Could We All Soon Be Taking the 'Limitless Pill', the Drug That Will Turn Us Into Superhuman Workers?
No one knows much about modafinil, the study drug on the rise in Britain's universities and workplaces, but we do know it works and that it gives you a terrible headache.
A pack of modafinil. Photo by the author
Wouldn't your career be going better if you could actually concentrate? Mine would. Imagine it: a workday without distraction, where the mere concept of rest was for the weak and puerile, and your mind was razor-sharp until you decided you were finished with it until the morning.
Study drugs – or, to be more accurate, prescription drugs not being used for their intended purposes – have been around for a while. The pros and cons of each are known to anyone into them. Ritalin, for example, which is used by people with ADHD and narcolepsy, improves concentration. However, it's highly addictive and carries a risk of leading to a psychological or physical dependence. The intense focus can backfire, too: one friend told me the day before his final exam, he accidentally spent hours alphabetising his bookshelf and cleaning his flat rather than studying. Then there's Adderall, which increases your mental focus and can be taken like coke as an upper on nights out, but can lead to paranoia, anxiety and severe depression with continued use. Another friend warned me about ethylphenidate, which is similar to Ritalin, because, in her words, "It is fucking horrid and will make you feel like you are having seven heart attacks, including sadness, and I wouldn't wish it upon my worst enemy."
But there's one pill rising to the top in Britain and overseas: the "Limitless pill", modafinil – the only smart drug clinically proven, as of last year, to actually work. It makes people alert, but isn't quite as intense as others. Professor Barbara Sahakian, who's leading the research into modafinil, told me that while she'd never advise anyone to take it until we know what it does in the long-term, she's done a number of studies with it and never experienced any adverse effects. As far as the experts are concerned, it's legit and safe in the short-term. So could popping pills to concentrate be the new normal in the near future?
The dramatic rise of modafinil use in universities suggests: yes. As many as one in four students are said to have taken it, and in 2013 Sky News found that there was a black market for the drug on campuses, with students bulk-buying it and selling it on. Dealers told me they've been surprised by the rapid price increase. "A few years ago I'd be able to get them for next to nothing," said one. "They'd be piss cheap from Mumbai. Now they're about triple or four times the price."
The problem is that, despite the fact we know it works, we don't know how. Originally synthesised in France in the 1970s, modafinil was approved as a treatment for narcolepsy and other sleep disorders in 1998. Some studies have suggested that it affects the brain similarly to substances like amphetamines and cocaine. Professor Anjan Chatterjee told me that, in animal models, it increases extracellular levels of dopamine – the hormone we release when we eat or have sex. This means that, like other study drugs, it could turn out to be addictive, but because there are no long-term studies we don't know that yet – or even it's dangerous or not. We don't know how it affects those with poor mental health, or if it reacts with mental health meds.
"I'd like to see the government look at drug-drug interactions," said Professor Sahakian. "It'd allow a young person with depression or anxiety, for example, to be able to go to their doctor and say, 'I'd really like to use this drug, but as you know I'm already taking this drug. Is it safe for me to use it?' And the doctor can also monitor you more carefully."
Conversely, we don't know how brilliant the drug could be. "I've actually used modafinil as an add-on to medication in people with schizophrenia, to try to improve their cognitive function for when they go back to work or university," Sahakian explained. "I think it could be a good cognitive enhancing drug for people with various mental health problems."
I wanted to see if modafinil would work for me, so came by some through a friend. Looking online to see what any prospective buyers should expect, I found one site selling 40 pills of 200mg pills for £52, which seemed pretty reasonable – at one £1.30 pill a day, that's enough to get you through an entire exam season.
This site advised taking 100mg, or half a pill, for beginners, so I split one in half and had it at 10.45AM. By 11.30 I felt no different, so in classic impatient high chasing I had the other half. I felt the effects by midday: it was like having a really strong coffee without the edginess. I realised that I didn't want to do anything else that day other than write this piece. I was supposed to be calling my friend at lunch and I was annoyed that I had to do that. I could definitely see how this would be great if you had an essay to write and you had all the research there for you. Other effects: I'm usually ready to chew someone's arm off by 1PM, but I'd lost my appetite completely. My mouth was like a bag of sawdust, no matter how much water I drank. I didn't have any caffeine all day and didn't need it or even think about needing, which is unusual, as it's normally a pretty vital part of my routine. Later, my editor asked me to draft someone else's piece and I can't remember the last time I was so irritated. I realised I was growling at the screen.
Most of the time, though, in between being an intolerant bitch, I felt happy. I was deriving more pleasure than usual from piecing together a feature. According to Dr Scott Vrecko, while modafinil might not increase a person's ability to receive, remember or process information, it can have a positive effect on a person's mood while performing these tasks. Vrecko spent a few weeks at an American university collecting testimonies from students who took Adderall, and many said that the pill made them feel more capable of performing their tasks – even before they got started.
As I typed, I couldn't identify any real issues with taking modafinil at work. I was steaming through my article at a decent pace and never felt an impulse to flick over to Twitter or Facebook or any other procrastination platform. The only immediate downsides were a) that it made me feel quite horny, which isn't ideal at work, and b) that I had a throbbing headache from 3PM onwards that lasted through to the next day.
With more students using the drug, universities are going to have to start addressing the topic in much more detail than they currently are. Earlier this year, a Bristol university doctor spoke out about the rise of modafinil, saying she'd seen students coming in with side effects like "jitteriness, anxiety and being on edge" from overuse. Obviously the awareness is there from universities, but their official stances on the subject aren't widely publicised.
A spokesperson from Bristol told me, "Ritalin, a class B drug, would fall under our illegal drugs policy unless a student has a prescription. Modafinil, although prescription-only, is legal, and therefore a student taking it would not be infringing any university rules." However, the spokesperson went on to say that if use got out of control the university would consider banning it.
A spokesperson from Oxford University replied: "If 'cognitive enhancement' drugs are a particular problem at Oxford we have yet to see any substantive evidence for it. We would strongly advise students against taking any drugs that have not been prescribed to them as this could involve putting their health at risk." Other universities chose to not respond, implying they're either burying their head in the sand or that they just don't want to be associated with the drug, even in passing.
That approach, unsurprisingly, creates its own problems. "Indirect coercion is a big issue when you're talking performance enhancing drugs," explained Professor Sahakian. "Some students have said to me that they don't particularly want to take drugs, but they feel there's pressure because they know that other students are taking drugs to do their exams, and they're worried that they will fall behind. A colleague did a survey of 1,400 respondents from all around the world; one in five of those was using a cognitive enhancing drug. He asked various questions, one was: 'Do you think healthy children should be allowed to use these smart drugs?' and people said no. Then he asked: 'If you found out that children at your kid's school were using these drugs, would you give them to your kid?' and then quite a percentage said they would."
It's one thing when you're at university for a stint of three or four years, but what if modafinil becomes a part of earlier schooling or general working culture? If I knew other journalists were taking the drug and then saw the great pieces they'd done with its help, I'd probably be necking it daily too. A world where high powered white collar workers are all shoving drugs down their throats to stay alert sounds hideous – but familiar. We drink coffee and tea all day to keep a buzz on. The take-away coffee cup has practically become a signifier for getting shit done. Still, it doesn't mean everyone drinks it – plenty choose not to.
According to Sahakian, though, in some industries modafinil use is already rife. She knows professors who take it to finish a paper or deliver a lecture when they're tired. Touring musicians have also turned to modafinil to wake them up before a show when their body clock is scrambled. "The military have been using it for a very long time," she explained. "They need to keep people awake and alert, particularly if they're flying planes long-distance or if they're in the war arena and have to stay alert for long periods of time."
While the idea of pilots being kept awake chemically doesn't sound all that ideal, Sahakian isn't against the use of modafinil. "There are times that people can be kept safe as a result of someone being on the ball – our doctors at night, bus drivers taking children home," she says. "There was an incident a couple of years ago where a bus driver fell asleep and a lot of children were killed. If that person had been on modafinil, perhaps that wouldn't have happened. A lot of people say, 'Well, these people should just get their sleep,' but if you're a shift worker it's sometimes not that easy to get a good quality daytime sleep, especially if you're not doing it all the time. Doctors shift back and forth all the time. You also don't know the quality of sleep that someone's getting. Even as healthy people we don't always perform at our best level, thanks to stress or external pressures."
Ethically, that seems sound. But working your average competitive white collar job – me writing this piece of content, a classic example – isn't a matter of life and death, and as a knowledge-based, competitive society, that's where we could most realistically see growth in the use of modafinil. As Professor Chatterjee ultimately asks: even if modafinil turns out to be safe in the long-term, in using it more and more, where are we going? And, importantly, are we going to like it when we get there?
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