I suppose, but anecdotally I was told I have ADD by my family physician and was prescribed various stimulants including adderall and ritalin. I only stopped and got on a patch based medication when I was losing weight because of the amphetamines destroying my appetite and I was already a skinny bastard. The only difference I felt on the medication is that I was methed up. This could have been a misdiagnosis but the tests I was given that led to my diagnosis were frankly bullshit. Looking back it seemed incredibly easy and 'hand wavy' for the doc to just shut up the parent and schools and write up a prescription to 'solve the problem'. In my eyes, the only problem I had is that I thought school was a meaningless chore. Should we make children take meth because they don't like the system they're in?

> Should we make children take meth because they don't like the system they're in?

The flip side of this is that being unable to thrive in the system they're in is effectively dooming them to a substandard, more difficult life. If you think the system is broken, fix it, but ripping off the bandage before you have any sutures on hand is the opposite of a solution.

If I had started on medication younger, I undoubtedly would have done better in high school. If I had done better in high school, I would have gone to a better college, better college, better job etc. On the flip side, had I not gotten medicated in college, I very well could have flunked out.

So, yeah, it's a fucked up that the system doesn't accommodate for people slightly outside neurotypical-ness, requiring stimulant use to thrive, just like it's fucked up that it doesn't accommodate deaf people, making cochlear implants an extremely valuable treatment. But so long as that system is in place, restricting access to harm mitigation from that system because the system is fucked is unquestionably wrong.

I'm pretty much ok with the system you appeared to have went with, which is wait for hard-core amphetamine use until they're an adult and able to decide for themselves the cost benefit analysis.

These kind of questions regarding the benefits of kids can be exceedingly difficult to answer. From a moral perspective, like you I take the hardcore an-cap kind of viewpoint that the family has the right to inject hard drugs for fulfilling what they view as industrial output needed for survival. Ultimately perhaps we have to trust the parent is making the best choice for their own family and try to defer to the family in this kind of gray area. Personally I would never give my kid amphetamines unless it was unambiguously life and death like they were unable to perform day to day activities without it.

Adderall and Ritalin are not meth, and the fact that you consider them equivalent demonstrates your harmful lack of knowledge on this topic.

Amphetamines and methamphetamine are closely related. Methamphetamine is actually a derivative of amphetamine.

So - you're wrong. And with that stupid insult you added at the end, you look even dumber.

> Amphetamines and methamphetamine are closely related.

In the field of biochemistry, this is virtually meaningless. A single substitution group is capable of producing wild changes in pharmacokinetics. The left and right-handed enantiomers of these molecules don't even act the same way in the body, and these aren't even positional isomers. The similarities with AMP and MAMP begin and end with being TAAR1 agonists. Off the top of my head, MAMP is also a potent agonist for sigma 1 & 2 receptors, and is generally more promiscuous.

Methamphetamine is a substituted amphetamine, not a "derivative". They're both simple substituted phenylethylamines, another TAAR1 agonist that is extremely prolific in your neurochemistry as we speak, and an incredibly diverse family of monoamines that range from lethal neurotoxin to serotonergic hallucinogen. The difference between the two is often as simple as a single atom moved 2 or 3 substitution points over. When you lack basic domain knowledge, please don't call other people dumb as you try (and fail) to correct them.

Methamphetamine is not a substitution for amphetamine. A substitution refers to the replacement of one atom or group of atoms in a molecule with another atom or group of atoms. A derivative, on the other hand, refers to a molecule that is derived from another molecule by modifying its molecular structure. In the case of amphetamine and methamphetamine, methamphetamine is derived from amphetamine by adding a methyl group (-CH3) to the amphetamine molecule, which modifies its molecular structure.

Amphetamines and methamphetamine are closely related drugs, as methamphetamine is a type of amphetamine. They both work in a similar way by increasing the release and blocking the reuptake of certain neurotransmitters, such as dopamine, norepinephrine, and serotonin, in the brain. As a result, they both have similar effect.

All you're doing is microdosing a terrible drug and calling it treatment. Addicts defend this, not logical healthy people.

Did you write this post with a chatbot?

> Methamphetamine is not a substitution for amphetamine.

I did not say it was a "substitution" which means something entirely different in this context, I said it was a substituted amphetamine. The rest of this comment reads like boilerplate drivel that completely ignores everything I actually wrote.

Still causes psychosis.

>Amphetamines and methamphetamine are closely related.

So are ethanol (vodka) and methanol (poisonous fuel). The difference is exactly the same - one methyl group (CH3).

If you think that it's a small difference, try drinking methanol instead of alcohol, and see for yourself.

(Or, rather, not see for yourself, given the side effects of methanol poisoning).

Prolonged use of amphetamines can lead to addiction, psychosis, cardiovascular problems, and other serious health issues.

This is the bottom line. It’s a drug, it’s not good for you. That euphoria is not treatment, your being drugged. Only addicts defend long term use

Would you say that amputees are addicted to using a chair? Or do you think that would be a bigoted thing to say?

A chair doesn't drug you and put you into psychosis. But nice try defending (terrible) drug use. Not even the good kind of drug either.

>Looking back it seemed incredibly easy and 'hand wavy' for the doc to just shut up the parent and schools and write up a prescription to 'solve the problem'

Exactly. The diagnosis is a tool for the system to give it a veneer of scientific legitimacy. There is no truth only power. In living memory, being gay was a diagnoseable disorder. In some countries political dissidents would be deemed insane and committed to institutions. Psychiatrists used to hand out lobotomies and electric shocks to anyone they felt like.

Good comment, but Adderall is Amphetamine, not Methamphetamine. Big difference.

Methamphetamine is a schedule 2 drug and prescribed in the US, though significantly more rarely than amphetamine. Is there a difference between oral consumption of amphetamine and methamphetamine dosed out in correct proportion to the salts in question? Maybe, but certainly not that "big" of a difference.

It's a pretty huge difference. Desoxyn's focus improvement comes with a full-body euphoric rush, which while fun and all, dramatically increases its abuse potential and addictiveness. Amphetamine, in contrast, is just makes it easier to focus. Properly dosed, there's no rush, no euphoria, just slanted walls on the sides of your train of thought.

It's actually a big difference. One feels downright euphoric, according to Desoxyn users. The other is a boring study drug.

https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

>The other is a boring study drug

That's quite the mischaracterization. Stimulants even at low doses increase the dopamine in the brain and lead to a mild high. I don't think I've ever heard anyone ever call Adderall "boring" before either. That's like calling alcohol boring, maybe someone may not like the experience, but they both have immediate and noticeable effects and it's not just "I love studying" either.

Even Scott's article has examples of this, here's a story of a little girl becoming very high from a prescription stimulant:

"A spontaneous report from the manufacturer of Strattera (atomoxetine) described a 7-year-old girl who received 18 mg daily of atomoxetine for the treatment of ADHD. Within hours of taking the first dose, the patient started talking nonstop and stated that she was happy. The next morning the child was still elated."

In my experience people who take adderall while partying do it to stay awake longer to party with other drugs or booze. In practice for most people that “high” isn’t really a thing. At least not with anyone I know who is prescribed it or sometimes takes it recreationally. Meth on the other hand? Yeah that’s going to give you a very noticeable high.

Please browse https://www.reddit.com/r/StopSpeeding/ (probably nsfw) for many stories of people struggling with prescription stimulant abuse. These people aren't taking it because it keeps them up longer for drinking.

I'm not denying that you can abuse prescription stimulants by taking large doses to get high but most people aren't taking 10-30mg a day and experiencing meth like feelings of euphoria. Especially with extended release formulations. It's also much harder to maintain the regular abuse of a prescription stimulant without resorting to illicit acquisition since most psychiatrists avoid prescribing high enough doses to make that feasible.

I can't speak for every person who abuses prescription stimulants but I've met people that do and they always had a meth or other addiction in their past and were either buying from dealers or seeing multiple doctors/pharmacies. It's been a while since I've run into someone with that problem though so I don't even know if the latter strategy is effective anymore. I assume the feds maintain some kind of database these days.

Why are you conflating Adderall with all or any stimulants? Might as well throw in caffeine and sugar as things that "even at low doses increase the dopamine in the brain and lead to a mild high".

Not disagreeing with you wrt atomexetine but really should compare apples to apples.

You're right. I wasn't as careful as I could be, my intention was to cover common ADHD stimulants: adderall, ritalin, vyvanse, etc. Basically any of them that gives you a quick boost of dopamine and are addictive. I'm not a smart psychopharmacology guy, just have a lot of experience with stimulants. Perhaps ask for clarification instead of throwing out 'conflating' next time though?

Adderall is an amphetamine. It's a hard drug. And methamphetamine are closely related. Taking small doses of this, essentially macrodosing, it's not good in the long term.

The long term health impacts of taking prescription stimulants at recommended doses for on-label management of disorders is well understood and extensively studied/documented. There's not a psychiatrist that's not going to take this and other factors into consideration when prescribing it and any decent one is going to discuss medication breaks with their patients they prescribe them to. Prescription stimulants aren't perfect but it's currently the most effective treatment that's broadly applicable and well-tolerated.

A lot of people are critical of prescription stimulants without presenting a comparable alternative that will allow disordered people (particularly adults) to maintain the ability to function, be productive and maintain happiness in our current society with it's expectations and capability requirements.

The alternative is easting healthy organic foods, pasture raised meats, and exercise. Even weed/DMT/LSD is loads better than 'adhd' medication - and might actually change your way of thinking.

Strattera is not a stimulant, not in the same method of action that Adderall or Ritalin is.

Thanks for the clarification, was just quoting from Scott Siskind's article which focuses on Adderall. I was responding to the suggestion that adderall is a mundane drug and doesn't get a person high.

I don't think that would be that hard to disprove, but I was trying to pull a quote from the article they linked.

Wikiopedia says Strattera can lead to increases in dopamine, whether that's relevant to that case I don't know.

The difference is one of chemistry, not law. A helpful analogy is to find another pair of drugs that people are more familiar with where the difference is a single methyl group: caffeine and theobromine (the stimulant in chocolate).

Saying that appropriately dosed amphetamine and methamphetamine don't have a "big" difference is like saying appropriately dosed chocolate and coffee don't have a "big" difference. The difference is clearly massive.

I disagree. In oral usage, when you control for potency, particularly with regard to the stereoisomer composition, amphetamine and methamphetamine are FAR closer in effect (and "side effects") than historically people have claimed.

Pointing to the methyl group is completely missing the point; I am not talking about the absolute chemistry, but the pharmacology.

Methamphetamine can be prescribed for ADHD under the trade name Desoxyn, but it's less common because the side effects are worse.

Sure, but they said they had been prescribed Adderall and Ritalin, neither of which are Methamphetamine.

Methamphetamine is actually a derivative of amphetamine.... So it's pretty damn close, effects are similar too.

The biggest flaw in this line of reasoning is that these drugs aren't inherently calming or causing docility. They are pretty powerful stimulants!

It's quite obvious when a troublesome kid has been misdiagnosed: they act as you would expect a child on stimulants to act. The behavior changes are mostly only useful if the child does have adhd. A non-adhd problem child on amphetamines is a powerful source of chaos.

> In my eyes, the only problem I had is that I thought school was a meaningless chore. Should we make children take meth because they don't like the system they're in?

This is what the problem was for you. It's quite a leap from there to assume that all children on ADHD medications also happen to have the same problem.

For many people with ADHD, the difficulty is beyond "the system they're in". Being regularly late to events, zoning out when talking to someone, living in a chaotic/messy living space etc. (common problems with those with ADHD) will still be a problem in a hypothetical better school system or post-scarcity communism society.

> Should we make children take meth because they don't like the system they're in?

>take meth

Ah yes, the good old "Adderall is meth" ridiculousness.

Sure, Adderall is amphetamine, and meth is methamphetamine, just one methyl group of a difference - practically the same thing, right?

Just like ethanol (aka vodka) and methanol (deadly poison, makes you blind) - one one ethyl group difference, practically the same thing!

Please stop referring to medication[1] many people rely on as "meth".

Or if you must do so - consider having a shot of methanol next time you go for a drink.

If it's the same to you, then why not?

[1]https://romankogan.net/adhd/#Medication

You underestimate college students because that is exactly what we did in college. People went to their doctor, faked hyperactivity, and were given adderall which they then sold to other students. I'm sure your ADD is horrible but try telling someone taking these drugs to stop. They won't. They depend on it too much and it's become part of their personality, and their belief that it is what they need.

Just. Like. Oxy.

That's only true if you squint real hard. Might as well say people are addicted to oxygen or food if you're going to oversimplify that far. Plenty of people are able to learn meaningful coping strategies for their ADHD and choose to go off medication (especially those medicated from a young age), or at least off of stimulant medication, choosing instead to treat their disease with non-stimulant options. You'd also have to ignore the fact that they're, umm, different drugs, and do different things. The pain relief granted by opiates, along with them being chemically addictive and the marketing put forth by Perdue Pharma leading to addiction, for which they've paid billion of dollars in fines. There have been no such issues for AmerisourceBergen Corp., Cardinal Health Inc. and McKesson Corp.

The thing about the drugs being different is the results on people's lives. Off medication and unmanaged, people suffering from ADHD go into depressive slumps of executive dysfunction and are unable to perform their EDLs (EveryDay Living activities; showering, putting on clothes, feeding one's self, using the bathroom, exercising), never mind things like cleaning, holding down a job or paying rent. Most are able to keep at the same dosage for the majority of their lives.

That's not what people happens to people chemically addicted to Oxy. They need more and more to get the same effect, and chase after it to the point that many have become hooked on heroin, absent a prescribed supply of Oxycontin. While on the drug their lives turn to shambles, getting fired from work and losing their jobs and then their housing and end up living on the street.

That difference is entirely material to the discussion. If people are able to make more of themselves on a particular medication, society is able to accept that a medication is good, rather than bad. That may be a tough pill for some to swallow, especially those that want to reject traditional societal norms for judging a person's life. Another tough pill is that the idea that Adderall blunts a person should really be considered a fringe belief these days, given how many people use Adderall to better their lives.

Are their people that abuse Adderall? Sure. Are their many more people that don't, and live much richer lives thanks to prescribed medication from a doctor? Absolutely.

ADHD is an ADA-recognized disability. I doubt you’d support secret limits on mobility scooter orders because college kids sometimes steal golf carts. Why is this different?

Because Adderall is 100% pure speed. A handful of Adderalls is more fun than a bag of cocaine (which is going to be more like 5% purity and adulterated with god knows what).

Mobility scooters can also be abused for a good time

Maybe if you stop taking Adderall for fun you won't need to compare it to your bags of cocaine.

Don't talk out of your ass. Cocaine comes with a much, much bigger euphoric rush than even methamphetamine, which has a much bigger rush than amphetamine. If your coke is less fun than some focus enhancement, it's because somebody sold you a gram of baking powder.

Basically all stimulants can be categorized by a level of euphoric rush, and a level of focus they provide. Caffeine sucks at both, methamphetamine rocks at both, cocaine's good for a body rush but isn't very good for focus, and amphetamine comes with relatively little euphoria for a methamphetamine-comparable level of focus.

>A handful of Adderalls is more fun than a bag of cocaine

Yeah, this is fear mongering; and I doubt any abuse you are seeing is actually happening on any sort of scale. To imply adderall is more fun than Cocaine/Cocaethylene is a completely strange assertion given cocaine's continued and greater penetration despite the fact it's a highly controlled schedule 2 drug. If you could have more fun with adderall, why would you spend more money on cocaine?

> given cocaine's continued and greater penetration despite the fact it's a highly controlled schedule 2 drug.

Not to take the wind out of your sails but adderall is also schedule II.

> Not to take the wind out of your sails but adderall is also schedule II.

OP was correct, cocaine is much more highly controlled despite sharing the same legal category. It’s only used in certain surgical procedures. You can’t get a prescription for it.

This is especially hilarious as I, a person with ADHD, am basically on speed whenever I loose access to Adderall. I would strongly encourage you to gain a better understanding of ADHD and other neurodivergent forms before continuing to speak on the topic.

I take one pill a day, not a handful. Please stop this.

A choice must be made. Either be more restrictive and controlling meaning that some people that need the drugs don't get them. Or be less restrictive and controlling meaning that some people you think shouldn't get the drugs get them.

There's other ways to realign incentives. A buy back program would do a lot honestly to restrict the supply. A lot of people who got them for legit purposes would still end up with a ton leftover when they would get their next prescription. If they were able to get more money returning them to the pharmacy or counting them towards their next prescription than selling them to other students, that's what they would do.

If we're still talking about ADHD medications then... I have no idea where you're coming from. ADHD medications are very tightly controlled - if you accidentally double dose a few times and need an early fill you're going to get grilled (or even denied) by the pharmacist. There is a small margin for error but for the most part people using ADHD medications get precisely what they need to get to the next drug refill and not a pill more.

> if you accidentally double dose a few times and need an early fill you're going to get grilled (or even denied) by the pharmacist

That's not a thing. Nobody is getting grilled coming in early for their stimulant medications. They just say "come back in a couple days" and "have a nice day." I've filled multiple stimulant meds in a period of 2 weeks from the same doc and same pharmacist. Neither care (I dumped out a drug that had side effects so I needed something else).

If people double up, after they run out they just don't have pills for a few days until they get another fill.

That's honestly pretty much what I said: if you run out and need to refill early it's a struggle. A lot of ADHD medications come with strong withdrawl symptoms so "don't have pills for a few days" for me will mean... day 1: sleep for like twenty hours straight and miss work, day 2: have massive headaches all day and miss work, day 3+: maybe be able to attend work? Certainly struggle to actually perform my job duties.

So running out of meds is something that's highly disruptive to my life and I'll always try and minimize gaps if they do occur.

>That's honestly pretty much what I said

You said " Nobody is getting grilled coming in early for their stimulant medications" ?

Okay then.

It's not that they are double dosing, its that the doctor is expecting them to be on this stuff 100% of the time but they only feel the need to take it when they are in the library studying or for certain classes, and there's no sense in taking it on the weekends when they are doing laundry or binge drinking (although snorting adderall while drunk is not that uncommon). So you end the month with extra by the time you can refill.

Where would leftovers come from?

Most ADD individuals skip doses periodically. Sometimes because they forget (we're treating an illness that causes you to get distracted, remember), or they slept in on the weekend and don't want to mess up their sleep schedule, or they simply don't have anything they really need to be able to pay attention to that day, or maybe they don't need their second dose in the day that particular day.

Unlike, say, antidepressants, there's no real backswing on off days: you just revert to your pre-medication attention levels which, especially in the case of people who got diagnosed later than usual, they have coping mechanisms for.

This results in the average ADD-medicated patient having a couple pills leftover each month.

do you understand how often there are issues filling one's adhd prescription on time even before the shortage? Almost every month the pharmacy is out of stock for a couple days. Very few people sell their couple of extra pills, they are saved for the inevitable delays in filling scripts.

And honestly? Why is this even being discussed, as if college kids getting adderall to study for math tests is some societal scourge ruining lives or something? Who gives a shit and why is it an issue that justifies making life difficult for people who are prescribed it?

I am prescribed to take one pill each day. I prefer to keep this up on the weekends because I like being able to function even when I'm not being paid to. I can only fill a prescription once a month. The pill bottles have 28 pills in them.

What possibly would be left over?

Most people I knew who were on them weren't taking the dosage they were being prescribed. The side effects were too much taking it daily, so they would just use it if they were spending a lot of time in the library that day, and would end the month with half the bottle still by the time they reupped. Just because you have ADHD and benefit sometimes from these meds doesn't mean you feel great being on them 100% of the time nor need to be taking them if you are not doing anything mentally demanding that day. It's basically meth lite, after all.

My experience is that I feel significantly better when I am on my meds and am able to function consistently. I envy people who function well enough off their meds that they can be choosy about when they take them. I have no experience with meth but my understanding is that it is only superficially similar to meth.

Sounds "Just. Like. Oxy." in that people who have no idea what they're talking about go based on their gut feelings as if science and medicine should yield to their imagination:

I mean I'm sure your diabetes is horrible but try telling someone taking insulin to stop. They won't. They depend on not being in a diabetic coma too much! And not slipping into a diabetic coma becomes a part of their personality.

-

ADHD doesn't mean hyperactivity despite hyperactivity being in the name. For me not taking ADHD medication results in what your proclivity for drug abuse was gaining you: the super human ability to focus on one thing for hours and hours at a time.

The difference is when the drugs you were abusing wore off, you'd go back to being able to do other things. I'd just keep being prisoner of whatever I'm doing indefinitely. It's an awful feeling to know you have to do something else, you really need to switch tasks right now, but it's like you're a prisoner in your own mind, just stuck.

So subjecting myself to that isn't really something I'd willingly... is that surprising?

I mean I've personally requested lower doses of medications, leaned towards less "intrusive" delivery methods like metabolized extended release versions, and stopped when I was injured and unable to do much (being stuck mentally wasn't a big deal when I was physically stuck)

But even if someone else dealing with this doesn't want to do that, I don't blame them. It's an awful disease that deserves proper treatment. Some dumb drug abusing kid isn't going to change that.

I'm not interested in protecting the people that game their doctor. They decided on their own they wanted the drug and dishonestly represented themselves to obtain it. That's their own prerogative, if that causes problems then that should not result in punishment for those acting with honesty.

This is not "just. like. Oxy." in so many cases. Many of these were people in pain management with zero deceit involved on the side of the patient.

What’s the big deal? The definition of ADHD is extremely fuzzy anyway. Why not just let whoever take them that wants them?

Well, IMO, it puts everyone into a mental arms-race reminiscent of steroid use in bodybuilding competitions.

If you told me I was going to take a standardized test where only the top 10% make the cut, and everyone serious about winning is taking a mental PED, then yeah I am going to feel intrinsic pressure to step-up and also engage in that mental arms race. I would've been just as happy to not do that if I were given a more level playing field.

It's no secret that there is a war going on to commoditize attention. I want to live in a world where people hone their ability to push back against having their attention leeched not one where everyone raises their baseline to cope temporarily.

I also have to think that, long term, it's kind of disrespectful to those with ADHD. If expectations of attention rise due to uptake in mental PEDs then where does that leave those who were originally disadvantaged? They lose their ability to exist on a more level playing field.

Bit of a tangent, but many years ago when I was wrapping up college, I was in a Calc III class over summer. The course was being taught at an advanced pace and basically everyone in the class was struggling after the first exam. The professor addressed the class about the poor performance and then called out a student in the front row. The professor said, "You! You did well on the exam. What was your secret to studying?" and, not missing a beat, the student responded, "Adderall!" I took the hint, bought some from a friend, and suddenly found myself passing the class with flying colors. It felt good in the moment, but honestly only because I wasn't being graded on a curve. It would've been wildly demoralizing if I'd been in direct competition with my peers.

I know life isn't fair and it's a pipedream to clamber on about desiring a level playing field, but surely we can agree that physical fitness competitions are more interesting when they are separated between "natty" and "enhanced" competitors? And that if we eliminated that separation that those without PEDs are disadvantaged? I don't see society making that sort of separation for mental fitness and so I am concerned about letting stimulants loose on the population.

> I am concerned about letting stimulants loose on the population.

They already have been. It's not hard at all to get an Adderall prescription. Just Google "ADHD symptoms" (the main one being trouble focusing) then go to your doctor and tell them you have those.

What is "disrespectful to people with adhd" is fucking with our med supply in order to prevent the horrific scenario of someone studying for a math test past their bedtime. Like, surely you see that right?

I want to move on with my life, instead I need to play games every couple weeks filling my prescribed meds because people are resentful that their peers back in college might have studied longer for a test? Are you fucking kidding me.

I'm still in recovery from abusing addy off-prescrip. I was citing an experience I had a decade ago which shaped my opinion of stimulants for the rest of my life. I wasn't trying to offend you personally. I was just sharing an opinion. Chill.

Personally I'd really really appreciate if you would dial back the medication shaming a fair amount. As someone who can function with a lot of effort and the support of medication and who has gotten into several rough spots in life when I've suddenly run out of meds and have needed to motivate myself independently to refill them... please don't opine on what other people's experiences are.

Additionally, Adderall and the like aren't just like +2 INT boosts - the stimulants have a different affect on most people with ADHD than it would on a regular person... so whatever you've experienced abusing the medication is probably quite a bit different from what I'll experience using it.