a computer program is almost never the thing to do.

    For sufficiently complex projects, I have often spent days or weeks in the mental planning stage, though for simpler projects of only a few thousand lines of code (as opposed to tens of thousands), I can often grasp it all in just a few hours or minutes, occasionally within seconds if it is similar to something I have dealt with before.

    I almost always take however long it takes to get it figured out in my head first, to get the general picture of what all I need to do, before I program a thing.

    Getting it right the first time is almost always better, even if it appears to take longer to deliver a finished product, because then the testing and debugging phase, which is often the longest part, is usually much reduced.

    I can’t remember how many times I have seen other programmers just jump into a project, start programming immediately, and make a mess that takes forever to get working correctly, if it can ever be made to work at all without a total rewrite, usually by somebody better (like me).

  27. The Mouth of the Yellow River Group says:

    Ni Hao!Western societies are already there and developing Asian societies are following. The solution is to decriminalize all currently illegal drugs and redirect the research industry away from the endless drug a month culture based on flawed basic biological understanding like simple DNA sequence. And that science is returned to scienc rather than domination by sociopolitical agendas.Unfortunately, this will continue as long as the genetic dogma that there is a simple gene or combination of genes that underlies every complex behavior or trait.For MOTYR SciGuy archives on the topic here (Find: MOTYR@25-50% scroll) and here (Find: MOTYR@90%scroll).Member MOTYR Group

  28. i also post here... says:

    As someone with ADD, who takes meds, let me chime in.

    First, there is a legitimate question that I have not seen asked, but I think is at the root of the problem:

    What is normal?

    The problem isn’t so much about the morals of taking drugs (uh, we all take drugs, everyday, in the form of food, and other societally accepted drugs – even mild speed like caffeine), but about the place of the medical community in restoring patients to this mythical state. The problem is that it doesn’t exist. When more than half of a population is classified as having a “condition” we do not have a growing epidemic (ahem… autism), we have ever-lowering standards for diagnosis.

    I’m not saying that’s wrong.

    If taking a drug improves someone’s quality of life, at no detriment to themselves or others, then there is no reason to prohibit that. But you are rarely if ever going to find this to be the case.

    I find that the drugs help me a great deal with certain things that I was practically incapable of before, no matter how much will I bent towards it – like paying attention in a class I was not really really interested in, or reading an extremely technical paper without spacing out every other sentence.

    But I know, 100% that this is NOT MAINTAINABLE. I have to up my dose every few months. Eventually I will switch to a new drug. I am certainly causing a measured amount of change in my brain. I plan to quit or dramatically reduce usage once I am out of school, and am already looking into things like my diet, etc. to find a non-chemical way to ease my ‘symptoms’ (quotes because honestly I think ADD is what you would call a “normal variant” in humans).

    Guys, there are no miracle drugs. They ALL have side effects, sooner, a little later, or a lot later. I suspect it will take millennia, perhaps forever, before humans understand the intricate biology involved, and are able to craft something worth taking every day for the rest of your life.

  29. PDQPete says:


    “I also post here…” you have a point, but I doubt that most people, let alone most medical professionals, would define “normality” for human psychology as a point, or a region with rigorous boundaries.

    “Normal,” to me, seems more like a probability cloud. It’s not homogeneous (it’s more densly-populated cear its centroid), and it has all sorts of odd little pseudopods, indentations and even lacunae.

    But I think we can agree there are some outliers who need treatment. “Normal” is a shorthand way of describing the end and goal of that treatment.

  30. Steve M says:

    Among many fascinating discussions on this blog, this is one of the most interesting. I don’t know a lot about the subject, but Corey’s discussion about long-term memory formation and sleep might have a lot of implications for a society that tends to encourage sleep deprivation.

    Posted by MOTYR:

    …genetic dogma that there is a simple gene or combination of genes that underlies every complex behavior or trait.

    MOTYR’s posts sometimes leave me scratching my head and wondering about the side effects of which some here have warned. However, the point about finding a drug to impact a narrow genetic target and assuming that this gives us understanding of the overall impact seems valid.

    Human behaviour and the complexity of the brain are incredibly complicated. We can only guess at the long term impact of drugs like those mentioned. Probably long term clinical trials are the only way to get a reasonable degree of certainty.

    It sounds like there may be a short term advantage to use of these drugs, in at least some situations, such as cramming for a test. I also foresee a high likelihood of adverse long-term consequences. The analogy to steroids may be apt. If you allow some to have an advantage, it increases pressure on others to use the same drugs, even though it may not be in their best interest in the long term.

  31. PDQPete says:

    P.S.–”I also post here…”, here’s another observation:

    You say you find yourself disinterested in class and unable to read your field’s technical papers–have you ever considered switching majors?

    I’m quite serious. Lots of people go into college saying “I want to major in X” when what they really mean is “I think I SHOULD major in X.”

    However they soon find that X bores them or that they have no talent for it–in short, they’re not cut out for X. They’re cut out for something else.

    Which is fine, or should be: how can we expect someone who’s 18 years old, never lived away from home and never held a professional job, to know for certain what they want to do for the next 50 years of their lives?

    So most of the time, they switch majors. But some people, out of an overabundance of responsibility, knuckle down, stick to it, get that sheepskin and then confront a lifetime of doing something they don’t like and aren’t good at.

    I’m not you and I don’t know your symotoms the way you do. But going by your description of them here (which is all I have), you may actually be suffering from….well, call it “vocational dysphasia.”

  32. Eric Berger says:

    Steve M,


    I agree. The quality of commentary on this blog has been approving and I appreciate the efforts of everyone to remain civil.


    I couldn’t put my finger on it when I wrote the blog entry, but this is a pretty good summary of my objections. I just don’t think monkeying around with pharmacology to get a short-term gain is doing anything good for my body, long-term. I suspect there’s a pretty good biological reason why we evolved to need 6 to 8 hours of sleep a night.


  33. Acroamatic says:

    A couple of cups of Community dark roast are sufficient for me. As my family might attest, anything else would be far too much of a good thing.

  34. KAB says:

    “A couple of cups of Community dark roast are sufficient for me.” Posted by: Acroamatic

    With a shot of Kahluha and honey toast at 7 a.m…..yeah.