Typically ‘performance and image enhancement’ drugs refers to a set of drugs taken to improve physical performance or appearance, or work on the body in ways that confirm to a particular set of expectations. Anabolic steroids taken to improve athletic performance or status in a bodybuilding subculture would be one example. Fat burning hormones or appetite suppressants can also be taken to speed weight loss. Beyond that we have a range of substances used to enhance sexual performance and cognitive ability, augmenting brain training apps, ‘smart’ drug use with Ritalin. Some of these drugs have notable effects on the brain. Then practices of using psychedelics that are aimed at addressing the human capacity to work and think. As with recreational drug use, problem drug and other boundaries, there is a fuzzy line between categories. I would frame this as purposeful use to change the trajectory of the self. Effects include: time compression, time shifting, focus locking, and a sense of being left behind otherwise. They deal with deficits not top performers.
Psychedelics have represented a useful study as they function as technical fixes, windows to the psyche, and probes into the mind. There has been for many years renewed research interest in psychedelics and renewed socially legitimated narratives for them. There is a push and pull between dominant Silicon Valley CEO style enhancement narratives which present themselves as rewiring the self to be more competitive, and many others which focus on treatment, transcendence, and the self in the world.
For example, Ibogaine is a natural hallucinogen used in ritual practices by followers of Bwiti, an animistic religion. Iboga used much as the sacrament in Catholic mass. Has powerful effects- sickness, frightening hallucinations, leaves you exhausted. It is hard to fit LSD or Ibogaine use into the schema of pleasure/hedonism, for instance, or that of Ketamine, a dissociative that produces in the user a sense of becoming dissociated from their body. They work on the same biochemical systems as the more hedonistic substances but do not appear to generate reward sensations and can be in fact quite disturbing – if satisfying, revelatory or otherwise worthwhile – experiences. Research hampered by legal, financial and epistemological considerations – it’s not really like a medicinal drug, can’t easily be brought to market and resists commodification.
One approach is epistemological and ontological. Since the 1990s ‘Decade of the Brain’ there has been a concerted attempt to understand the neural substrate of all mental states, states of mind, especially consciousness. LSD and hallucinogens then are treated not lenses on the psyche (as in the 1960s) but probes into the brain. The neuroscience now follows the principle of materialism – that mental states can be reduced to physical states. Every single thought pattern has its neural substrate. The use of enhancement drugs and the materiality of mind mean medicalisation is no longer about sorting the normal from the pathological and sociology of medicine cannot hang our hat on that.
Canguilhem, Georges. On the Normal and the Pathological. Vol. 3. Springer Science & Business Media, 2012.
Durkheim, Emile. “Rules for the Distinction of the Normal from the Pathological.” The rules of sociological method. Palgrave, London, 1982. 85-107.