A 2015 article in The Guardian claimed that modafinil (marketed as Provigil) is the world’s safest smart drug while a systematic review published in European Neuropsychopharmacology found that modafinil does in fact enhance cognition, and it is safe in the short-term, with few side-effects and no addictive properties.
And the evidence supports its popularity. In the systematic review just mentioned, the authors concluded that it improves thinking skills, particularly those involved in complex tasks. It was also found to help with planning, decision-making, flexibility, learning, memory, and creativity. It is thought to enhance memory by up to 10% through its influence on the neurotransmitter glutamate.
So far it sounds like a silver bullet for cramming for exams and writing a dissertation with the little time you’ve allocated yourself. But is modafinil really the best smart drug? Could microdosing LSD be a better alternative? First, let’s take a look at modafinil’s safety profile.
The Safety Profile of Modafinil
While the researchers who conducted the systematic review of modafinil highlight its safety in terms of short-term effects, they also acknowledge the limited information we have about its safety in the long-term. Novelist MJ Hyland has said that any risks associated with modafinil are worth it, because of the immense benefits it’s given her.
But it’s still crucial to understand modafinil’s safety profile if people are to make informed decisions about whether to use it or not. This is especially important, considering that students are using the drug frequently.
Professor Barbara Sahakian, from the University of Cambridge, has written a book titled Bad Moves, which explores the subject of healthy people taking smart drugs. She urges caution in terms of how the drug is purchased:
A lot of people, especially students, are getting it off the internet so they don’t know what they’re buying – it could be anything. It’s not coming from a reputable source, they don’t know it hasn’t been contaminated, and they don’t know it’s safe for them to take.
Although modafinil has been deemed to have no addictive properties in the short-term, other research points to its potential for abuse. For example, a pilot study found that modafinil increases dopamine (a ‘reward chemical’) in the human brain (including in the nucleus accumbens). This is also what cocaine does. Drugs that increase dopamine in the nucleus accumbens have the potential for abuse. Taking into account the rising popularity of modafinil, those who are vulnerable to substance abuse should be aware of this.
Sahakian also draws our attention to the particular way that modafinil is used by students, and how this involves a number of health implications:
Some professionals tend to use it on specific occasions – when they’re jetlagged or when they’ve had a particularly bad night’s sleep. They don’t use it every day and they don’t use it in multiple doses. Whereas, if you talk to students, they’ve often taken a dose and then, when they feel it’s wearing off, they’ve taken another dose.
And of course that does affect their sleep pattern, because when they should be going to bed, they’ve still got the drug in their system, still exerting its wake-promoting effects. This is of course counter-productive, as we consolidate our memories during sleep.
Several students spoke to Sahakian who used modafinil during the exam periods. They revealed that after several weeks, they had the sensation of being neither awake nor asleep: trapped in a kind of twilight zone. This twilight zone between wakefulness and sleep can result in confusional states and delirium. Sleep deprivation caused by the frequent use of modafinil could result in some serious health issues.
Dr Peter Morgan, from the University of Yale, compares modafinil users to cocaine users. He said:
If somebody takes modafinil long-term, they may develop some of the same deficits in slow-wave sleep as cocaine users. Slow-wave sleep is the deep sleep that we tend to get early in the night. But by taking a stimulant that forces the body to be awake more than it wants to be, you’re disrupting its ability to regulate how much sleep it gets and the kind of sleep it gets, so it never feels properly refreshed.
It looks like the long-term use of modafinil has many potential risks. However, more research will need to be done to clarify these, and just how serious they are. But what about LSD? Can it also be used as a smart drug?
In the 1960s, LSD was usually dosed at 100 to 300ug (micrograms). On Erowid, 300ug is considered a strong dose (it is definitely high enough to induce an intense, mystical experience). Today, street LSD is about a third of that range. But there are many people who are using LSD not to ‘trip’ but to get their work done. And so they’re taking even smaller amounts – what are called ‘microdoses’. This might involve cutting up a 100ug tab of acid into 10 pieces, leaving you with 10 10ug doses, or alternatively doing volumetric dosing, dissolving 100ug of LSD into a 100ml solution, allowing for more accurate dosing. At the level of a microdose, you don’t get the usual psychedelic effects (such as deep introspection, time dilation, or auditory and visual distortions). So what do you get? ‘Sub-perceptual’ effects, but still effects that are supposedly beneficial.
Microdosing entered public awareness when media outlets started reporting on Silicon Valley types using small quantities of LSD to boost concentration and productivity. Indeed, it is interesting to see LSD, a drug associated with hippies and spiritual experiences, become used for performance-enhancing purposes – a counter-cultural drug has strangely become a pro-cultural drug, helping workers to line the pockets of their bosses, rather than cause people to ‘drop out’ of conventional, money-focused activities. This change reflects both the versatility of the drug, and the dynamic way in which culture and drugs interact with each other.
The Swiss chemist Albert Hofmann who first synthesised LSD in 1938 microdosed during the last couple of decades of his life. In his view, microdosing LSD clarified his thinking, and even suggested that microdoses of LSD could be a better alternative to Ritalin (also commonly used as a smart drug). Many proponents of microdosing today exalt its benefits. Software engineers, biologists, and mathematicians claim it induces a ‘flow state’, which is when someone is fully immersed in some activity, with a feeling of energised focus and enjoyment. These proponents also say taking LSD in small amounts enhances lateral thinking and encourages empathetic interpersonal relationships.
LSD researcher James Fadiman, and author of The Psychedelic Explorer’s Guide, states:
What you get is the best parts of Adderall with none of the side effects. You function better physically and mentally. You find the office jerk bearable and you’re more compassionate about the flaws of others. You feel you’ve had a pretty good day.
It sounds like LSD has a clear advantage over smart drugs such as Adderall and modafinil. However, many of these benefits toted by its proponents are anecdotal in nature. There have been limited clinical trials on the effects of microdosing, with mixed results. For example, we know that microdosing LSD has non-placebo effects, based on placebo-controlled studies, with such effects including enhanced sustained attention but also reductions in creativity (measured by the number of attempts on a creativity task).
A study based on a collection of self-reports (which will be less objective than a placebo-controlled study) found people felt more productive from microdosing psychedelics while a placebo-controlled study did in fact find that microdoses of LSD increased subjective reports of productivity (however, this is a subjective sense of being more productive; researchers did not actually discover whether the microdosers worked more efficiently or had a higher output compared to participants who took the placebo).
A more recent study from Imperial College London on microdosing – the largest ever such study, in fact – found that a placebo works equally well as a microdose of LSD. In other words, the expectation that microdosing will have positive effects may be what is driving those outcomes. This was precisely the conclusion of a separate study from Imperial College London, published in Scientific Reports.
There are some potential design flaws associated with this study, nevertheless: the participants sourced their own drugs (so we don’t know whether they all took LSD or the dose they took), and moreover, many participants were familiar with microdosing, so they might have been able to guess whether they had taken a microdose or not, which naive users may not have been able to do.
Also, since the study was self-blinded, this means participants implement placebo control and randomisation without clinical supervision, which is less likely to be robust than if researchers were supervising the process. The authors of the study state “We could not confirm whether participants followed accurately the self-blinding procedure.”
Despite uncertainties surrounding the non-placebo cognitive effects of microdosing, it’s still a practice that continues to gain traction – Reddit’s microdosing subreddit is growing. And many microdosers aren’t too bothered whether the positive effects come down to the placebo effect, since this effect can still be powerful, and there are no or minimal side effects involved (which can’t necessarily be said for modafinil). Another piece of good news is that the placebo effect seems to work even when you know the substance is a placebo.
LSD may have another clear advantage over modafinil. And that relates to its safety profile.
The Safety Profile of LSD
First, let’s address the long-term mental health effects of LSD. A study published in the journal PLOS One concluded:
There were no significant associations between lifetime use of any psychedelics, or use of LSD in the past year, and an increased rate of mental health problems. Rather, in several cases psychedelic use was associated with a lower rate of mental health problems.
Of course, this does not make LSD a psychologically safe drug. For those with certain pre-existing mental health conditions (such as those predisposed to psychosis or schizophrenia), or who use the drug with a negative mindset or in an unsuitable environment, there can be mental health repercussions. A difficult or even hellish experience is one thing. But being negatively affected by that experience in the long-term is something else entirely.
If we’re looking at LSD’s physical safety, then there are few safer drugs. Using Professor David Nutt’s drug-related harm scale, we can see that LSD is right at the bottom (so relatively speaking, it’s extremely safe), with magic mushrooms being slightly safer. Nutt highlighted that LSD causes no harm to others, and minimal harm to oneself – at least when compared to alcohol. However, chronic microdosing of LSD could potentially be damaging to the heart, so if you want to err on the side of caution, it’s better to microdose for a limited amount of time (a few weeks to a few months) with long breaks.
With the evidence that’s available, it is up to the user to decide which drug suits them best. There is more clinical evidence that modafinil is effective at improving cognitive performance than LSD. But LSD appears to be physically safer, with less potential for abuse. While more research is being done, one thing is obvious: using drugs to boost performance is a trend that isn’t going away.