Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence?

Abstract

Purpose European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs. Design/methodology/approach This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey. Findings There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context. Originality/value Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.

Sociological investigations of human enhancement drugs: The case of microdosing psychedelics

“…in the legal regulation, scientific traditions, health policies, cultural resonance and public debates pertaining to these drugs. Looking into the possible effects factors such as the above can have on, for instance, users' decisions to initiate and/or (dis-)continue use builds on and tests previous findings on microdosing and cognitive enhancement drugs more generally (Cameron et al, 2020;Hupli 2020).…”

New Psychoactive Substances: Major Groups, Laboratory Testing Challenges, Public Health Concerns, and Community-Based Solutions

“…Synthetic stimulants were originally made for the treatment of Parkinson's disease, depression, and/or obesity but were withdrawn because of concerns about their abuse and potential harmful efects. But in recent years, some synthetic stimulants have been used as nootropics or cognitive enhancers and for weight loss [153,154]. Te acute mental health and physical efects associated with synthetic stimulants usage are because of sympathomimetic toxicities that can present as hyperthermia, agitation, hypertension, nausea, tachycardia, palpitations, vomiting, and headache, which are more common; seizures, collapse, paranoia, and hallucinations are less frequent [154,155].…”

New psychoactive substances: a review and updates

“… 29 , 51 Some have recently been reported to have been used as cognitive enhancers or ‘nootropics’ (classically to help students with their exams, with some reports of professionals using them to maintain attention at work in stressful environments) and as part of weight loss regimens. 52 , 53 The acute physical and mental health harms associated with the use of synthetic stimulants are due to sympathomimetic toxicity, which may present as agitation, nausea, vomiting, headache, palpitations, tachycardia, hypertension and hyperthermia, and less frequently as paranoia, hallucinations, seizures and collapse. 54 Less commonly, severe adverse effects such as significant peripheral organ damage and rhabdomyolysis have been reported, whilst deaths have been linked to hypertensive crises, hyperthermia, cardiac arrest and/or serotonin syndrome.…”