The ‘smart drugs’ revolution: how pharmaceuticals will leave us ‘accelerating into a 24/7 society’

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You probably know someone who takes cognitive-enhancing drugs.

Pilots, heart surgeons, famous novelists, pressured city traders, renowned professors (and their students), as well as astronauts, soldiers and IT analysts, to name a few.

If you asked them about their diphenylmethylsulfinylacetamide use, they’d stare at you blankly.

But mention Modafinil, and they’d know that you know.

‘With the knowledge economy, a lot of people require long periods of concentration and are having to use their brainpower for long periods of time,’ says Barbara Sahakian, professor of clinical neuropsychology at the University Of Cambridge.

‘People are using [smart drugs] to keep competitive, to get into the best universities, and then to get the best exam scores.’

The use of smart drugs, like Modafinil, is at an unprecedented scale – and it shows no signs of slowing down.

Between 2015 and 2017, people using substances for ‘pharmacological cognitive enhancement’ jumped from 5% to 23% in the UK alone, according to a survey of tens of thousands of people.

It’s predicted the global brain health supplement market will reach $10.7bn (£8.3bn) by 2025. As a comparison, it was worth $1.74bn (£1.35bn) in 2016, the most recent figures available.

Though not all of that money will be spent on Modafinil, it shows the public’s creeping appetite for drug-based brain enhancements.

Aside from the medically-approved Modafinil, a vast, often unregulated industry is booming, from podcast superstar Joe Rogan-endorsed Alpha Brain to actress turned wellness expert Gwyneth Paltrow’s own Goop-branded Nerd Alert.

And the future will see not just the amount of drugs consumed go up but the level of impact they have on the people using them.

All these drugs fall under the broadly-defined umbrella of ‘nootropics’ – a term coined by 1960s Romanian chemist Dr Corneliu Giurgea, when he accidentally discovered apparent memory-enhancing effects of a drug called piracetam.

Dr Giurgea’s decree more than 40 years ago that ‘man is not going to wait passively for millions of years before evolution offers him a better brain’ now seems prophetic.

Today, nootropics spans from simple ‘natural’ supplements, like caffeine, to obscure ‘synthetic’ research chemicals tested by enthusiastic hobbyists – though some experts see less of a separation.

Caffeine is the active ingredient in coffee and has been used for hundreds of years to promote wakefulness. While proponents claim it can enhance memory, the medical evidence is inconclusive.
Modafinil was used in treatments for narcolepsy since the 1990s. It’s since become widespread for it’s supposed focus-enhancing effects, though there are arguments against its longterm safety.
Piracetam was discovered in the 1960s by Dr. Corneliu Giurgea, who coined the term ‘nootropics’, after finding the drug helped improved patients’ memory. The medical establishment still isn’t sold, however.
Noopept was developed in Russia in the 1990s based on Piracetam, and is highly popular today in the ‘biohacking’ community. Thousands of people take it daily, but it was made illegal in 2016 as part of the government’s ‘legal high’ ban.

‘People make this distinction, but a lot of our drugs come from natural sources,’ says Sahakian.

‘Cocaine is one example. I think this sort of distinction is a false one.

‘There are things in the environment, and some of these are synthetic compounds, but what you’re essentially doing is finding what the active compound is, and whatever the natural product might be and enhancing it to some extent.’

While natural, so much is still unknown: just how many people are using any of these drugs for a competitive edge? How many more drugs like Modafinil are on the horizon? And how safe are they long-term?

Pick-me-ups have always existed.

Coffee beans and Guarana leaves have been consumed for their caffeine for hundreds of years, while amphetamine-based stimulants were consumed en masse on the battlefields of World War II.

But drugs like these have unwanted side effects; take too much caffeine or amphetamines, and you’ll feel dizzy, nauseous or much worse.

It wasn’t until the widespread recognition of attention deficit hyperactivity disorder (ADHD) that neural enhancers became more refined.

Methylphenidate (sold as Ritalin) and amphetamine salts (sold as Adderall) production boomed in the US, being prescribed to millions of kids (and inevitably ending up in the hands of not-kids, wanting the attention-focusing effects for non-ADHD reasons).

These chemicals play with specific neurotransmitters in the brain, improving what’s called cold cognition – a sort of mental processing independent of your emotions.

‘Drugs like Ritalin block reuptake, so they increase the amount of dopamine and noradrenaline that’s around,’ says Prof Sahakian.

‘Noradrenaline is very useful for attentional purposes, while dopamine is very useful for what we call executive processes, being involved in motivation.’

However, the rush that some of these neurotransmitters produce also raise the risk of addiction and abuse (millions of ADHD-related drugs are prescribed in the UK each year).

It’s these downsides that have led to resistance against wide-spread adoption of neurologically-enhancing drugs.

But Modafinil, which also works on dopamine, has shown the first glimpse that an alternative exists.

‘A lot of these drugs are working through similar systems to some extent, but the difference is that Modafinil so far has not been shown to have any abuse potential,’ says Sahakian.

The task-related motivation boost with no major downsides, previously the stuff of fiction like Bradley Cooper-blockbuster Limitless, appears to be within reach (though only under strictly controlled conditions).

But could we do better, and will it ever become normalised?

‘People are becoming more accepting,’ Sahakian says.

‘Before, there used to be more people who thought that healthy people shouldn’t be taking these drugs, but now there seems to be a change.

‘A lot of what stops people is the concern about side effects and addiction.

‘If you could ensure these side effects and the addictive properties were very low, I think the drug would be very attractive.’

Even with the purported side effects of higher dosages, Modafinil use is remarkably widespread, with almost 1 in 4 Brits having tried it in the past year.

This could just be the beginning. As we understand more about the specifics of the brain, and the ways in which different areas relate to cognitive tasks, the potential for new drugs increases.

‘We’re getting better and better in studies that we’ve been doing in animals with trying to deliver specifically to different brain areas,’ says Sahakian.

Though not drug-related, one study found that obsessive-compulsive disorder (OCD) symptoms could be reduced by targeting very specific regions in the brain.

This technique of a machine providing what’s called Transcranial Magnetic Stimulation (TMS) has already shown to increase cognitive abilities in healthy people.

It’s easy to imagine a future where you could walk into a pharmacy and choose between a single pill or ten minutes on a TMS machine, and walk out markedly smarter.

Given the apparent lasting effects of TMS, it could even be both: smart drugs for a short term boost and TMS to cement your mental gains, or TMS to nullify the worst side effects of the smart drugs you’re taking.

There is no scientific consensus on where this ends up: humans taking control of evolution could end up with microchips and/or telepathy being the norm, an increasing number of potions and pills being taken or a reaction back to a more ‘natural’ way of living.

While controversial, acquired savant syndrome – where some kind of brain damage unlocks some kind of ‘genius’ ability previously hidden – has led some researchers to believe that there is so much untapped potential in the brain that is just waiting to get out.

For now, there are still too many unknowns about the brain for the potential future uses to be clear.

But smart drugs are already here and the history of human beings and their drug use can give us clues for the rest of us.

The drugs of an era can often mirror the times people live in.

The 1960s, with its mind-altering lysergic acid (LSD) echoed the remoulding of politics and protest. The 1980s embodied enormous growth and full-throttle capitalism, so cocaine was a natural choice.

So what is the drug of the 21st century?

‘We’re accelerating into a 24/7 society,’ says Sahakian.

‘When people want to take a smart drug and cognitively enhance themselves, it’s usually in the context of what we call cold cognition.

‘They want to remember more, they want to do better in the exam, they want to be able to produce better, faster work than their colleagues.

‘But nobody really says “I’d like to improve my heart cognition, my emotional and social skills”, which is so important for bringing people together.’

And people don’t often realise there’s a cheap, drug-free way of making you smarter: exercise.

‘Exercise is a very good means of boosting your brainpower, improving your mood and improving your physical health.

‘But people don’t want to put in the time for that sort of thing or don’t enjoy exercise and would just prefer to take a pill.’

This pill preference is the reality for many— the pilots, surgeons and professors of the world.

With ever-increasing pressure from all angles, it’s unlikely the relentless pace of modern life will let up – leaving space wide open for a vast ‘smart drug’ business.

It just depends if the ‘savant syndrome’ drug can be devised and manufactured safely, if people will move towards implants before scientists ever find the magic pill or if we let natural evolution run its course.

The smart money is on one of the first two.

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