Cognitive enhancement drugs (CEDs), such as Ritalin, Adderall, and Provigil, are most commonly known for their use in treating patients with Attention Deficit Hyperactivity Disorder (ADHD). But these drugs, often called “smart drugs,” can profoundly enhance a perfectly healthy person’s ability to sustain concentration and thus improve the effectiveness of his mind for a period of time. When working on a difficult mental task—engaging in research, taking a test, performing an operation, or the like—sustained concentration can be the difference between success and failure. Although research on CEDs is still in its infancy, a handful of compounds on the market are showing remarkable results—and, of course, generating much controversy.
Various ethicists and policy advisers object to the use of “smart drugs” by healthy people. They allege, among other things, that such usage is dangerous because it can make criminals more effective at doing harm, or that it is “unfair” to those who don’t use the drugs, or that it is akin to the dishonest use of steroids by professional athletes.1 But do such objections make sense in light of the relevant facts? Are these legitimate grounds for morally condemning or even legally prohibiting the use of CEDs by healthy people? Are there circumstances in which the use of such drugs by healthy people can be moral?
Toward answering these questions, let us begin with a brief indication of the basic nature of these drugs and how they work.
Prominent CEDs include methylphenidate (Ritalin is a brand name), modafinil (Provigil is a brand name), and that great staple in life, caffeine. Each of these drugs stimulates the nervous system and regulates the cellular release and uptake of neurotransmitters, which are chemical compounds that transmit signals from one nerve cell to another. Consider first the most common of these, caffeine.
Research has shown that caffeine improves cognitive performance mainly by inhibiting a brain-activity inhibitor known as adenosine. Adenosine is a neurotransmitter that suppresses brain excitation and is involved in regulating the sleep cycle. Caffeine blocks adenosine receptors in the central nervous system, preventing adenosine from binding to nerve cells.2 This, in turn, reduces the inhibitory effect of adenosine on the brain and enables greater neural activity.3 Caffeine is used by many millions of people every day to increase alertness and mental efficacy. It is by far the most widely used CED.
Ritalin, originally intended to help ADHD patients concentrate, works by preventing the neurotransmitters dopamine and norepinephrine from being stored within nerve cells. . . .