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FEATURE: Man and superman: Are neurocognitive enhancing drugs the steroids of the academic world?

Lucas* weighs over 350 lbs. He has a shaved head and a large frame densely covered with a menacing coat of tattoos. He’s also the strongest human being I’ve ever met. While waiting at the dingy 24-hour coffee shop where we had arranged to meet, I bumped into two friends and we spoke to pass the time. When Lucas arrived, and I excused myself from the conversation, one of them whispered, wide-eyed, “Did that guy just eat someone?”

Lucas, whom I’d met several years ago at my gym, had mentioned numerous times that he supplies steroids to those who seek them, but that he would tell people how to use them in moderation rather than watch them damage their health and throw money down the anabolic drain.

I was curious to speak to Lucas because of a recent academic paper written by Steven Hyman, the former director of the U.S. National Institute of Mental Health. In recent years, the medical community has been in the throes of a vigorous debate regarding the use of neurocognitive enhancing drugs—such as Provigil and Adderall—in the healthy population. While voicing a cautiously optimistic view of neuroenhancers, Hyman pointed out how similar these substances were to performance enhancing drugs in sports.

“A player who did not want to take anabolic steroids or growth hormone when nearly everyone else, including his own teammates, was taking such drugs, would be at a significant disadvantage ‘playing naked,’ as it has been said. If an athletic scholarship or a high salary were at stake, it might be very difficult to resist the unfortunate community norm. This scenario can be extended to performance with psychotropic drugs,” wrote Hyman in Neuron, in 2011. The comparison between taking the occasional dose of Ritalin to study and using steroids for sports seems excessive, but its potential merits are troubling enough to investigate.

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Adderall is a brand name psychostimulant drug. Adderall directly affects the neural pathway associated with reward, leading to risks of addiction.

Lance Armstrong’s public lynching following the U.S. Anti-Doping Agency’s October 2012 report came with brutal swiftness. The damning evidence comprised of over 200 pages of testimony by those, including many teammates, who witnessed his personal blood-doping habits and his coercive intimidation of those who failed to fall in line.

Immediately, two camps emerged: those who wished the seven-time Tour de France winner and cancer-survivor well, and those who felt betrayed by his mendacious denials of doping; the former, it seems, comprised a controversial minority.

Ironically, the history of the Tour—a grueling road race spanning some 3,500 km and lasting the better part of a month—is replete with drug use. Since its inception, competitors took strychnine to tighten weakened muscles, sniffed ether to dull the pain in their legs, and regularly consumed amphetamines.  Fausto Coppi, a two-time winner, once declared that “those who claim [that cyclists do not take amphetamine], it’s not worth talking to them about cycling.”

When I asked Lucas about other sports, he categorically denied that such prevalent use is unique to cycling. “They all do juice, [Armstrong] just got caught. Carl Lewis even said years later that he was on juice when he was competing against Ben Johnson [in the 1984 Olympics], now he’s laughing, ‘I was on juice too!’” Lucas echoed Lewis’ laugh. “Every baseball player over 30, guaranteed, takes steroids. There’s no way a grown man can run every day, play a game every day.
His joints, forget about it. Society wants to be naïve and think nobody’s on juice, it’s stupid. Give the same amount of juice to another player, and they won’t be able to perform that way. What makes a guy in the top five and in the top 25? It’s genetics. If you’re going into any field where you’re a professional athlete, you’ve got to realize that you’ll need to take steroids. It’s impossible to recuperate from your workouts without taking that supplement to rebuild your muscle.”

Paradoxically, we tend to enjoy displays of preternatural athleticism as long as we remain unaware of their connection to banned substances. When we learn of steroid use, criticisms generally include the health risks which accompany this substance’s abuse, the unfair “loading of the dice” in one athlete’s favour, and the poor example that athletes who use such substances set for the public.

Kyle,* a former captain of a McGill varsity squad who competed at a national level, admits that this is a strange juxtaposition.

“I watch the NFL. It’s like going to the zoo and watching animals play. I watch the NBA, it’s like seeing a spectacle. There’s nothing I can do that even remotely resembles anything they can. Steroids are pretty prevalent in the NFL—if you don’t know that, you should. Get over it, cause it’s the way it is. Those guys aren’t natural. They get paid to be unnatural!” he exclaims. If anything, he notes, it would be dangerous not to use them. Yet, he remains uncertain.

“Is it wrong? I’d like to think so. I’d like to think that there’s some sort of honour in sport that people should try for, that’s what I’ve seen in my day. But, Lance got his title stripped. The guy before him got his title stripped, and how many of the [winners] were celebrated? I feel bad for Lance, he lost a lot. They’ve had a target on his back for a long time. He was just lucky to get away with it, but so did everyone else. If you want to have a level playing field, make it clean for everyone. If you want to have a clean, natural sport, have a clean natural sport.”

***

Also known as Modafinil, Provigil is a treatment of narcolepsy, shift work sleep disorder, and sleep apnea. Studies of healthy individuals have noted its short-term increases of attention in the well-rested; and maintainance of wakefulness, memory, and executive function in the sleep deprived

Interestingly, our attempts at enhancing mental powers are no more recent than our attempts to improve our physical condition. Many romantic poets used opium while writing. Coleridge produced his famed Kubla Khan under its haze. Writers, such as Hemingway and Faulkner, imbibed near superhuman amounts of alcohol. And the Beatles, as Chuck Klosterman notes in a 2007 essay, “started taking serious drugs, and those drugs altered their musical performance. Though it may not have been their overt intent, the Beatles took performance-enhancing drugs. And this is germane to sports for one reason: Absolutely no one holds it against them. No one views Rubber Soul and Revolver as “less authentic” albums, despite the fact that they would not (and probably could not) have been made by people who weren’t on drugs. Jack Kerouac wrote On the Road on a Benzedrine binge, yet nobody thinks this makes his novel less significant.”

We pardon this mix of creativity and substance use, in part, because it leads to such subjectively varied results. Who’s to say that A Farewell to Arms was a better novel than Absalom, Absalom? Whereas marathon times can be measured precisely, we have yet to convince ourselves that drugs such as Adderall or Provigil have equally concrete effects. No surprise, considering that the short-term cognitive benefits of such drugs in healthy people are a recent finding.

The academic setting, in particular that of an elite university, is a fertile climate for exploring such ideas. Kyle, an excellent student himself, believes that McGill’s high-achieving students are more likely to use study drugs, than its varsity players are to use banned substances.

“They call it the ‘Brawn Drain’—it takes our top quality athletes and brings them [to the big colleges]. They get better deals down there. Even if it’s a fringe sport—they give you a full ride, why would you turn it down, to be in a [Big 10 school] environment? They have more flexibility to let kids in, whereas McGill’s a highly academic school. A lot of the time, you can’t get the best athletes through the door. McGill athletics has really been [trying to] make it a welcoming place, just to have people come and play. Lots of great programs—but it’s far behind other schools.”

While the focus on McGill’s varsity sports is a fraction of that found in many U.S. schools,  Kyle notes McGill students can be incredibly competitive when it comes to grades. This is their professional domain, whether they’re vying for places in grad school, or lucrative job offers. In fact, a paper in Addiction showed study drug use to be more prevalent at competitive schools.

Jonathan, a first-year in one of McGill’s most competitive programs, states that, while a stigma surrounds neurocognitive enhancing drugs, he doesn’t take it too seriously.

“It doesn’t mean that you can’t have a non productive day—it’s just a bit of a facilitator. The only reason you feel a little bit guilty is because there’s a bit of a stigma, but when my friends asked me if I did, I said yes straight up. After taking it, I don’t feel like it gave me an IQ boost. It’s still working with what you have.”

***

Methylphenidate (MPH; MPD), better known as Ritalin, is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy. In healthy individuals, MPH has a positive effect on memory.

For those who don’t engage in steroid use to improve sports performance, the goal is aesthetic. Kyle notes a marked difference between the McGill’s varsity gym and its main gym in this regard.

“[At] the main gym—I’ve seen a lot more, and talked a lot more about banned substances. In the varsity gym, I haven’t seen anything that’s been below board. It’s a huge attitude shift between the two. People who train in the varsity gym aren’t there to look good. It’s very functional, very much sports specific, and oriented towards being an athlete. By the time you hit our age, and you’re doing a sport, you know that you’re either going to be able to do it after university or you’re not. In 99 per cent of people’s situations, this ends after university. You lose the drive, you lose your team, because you’re done. You lose structure. That’s when you start to embrace training for other things. The use of banned substances is more associated with commonplace training than the McGill varsity community.”

Lucas agrees.

“People that are doing stuff like steroids, it’s because they’ve been brought up on the Internet,” he states emphatically. “The most popular thing on the internet is the porn star world, and the new culture is a Jersey Shore culture: everyone wants a six pack, everyone wants to have muscles, because they associate muscles with getting pussy. It’s all vanity.”

Even in academic circles, placing such importance on cognitive function is rare. If the ability to remember a nine-digit string of random numbers led people to be more attractive, our society would be a vastly different place, and the debate on study drugs would be much more one-sided.

Of course, while numerous studies have confirmed the harms of steroid abuse, use of neurocognitive enhancing drugs in healthy individuals is relatively recent, and long-term study data is scarce. And, although substances such as Addrall and Ritalin affect the dopamine pathways, leading to potentially addictive properties, others, like Provigil, are less understood. Jennifer Fishman, Assistant Professor in the Biomedical Ethics Unit at McGill University,  expresses concerns regarding long term use.

“Even if there are no short-term side effects, [study drugs impact our] brain chemistry, and we don’t know the long-term effects.”

Hyman’s comparison of steroid use to neurocognitive enhancing drugs is, in part, correct. To a significant degree, a historical distinction is responsible for our differing attitudes towards the two: while we’ve possessed methods of increasing strength and muscle mass for decades, our discovery of reliable mechanisms for improving mental attributes is a recent development. In light of such novelty, and its corollary lack of data on the detrimental effects of neurocognitive enhancers, its seems that many ethicists are wise to reign in our enthusiasm regarding such drugs.

Fishman believes that, pressures aside, the decision to enhance performance ultimately comes down to a personal choice.

“I think many would say that it’s naïve to think of any of these as a free choice—to take these drugs, or not. But on the other hand, we are all subjecting ourselves to this kind of society which makes us want to keep up. We do it to ourselves, right? Nobody makes us to it. When we talk about the pressures, they’re amorphous. Unless you’re an extremely high-level athlete, there’s no coach,” she said. “I think the hardest part is that we each choose how we’re going to participate. And, while it’s not a free choice in any way, it’s not a conspiracy. It’s not big brother surveillance society. It’s much more of the self-surveillance that we all do.”

*names have been changed to ensure anonymity

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