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Pill wars: debate heats up over 'brain booster' drugs.

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Ultimately, it raises the most fundamental questions about identity and what it means to be human: Are we the sum of our experiences or the sum of our pills? As Carl Elliott writes in his book, "Better than Well: American Medicine Meets the American Dream": "Today, enhancement technologies are not just instruments for self-improvement, or even self-transformation – they are tools for working on the soul."

LAST SUMMER, Michael Arrington, the founder of the influential technology blog TechCrunch, wrote a post asking, "How many Silicon Valley start-up executives are hopped up on Provigil?" He was referring to the stimulant, which is the brand name for modafinil, that doctors normally prescribe to treat excessive drowsiness associated with narcolepsy and other sleep disorders. "[T]he buzz lately is that it's the 'entrepreneur's drug of choice' around Silicon Valley," the post said.

In an online poll in the British science journal Nature last year, answered by 1,400 people in 60 countries, 1 in 5 said they had used drugs for nonmedical reasons "to stimulate their focus, concentration, or memory." Only about half had a prescription for the drug they were using. A third had bought the drugs over the Internet. And even though about half reported unpleasant side effects, 4 out of 5 "thought that healthy adults should be able to take the drugs if they want to," Nature reported.

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