Drugs

Baroness Greenfield Excerpts

Thursday 17th October 2013 Lords Chamber

[Baroness Greenfield (CB)]

My Lords, I congratulate the noble Baroness, Lady Meacher, on bringing attention to these important reports. I declare an interest as an ambassador of the Angelus Foundation, which aims:

“To help society understand the dangers of ‘legal highs’”.

As a neuropharmacologist researching the cellular mechanisms underlying various neurological and mental disorders, I have a particular interest in the impact of recreational drugs on the brain. After so many eloquent and informed speeches, I would like to make just two points.

The first is to question the actual meaning of the phrase “relatively less harmful”. Much is often made of the fact that, in a 2007 paper, cannabis came in with a final net score lower overall than that for tobacco or alcohol, suggesting that it might be safer, but then again, in the same paper, cannabis scored higher than LSD, which is widely regarded as a model for psychoses such as schizophrenia. Is having hallucinations really more welcome than, say, the relaxing effects of moderate amounts of alcohol? Similarly, on the same scale, cannabis also had a higher score than ecstasy, a drug for which in the past five to six years more than 60 papers have documented adverse short and long-term effects on the brain. Therefore, on that comparison, cannabis should be more harmful. Moreover, smoking cigarette after cigarette in one sitting is unlikely to achieve an “overdose” akin to a single session of marijuana that can send smokers to A&E with acute panic attacks.

These drugs all have detrimental effects, but they are qualitatively different. Surely any direct comparison is like benchmarking apples against pears. Further factors might come into play, such as the differential effects of certain drugs on the still developing adolescent brain. In teenagers a certain region, the prefrontal cortex, is still not fully operational, accounting perhaps for the tendency of young people to take more risks and seek sensation. This, in turn, may be reflected in the differential statistics, where the risk of cannabis addiction has been estimated for adults to be about one in 10, but almost doubles for teenagers to one in six. A recent report in the Lancet has documented cannabis as having a dependence syndrome in the young, including,

“increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease and adverse effects on adolescent mental health”.

Subsequently, a paper published in Proceedings of the National Academy of Sciences has shown that persistent cannabis use was associated with neuropsychological impairment among adolescent-onset users, for whom cessation did not fully restore neuropsychological functioning. Confounding factors such as socioeconomic status or personality differences were subsequently eliminated: the link appears direct between cannabis use and an irreversibly lowered IQ. No similar claims have been made for nicotine. Even if such qualitatively different drugs could be compared on a quantitatively single scale, the crucial question is then: just how harmful is a “less harmful” drug? The phrase lacks any precise definition, and cannot therefore really be used as a valid justification or a starting premise.

My second point relates to the paradoxical signals sent out that, although the laws may be relaxed on a drug, it is still to be avoided. Already the possibility of cannabis legalisation is all too readily glamorised as a cool and trendy campaign to support, with little negative publicity offsetting that image, in contrast, for example, with tobacco. It would be helpful to know how the preventive programmes mentioned in the reports—we have heard too little about those this afternoon—will be funded and rolled out. The reports paint a rather gloomy picture of the preventive programmes, yet one initiative they did not explore, which has proved successful, is a community-wide approach, such as the one in the US, where community anti-drug coalitions have shown positive impacts when a community-wide response is taken up.

Another possibility has been prompted by my own experience of speaking in schools and penal institutions on drugs and the brain. Adults and teenagers alike get fascinated by basic neuroscience that can give insights into drug action: the “plasticity” of the brain whereby dynamic, endless reorganising of individual neuronal connectivity is driven by individual experience through chemical messengers signalling between different brain cells. It is this chemical transmission, this plasticity, that is modified in various ways by different recreational drugs. If this personalisation of the brain could be the individual mind, then “blowing your mind” might be an unintentionally accurate description. I have found from experience that this carries weight with young audiences.

Other noble Lords have spoken on the legislative and political merits of the recommendations of these reports. I would urge that such considerations be placed in the wider context of a thought-through programme of prevention that should first be in place and proven to be effective.

Digital Technology

Baroness Greenfield Excerpts

Monday 5th December 2011 Lords Chamber

Asked By

[Baroness Greenfield]

To ask Her Majesty’s Government what assessment they have made of the impact of digital technologies on the mind.

[Baroness Greenfield]

My Lords, I am delighted to have the opportunity to introduce this timely debate.

We humans occupy more ecological niches than any other species on the planet. This is because our brains are superlatively evolved to adapt to our own particular environment: a process known as neuroplasticity. Thanks to their plasticity, the connections between our brain cells will be shaped, strengthened and constantly refined by our individual experiences. It is this personalisation of the physical brain, driven by unique interactions with the external world, that arguably constitutes the biological basis of each individual mind, so what will happen to that mind if the external world changes in unprecedented ways, for example with an all-pervasive digital technology?

A recent survey in the US showed that over half of teenagers aged 13 to 17 spend more than 30 hours a week, outside school, using computers and other web-connected devices. It follows that if the environment is being transformed for so much of the time into a fast paced and highly interactive two-dimensional space that is unprecedented, the brain will adapt accordingly, be it for good or ill, in unprecedented ways. Professor Michael Merzenich, from the University of California, San Francisco, gives a typical neuroscientific perspective. He states:

“There is a massive and unprecedented difference in how their (the digital natives') brains are plastically engaged in life compared with those of average individuals from earlier generations, and there is little question that the operational characteristics of the average modern brain substantially differ”.

The implications of such a sweeping change in mindset—let us call it mind change—must surely extend deep and wide into future education policy. Most obviously, time spent in front of a screen is time not spent doing other things. Indeed, several studies have already documented a link between the recreational use of computers and a decline in school performance. More basic still, though, is to understand in the first place why a screen environment using only sight and sound out-competes three-dimensional activities with all five senses stimulated.

Perhaps most important of all, we need to understand the full impact of the current cyberculture on the emotional and cognitive profile of the 21st century mind. Inevitably, there is no single catch-all soundbite but rather a variety of diverse issues. In the brief time permitted, let us look at just three. First, what is the impact of social networking sites on interpersonal skills and personal identity? Eye contact is a pivotal and sophisticated component of human interaction, as is subconscious monitoring of body language and, most powerful of all, physical contact, yet none of these experiences is available on social networking sites.

It follows that if a young brain with the evolutionary mandate to adapt to the environment is establishing relationships through the more sanitised medium of a screen, the skills that are so essential for empathy may not be acquired as naturally, as well or as quickly as in the past. In line with this prediction, a recent study from Michigan University of 14,000 college students has reported a decline in empathy over the past 30 years, which was particularly marked over the past decade.

Such data in themselves do not, of course, prove a causal link, but just as with smoking and cancer some 50 years ago, epidemiologists could investigate any possible connection. Similarly, the factors should be explored that account for the appeal of the cyberworld for those with already recognised impairments in empathy, typifying autistic spectrum disorders. What about exploring other coincidental trends for a causal link, such as the obsession with the solipsistic read-out of unremarkable moment-by-moment daily routines, for example through Twitter? The psychologist Sherry Turkle, from MIT, has argued persuasively in her recent book Alone Together that the more continuously connected people are in cyberspace, paradoxically the more isolated they actually feel. More worrying still is the tendency to define oneself by the amount of attention garnered online, particularly when excessive bullying, spitefulness and plain cruelty are used to enhance such attention, as with the pernicious trend of “trolling”. Might these phenomena, based as they are on the reassurance of incessant feedback, indicate a less robust sense of identity?

Secondly, on video games, I declare an interest as a patron of the charity Safermedia, and mention that I recently met representatives from the industry who are very keen to discuss the best way forward in the light of growing concerns. For example, neuropsychological studies suggest that frequent and continued playing might lead to enhanced recklessness. Perhaps this is not surprising as it is surely a dangerous lesson to learn that actions do not have consequences and that victims of a shooting can become “undead” the next time around. In addition, data indicate reduced attention spans and even possible addiction. In line with this, significant chemical and even structural changes are being reported in the brains of obsessional gamers that require at the very least wider discussion beyond the scientific community.

No single paper is ever likely to be accepted unanimously as conclusive, but a survey of 136 reports using 381 independent tests and conducted on more than 130,000 participants concluded that video games led to significant increases in desensitisation, physiological arousal, aggression and a decrease in prosocial behaviour. Needless to say this “meta-analysis” has itself been criticised, but then such is the iterative nature of evaluating research. This is neither the time nor place for an exhaustive review of the literature, but there should be a means for all these burgeoning scientific findings to be translated on a rolling basis into simple, jargon-free summaries which the non-specialist can readily access, evaluate, and, most importantly, question.

Thirdly, on search engines, can the internet actually improve cognitive skills and learning, as has been argued? The problem here is that efficient information processing is not synonymous with knowledge or understanding—a point well argued and supported by empirical evidence and summarised in, for example, Nicholas Carr’s book The Shallows. Even the chairman of Google, Eric Schmidt, has claimed:

“I worry that the level of interrupt, the sort of overwhelming rapidity of information—and especially of stressful information—is in fact affecting cognition. It is in fact affecting deeper thinking. I still believe that sitting down and reading a book is the best way to really learn something. And I worry that we’re losing that”.

We need to understand much more about the impact of search engines on comprehension skills. I suggest that the difference between processing and isolated fact, and understanding it, is the ability to place that fact into a wider conceptual framework that indeed gives it a meaning. Hence, the famous line from “Macbeth”—“Out, out, brief candle”—is powerful, not because of the literal image of a flickering flame but because the extinction of that flame can be linked to the extinction of life.

Conceptual frameworks can also have a time dimension: hence the meaning of an object or a person can be derived from how that object or person has connected to events and relationships in the past. This is why perhaps the characters in novels are compellingly meaningful in a way that an icon in a computer game is not. When you play a game to rescue the princess, you probably do not care much about her as a person.

Given the plasticity of the human brain, it is not surprising that adaption to a cyberenvironment will also lead to various positives—for example, enhanced performance in a variety of skills that are continuously rehearsed, such as a mental agility similar to that needed in IQ tests or in visuo-motor co-ordination. However, we need urgently to gain a much fuller picture.

I agree that the UK Council for Child Internet Safety—UKCCIS—already brings together more than 170 organisations and individuals from diverse sectors to keep children and young people safe online. However, much more is surely needed than minimising the threats. The time has come to start to maximise the opportunities. Whether it be through UKICCIS or some other co-ordinating organisation, or even a new mind-change initiative, I urge the commissioning of epidemiological studies exploring the significance of various societal and medical trends in relation to a screen-based lifestyle, as well as ring-fencing funds for basic brain research into, for example, the neural mechanisms of addiction and attention, the long-term effects of various screen-based activities on brain structure and function, and the neural processes perhaps underlying deep understanding and creative insight.

The design of truly innovative software that attempted to offset some of the perceived or agreed deficiencies arising from the current digital culture would also be enormously valuable. Most immediately we need more detailed profiles and breakdowns of computer use in the UK, along with surveys of the views and insights of various relevant sectors such as parents, teachers and employers, who until now have had no voice. Then finally, in the light of all this input, this hypothetical body would make recommendations for proactively planning the most effective environment. It might well include a root and branch, paradigm-shifting re-examination of education and subsequent training that best equips the citizen of the 21st century to be personally fulfilled and useful to society.

Currently, we are in an economic crisis, but this would be massively helped by innovative wealth creation, new types of jobs, new and more varied types of training for the growing numbers of unemployed school-leavers and possibilities other than a conventional university education whereby only one in 80 graduates can obtain an appropriate job.

Science and technology are transforming society. We have an extended life span and extended leisure time. Could not baby boomers who currently feel undervalued but have precious entrepreneurial and interpersonal skills be teamed up with the younger generations who are so adept at cutting-edge digital technologies, so that they could develop and commercialise unprecedented goods and services that neither group could conceive or produce unilaterally? Such a scheme could be brokered by the Government and funded by the companies currently dealing only with student loans—along with investment from the private sector. These ventures would be based on a comprehensive appreciation of not just how the future consumer will think and feel but on innovative ways for bringing real added value to them.

Like climate change, this transformational scenario of mind change is complex, unprecedented and controversial. However, unlike climate change, the end point is not one of just damage limitation but rather of ensuring that we deliver to the next generation an environment that can for the first time enable the realisation en masse of each individual’s full potential.

[Baroness Verma]

My Lords, I gently remind all noble Lords that this debate is time-limited and that Back-Bench contributions should be limited to five minutes.