Psychopharmacology will always occupy a special place in my heart, because it was through addiction research that I became interested in neuroscience. My memory of my intellectual development is generally quite fuzzy, but I can clearly remember the formative experience that sparked my interest in psychopharmacology. Through the College Now program, I was taking an introductory neuroscience course at CUNY Queens College despite the fact that I was still in high school. During the unit on psychoactive drugs, the professor mentioned that ADHD drugs like Ritalin (methylphenidate) and Aderrall (amphetamine) are routinely used as cognitive enhancers by students and professionals. This was the first time I had ever heard of these drugs being used recreationally, and I distinctly recall that my first reaction, based on the little information that I had been presented, was not just skeptical but positively censorious: these drugs represented a threat to the meritocratic ideal of education, and the case for prohibiting them seemed airtight. Then, one of the other students asked the professor a question about the ethical issue of using such cognitive enhancing drugs, making an invidious comparison between her own unassisted work ethic and her friend’s dependence on these drugs. The professor began his response by pointing to the cup sitting on the student’s desk, which was clearly coffee. He went on to say that caffeine is also a stimulant that improves attention and memory, but no one would think of stigmatizing someone who drinks coffee to improve their performance on an exam. This was a revelation to me, and a lesson: do not make scientifically uninformed judgments, or you will pay a cost in public criticism and private embarrassment. Outside of this general lesson on intellectual humility, my interest in the neuroscience of psychotropic drugs was kindled. As I read more into the subject, I increasingly realized that psychotropic drugs resided at the nexus of so many other fascinating intersectional issues:
- Evidence of evolution, and encouraging doubt in religious explanations. “Nothing in Biology Makes Sense Except in the Light of Evolution”. This was the title of a 1973 essay by evolutionary biologist Theodosius Dobzhansky, and this notion is absolutely critical in order to make sense of psychotropic drugs. Dobzhansky’s essay was a rebuttal to creationists who argued that evolution could not possibly explain the complexity of life, but it serves just as well as a reminder to biologists not to immediately assume that any structure or behavior they observe in an organism has adaptive significance. A recognizable example is the human appendix, which has no known function other than to become infected and then burst; and removing it has no obvious medical consequences. If you are a creationist, a patently maladaptive organ like the appendix presents a problem. Without recourse to evolutionary theory, your options are limited to (a) postulating a conspiracy among doctors to hide the true, magnificent function of the appendix, (b) ascribing the appendix to a malicious designer god or demon, or (c) ignoring this piece of counter-evidence entirely, hoping nobody notices. Anything but consider the evidence supporting evolution. From my perspective, the sheer maladaptiveness of drug addiction, and the way it nastiness cuts across populations both godly and secular, is so salient that ignoring it is impossible, and religious notions like demonic possession and inherent sinfulness have to be marshaled. The fact that these nonsensical psychotropic drugs of abuse are persuasive to so many is less important than the fact that religious authorities consider it a priority to immunize their flock against the reality. This suggests that as the lingo, major concepts and ethical implications of the neuroscience of addiction increasingly trickle down into the general population –as they are in the process of doing– religious explanations of addiction will be replaced with scientific facts. And, hopefully, the manifest conflict between religious dogma and settled science will propel more people towards rationality an skepticism.
- The myth of a hard distinction between evolutionary psychology and evolutionary biology. There is a corresponding –though far less pernicious– form of evolution denialism that has been espoused by left-leaning scholars and scientists (e.g. Steven J. Gould) whose values I otherwise share, one that recognizes the primacy of evolutionary explanations when it comes to physical traits like height and automatic behaviors like the knee-jerk reflex, but when in comes to the mind privileges environmental explanations over evolutionary ones even in face of contrary evidence. This tendency, which was the subject of Steven Pinker’s masterpiece, The Blank Slate: The Modern Denial of Human Nature, is at the heart of much of the criticism of evolutionary psychology, and is the product of lazy thinking that makes a sharp distinction between the body (which evolution acts on) and the mind (which is shaped by the environment). Such a hard distinction is incompatible with modern neuroscience, which reveals that the mind is a byproduct of the workings of the brain, and the brain is the product of evolution by natural selection. In my estimation, psychotropic drugs are the most compelling evidence for the interrelationship between mind and brain. Whereas most kinds of scientific evidence are accessible only to experts in the field, any layman with a dose of LSD can verify the extent to which the mind is influenced by the physical factors (in this case, the binding of drug molecules onto receptors, triggering the cascade of events that corresponds to the experience).
- The sociology of addiction. In Fall 2009, during my abortive semester at Skidmore College, I was fortunate to have taken a course called “Neuroscience and Addiction”. Unlike most introductory psychopharmacology courses, this one emphasized not only the biology but also the societal impact of addiction. The first unit of the course examined the impact of drugs on human societies, both throughout history and among various countries. Far from being tangential, these historical and cross-cultural perspectives were crucial to understanding how misguided, provincial, unscientific, and unethical the current U.S. drug policy is. A theme of the course was that drugs/addiction are highly moralized in our society in a way that is not only uncompassionate to those afflicted, but also counterproductive with respect to prevention and treatment. More so than any other aspect of our national policy, the screwiness, unfairness and futility of the War on Drugs holds a special place in my heart as the most sparkling example of government incompetence.
I have some truly remarkable insights regarding the kind of cognitive enhancing drugs that I mentioned before that, alas, are too small to fit in the margins of this post. However, I look forward to dedicating an entire post to this engrossing topic (about which I consider myself an somewhat knowledgeable) in the near future.