Tuesday, July 21, 2015

"Memory Enhancement: A Perspective within Bioethics"

Posted for John Holloway

“There is no such thing as philosophy-free science, just science that has been conducted without any
consideration of its underlying philosophical assumptions. “ – Daniel C. Dennett, Intuition Pumps and Other Tools for Thinking

Memory enhancement modern day via nootropics, or brain-enhancing drugs, has been swelling
since Piracetam in the 60’s with a potent subtlety.  While this movement of sorts has quickly washed
over the modern day college student, and other groups, the waters grow increasingly muddled as the
number of nootropic users rise. I would like to discuss some of the risks and dangers of nootropic use, the disparaging fairness to differing socioeconomic levels, neurochemical repercussions that are slowly but very surely being included in the literature, and how I believe these substances could make for a misrepresented level of functioning among seemingly untraceable individuals in populations where such functioning is rewarded and admired.  

Nootropics drugs can increase memory encoding and recall, overall mental acuity, brain-derived
neurotrophic growth factor, attention and even analytical ability (variably and respectively.)  There are nootropic drugs that have expansive mechanisms of action and are widely available without prescription or clinically noted cognitive defect. Primarily, these drugs work to increase hemispheric communication, raise levels of availale acetylcholine (acetylcholinesterase uptake inhibitors, the racetams), antagonizing NMDA receptors (Namenda), or simply boosting attention with substances like amphetamines so more astute and fine-cut observations/connections can be established while
distractibility is minimized. Taking a step back to the availability, is it fair that some people can afford quality nootropic substance while others may not have the means to do so, or may only be fiscally prepared for a substance from an disreputable brand? What kind of edge do the people who are knowledgeable on, and can afford, these products have on others who are oblivious to their existence or don’t have the means in the classroom? What about standardized tests? There is a lofty
misrepresentation of the thought-action repertoire and overall capabilities of an individual’s mental
faculties that can occur in someone taking these drugs- and this misrepresentation can make for a slew of ethical concerns. I suppose misrepresentation would only be appropriate if the drug works when you decide to take it, but holds no foregoing benefits of use after discontinuation.

Often an oversight in this area is that of long-term nootropic use with improper cycling. While
with certain nootropic families who have been around for decades (the racetams, piracetam in
particular) and have no reported adverse effects in chronic use, other newer formulas have serious
potential adverse effects on one’s biochemistry as a whole. For example, Huperzine A, or huperzia
serrata, a Chinese club moss is popularly thrown into nootropic blends and sold over the counter
without proper labeling of the risks or instructions of proper cycling. Huperzine A, an acetylcholine
esterase uptake inhibitor, breaks down the enzyme that removes acetylcholine (holds a strong role in
learning acquisition and memory) from the cell cycle after it binds to its postsynaptic receptor. In
individuals who are “healthy” and take Hup A, this means the acetylcholine continues to be recycled
through the cell cycle and builds up in comparative abundance, eventuating into more cholinergic
postsynaptic receptors being constructed, so more acetylcholine can take effect at once. What
eventually happens through daily use (it should be cycled), is the levels of acetylcholine become so high that its very production is slowed (downregulation). As the production of your endogenous (naturally produced within the body) acetylcholine is slowed, you are also building a tolerance to the Huperzine A. What do you do when a medication stops working? Most people will either increase the dose or switch medications, but increasing the dose here will simply exacerbate the precise issues I am writing of. The combination of ACh downregulation, tolerance build up, and ceasing the medication can result in major cognitive impairments in the way of learning acquisition and memory encoding/retrieval as now what little ACh is being produced is only binding to a fraction of the available postsynaptic receptors, plus the acetylcholine is leaving the cell cycle as opposed to being recycled through, making for a large leap away from our body’s natural homeostatic state. We now have very little acetylcholine being produced, our memories are shot and the question arises of is your motivation/willpower strong enough to push through these defects and into the waters of intellectual pursuit to try- pressuring your brain through intensive stimuli and hurdles of analytics to create more acetylcholine, or upregulate it- and succeed with a likely fickle and tentative neurochemical state?

Moving to the future with genetic enhancement of memory, in Sandel’s The Case against Perfection, it was discussed how researchers produced “smart mice” via mouse embryos containing extra copies of a memory-related gene. The impressive, and terrifying, factor to note from this research was that the mice passed their enhanced cognitive abilities onto their offspring. Sandel says “such use would straddle the distinction between remedy and enhancement.” With respect to the concern noted in Sandel’s book, I believe two subspecies of human may very well be a logical eventuation of the cognition enhancement wave- especially with the increasing disparity between socioeconomic levels.
Should we even aspire for such use of our bioengineering capabilities? My theory, being that we are
very social creatures and the peer influence effect is ever so potent, humans will continue to do what
makes them feel good and what they see makes their closest friends feel good. Nootropics could
become the “drug of choice” for a swelling mass of individuals who take pride in perceived cognitive
capabilities over sedation or transcendence-abating stagnancy. This could be especially so if in a world where the population could be seemingly splitting in such a way Sandel spoke of. I believe most with a healthy prefrontal cortex would find the means to become “enhanced.” I say this, just as many impoverished find the means to get “high” in today’s society. Who knows, with so many bold and astute intellectuals bumping heads, the drive to succeed seems likely to skyrocket in such a scenario. Assuming the nootropic game isn’t streamlined in the future where everyone is taking the same concoction, many people will be enhanced with respect to specific areas of cognition, but not all will be the same. Certain jobs are particularly catered to different modes of cognition, like a taxi driver’s need for spatial awareness and memory. While the idea the opposites attract is but a myth, it means we as humans generally like people who are similar to us- but not necessarily similarities with respect to how much we can memorize. Though, we also tend to like people who possess traits we ourselves wish to possess, so in that way the danger of two subspecies of human (intellect) developing may whisk about in a world where people aspire to be sharp-minded. The average Joe with a baseline working and short-term memory taking an Icelandic vocabulary test will do better than “enhanced joe” who took a nootropic, one that has a mechanism of action working on GABA receptors for test-anxiety relief and enhanced concentration (due to less rumination), because joe is likely to be inducing impairments to his memory via the sedating influx of GABA or GABA agonists.

Will we reach a point where in order to keep up with the rat race everyone must ingest some
form of brain-boosting compound, or otherwise be deemed lowly or seen in an inferior light of sorts
when it comes to matters of the mind? Even more problematic, isn’t everything we do on a day to day
basis a series of personal choices, so all of our thoughts and consequential behavior are a “matter of the mind” in essence? Maybe, however, your endogenous levels of acetylcholine are actually too low, and you need the boost to function at some level of equivalency to others of your age of your level of
education. Well, first off, how do you know past pure speculation or experience of a subjectively
withered mental state that you are deficient in some regard? We don’t quite have the tests to
accurately measure neurotransmitter levels- while claims are made on this topic and some tests offered- I believe, in line with the literature, you cannot accurately measure these levels through blood serum.

How would you know where you stand in comparison to others with regard to mental functioning?
Neuropsychological evaluation, sure, but in all reality this wouldn’t be feasible for all, or many.
So what, then, should be the cause for pause or the green light when it comes to supplementing
with these “smart pills?” Should it be done at all? To feel better about yourself in that you function at a perceived higher level of cognitive faculties than you once did? Than your competition currently does?

We do many things to feel better about ourselves, to patch up invisible defects within our homeostatic
state, but nootropics bring about that point where feeling better meets with being psychologically more resilient through a widened spectrum of thought and perception on matters at hand and to come. There could likely be a perceived lacking of innate abilities, I should say, and a danger is exactly that. If one feels a lacking, sometimes a pill of any sort, or a prayer, etc. is enough to make the lacking dissipate into feelings of contentment with one’s own self. A placebo- it can be anything, not just some inert pill. Let’s talk about, not the potential of two subspecies of human, but rather a perceived split-self. Instead of filling a perceived lacking you may possess (you #1) by examining what areas of your life may be lacking in attention, why not take the drug that will make you smarter and more equipped to handle the situation? So, the novel smarter you (you #2) comes about as the nootropics take effect, or even before, and this creates two semi-fixed points on two different spectrums of self. You held consistency of self in your non-nootropic state (barring experiments in inebriation) until you switched gears into the realm of perceived higher mental functioning you didn’t think you were capable of, and the two selves dance and glance about one another, fighting for prominence of being. When not on the nootropics, an intellectually-trying situation may arise where instead of comparing your perceived detriments of cognition to other individuals’ seeming superior abilities, you may now also compare your perceived detriments in an area to something you #2 could have handled with ease. 

The science is far too scarce on the collateral effects, or undesired effects, these drugs may have
in the long-run. Further, if it is true that these drugs can induce a profound deviation from the body’s
homeostatic healing mechanisms even after having been ceased, for the better or worse, are you, as
Hesse would say, “living in accord with (your) true self?” Or James, living in synch with your “habitual center of personal energy?” If an individual approaches you and tells you of a, truthfully, very brilliant idea- one he later says arose after taking a nootropic substance- would you attribute a greater degree of the brilliance to this individual or one who had the same unprovoked idea, by means of his ‘natural’ mind? An issue here within the field of AI would be known as “credit assignment.” Whom, or what, do we attribute the great idea to? If an employee receives a promotion due to landing 4 accounts in one week while experimenting with nootropics, should the individual’s boss be made aware of the substance use? Can he make the promotion contingent on a necessitated continuation of his nootropic regimen?

Further, if individuals use these substances to get ahead in the job market, it is possible one may simply feel obligated to remain on the nootropic they used throughout college. Possibly to impress an
interviewer for a job in your field with “enhanced” mental fortitude and veracity, in fear of a
consequential subpar quality performance of work.

Well the waters start to get muggy when you also consider the fact that by definition, food in
general is a drug. Many foods- like blueberries, lion’s mane mushrooms, sauerkraut, and wheatgrass-
have nootropic effects. Anything consumed that benefits the body nutritionally will inevitably aid in
brain functioning via the very pertinent gut-brain connection, where constant communication is taking place. The gut is considered our 2nd brain, wherein resides close to the number of neurons as your spine possesses, so we are impacting far more than our hippocampus or prefrontal cortex (or other ideal/designated areas) when we consume a nootropic substance, or any substance for that matter, which is important to know but rarely said. A distinction I would make, however, is the literature on nootropics compared to the literature on whole foods would note a statistically significant profundity in psychoactive effects with respect to attention, etc., that is rarely experienced of similar degree after consumption of blueberries. All of this to note that nutrition and whole foods aren’t offering the, generally, instantaneous and flagrant cognitive benefits that nootropics offer- so they are surely something we should examine further, no?

It would seem that, as is typical, knowledge of the realm is pertinent to travelling safely within
its parameters. Those who know how to use these drugs so downregulation (for example) of crucial
neurotransmitters is avoided, those who know where to get the highest quality for the best price, those who know that even after chronic exposure to the substance and a ‘proper’ cycling of your brain-boosting regimen, there is still a chance that one may incur some serious cognitive defects because every individual is different--- these are the ones who will be of a more-informed, and consequently (arguably) superior (in some respects), stature with risk variably but significantly more minimized than those approaching these substances expecting intelligence in a pill with the blind faith positing that if it weren’t safe it wouldn’t be sold over-the-counter, or so popularly used (or abused.) There must be a certain level of knowledge acquired before one can safely swim these waters, just as for driving a motorcycle or knowing how much sugar is too much. If nootropics do become commonplace, considering the multitude that exist nowadays, harm reduction must be priority.