The False Promise of Smart Pills in a Loosely Regulated Market

by Spencer Andrews

We’ve all had the experience: you receive a targeted ad on your phone or computer which mysteriously seems to read your mind. This happened to me recently when I, a busy law student, began receiving a wave of ads selling supplements which purport to improve brain focus, clarity, and memory. I had been thinking about ways to increase my productivity, and just in the nick of time, a miracle drug appeared to answer my need. As it turns out, the product being advertised was of a little-known class of substances known as nootropics. And as you might expect, nootropics are hardly a miracle drug.

What is a Nootropic?

The word nootropic is colloquially used to describe a wide range of natural and synthetic substances thought to have cognitive enhancing properties. Romanian psychologist and chemist Corneliu Giurgea coined the term nootropic in the 1970s. He first used the term after synthesizing piracetam, a compound which he claimed would improve cognitive functions like memory and learning. Clinical studies have since shown that piracetam is not a dependable cognitive enhancer nor does it have long-term efficacy against cognitive impairment. Nonetheless, it has shown modest efficacy as an anti-depressant, and most recently, it has demonstrated some promise as a neuroprotective drug for patients undergoing coronary bypass surgery. Notwithstanding piracetam’s clinical success, or lack thereof, the term nootropic has since evolved into something else entirely.

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Third Places: A Framework for Communities AND Crisis Care

by Spencer Andrews

What makes a city livable? The answer, some say, is more “third places,” spaces distinct from one’s home (the first place) and one’s workplace (the second place). A third place, like a café, park, or library, fosters the sense of community and connection that makes a neighborhood great to live in. This imprecise yet uncomplicated framing effectively refocuses a complex set of social, economic, and urban design issues on a simple solution to the “livability” problem.

I believe that the “third place” framework also can usefully reframe another discipline: emergency mental health care. Individuals experiencing mental health crises lack an appropriate setting to receive care. Typically, individuals experiencing acute, emergency mental health crises-–whether related to substance use or not-–end up in one of two places: the hospital emergency room (ER) or a jail cell. The problem is that neither of these two places is well-equipped to treat someone in the midst of a mental health crisis. A third option is needed.

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