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12th January 2011

Chemical Intelligence? – Modafinil

An ethical dilemma: Two people take an exam. They are of near equal intelligence and good at their subject. One studies for six hours a day before their exam and gets a 2:1. The other student takes a pill for concentration and revises for 10 hours a day. They get a first. The question is: is it cheating? Does the person with a pill for concentration have an unfair advantage?

This is not an abstract question or science fiction: this is a choice students may have to make in the future.

Concentration drugs boost the brains’ level of neurotransmitters, particularly noradrenalin, acetylcholine and dopamine. This improves the communication between brain cells and creates heightened states of alertness and attentiveness.

The neuroenhancers are available over the internet, the cheapest being available for around £2 a pill. Modafinil and Ritalin are the most commonly used ‘smart drugs’, and are used to increase alertness and stave of tiredness for long periods of time. The prescription drugs are normally prescribed to sufferers of attention deficit hyperactivity disorder (ADHD) and narcoleptics. But they are increasingly being used ‘off-label’ by students in the UK.

Barbara Sahakian, University of Cambridge professor, is calling for an ethical debate on these drugs after a rise in use by students in the UK. Sahakian, a professor of clinical neuropsychology, is suggesting the Universities bring in measures to test for usage. But is random dope testing going to become part of University life?

“Since exams for entrance to university or for degree marks are competitive situations, it may well be that in future some universities adopt this procedure,” said Professor Sahakian.

“But, as yet, from the informal survey that I did with Sharon Morein-Zamir; few universities have a formal policy as yet about the use of cognitive enhancing drugs by healthy students,” she added.

The Home-Office consider the possession of prescription only drugs without a prescription a “serious criminal offence.” But as yet, few universities are taking steps to bring about a change in policy. This includes the University of Manchester. A spokesperson from the University said: “The University has no official position on neuro-enhancing substances. However, the University does not condone the misuse of prescription drugs to enhance educational performance.”

There are very few known short-term side effects, besides weight-loss. The long-term effects of healthy people using these drugs are not yet known, and those using the drug off-label are doing so without the consultation of a doctor.

Sahakian adds: “You do not actually know that the substance you are buying is quality-controlled modafinil. It may be a placebo or a contaminated substance. You may have a pre-existing medical condition, which is counter-indicated for taking modafinil. You may be on other drug treatments for medical conditions that are counter-indicated for modafinil, as they cause drug-drug interactions.”

Surveys in the United States suggest that around 20% of university students are using concentration drugs regularly. A Varsity study earlier this year claimed that 10% of University of Cambridge students were using neuro-enhancing drugs.

Are there any ways for students to increase their concentration levels naturally? “Yes,” Professor Sahakian shouts emphatically. “My favourites are education and exercise”

Modafinil has broader uses. The British military stockpiled large quantities of Modafinil before the invasion of Iraq in 2004, for soldier use on the ground. The drug is also used for shift-workers and pilots who require intense periods of alertness.

Modafinil Diary

During the exam period, a student took Modafinil to see how it would affect their revision and concentration.

Day One

Exams are about to begin and the pressure to perform is intense. This morning, a flat, brown, cardboard envelope is pushed through my door, with post marks from India. I peel open the seal to reveal two strips of silver foil, with 30 airtight sealed pills. Modalert is printed in purple lettering across the front. I pull one out and break it in two. I take half, just to be safe, and head off to the library.

On the bus, a warm sensation comes over my frontal lobes. My thoughts are beautifully clear and purposeful. I get excited and pop the other half.

I find a quite spot in the library and take out the most difficult piece of revision on my poorest subject. I don’t look up from the book for the next four hours.

My first bathroom break shocks me. An unusual smell, metallic and acrid, is coming from the urinal I am using. It turns out to be my urine.

Ten hours in the library and I am finally worn out. I feel empty. I meet some friends on the way out but I have no idea what to say to them. The constellations of thoughts and ideas that are usually brimming over in my mind are dulled. I must get some sleep.

Day Four

It dawns on me how foolish I am. These are prescription drugs and I am taking them with no advice from a doctor. Perhaps I would be working this hard anyway, without these pills. How can I tell?

Each time I take a pill, I feel as if the effect is less substantial. But I am still in the library, doing 10 and 12 hour days. I am feeling less and less like myself but I attribute it to stress. Still a long ways to go before my exams are over.

Day Ten

I have a Modalert tablet at nine o’clock at night because I missed a whole days worth of revision. My mind is still working at five in the morning, but I stopped revising at three. My body is exhausted but my brain is reeling.

Day Sixteen

Seven exams finished, and I’m so thankful that I drink myself into oblivion.

Revision was easier, with far less distractions, but I feel a fraction of my creative self. Productivity was up, but thinking of new ideas near zero.

Image: Pills by Mattza via Creative Commons

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