| A blessing in disguise, albeit a very good disguise |
[Sep. 30th, 2012|04:05 pm]
Scott
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Very many of my friends sing the praises of modafinil (I have not tried it myself). They say it can make you more focused, more productive, and at least temporarily remove the basic human need for sleep. It doesn't have the normal stimulant side effects of "buzz" and agitation. And it's cheap and has fewer side effects than aspirin (EDIT: it does interact with other drugs including birth control and should be used with caution if you're on anything else; thank you  celandine13).
(it's really convenient that aspirin became a poster child for "safe, commonly used medication" despite having such an crazy array of potential deadly side effects. It means that whenever you want to push a new drug, you can say it has "fewer side effects than aspirin" and be pretty sure that you're right)
Despite its excellent safety profile, it is currently a Schedule IV controlled substance in the United States.
Doesn't this mean that I must be wrong about its excellent safety profile? No. See for example Gwern's research on the subject. About half the people reading this paragraph are going to say "Wait, don't the FDA and the entire decision-making apparatus of the United States government have more data and credibility than one guy with a website?" The other half of the people know Gwern.
It's also worth noting that adrafinil, a prodrug of modafinil which is strictly more dangerous because it contains all the side effects of the latter plus a risk of liver damage, is totally legal without any prescription at all. And modafinil is freely available over the counter in various countries (I think Spain and India) and they have yet to collapse into unspeakable wastelands of despair.
(actually, Spain kinda did, but it seems unrelated.)
It's also worth noting that the alternative to modafinil is using legal stimulants, like Red Bull and Four Loco. These actually are dangerous and can, for example, cause abnormal heart rhythms that kill you. We also saw a steady trickle of energy drink overusers in the psychiatric hospital, and although you probably need to have an inborn disposition for energy drinks to tip you over the edge, who knows how common such an inborn disposition really is? Modafinil is probably way safer than these totally unrestricted alternatives.
So you would think that I am going to argue that modafinil should be legalized. Or at least that the cultural stigma against using it should be relaxed. But that would be too easy. Actually, I want to argue the opposite.
Let's assume that the wildest claims of my friends are correct. Some of these friends got through medical school with relatively little damage by using modafinil to study eight or ten hours a day and skip sleep. Others are in the rationality community and use it to concentrate on their programming or mathematics work. They mostly agree with Gwern that it can be modeled as adding four hours to the day, both in the form of costlessly lost sleep and in the form of greater attention during waking hours.
Economists distinguish between positional goods and...and I can't find what the opposite of a positional good is, so let's call it an absolute good. A positional good is something where it doesn't matter exactly how much of the good you have, but only what your ranking is relative to everyone else. Superyachts are probably a positional good. I don't think anyone thinks "Man, this 100 foot yacht is crap, there isn't nearly enough room for all my yachting-related activities." They think "My neighbor has a 200 foot yacht; my 100 foot yacht looks crappy in comparison. I should build a 300 foot yacht." If the person involved had the option of destroying her neighbor's 200 foot yachts, then her 100 foot yacht would suddenly become more than enough.
An absolute good is the opposite. For example, if you're injured, you want painkillers as an absolute good. It doesn't matter whether your neighbors are getting more or less painkillers than you are, so much as that you are getting enough painkillers to take away your pain.
Except it's actually really hard to think of pure absolute goods. A lot of things I was going to put as my absolute good example don't really work, because our idea of what's acceptable is set by our friends and neighbors. In Haiti, people who had a house made of real sheet metal felt awesome, because most of their neighbors were still living in refugee tents; meanwhile in America a house made of sheet metal would be awful because everyone needs to have a McMansion; a McMansion, however, is quite sufficient. But in the postsingularity thoughtspace of 19-uvara-46-asxura, everyone has their own continent perfectly terraformed as a projection of ver innermost dreams, and someone with a McMansion feels as left-out and squalid as someone living in a sheet-metal shack in America.
The richer you are, the more your goods shift from absolute to positional; 90% of the value of a $5000 used car is its getting-you-places-ness, but 90% of the value of a $500000 Ferrari is its looking-cool-relative-to-other-cars.
Right now America and to a lesser degree other first-world countries are caught in a trap where almost all of their economic growth is funneled to the rich and upper-middle-class, who spend it on positional goods. Since all the rich people are spending it on positional goods equally, none of their relative position changes in any interesting way and all of the positional goods are useless.
Therefore in the modern era most economic growth in first-world countries is pretty useless as a direct action. There may be useful indirect actions, like advancing technology, increasing tax revenue that can be spent on useful absolute goods, and increasing the amount that flows as charity to the Third World, but the actual direct effect of economic growth is pretty close to zero.
Okay, let's go back to modafinil. Right now the FDA is pretty incompetent and doesn't enforce any of its own restrictions, so in practice anyone can get modafinil. And getting modafinil is currently very useful. If you're in medical school, and you're not doing very well, you can take some modafinil, gain a big unfair advantage over your peers, and shoot up the class rankings. If you're an executive, you can work much harder and get a promotion your friends can't. If you're a programmer, you can amaze the world with your vastly improve programming output.
But let's say the FDA restrictions on modafinil switched from "poorly enforced" to "nonexistent", and let's say that at the same time the cultural stigma against using mind-enhancing drugs went away. Now what?
Now instead of hiding their use behind vague rumors, those medical students trumpet their brilliant discovery of this new wonder drug to everyone. All medical students start taking modafinil, except maybe some with religious restrictions or something. Of course, this doesn't mean that all medical students get As all the time. It means that the medical schools make their coursework much harder, and the medical students go back to being on the cusp of failure. Except now that it's harder, it's impossible for most students to pass medical school without modafinil. So the religious people flunk out, everyone else has to work much harder, and in the end no student gains. Arguably future patients might gain from having better trained doctors, but I think this wildly overestimates the usefulness of the medical education system.
The same is true of executives. Now modafinil no longer means an easy promotion. Now all the executives start taking modafinil, and everyone has the same chance of getting promoted as before, except the religious people and the people who are allergic to modafinil and anyone who has a personal preference for getting more than three hours of sleep per night even though it's not strictly necessary.
Basically, obligations are a demon that eats up all the free time and happy things in your life. If only a few people have modafinil, they have an extra weapon against the demon. If everyone has modafinil, expectations and competition increase and so the demon becomes stronger. A new equilibrium is established in which there's more economic growth (so the rich get some more useless positional goods) but everyone gets four hours less sleep per night, plus they have to spend money on modafinil, plus the few people who can't take modafinil for one reason or another are screwed.
"But wait," you say. "Couldn't people just decide to work shorter hours and instead use the extra time they have in the day to see their family or pursue their hobbies or volunteer or do something good?"
Yes, we don't live in a totalitarian society, so that choice technically exists. Just as the choice technically exists for people to try that now. Most people earn much more than they need to live. So in theory, they have the option of working twenty-five hour weeks and spending the extra fifteen hours hiking or gardening.
But in practice, people don't. The majority of well-paying acceptable jobs demand a forty-hour work week, and most people don't have the freedom to look for the ones that don't. It costs companies less money in training and overhead to hire two people to work 40-hour weeks than four people to work 20-hour weeks, and so they will always prefer the 40-hour workers. If you want to be a prestigious doctor or lawyer or executive or whatever you have to signal your commitment by working even longer than the 40-hour Schelling point. In practice, you're working as long as the companies are legally and socially permitted to make you, which in our society is 40 hours.
If suddenly days magically get four more hours in them, then the work week will shoot up to 60 hours and stay there. People might get paid more, but the economy will adjust so that the extra money becomes necessary just to tread water, the same way it looked like people were getting paid more when women entered the work force and the family could theoretically double its income but everything adjusted. The extra economic growth will go to positional goods for the rich, and you will get 20 hours less sleep per week (granted without a corresponding decrease in restfulness), have to pay for modafinil out of your own pocket, but otherwise be in about the same position.
(couldn't the government just make a law fixing the work week at its current length thus preventing this race to the bottom and all of its unfortunate consequences? In an ideal world, yes, but the small-L libertarians would never allow it.)
So legalizing modafinil (with corresponding reduction of stigma) leads directly to you having to work four hours more every day, gain an extra item on your budget (modafinil: $1000-$3000/year), get four hours less sleep (admittedly without restfulness cost, but still unpleasant especially for a lucid dreaming hobbyist like myself), plus suffer any unknown side effects of the drug that might turn up. And for all this, you get the chance to earn money that the economy immediately siphons off and throws away on more positional goods.
Despite this I'm still not sure it would be so bad. Economic growth is a pretty powerful force, and even if most of the force is wasted there are still those small direct effects on the poor/middle class plus the indirect effects which might end up being much more powerful. And maybe the government will stand up to the libertarians and fix the work-week, or the creeping increase wouldn't be as inevitable as I think.
But compare these possible benefits of legalization to how downright optimal the current modafinil regime is.
From what two of my friends in the modafinil business have told me, it's really easy to get modafinil now - just order it online with PayPal and wait a little while for shipping. And no one ever really gets in trouble for it; Gwern's research turns up only a single case in the entire history of the US in which someone got busted for modafinil, and he speculates it was just a racist Southern court looking for some excuse to convict a poor suspicious-looking black person. This probably does not generalize to risk for the average user.
So in practice, the current regime offers no downsides to seeking modafinil. It is much more of a psychological barrier than an actual barrier. But it is an effective psychological barrier, which only a few people get across. Who?
First of all, they have to be individuals rather than institutions. A big Fortune 500 company requiring all of its employees to take modafinil probably would get busted by the FDA.
Second, they can't care too much about social stigma. There's still a stigma on stimulant use, probably carried over from some of the other stimulants which really are pretty scary (WAItW, anyone?). And of course there's a stigma on breaking the law.
Third, they have to be intelligent. Anyone without at least a little curiosity is going to do what everyone else is doing and take Red Bull or Four Loco. They're never going to find good analyses like Gwern's research, and they probably couldn't understand them even if they did. An unintelligent person won't be able to distinguish modafinil from the thousand different quack remedies that are supposed to make you "more awake!" and "give you the extra energy you need to complete your day!"
Fourth, they have to be kind of..not really anti-establishment, but at least less violently pro-establishment than usual. It's pretty hard for most people to say "Well, I guess the government is wrong about this, might as well circumvent them." But that's pretty much all the counter-culture ever does.
So: individual intelligent non-social anti-establishment people. Basically geeks. And a very specific kind of geek, too. I won't specify exactly which kind beyond that link, because internecine geek feuds always turn ugly, but I think it is pointing to a particular geek cluster.
It's hard not to be suspicious that God has planned this all along. He's basically saying "Behold, geeks, you are My chosen people, so I give unto you a major advantage over non-geeks. The hilarious part shall be that it is self-selecting; anyone who chooses to use this is the sort of person I trust to have an advantage in society. Anyone who chooses not to use it, well, they probably would just screw it up anyway."
And because these geeks remain a very small percent of the population, the problems with large-scale use don't occur. The angel Technology giveth with the right hand, but the demon Economics doesn't notice and so doesn't wake up to taketh away with the left hand. It's not that it's a win-win situation. It's that it's a win-neutral situation, which in terms of positional goods is even better.
So what does it say about me that I don't (haven't yet?) used modafinil? I'm not sure. I've always known I'm not a very good anti-establishment specific-cluster geek. Last night when a friend was explaining his theory of PCs (people who are actively doing interesting work and changing the world in such a way that things revolve around them) and NPCs (people who mostly just hang around and provide background), I might have been the only person at the table not especially convinced he was a PC.
Not that I feel any deep sense of inadequacy about this. NPCs can be pretty neat too. Schala was an NPC. If I can be as awesome as she was, I'll be pretty happy.
Oh, right. Nothing in this post should be taken as any kind of official medical endorsement of modafinil, which I have not studied in a medical context and which I am not anywhere near officially qualified to recommend or disrecommend. Nothing else in this post was more than about 60% serious, but this paragraph is entirely serious.
[EDIT: 60% serious may have been an overestimate (or we may have different scales of seriousness percent). I think the argument is correct in saying the benefits from modafinil would be much lower than most people think, but I was not entirely serious in saying they would be zero, or less than the costs. I would, with some trepidation and a high expectation of regretting it later, endorse legalizing modafinil] |
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