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Pill that boosts productivity gaining favor, raising concerns among medical ethicists By Steve Johnson
http://www.JewishWorldReview.com | (MCT) In a place like Silicon Valley, where career prospects often hinge on a person's intelligence and ability to work hellishly long hours, "brain doping" probably was inevitable. The expression refers to a growing national trend that troubles some medical ethicists, in which pills designed to treat sleep and mood disorders are being popped by healthy people to help keep them mentally sharp and boost their productivity. In April, the prestigious journal Nature reported that one-fourth of the 1,400 people responding to an informal survey admitted they had taken drugs for nonmedical reasons to improve their concentration or memory. The medicines included Ritalin, a stimulant for treating attention-deficit hyperactivity disorder; Provigil, for sleep disorders; and so-called beta blockers for cardiac arrhythmia. The practice appears to have gotten at least a foothold in Silicon Valley, especially with Provigil, a prescription medicine approved for narcolepsy, obstructive sleep apnea and shift-work sleep disorder. Although local police and drug counselors say they've had no experience with it, Provigil seems to be gaining favor among workers here, according to TechCrunch founder and influential Internet commentator Michael Arrington, In a blog posting titled "How many Silicon Valley startup executives are hopped up on Provigil?" Arrington declared in July that "I've spoken with one executive who says he uses it regularly to work 20-hour days, and the buzz lately is that it's the 'entrepreneur's drug of choice' around Silicon Valley." Arrington couldn't be reached for comment. But his blog triggered a spirited and contentious outpouring from its worldwide readership. Of the 150 or so responses it generated, about 20 reported having used Provigil, also known generically as modafinil. Some denounced the idea of using prescription medicines for nonmedical purposes and blasted Arrington for writing about the topic, saying it would encourage people to try the drug. But others described the medicine's effects glowingly. "I use Provigil when we have a large amount of work that needs to be done," Nick wrote. "Sure beats caffeine." "You can stay up pretty much as long as you want, then hit the sack and sleep like normal," added Murphy. Hank Greely, a law professor and director of Stanford University's Center for Biomedical Ethics, said he also knows some academics and doctors who have tried Provigil and who apparently didn't have sleep disorders. He added that some of them may have had prescriptions for it, however, which muddies the issue of how appropriate it was for them to use the drug. Doctors can legally prescribe a medicine for off-label uses, purposes not specifically approved by the U.S. Food and Drug Administration. But Casey McEnry, spokeswoman for the U.S. Drug Enforcement Administration's San Francisco office, said it is illegal to sell Provigil or give it away, as well as to buy or use it, without a prescription. Using the drug without a prescription also can be hazardous. Cephalon, Provigil's Pennsylvania manufacturer, says in its literature that the drug "is structurally distinct from amphetamines" and "promotes wakefulness without causing generalized stimulation in the brain." But it also notes that Provigil, approved for sale in the United States in 1998, "may cause you to have a serious rash or a serious allergic reaction that may result in hospitalization or be life-threatening." In addition, Cephalon warns, Provigil can lead to dependence and cause such side effects as headaches, nausea, nervousness, diarrhea, back pain, anxiety, dizziness and upset stomach - not to mention trouble sleeping. Oakland native Kelli White lost the two track gold medals she won at the 2003 world championships after testing positive for using the drug. And last year, a container ship piloted by Capt. John Cota, who had a sleep disorder he was treating with a Provigil prescription, slammed into the San Francisco-Oakland Bay Bridge, causing a major oil spill. Investigators are trying to determine whether the drug contributed to the accident. McEnry said the DEA officials she checked with in several Northern California offices were unaware of anyone being arrested for illegally selling or using Provigil. Sgt. Dave Moody of the San Jose Police Department's narcotics unit similarly hadn't heard of arrests in that city related to Provigil or attention-deficit drugs such as Ritalin. The clinical directors contacted at three Silicon Valley drug-treatment centers also said they could think of no one they had treated specifically for brain-doping Provigil. One Bay Area professional who asked not to be identified said he tried Provigil in hopes it would help him stay awake on a red-eye airplane flight. "I was very alert," he said, adding that he obtained the drug from someone with a prescription for it. "I worked productively on the flight." Nonetheless, the idea of taking such drugs to improve performance could have mixed consequences, some ethicists say. "If, in fact, drugs are able to make people smarter and more effective in their work, that could produce net benefits to society," said Stanford's Greely. But he expressed concern that the poor might not have equal access to the drugs and that bosses might coerce employees to take them to increase the work they do. Those fears are shared by Anjan Chatterjee, a University of Pennsylvania neurology professor who has written about the subject and believes brain doping will increase. "I think there is this kind of worship of progress or productivity" in society today, he said. "I am worried about it." Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.
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Mitch Albom | |||||||||||
