TR: Do you think it’s possible to avoid making people feeling obligated to take these drugs to keep up? Especially given the huge amount of money spent on pharmaceutical advertising and the broad impact it has been shown to have?
MG: Rates of off-label drug use will stabilize. I think they will stay low. One could easily obtain Ritalin now for afternoon lassitude but the vast majority of people don’t. The afternoon cup of tea or coffee sustains and seems to do the trick for most of us.
TR: Really? What about in high-pressure situations, like academia?
MG: Remember, these drugs don’t make you smarter. They keep you awake so you can study so you can be smarter. While there are always fads of use with such products, usage will settle down to a base rate. That base rate may be higher than some people like, but it will be established no matter what the external drug policy might be.
TR: What about the potential for abuse and dependence? How would you ensure they are used responsibly?
MG: Education is the only tool that works. As we have learned from illicit drug use, it is virtually impossible to keep drugs out of a community. The rate of demand for any given drug, whether illicit or off-label legal, is set by the local social context. One can’t ensure drug products will always be used responsibly. It is up to each community to teach about the hazards of inappropriate drug use and, by doing so, control the base rate of use. It is not a perfect world!
TR: One of the major arguments against widespread use of cognitive-enhancing drugs is that it’s “the easy way out.” Why do you disagree?
MG: Most of these drugs are used in spurts when huge mental demands are called for. They are not for everyday mental routines. Having said that, I think it is a fair concern to make sure people don’t become dependent on them as a way of life. Working above one’s pay grade in the end has tremendous costs.
TR: What are some of the safety concerns? When giving drugs to healthy people, tolerance for risk is low.
MG: As it should be. Remember, do no harm. I think the concerns are on the mental states if misused. Images might be too vivid, for example. Careful tests and analysis should be run.
TR: Why do you think the idea of using drugs to enhance cognitive function makes people so uncomfortable?
MG: Messing around with the mind is a dangerous and delicate matter. None of this should be taken lightly.