The New Generation of Performance Enhancement: The Use and Regulation of Cognitive Enhancers

Abstract

Over the past decade, the use of steroids and other performance enhancing drugs has shaken the sports world. As athletes search for new and creative ways to gain advantages in their disciplines, nearly every major professional U.S. sports league as well as the National Collegiate Athletic Association (NCAA) and the United States Olympic Committee (USOC) has struggled to develop and enforce new rules against performance enhancing drugs. Much of the public attention and regulatory reaction has focused on anabolic steroid and hormone use, in part because these drugs appear to be the most commonly used substances and also because they are perceived to provide the most significant unfair advantages to athletes. However, while these drugs dominate the headlines, cognitive enhancers, also known as nootropics, have more quietly begun to assert themselves as the new generation of performance enhancement, promising implications far beyond the sports field. For centuries, certain foods and chemicals have been thought to increase cognitive abilities. Even today folk wisdom and marketers of supplements advocate the mental boosting properties of vitamins and “brain food” ranging from B5 to cranberries to chocolate. But an increasing number of drugs recently have been shown to improve memory, concentration and other cognitive ability. Three such drugs, Ritalin, Adderall and Provigil, have received Food and Drug Administration (FDA) approval for disorders such as narcolepsy and Attention Deficit/Hyperactivity Disorder (ADHD), but widely are being used off-label and without doctor supervision by athletes, students, businessmen, the armed forces and even scientists themselves for cognitive enhancement. As with any drug, though, unsupervised use poses risks of harmful side effects, drug interactions and addiction, risks that are still relatively poorly understood. But given the competitiveness and pressure of the modern world, it is hardly surprising that the promise of cognitive enhancers is seductive for so many. Furthermore, scientists agree that many more such drugs will be developed in the upcoming years. This paper will examine cognitive enhancers and their dramatic, somewhat unspoken increasing prevalence in our society. After analyzing efforts to regulate their use by various sports organizations and governing bodies, this paper then will address the reasons behind, and moral issues raised by the use of cognitive enhancers by others in society, ranging from university students to air force pilots. Finally, this essay will conclude by suggesting cognitive enhancers pose a new regulatory challenge that the FDA can no longer ignore: Countless Americans from a wide array of backgrounds already use cognitive enhancers illicitly, either obtaining them through acquaintances or sometimes by faking symptoms of ADHD or narcolepsy to a doctor. Because society stands on the precipice of an age in which psychoactive drugs will be used primarily for enhancement, rather than medical treatment, the FDA should recognize this new drug use reality and establish a separate, appropriate regulatory scheme for cognitive enhancers, one that responds to the common non-medical use of these drugs and best ensures their safety and efficacy.