FORESIGHT BRAIN SCIENCE, ADDICTION AND DRUGS PROJECT

  Foresight[1], and its associated horizon scanning centre aims to provide challenging visions of the future, to ensure effective strategies now. It does this by providing a core of skills in science-based futures projects and unequalled access to leaders in government, business and science. The current round of Foresight—launched in April 2002—operates through a fluid, rolling programme that looks at three or four areas at any one time. The starting point for a project area is either: a key issue where science holds the promise of solutions; or, an area of cutting edge science where the potential applications and technologies have yet to be considered and articulated. The Foresight project on Brain Science, Addiction and Drugs was launched in July 2005, and investigated how to manage the use of psychocative substances in the future to the best advantage for the individual, community and society. It touched upon some issues related to cognitive enhancement, which may have some applicability to the Human Enhancement Technologies in Sport that are the subject of this inquiry. While the Office of Science and Technology (as was) commissioned these Foresight reports, the views were those of the authors, are independent of Government, and do not constitute government policy.

  The project looked at the future implications for society of drug use in the future. In terms of performance drugs, it concluded that[2]:

  It is likely that we will be able to produce a wide range of cognition enhancers. They will be used as mental health treatments, and may be used more widely by healthy people to optimise their mental performance.

  Cognition enhancers are likely to be developed to treat people who need to improve attention, memory, planning or wakefulness and to help people to forget, sleep more efficiently and be less impulsive. We have already seen advances in this area. Modafinil has been introduced to treat narcolepsy, while beta-blockers help reduce unpleasant memories from stressful situations.

  A more immediate question is how to respond to the increasing use of cognition enhancers by healthy individuals. While modafinil was developed to treat people with narcolepsy, it can allow healthy people to stay awake for up to 36 hours. It does not yet appear to have any negative side-effects and the long term effects are not certain. If the science community discovers how modafinil works, it could herald a new category of cognition enhancement for the healthy. Modafinil itself has other potential uses. In addition to keeping people awake, it makes the user think through issues more carefully before making decisions. Decisions made under its influence tend to be less rash but take longer.

  Methylphenidate (known as Ritalin) is another prescription drug that is being used off-label by healthy people as a cognition enhancer. It is being used by a small number of students in an attempt to improve exam results and by business people to improve their performance in the boardroom. Since its adoption at the fringe, following self-experimentation and word of mouth, scientific analysis has found that taking Ritalin can increase working memory. D-amphetamine also improves memory, but only for people with a certain genotype. There are other categories of drug that may improve memory.

  In a world that is increasingly non-stop and competitive, the individual's use of such substances may move from the fringe to the norm, with cognition enhancers used as coffee is today.

  It is unlikely that we will be able to increase the performance of our brain in all ways at the same time. It is more probable that we will develop substances that allow us to optimise the performance of our brains for specific tasks at given times, whether that is paying attention to a complicated argument, enjoying time with friends or falling asleep at the end of a busy day. Just as in recent times there has been a pursuit of happiness, in the future the aim may be optimisation of the brain's performance. Individuals will still want to avoid addiction, so the aim may be optimisation with control.

  It will be important to understand the long-term effects of such substances before their use becomes embedded in business and social culture. We would also need to develop a culture to support the sensible use of cognition enhancers and minimise the risks for example; it is not clear whether such substances will be addictive.

  Cognition enhancers for the healthy do not fit easily into the regulations for food, medicines for mental health or drugs of abuse. The closest fit might be dietary supplements but substances that can enhance mental performance rather than just improve well-being could have far greater social impact. Given this potential significance, it is possible that there will be specific regulations dealing with the management of cognition enhancers for the healthy in the future. These regulations would seek to minimise any risk of harms and would be likely to cover issues such as age and amount of use, use in education, the workplace and leisure.

  The project also consulted with members of the public to seek their views on psychoactive substances and the future. In relation to cognition enhancers, this phase of the project reported that:

"Case studies involving cognition enhancers often led to discussions about their use being `unnatural'. There was little explicit moral condemnation of this class of substance, perhaps because substances to `keep you alert' or `improve your brainpower' are available commercially and used by the public at large. However, many participants made a distinction between the substances that are currently available, largely in healthfood stores, which are seen as natural and therefore as harmless, and cognition enhancers. The latter were seen as drugs while the former were not. The distinction appeared to be based on the nature of production undergone by a substance. A substance synthesised in a laboratory stands at one end and a substance picked from a garden or from the wild at the other. There was no clear line between `natural' and `unnatural'.

In addition to the unnatural nature of the substance itself, its use was seen as providing unnatural advantages and this in itself was thought to carry a risk. It might be that the benefits were not seen as sufficient to warrant the potential risks involved. This is not an issue that arose in discussions of the use of psychoactive substances for recognised medical needs. However, there was clearly also a deeper fear, which attaches also to genomics, that `messing with nature' can carry unspecified and perhaps dire consequences. `Nature' in this context is situated inside the body and, more specifically, in the brain." [3]

HORIZON SCANNING CENTRE

  The Horizon Scanning Centre (HSC) [4]forms part of the Foresight Directorate within the Office of Science and Innovation. Its purposes are to inform departmental and cross-departmental priority-setting, and to facilitate horizon scanning capacity-building being carried out by others inside government.

  The HSC's work is underpinned by its two strategic scans:

—  The Sigma Scan is a synthesis of future issues and trends covering the full public policy agenda drawn from a range of sources (including think tanks, academic publications, mainstream media, corporate foresight, expert/strategic thinkers, government sources, alternative journals, charities/NGOs, blog sites, minority communities, futurologists).

—  The Delta (S&T) Scan is an overview of future science and technology issues and trends, with contributions by science and technology experts from the worlds of government, business, academia and communication.

  These scans, and associated material, have been used to inform this input. Again, the findings are independent of Government, and do not constitute Government policy.

Major trends in human enhancement technologies with possible implications for sport in the future

  A range of technological advances are likely to offer the potential for enhancing human sensory and motor (ie skeleto-muscular) capabilities.

  Sensory capabilities may be extended by devices such as artificial retinas which are sensitive to the non-visible parts of the electro-magnetic spectrum, such as ultra-violet light. Hearing ability may be enhanced or restored by cochlear implants. However, although of clear benefit in areas such as medicine and security, it is not obvious that sensory enhancements could affect general sporting performance: their applications would be likely to be limited to sports which rely on extreme visual acuity—such as shooting.

  Motor capabilities which affect sporting performance could be extended by a range of ever-more capable orthotic devices, such as shoes which temporarily store energy generated by one body movement and release it later to increase the power of a particularly critical move. However there are no particular technologies that are generally applicable to all sports: any particular device or development is only likely to be of use in a particular activity. For example, adding "webbing" made of artificial skin and connective tissue between fingers might improve the efficiency of swimmers' actions but would be likely to hinder activities requiring fine control of a few individual fingers, such as fencing with a foil. Shoes optimised for a runner will not be ideal for a shot-putter.

  Advances in external prostheses (replacement limbs) are not likely to be relevant, since these are likely to be readily detectable.

  There are likely to be developments in our ability to grow replacement tissues, and entire organs, including muscle tissue, from an individual's own cells. The challenge for sport would be to detect the signs that such implants have been made. A similar challenge may exist to detect the implantation of artificial joints which might provide a wider range of movement, or greater load-bearing strength, than naturally occurring ones.

  Many technologies already exist to prevent accidental injury from sporting activities, and in some sports, such as fencing, riding, canoeing, the use of various forms of helmet, mask or padded clothing is mandated by the laws of the sport to enhance our body's natural defences against impact and other causes of injury. Improvements in the energy-absorbing characteristics of materials, and advances in the design of protective equipment, are likely to continue to offer scope for improving athletic performance whilst maintaining, or even improving, existing safety standards.

Drugs

  A wide range of physical and cognitive performance-enhancing drugs already exist, and their effectiveness is likely to increase. Developments in scientists' ability to mask their presence, and to detect them, are likely to continue. Related developments in drug development, and in screening procedures, in horse and dog-racing are likely to be relevant since these sports may act as "safe" test-labs for substances and procedures before attempts are made to apply them to human athletes.

  A clear trend in mainstream Western society is the increase in "off-label" use of substances which were originally introduced as pharmaceuticals but rapidly became drugs of choice for many who wished to enhance their lifestyle, or improve their mental performance. Viagra is one example of the former; the widespread use of Ritalin amongst US college students at exam time of the latter. The issue for sport is whether the increased acceptability of drug-use to enhance performance in society in general will lead to similarly increased acceptability of their use in sport. If it is common practice, and therefore, by definition, acceptable to a large minority (or even a majority), to take a pill to boost one's chances of a First Class Honours Degree at the end of many year's training, then why shouldn't it be equally acceptable to the majority for athletes to do the same to gain an Olympic Gold Medal? The tension between this attitude, and those who pursue the ideal of a "clean" Olympics are obvious.

Other S&T issues

  The application of psychological theory and knowledge is likely to become more important as understanding of the effects of factors such as motivation and stress on mental and physical performance increases.

  Technology can also directly affect training and preparation regimes. For example it is possible that simulations, virtual reality devices, and other forms of synthetic environments could help participants visualise obstacles, and "experience" the conditions, and so help them "learn the course" in advance. Sports which could particularly benefit from these technologies include equestrian activities, yachting and white-water canoeing.

  Advances in biotechnology, in areas such as gene therapy, might offer the potential for an individual's performance to be enhanced by the insertion of genes which, for example, controlled the efficiency of some underlying biochemical reaction or metabolic activity that determined some factor, for example the rate at which muscles fatigued, or at which they recovered from exertion, which itself affected athletic performance.

Paralympics

  All the S&T developments that may affect "mainstream" sport have similar potential to influence paralympic sports. However, there are also many additional areas where S&T developments might have an impact on orthotic, prosthetic and other aids, such as wheelchairs, whose use in some form or other is entirely within the laws of the paralympic sport. For example, developments in advanced materials could further reduce the weight of wheelchairs; prostheses could operate at speeds determined by the characteristics of embedded processors, control systems and mechanical actuators rather than by any human attribute. Alternatively, prostheses may be highly integrated with the human nervous system; in these cases performance of the limb is likely to be determined by the success, or otherwise, either of the surgeon joining the nerve to the device at the large-scale level, or of the scientist growing the neuro-silicon junction at the molecular scale. In all areas of paralympic sport, a similar environment to that that exists in Formula 1 motor-racing is likely to prevail: a set of rules are defined and the challenge then becomes to maximise the performance of the technology (rather than the human) within them. (This is not to deny that there is a role for either the F1 driver or the paralympian, nor that some individuals will be better in that role than others: merely that as the allowable technology becomes more complex, it becomes increasingly likely that the technology will be the dominant factor that determines the outcome of any competition, rather than any attribute of the contestants.)

RESEARCH COUNCILS

  The Office of Science and Innovation funds research through the Research Councils who are submitting evidence to this enquiry. While OSI sets the overall strategic objectives and priorities for the Science Budget consistent with wider Government priorities, Research Councils are independent bodies and are responsible for detailed prioritisation within their particular areas. OSI provides three-year funding settlements to the Research Councils, and it is they who make the decisions on the funding of research proposals, programmes and projects. They are best placed to evaluate individual proposals in terms of scientific excellence and value for money.

May 2006

2   Drug Futures 2025? Executive Summary and Overview, Office of Science and Technology, July 2005. Back

3   Drug Futures 2025? Public Perspectives, Office of Science and Technology, July 2005. Back

4   For more information on the HSC, see www.foresight.gov.uk/horizonscanning Back