Article summary of Neuroenhancement as Instrumental Drug Use: Putting the Debate in a Different Frame by Schleim - Chapter

Neuroenhancement, or the use of performance-enhancing drugs to increase performance received a lot of attention by ethicists, scholars, pharmacologists and researchers from other disciplines. The most often discussed drugs are amphetamine, methylphenidate, and modafinil. Currently, questions about whether the use of performance drug use at universities should be seen as cheating are discussed.

Publications in neuroethics often used the term “enhancement”, but the author wants to use another term: “instrumental drug use”. He suggests that, if we frame the phenomenon as instrumental drug use, it could be easier to integrate different types of research fields: neuroethics, addiction, substance use, drug diversion, and diffusion.

What is meant by ‘instrumental drug use’?

When people use substances to achieve goals, this is called instrumental. The author wants to explain that substance use is not only of irrational addictive origin, and it can also be instrumental. Drugs can be instruments. Christian Müller described how instrumental drug use has been prevalent throughout human history. Animals use drugs to increase their chances of survival and to reap evolutionary benefits. He distinguished nine different goals of drugs:

1. Improve social interaction.
2. Facilitate sexual behavior.
3. Improve cognitive performance or counteract fatigue.
4. Facilitate recovery or coping with stress.
5. Self-medicate for psychiatric disorders and mental problems.
6. Sensory curiosity; expand one’s perception.
7. Experiencing euphoria, hedonia, or a ‘high’.
8. Improve physical appearance or attractiveness.
9. Facilitate spiritual or religious activities.

In the debate about neuroenhancement drugs, the term ‘enhancement’ signals that it is something positive. When we would use the term ‘instrumental drug use’, this is a more neutral term.

What is the known about instrumental drug use?

There have been a lot of studies conducted on instrumental drug use. A review of 28 different articles investigating “nonmedical stimulant use” (instrumental drug use) between 2000 and 2009 showed that the methodologies varied widely, and that most of the studies were based on self-reports from non-representative samples and those samples differed from 50 participants to 54.000 participants. The kinds of drugs studied differed, and also the time span differed. These studies also differ in their outcomes: the reported prevalence of instrumental drug use varied between 1.7 and 55%. Among the studies published about instrumental drug use, there were a lot of differences in the publications in terms of the definitions used to study nonmedical use, methodologies, and samples. It also seemed that academic motivations were mentioned most frequently. However, this may also be because students were most often studied! The second reason seemed to be recreation: getting high, help with socializing. Weight loss was not cited as often. Instrumental drug use was reported to be a public health problem, but not in epidemic proportions. Data from the Global Drug Survey of 2015 and 2017 showed that there has been an enormous increase in just two years!

However, a study by McAuliffe and colleagues showed that the use of instrumental amphetamine is declining since the mid-1960s, and that the use of recreational drugs is increasing. This study showed that the use of nonmedical drugs was more common in the 1960s to the 1980s than now in the 21^st century.

What can be concluded?

The author concludes that it is difficult to come to a conclusion of the prevalence of instrumental drug use because there are a lot of different definitions and methodologies. The evidence reviewed in the current article shows that neuroenhancement is not new. Stimulant drugs and mostly amphetamine and methylphenidate are the most frequent non-medically used drugs. However, evidence that these drugs can benefit functioning is scarce. The effects of taking  does not seem to be better than computer training, physical exercise, and healthy sleep. Also, even if there are benefits, there are also risks and side-effects.

BulletPoints

• Neuroenhancement, or the use of performance-enhancing drugs to increase performance received a lot of attention by ethicists, scholars, pharmacologists and researchers from other disciplines. The most often discussed drugs are amphetamine, methylphenidate, and modafinil. Currently, questions about whether the use of performance drug use at universities should be seen as cheating are discussed.

• When people use substances to achieve goals, this is called instrumental. The author wants to explain that substance use is not only of irrational addictive origin, and it can also be instrumental. Drugs can be instruments. Christian Müller described how instrumental drug use has been prevalent throughout human history. Animals use drugs to increase their chances of survival and to reap evolutionary benefits. He distinguished nine different goals of drugs.

• The author concludes that it is difficult to come to a conclusion of the prevalence of instrumental drug use because there are a lot of different definitions and methodologies. The evidence reviewed in the current article shows that neuroenhancement is not new. Stimulant drugs and mostly amphetamine and methylphenidate are the most frequent non-medically used drugs. However, evidence that these drugs can benefit functioning is scarce! The effects of taking  does not seem to be better than computer training, physical exercise, and healthy sleep. Also, even if there are benefits, there are also risks and side-effects.