Derek Lowe has a provocative post pondering the future role of drugs that enhance cognition. He speaks as someone who doesn't drink and has never used recreational drugs:

I’ve been meaning to write something about this story for a while, but one of the problems has been that I’m still quite divided about what I think about it. (Normally my opinions come to me more quickly, for better or worse). Some background: people who’ve known me personally for a while generally know that I’m personally very much opposed to chemically altering the way that I think or feel. I never drank in high school, for example, which I can tell you made me stick out a bit in late-1970s Arkansas. Nor did I in college or afterwards; I still don’t drink now. And that personal prohibition goes even more for other recreational drugs, as you’d imagine.

My reason for that has long been that I enjoy my brain the way it is, and have seen no reason to mess up its function for fun. But the advent of cognition enhancing drugs is a scalpel to dissect that line of thought. What if the ingested chemicals add to some of the parts of my brain that I value the most? That “mess up its function” clause has been taken out and flipped upside down. And what if it’s for work, and not for recreation? Is that more allowable, because it’s somehow less frivolous? (All right then, what if I were to enjoy having a better memory, which I likely would?) That gets to a less creditable reason for my objection to alcohol and other such drugs – perhaps I’m not just objecting to them on practical grounds. Perhaps I’m objecting because I don’t want other people to have a good time, at least not like that.



I didn't drink for three years because it reacted badly with some other medication I was taking. Not drinking is, it turns out, a very good way to find out which of your friends and acquaintances are alcoholics. It's also an interesting window on yourself, pre- (and post) temperance. When other people get drunk, you sort of cringe for them--you imagine how you would feel if you were saying or doing those things right now, sober. Which is not the actual social space that inebriation occupies; we're more tolerant of various sorts of silliness in people using brain-altering drugs, and also, it's fairly likely that if you're drunk, everyone else around you is too drunk to much remember whatever you're saying. But it's psychologically very difficult to convince your empathy muscles of that.

Watching people perform fantastic memory stunts does not trigger the same reaction.

I'm much more tolerant than Derek of using various sorts of brain-altering drugs. think Thomas Szasz greatly overstates his case, but I think he has a valid core insight: we medicalize various mental states in order to give ourselves an excuse to treat them--and also in order to give society (and the state) control over how and to whom that treatment is administered. I think depression and ADD and so forth are fine categories insofar as they point towards which therapies might be most helpful for a given person. But if anti-depressants make you feel better, and you want to feel better, I don't see any reason that you shouldn't take them, even if you aren't depressed. Likewise, if you want to concentrate, or stay awake, or have a better memory. And if smoking pot makes you feel better than Prozac, I think you ought to be able to self-medicate that way.

Americans are generally deeply uncomfortable with the idea of giving people that kind of unfettered control over their mental state. In some way, altering our mental state seems to deeply violate the self--I think that's why so many people with depression insist so strenuously that the self on drugs is their "true" self, while the depressed self was some diseased aberration.

As I've written before, I don't think that there's any metaphysical state which can be defined as the "true" self, such that people shouldn't depart from it. We all have multiple potential selves within us, none of which is more "real" than any other. To me, the important question is: does the self I have now want to be different from what it is in some fundamental way? If so, you have a perfect right to seek other, more satisfying selves, whether through drugs, transcendental meditation, or voting for Barack Obama.

With a stunning lack of originality, what I worry about is the long term effect of these things. Mark Kleiman once said to me "Amphetamines don't actually give you more time--they just let you borrow it from the future at an extremely high rate of interest." The new class of cognitive enhancers seems to be less usurious, but what happens to the only brain you've got once you've been soaking it in chemicals for thirty or forty years? Paging Timothy Leary's ghost . . .

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