At a point, this just goes to the competitive nature of our society. From a moral standpoint, if who we are is a product of our environment and our genetics, then we ourselves aren't anything that isn't predefined. Someone who is lazy is a product of their genes and environment in the same way that someone with a disease is the product of their environment and genes. So, what makes asthma (which I have) something that I'm applauded for overcoming with medicine while obesity is something people are generally frowned upon for overcoming with medicine? Well, the fact that we want to ascribe the later as a choice - the choice to eat.
Einstein didn't believe in free will. However, he said that holding people responsible for their actions was a pragmatic approach for society to take (presumably because such action changes the environment that we are all in).
There are huge struggles because people don't want to accept that they have less free will than they ascribe. As such, the goal is to hold people responsible for faults that you don't have and find excuses that let you off the hook for any faults that you have. There are organizations that create campaigns to get society to accept their fault as something that should be compensated for. Short attention span? That's ok because it's medical. Stupid? Lazy? Those are things that are the fault of the individual.
It's really hard. If you can medicalize your faults, you get legal protection for them. If you can't medicalize them, you're personally responsible for keeping them in control. That creates a huge incentive for medicalization of everything in the human condition. And we're all worried about being left behind in this Red Queen's Race.
As for free will, Einstein was particularly offended by some of the consequences of quantum mechanics which seemed to remove determinism from the most elementary of particle interactions.
If fundamental interactions are in fact deterministic at this point, we haven't learned how to predict their consequences, which has led to the many interpretations of quantum mechanics. Einstein was fond of "hidden variables" since it held out some hope of quantum mechanics at some point being deterministic once again:
I find it disturbing that this is even controversial.
First, the notion that there is an optimal "healthy" state is make-believe. We all get old and die, so in a sense we are all terminally ill. We should have a right to improve our minds and bodies as long as there is room for improvement.
More to the point, brain types fall on a spectrum. ADHD is just one extreme. Equating "median" with "healthy" is a fallacy. Consider this: is synesthesia a disease? It can make life very hard, but it can also make patient extremely creative. Imagine a world where synesthesia is the normal condition -- non-synesthetes would be considered retards!
If there were a drug that could turn you into a synesthete, should the drug be illegal?
Second, we all already take a brain-boosting drug: caffeine, which is both undeniably effective, and has a wide spectrum of side effects. Other drugs like modafinil have almost zero side-effects in comparison, but they are prescription-only because they don't have a history of social acceptability. "Used historically" = "safe" is an even bigger fallacy.
Third, you can't prevent people from taking brain pills by not funding research (if the research doesn't happen in the U.S, it will happen in other countries.). All that this policy will achieve is encourage a black market and unsafe usage.
A hallmark of conservativism is to recognize that 90 percent of our behavior is much the same as occurred 2000 years ago, but many, many innovations came and went in between (Heroin: Cure for morphine addiction). What happened to them? They were tried, and they were discarded by the credible professions.
Maybe these drugs are good. "Maybe". Most drug tests occur over a matter of months, rather than a lifetime. Caffeine has been tried over centuries, and that fact has value, because within those centuries are lifetimes and generations. Every new drug is roulette, and you know it.
modafinil have almost zero side-effects in comparison,
If I understand correctly, that page says that 34% of modafinil takers reported headaches, compared to 23% of non-modafinil takers, 11% reported nausea (vs. 3%), 7% reported nervousness (vs. 3%), and 5% reported insomnia (vs. 1%). What do you think the numbers for caffeine would be? Caffeine withdrawal is a major cause of headaches, and caffeine is a major cause of nervousness, insomnia, tachycardia, hypertension, dizziness, etc.
I'm not saying caffeine is some kind of dangerous drug; I'm just saying that "almost zero side effects in comparison" is at least plausible given the Wikipedia page.
Modafinil is effective in small enough doses that you could put it into just about any beverage you like, just like amphetamine, piracetam, and so on, and unlike ethanol. You may enjoy quaffing toxic organic solvents like ethanol, but I don't particularly fancy the idea myself.
You can't really put piracetam in "just about any beverage", both because of the taste and the sheer quantity. That would be like trying to hide a tablespoon of ground-up mothballs in your orange juice. (Aniracetam or oxiracetam, maybe.)
Once upon a time I bought a large can of piracetam powder from a random Internet site, wondering why the pills were so much more expensive than the powder. I found out with my first drink -- dear god, the bitterness! I drank a few gulps, gave up, and haven't tried it since.
The only difference is, modafinil is classified as a drug and so the negative effects are termed "side effects" while caffeine is classified as food and so the same exact negative effects are termed "overuse". It's an emotional/connotative difference. The list itself is almost identical: nervousness, headaches, insomnia, dry mouth, rapid heartbeat etc. In fact, I don't see caffeine's potential dangers of mania, depression and psychosis on the modafinil list. How's that for conservative?
I guess that's why I'm not a conservative; I certainly don't agree with that statement. But it's not something you could prove or disprove factually, so let's just call it a difference of opinion.
What you linked to is actually a pretty mild side effect profile, although I take back "almost zero side effects." The maximum increase compared to placebo is 11% (for headaches), whereas the majority of people have caffeine-related headaches at some point.
"Other drugs like modafinil have almost zero side-effects in comparison"
Oh? I'd love to read the study on the safety of long term modafinil usage that you are doubtlessly referring to.
I think it's ridiculous that the government prevents me from taking various substances, but claiming that poorly understood drugs are safe is ridiculous. No one even knows how modafinil works.
Sure, there's no long-term studies, but we can extrapolate from the receptors that it acts on and its relatively minor side effects that it wouldn't be too bad to take it over a long term. At least for it's main indication, ADHD, it's far better than the alternatives of Ritalin or Adderall.
Modafinil (Provigil) is indicated for use treating narcolepsy, which was it's initial indication. Recently, the FDA has approved it for treatment of symptoms of obstructive sleep apnea (which I take it for), and shift work sleep disorder.
Here's the point you've missed: I can, and do, abstain from caffeine and pretty much all other drugs. Mind-enhancing drugs will become compulsory for everyone who want to keep their jobs - else competition will elbow them out. Imagine that in society with 99% uptake of a certain drug the sideffects start showing up after 40 years of intake. What then? Two full generations of cripples? Even the people who wanted to abstain would be victimized.
Why would mind enhancing drugs become compulsory to keep your job? As someone already pointed out, caffeine is a mind enhancing drug, and I've never heard of anyone get fired for not drinking a latte. Or what about alcohol? You could certainly make the argument that drinking alcohol can help you professionally, either by making you more extroverted or social at events, or because you like to go to happy hour with your co-workers.
Even in the sports industry, where performance enhancing drugs are relatively pervasive, you don't see steroids becoming compulsory for athletes. I know professional athletes who don't even take protein shakes.
Whether caffeine improves performance is questionable. It certainly does for caffeine addicts - they can't funciton without a fix, but those who are not hooked function well enough.
Even then, caffeine does not have long-lasting side-effects as has been proven over few hundred years.
conflating "median" and "correct" is the natural result f people being steeped in collectivist ideology and politics their whole life. in a true democracy you have social constructivism.
There could be nasty side-effects twenty years down the road, so I'd rather abstain.
It would totally suck to be forced to take those drugs to remain cometitive, so I hope they will keep those drugs in limited circulation until their safety can be proven beyond doubt.
First of all, the effects of these drugs have already been studied for many years. Modafinil was first experimentally used in the treatment of narcolepsy in 1986, so over 20 years ago.
Second, what do you mean proven beyond doubt? Testing these drugs is a statistical process, so what kind of confidence interval are you willing to accept? Keep in mind, that becoming more confident in your statistics means more testing, which makes the drug more expensive to bring to market and takes longer as well. Even then, a few drugs are going to pass the FDA approval process and cause unintended side effects, and people are going to argue for an even longer approval period.
You have to consider the opportunity cost of keeping these drugs in limited circulation. Most people don't take this into account, and there's plenty of research that shows that the FDA's requirements are actually probably too stringent, because government bureaucracies tend to be too risk averse. I think it takes an average of 12 years for a drug to pass FDA inspection and get to market, so imagine if it was 20 years. This means that during those extra 8 years, people weren't able to reap the benefits of a drug like Modafinil to stay awake. How many driving deaths could be prevented during those 8 years if people weren't driving while sleepy? Or what about the productivity gains from scientists or hackers that can get away with 4 hours of sleep a night instead of 8, without reducing their cognitive abilities?
I'm not saying there couldn't be unforeseen nasty side-effects of using the drugs fourty years from now, but given the evidence it seems like it's probably a negligible risk for most people.
Long testing period is fine - what sets this particular class of drugs apart from all others is that it will in all likelihood be taken by every single man, woman and child (except the amish maybe) - they will have to take it under the economical pressure. Approving this drug is like putting all eggs in one basket, and so this better be one hell of a good basket.
Now, I do not mind these drugs being distributed under presecritiption well before that, because it will be only a fraction of percent of the total population.
No drug stays in development for 20 years (AFAIK), so the risk of nasty side-effects after 20 years is there with all newish drugs. And in practice, how often does that turn out to be a problem? In my understanding, almost never.
If you're so risk-averse that this isn't good enough for you, you should feel free not to take them, but insisting that others don't take them crosses over into the territory of "meddlesome".
You did not read my post, did you? Let me repeat it here for you:
[quote]
It would totally suck to be forced to take those drugs to remain cometitive, so I hope they will keep those drugs in limited circulation until their safety can be proven beyond doubt.
[end of quote]
If these drugs are allowed, everyone will have to chose between employment + drugs or drug-abstinence + unemployment. There will be no opt-out. At all.
Sure there will be opt-out. If drugs double your productivity, then a non-user's salary will be half of a user's salary, and no less than that. That's just basic economics. Which is as it should be. They create double the wealth; they get double the money.
Of course this will suck for you, because from your point of view, it will be as if the number of programmers in the world has just vastly increased, creating competition for you and driving down your salary. Presumably just as candle-makers' salaries were driven down by the invention of the light bulb (which could make you blind after 20 years--nobody knew for sure).
I don't think it works that way. If you sell half as much stuff as others sales agents in the store you will get fired rather than get your salary cut in half. But ok, let's suppose it's true.
Let's take this to extreme - suppose that there is a ticking bomb in these drugs and after 20 years of intake one becomes a medical ruin, similar to crystal meth addicts.
So you can take the drugs and die in 20 years from now, or you can abstain and live for another 20 years (40 years total). Those who abstain will be priced out of their lives, but most will give up and start taking drugs - let's be real.
Nobody knows about it now, so there will be no push-back until 20 years later, and when the time comes everyone will be medically ruined by then (except the youngest kids).
And you are really stretching it wrt lighbulbs making people blind - it's not in the same ballpark of likelyhood as drugs ruining people's health.
If you sell half as much stuff as others, it means you're costing the store customers, because presumably you approached close to the same number of customers as the other sales agents approached, but more of your customers decided to take their business elsewhere. This not an issue in a programming job.
Let's not "take this to the extreme", and instead be realistic. Your "ticking bomb" would be the first in history. Like I said, no drug is tested for 20 years before being released (and approved by FDA), so if there was such a risk, then with the sheer number of new drugs developed, you'd see these disasters left and right. Where are they?
Tobacco causes severe side effects which get progressively worse before the "big stuff" kicks in. That's a pretty good cue that you're poisoning yourself. Not so with Provigil.
If you want one that sneaks up on you, try fen-phen. No noticeable side effects and then you die of a heart attack.
As for modafinil, a quick look doesn't turn up any long-term safety studies (pub med is either down or even slower than usual today, which amounts to the same thing, so I might be missing something), except for one 9-week study. You could smoke for 9 weeks without being affected much.
It's not like it's a rare thing for drugs to turn out to be harmful. We'll just have to wait and see.
EDIT: given the lack of long-term safety studies, but also the lack of problems with short-term studies, I personally would use modafinil for finals week or a long car trip or something like that but not day-in day-out for years.
Realistically, I am not going to read every single study on every single substance and make my own judgments. The government doing it for everyone, with force of law behind them, is better for all of us than just letting anyone sell anything and make any claims about it they want and expecting all of us to do all of our own research about everything.
Can the FDA make mistakes? Of course. Realistically, are they more likely to make a mistake than me, based on my own research and interpretation about things on which I am not an expert? No.
I hope that FDA keeps those drugs unavailable for next 40 years, and during that time hundreds of organization and individual doctors around the world will be able to test the long-term safety.
What incentive does a drug company have into spending millions of dollars researching and developing a product to maybe reap benefits 40 years in the future? In a similar situation, I would move onto something more lucrative in a reasonable time frame. It's conceivable to imagine an industry completely stifled by having extremely high barriers to market entry.
Additionally, imagine being forced to use research that is at least 40 years behind the curve (undoubtedly it'll be more), when the new is available.
I understand you may have been exaggerating -- but this is still a good point to bring up.
Well, not everything on earth should be done by the private businesses. This one can be financed by the public, knd of like the nuclear bomb and stuff.
Legal mind-enhancing drugs are a great danger to society. They will put everyone in the position where they have to take those drugs, or risk perpetual unemployment. If side effects surface decades later they will cripple entire population of the country because no one will be able to abstain. The same level of danger is not present in any other drug - there is currently no pressure to take drugs on anyone but small group of competitive athletes.
"Legal mind-enhancing drugs are a great danger to society. They will put everyone in the position where they have to take those drugs, or risk perpetual unemployment."
Replace "drugs" with "education", and ask what should be done. Ban learning?
By contrast to drugs, "education" has thousands of years to prove it's long-term medical safety. Different drugs have proven to have all kinds of nasty side-effects to a point where it is normal to hold them all suspect by default.
Sometimes you have to take risks. There is some question as to whether cell phones have long term medical risks, but I bet you use a cell phone (for increased productivity no less).
"Steps to keep the benefits from making socio-economic inequalities worse."
Not impressed - they would rather everyone be equally "stupid" rather than some people be smarter than others? These drugs do not take away from anyone, they only add.
"But she said she was concerned that wider use of stimulants could lead more people to become addicted to them. That's what happened decades ago when they were widely prescribed for a variety of disorders, she said.
"Whether we like it or not, that property of stimulants is not going to go away," she said."
So, substances with a known history of addictive behavior. This is what we call burying the lede (quote from page 3 of the article). As important as the other considerations are that were brought up, this seems to trump them.
Do we know how addictive? Addictive like caffeine, or crack, or somewhere in between?
Modafinil seems to be an interesting way to augment your mental ability - No short term effects, except for a slightly increased heart rate. [see link for experiences]
Are use of drugs like these prevalent in the startup world? I can imagine it has to be pretty tempting. Plus there's the added incentive that you already (should?) have pretty productive people and stacking another multiplier on top of their productivity would be hard to turn down.
Or is it the case that working in a startup is already motivating enough that there wouldn't really be much of an additional benefit?
No because unlike sport, which is artificial competition for entertainment, mental work is real productive work that benefits society. Increasing our mental abilities can make the the world a better place, the same cannot be said of steriods and sporting ability.
Another difference is that steriods at the level taken by athletes use is demonstrably harmfull for their health, this is not necessarily true for mental boosters.
"which is artificial competition for entertainment, mental work is real productive work that benefits society"
Uhhh, professional sport isn't 'real' work? I would would say without a doubt every single processional athlete probably works much harder then your typical white collar worker (due to the fact that they are not typical athletes) As far as "productive" goes, each pro organization is staffed with hundreds of people all doing 'productive' work which is possible because of the athletes that work for the corporation.
I have nothing against professional athletes. In fact I admire them a lot. But let's face it, sports is a zero sum game from the perspective of skill level. What real difference would it make to the world if all the world's athletes were 10% less fast/strong/coordinated etc...? Would people still be interested and entertained by sports - of course they would. In watching sports people like to see a contest of the best but the absolute standard of the best doesn't really influence that value. This is even more the case in sports participation. People like to feel they can compete at a particular level but it is all relative.
Now contrast this with mental abilities. If people can solve medical problems then they can prevent deaths and enhance health. If they can solve technical problems they can make peoples lives easier and allow them to achieve more. In general mental skills can make the world a better place. Not a zero sum game.
Sports is artificial competution under arbitrary rules. There is no benefit to people violating the rules. Using steroids in sports is like riding a bike in the marathon.
In contrast, regular "productive" work is not trying to be entertaining, it has other goals (e.g. moving packages from one place to another). If I ride my bicycle while delivering packages, more packages get delivered.
I think the mainstream attitude towards steroids is very hypocritical. If you're meant to play with what God gave you then surely athletes shouldn't even wear glasses! Tiger Woods had his vision surgically "corrected" to 20/15 (better than "normal") and no-one bats an eyelid (haha). Athletes regularly use the steroid cortisone to recover from injury, is that not cheating too? All anabolic steroids do is enable an athlete to train harder and recover quicker, they are not magic, you still need to put the work in, you can just choose to burn twice as bright for half as long.
There are sooo many downsides to anabolic steroids. Especially if you take them when you're young.
And cortisol is technically a steroid, but not the body-enhancing type that everyone refers to.
And steroids do allow you to train harder and recover quicker, but you still have to cycle off after 6-8 weeks... and then you go back to your original strength.
There are downsides to the pro athletic lifestyle, full stop. Why do you think there are so many teenagers in Olympic gymnastics? This is what I mean when I say hypocrisy; no-one has any problem with a 14-year-old winning their country a medal, who even remembers them when they're 24? The puritanical attitude towards steroids is inconsistent.
Sure, that may be bad, but steroids have much, much more downside relative to the other examples you have given.
Hard training at a young age can lead to amenorrhea and slowed hormonal development, but anabolic steroids cause irreprable damage to your liver and kidneys. And will ruin your joints.
There is no inconsistency here. It's not binary, it's on a gradient.
There isn't any medical evidence for that. Overuse of anything is bad for you. There is no medical reason that, if used under proper supervision, steroids should result in any long-term physical damage. In fact, as is the case with cortisone, steroids can improve an athletes chances of recovering from an otherwise career-ending injury. These aren't drugs remember, just more of what your body produces naturally. If you want to ban people from adjusting their hormonal systems in support of their lifestyle choices, you'd have to ban the Pill too.
I'd like to see an incident where caffeine has caused such severe cutaneous and dermatologic reactions as modafinil has. If such drugs were deregulated, we would certainly see the number of victims of these horrible reactions go up.
Can't really call them victims if they go into it with knowledge of the drug and it's effects.
Now if deregulation also resulted in drug companies actively concealing negative side effects, and thus duping consumers, then they would have been victimized.
Einstein didn't believe in free will. However, he said that holding people responsible for their actions was a pragmatic approach for society to take (presumably because such action changes the environment that we are all in).
There are huge struggles because people don't want to accept that they have less free will than they ascribe. As such, the goal is to hold people responsible for faults that you don't have and find excuses that let you off the hook for any faults that you have. There are organizations that create campaigns to get society to accept their fault as something that should be compensated for. Short attention span? That's ok because it's medical. Stupid? Lazy? Those are things that are the fault of the individual.
It's really hard. If you can medicalize your faults, you get legal protection for them. If you can't medicalize them, you're personally responsible for keeping them in control. That creates a huge incentive for medicalization of everything in the human condition. And we're all worried about being left behind in this Red Queen's Race.