Love Drugs: The Chemical Future of Relationships, by Brian D. Earp and Julian Savulescu (Stanford University Press/Redwood Press), $25
Love potions have existed for a long time — in fiction: from Shakespeare’s A Midsummer Night’s Dream to the memorable 1959 pop song Love Potion # 9 by Leiber and Stoller, to the entirely unmemorable 1992 Sandra Bullock film of the same title. Now they are becoming real. Like a number of technologies that would until recently have been considered science fiction, chemical substances that can stimulate or suppress attraction, affection and similar feelings are either already available or soon will be. The inevitable result is that exploring the ethical issues they raise is no longer a matter of amusing speculation, but one of practical urgency.
The “love drugs” considered by Brian Earp and Julian Savulescu in their new book are a varied lot. MDMA seems to help some people in pre-existing relationships improve communication and intimacy. Various substances may encourage attraction and increase desire both in and out of relationships. Still others act as anti-love drugs, discouraging the development or persistence of attraction, affection, and attachment. None of them, as of yet, are as tightly targeted or as efficacious as the juice of the “love-in-idleness” flower Oberon applies to Titiana’s eyelids; at most they can give us a push in one direction or another. Like most drugs, they can be somewhat unpredictable. Indeed, one of the main purposes of Love Drugs is to argue in favour of research that might decrease their unpredictability and make them both more effective and less hazardous.
Earp and Savulescu make a compelling case that current policies regarding these drugs are largely the result of unreliable, at times irrational political processes. They relate how the US Drug Enforcement Agency and Food and Drug Administration have not only prevented the use of MDMA in therapeutic treatment, but blocked research into whether it is safe and effective. The primary justification rests on “the hypothetical risks of MDMA neurotoxicity” — but this, the authors write, is mere speculation: without the very research that these agencies are forbidding, it cannot be known whether or not MDMA risks toxic effects, nor whether it might be helpful to some patients.
Another case study illustrates the way pharmaceutical companies come up with creative, and at times downright phony, medical conditions in order to sell their products. Earp and Savulescu relate how, in order to sell Addyi — “the so-called female Viagra” — Sprout Pharmaceuticals “recruited physicians and researchers to give paid promotional talks” to convince people of the existence of a widespread sexual disorder called “hypoactive sexual desire disorder”. The strategy was to make women feel anxious or inadequate about their level of sexual desire, convincing them they had a problem that Addyi could solve.
Though they have little sympathy for the corporate malfeasants in the latter case, there are other situations, not entirely dissimilar, where Earp and Savulescu feel less temptation to cast blame. In general, it is substantially easier to prescribe a drug that fixes a problem or addresses a recognised medical condition than to prescribe a drug that simply improves what is already working reasonably well — a practice the authors find themselves unable to fully endorse. “Psychiatrists”, they write, “shouldn’t have to first make up a raft of ‘relationship disorders’” in order to justify providing patients with drugs which, in their view, may well improve the quality of their relationships and their lives. As they write elsewhere:
“[I]t may not be necessary to pathologize — that is, characterize as a disease state — ordinary human experiences in order to recognize that our romantic biology may sometimes pull on our conscious thinking and behavior in unproductive ways, posing a serious threat to our well-being and that of our partners. Moreover […] sometimes a biological intervention, especially when combined with appropriate psychosocial or therapeutic approaches, can help eliminate the threat, whether or not we want to call the intervention ‘medicine.’”
Readers will likely sympathise with a good deal of this. Certainly the need for research into the therapeutic potential of MDMA and other “love drugs” is real. And some possible uses of these drugs are bound to strike many readers as legitimate. Suppose, as seems likely, that some such drugs can help people overcome harmful love addictions, like detaching from abusive partners. This will strike many people as a good thing, whether or not such relationship “addictions” are labelled by authorities as a medical issue.
If I have an issue with Love Drugs, it is that Earp and Savulescu sometimes pass too quickly over the deeper ethical issues. It is likely, after all, that there is something to the intuition that therapy — i.e. fixing medical problems — is easier to justify than enhancement. I am not claiming that the intuition is obviously correct, but the authors’ apparent dismissal of the possibility feels glib:
“[D]rugs are just chemicals. You can call them medicine if you want to, but chemicals don’t know if you have a disease […] [T]hey just do what they do, whether you intended them as a cure for a pathology or just believe they could improve your life.
We should be open to the idea that certain chemicals can increase people’s happiness or well-being, on balance and under the right conditions, without our first having to invent a disease for those chemicals to be addressing.”
The argument that drugs are just chemicals, and that they don’t know what they are doing, appears elsewhere in the book as well. But it is a highly odd argument. Obviously, since no one thinks the chemicals do know anything, the claim is standing in for some other argument. But just what is the argument?
The therapy-enhancement distinction is likely rooted at least partly in judgements about just how much, and what kinds of, control it is good for us to have. Here, too, Love Drugs feels a bit superficial. Contra Earp and Savulescu, being hesitant about the kind of control offered by chemical interventions does not necessarily imply that one altogether rejects all forms of control over one’s emotions:
“There can be great value, we suggest, in regarding love as something that is — at least to an extent — up to us. Something that requires choice, skill, and determination, not passivity and acquiescence. It is true that we cannot simply wave a magic wand to bring love in or out of existence (nor should we necessarily want to); but we can decide whether and how to intervene in the course of love, helping it to last or, where appropriate, expire.”
What the authors do not say here — though it needs to be said — is that all interventions are not necessarily equal; that there are many ways of trying to help love last or expire; and that since our feelings and desires are among the most crucial sources of information about who we really are and what we really want, deciding when it is “appropriate” that love do one or the other of these things might well be rendered far more difficult by the practice of using drugs to stimulate, suppress, or otherwise manipulate those feelings and desires. The choice between controlling our emotions with drugs and not trying to control them at all is a false dilemma.
Love Drugs, then, is far from the final word in what promises to be a lengthy and lively philosophical debate. But as an opening statement, and an informational primer to help bring us up to date on the intersection between the emotional and the pharmacological, it will serve quite nicely.