Adderall and desperation

“Butler Library smells like Adderall and desperation.”

That note from a blogger at Columbia University isn’t exactly scientific. But it speaks to the atmosphere that settles in around exam time here, and at other competitive universities. For some portion of the students whose exams I’m grading this week, study drugs, stimulants, and cognitive enhancement are as much a part of finals as all-nighter and bluebooks. Exactly how many completed exams are coming to me via Adderall or Provigil is impossible to pin down. But we do know that studies have found past-year, nonprescribed stimulant use rates as high as 35% among students. We know, according to HHS, that full-time students use nonprescribed Adderall at twice the rate of non-students. We can suspect, too, that academics aren’t so different in this regard from their students. In unscientific poll, 20% of the readers of Nature acknowledged off-label use of cognitive enhancement drugs (CEDs).

If this sounds like the windup to a drug-panic piece, it’s not. The use of cognitive enhancement drugs concerns me much less than the silence surrounding their use. At universities like Columbia, cognitive enhancement exists in something of an ethical gray zone: technically against rules that are mostly unenforced; an open conversation topic among students in the library at 2 a.m., but a blank spot in “official” academic culture. That blank in itself is worth our concern. CEDs aren’t going away–but more openness about their use could teach us something valuable about the kind of work we do here, and anywhere else focus-boosting pills are popped.

In fact, much of the anti-cognitive enhancement drug literature dwells on the ethics of work, on the question of how much credit we can and should take for our “enhanced” accomplishments. (In focusing on these arguments, I’m setting to one side any health concerns raised by off-label drug use. I’m doing that not because those concerns are unimportant, but because the most challenging bioethics writing on the topic is less about one drug or another than about the promises and limits of cognitive enhancement in general–up to and including drugs that haven’t been invented yet.) In Beyond Therapy, the influential 2003 report on enhancement technologies from the President’s Council on Bioethics, the central argument against CED use had to do with the kind of work we can honestly claim as our own: “The attainment of [excellence] by means of drugs…looks to many people (including some Members of this Council) to be ‘cheating’ or ‘cheap.’” Work done under the influence of CEDs “seems less real, less one’s own, less worthy of our admiration.”

Is that a persuasive argument for keeping cognitive enhancement drug use in the closet, or even for taking stronger steps to ban it on campus? I’m not so sure it is. This kind of anti-enhancement case rests on an assumption about authorship, which I call the individual view. It claims that the dignity and authenticity of our accomplishments lie largely in our ability to claim individual credit for our work. In a word, it’s producer-focused, not product-focused.

That’s a reasonable way to think about authorship–but much of the weight of the anti-cognitive enhancement drug case rests on the presumption that it’s the only way to think about authorship. In fact, there’s another view that’s just as viable: call it the collaborative view. It’s an impersonal way of seeing accomplishment; it’s a product-focused view; it’s less concerned with allocating ownership of our accomplishments and it’s less likely to emphasize originality as the most important mark of quality. It is founded on the understanding that all work, even the most seemingly original, is subject to influences and takes place in a social context.

You can’t tell the history of accomplishments in the arts and sciences without considering those who thought about their work in this way. We can see it in the “thefts” of content that led passages from Plutarch, via Shakespeare, to T.S. Eliot’s poetry, or in the constant musical borrowing that shapes jazz or blues or classical music. We can see it in the medieval architects and writers who, as C.S. Lewis observed, practiced a kind of “shared authorship,” layering changes one on top of the other until they produced cathedrals or manuscripts that are the product of dozens of anonymous hands. We can see it again in the words of writers like Mark Twain, who forcefully argued that “substantially all ideas are second hand,” or Eliot, who advised critics that “to divert interest from the poet to the poetry is a laudable aim.” We can even see it in the history of our language. Consider the evolution of words like genius (from the classical idea of a guardian spirit, to a special ability, to a talented person himself or herself), invent (from a literal meaning of “to find” to a secondary meaning of “to create”), and talent (from a valuable coin to an internal gift). As Owen Barfield has argued, these changes are marks of the way our understanding of accomplishment has become “internalized.” Where earlier writers tended to imagine inspiration as a process that happens from without, we’re more likely to see it as something that happens from within.

The collaborative view is valuable even for those of us who aren’t, say, producing historically-great art. It might relieve of us of the anxiety that the work we produce is a commentary on our personal worth. It’s well-tailored to the creative borrowing and sampling that define the “remix culture” celebrated by writers like Lawrence Lessig. And it is, I think, a tonic against the kind of “callous meritocracy” that John Rawls cogently warned us about.

That’s not to suggest that the collaborative view is the one true perspective on accomplishment. I’d call it one of a range of possible emphases that have struggled or prospered with the times. But if that’s the case, then we’re free to think more critically about the view of work we want to emphasize at any given time.

What does any of this have to do with cognitive enhancement? The collaborative view I’ve outlined and a culture of open cognitive enhancement share some important links. It’s certainly not true that one has to use CEDs to take that view, but there are strong reasons why an honest and thoughtful CED user ought to do so.

Consider the case of a journalist like David Plotz, who kept a running diary of his two-day experiment with Provigil: “Today I am the picture of vivacity. I am working about twice as fast as usual. I have a desperate urge to write…. These have been the two most productive days I’ve had in years.”

How might such a writer account for the boost in his performance? Would he chalk it up to his inherent skill or effort, or to the temporary influence of a drug? If someone singled out his enhanced work for praise, would he be right in taking all the credit for himself and leaving none for the enhancement?

I don’t think he would be. There is a dishonesty in failing to acknowledge the enhancement, because that failure willingly creates a false assumption: it allows us to believe that the marginal improvement in performance reflects on the writer’s efforts, growing skill, or some other personal quality, when the truth seems to be otherwise. In other words, I don’t think enhancement is dishonest in itself–it’s failing to acknowledge enhancement that’s dishonest.

There’s nothing objectionable in collaborative work, forthrightly acknowledged. When we take an impersonal view of our work, we share credit and openly recognize our influences. And we can take a similar attitude to work done under the influence of cognitive enhancement drugs. When we speak of creative influences and working “under the influence” of CEDs, I think we’re exposing a similarity that runs deeper than a pun. Of course, one does not literally “collaborate” with a drug. But whether we acknowledge influences that shape our work or acknowledge the influence of a drug that helped us accomplish that work by improving our performance, we are forgoing full, personal credit. We are directing observers toward the quality of the work, rather than toward what the work may say about our personal qualities. We are, in a sense, making less of a “property claim” on the work. Given the history of innovators who willingly made this more modest claim, and given the benefits of the collaborative view that I’ve discussed, I don’t think that’s such bad news.

But could a culture of open cognitive enhancement drug use really one day change the way we think about work? There are no guarantees, to be sure. When I read first-person accounts of CED use, I’m struck by the way users perceive fast, temporary, and often surprising gains in focus, processing speed, and articulateness. With that strong subjective experience comes the experience of leaving, and returning to, an “unenhanced” state. The contrast seems visceral and difficult to overlook; the marginal gains in performance seem especially difficult to take credit for. The subjective experience of CED use looks like short-term growth in our abilities, arising from an external source, to which we cannot permanently lay claim. For just that reason, I have trouble agreeing with those, like Michael Sandel, who associate cognitive enhancement with “hubris.” Why not humility instead? Of course, I don’t claim that CEDs will inspire the same reflections in all of their users. It’s certainly possible to be unreflective about the implications of CED use. I only argue that it’s a little harder to be unreflective.

But that reflectiveness, in turn, requires openness about the enhancement already going on. As long as students fear job-market ramifications for talking on the record about their cognitive enhancement drug use, I wouldn’t nominate them as martyrs to the cause. But why not start with professors and academics–with, say, those 20% of respondents to the Nature poll? What’s tenure for anyway?

We simply can’t separate enhancement, of any kind, from the ends we ask of it and the work we do with it. So I sympathize with the New Yorker’s Margaret Talbot when she writes that “every era, it seems, has its own defining drug. Neuroenhancers are perfectly suited for the anxiety of white-collar competition in a floundering economy…. They facilitate a pinched, unromantic, grindingly efficient form of productivity.” Yet that’s giving the drug too much credit. I’d look instead to the culture that surrounds it. Our culture of cognitive enhancement is furtive, embarrassed, dedicated to one-upping one another on exams or on the tenure track. But a healthier culture of enhancement is conceivable, and it begins with a greater measure of honesty. Adderall and desperation don’t have to be synonymous, but as long as they are, I’d blame the desperation, not the drug.