Sure, in the same way that rubbing alcohol is basically vodka.

I'm sure you didn't mean anything by it, but it's frustrating to hear this line over and over as someone who needs these prescriptions to function.

Have you ever tried meth? I feel like you’re demonizing meth. There is someone reading this who needs meth to function and you’re comparing their prescription to rubbing alcohol.

Meth has higher user ratings on Drugs.com for treating ADHD than dextroamphetamine or Adderall etc have. If it weren’t for the side effect profile and potential for abuse, I reckon it would be the mainline treatment.

I empathize and understand what you mean though. When others say you’re basically on meth, that must not feel good.

A. They aren't comparing it to rubbing alcohol. The analogy is that they are both alcohol so they are the same right? Obviously not.

B. I've tried meth. It's nothing like Adderall and much, much more potent.

I've tried both as well, and I suspect your lying to yourself about potency.

I certainly didn't have a scale to measure the dosage to match say a 10mg orange adderall pill.

By analogy, if you did a 75ml "shot" of alcohol each day, and then had a mixed drink one day, you would think it's a lot more potent.

Meth is substantially more serotonergic IIRC. Can’t find the numbers.

Serotonegic? What does that even mean?

For a given quantity, eg 1mg, of methylamphetamine vs d-amphetamine, the meth will release more serotonin?

Higher relative affinity for 5-HT receptors over DA.

There's no way. I snorted a bump of approximately 50mg, at the most, off of my hand and was completely jacked for 48 hours. It was the most uncomfortable speedy high I've ever experienced. I drank an entire case of beer trying to come down and it did almost nothing. I've gone through a gram of coke in a night, snorted and/or smoked, and it was nothing compared to meth. I'm on 30mg Adderall daily and I can sleep just fine.

I remember thinking "Why would anyone want to feel like this?" Will never touch the stuff again.

You most likely did far more than 50mg of methamphetamine.

I just weighed a couple 20mg orange adderall pills, they're each around 0.2-0.3 grams (my scale is only accurate to 0.1g)

> The analogy is that they are both alcohol so they are the same right? Obviously not.

They are the same. The difference is just that the bottle sold as "rubbing alcohol" has been intentionally poisoned.

Rubbing alcohol is isopropanol. Drinking alcohol is ethanol.

You can get “industrial ethanol” that has some methanol added to prevent people from consuming it, and pay liquor tax on it. These are for chemists for specific applications.

None of these things are “the same”.

Rubbing alcohol is isopropanol, not ethanol.

In the same way that amphetamine is not methamphetamine. Different molecules, different chemistry!

Iso and ethanol are NOT the same.

Rubbing alcohol, in the US at any rate, is isopropanol and vodka is ethanol. You're probably thinking of denatured alcohol which is ethanol with methanol added.

You're right, sorry. The point of their analogy is that they aren't similar, because they're pointing out the parent comment's analogy is likewise bad.

A lot of people that have tried both meth and amphetamine in comparable dosages would tell you they are very comparable, though.

But you are not ingesting rubbing alcohol.

Equality is symmetric ;P

What an inappropriate response

No.

Adderall is normally prescribed in the XR formulation (meaning it's an extended/slow release capsule), and has amphetamine as the active ingredient.

Methamphetamine is a different molecule altogether, and typically it's not packaged in slow-release capsules.

Yes, methamphetamine is structurally related to amphetamine, but you shouldn't make the mistake to think they are interchangeable. Very often the difference between two very similar molecules is the difference between life and death (for a classic example, look up the two enantiomers of thalidomide).

I've got some H3O+ for people who want to try something "similar" to water in the same way that Adderall is meth.

This comparison is completely nonsensical.

Yeah, this guy doesn't know what he's talking about.

If we just discussed this as d-amphetamine, l-amphetamine & methyl-amphetamine, the issue of interchangeability would be less confusing.

Ok, but lisdexamphetamine (Vyvanse) and meth end up very similar in terms of pharmacokinetics and effects.

Adderally XR formulations are still a minority of prescriptions.

Talking about methamphetamine as a different molecule is not helpful, as Adderall itself is not a single molecule.

Which I suspect you know, as you mention different enantiomers of thalidomide. However you don't point out that adderall itself is a 3:1 racemic mixture of l and d amphetamine.

The real discussion here is the receptor binding affinity of the various targets of the drugs, and how they compare.

Racemic means 1:1. You can’t have a 3:1 racemic mixture.

The vast majority of adderall prescriptions are XR.

Enantiomers are structurally “the same molecule” (or people often speak this way depending on the context) but with different optical configurations.

That is not what racemic means, ratios can exist.

There's a whole section, "Single-Isomer Versus Racemic Formulation", in this recent review article titled "Novel Formulations of ADHD Medications: Stimulant Selection and Management" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412159/

The psychiatry handbook of Massachusetts General Hospital also uses racemic in this context https://www.sciencedirect.com/science/article/abs/pii/B97814...

Also, I can't find any data on what percentage of Adderall prescriptions are XR, have you found anything?

Looks like the LRx database would be the place to look from scanning this report for the DEA. https://www.deadiversion.usdoj.gov/pubs/docs/IQVIA_Report_on...

They are very similar, but the euphoria with Adderall is significantly less than with meth or other speed you'd buy on the street. For some people meth might be an effective substitute, but I think most people would find the high and the side-effects too distracting. Plus, that euphoric high increases the likelihood of abuse and addiction.

I'd add that the people I've known who did a lot of meth tended to have physical health issues and looked like shit, which was not the case with the people I've know who abused Adderall.

People who do a lot of meth tend to smoke it.

Method of administration affects the time delay for euphoria. Smoke > Shooting > Eating.

People who do a lot of meth (or drugs outside of a prescription) tend to do as much as they can purchase and/or tolerate.

When you see someone who has a doctor (dealer) that gives them as much adderall as they want, illusions of differences between the two drugs rapidly fade. I'm talking about 100+mg a day, I've seen it happen, still have 50mg adderall pills from the person in the story.

No. That's like saying methanol is basically ethanol. Sure they are chemically similar, but the differences are distinct and very important.

This is a terrible comparison. Meth[amphetamine] and Adderall [amphetamine] are extremely similar. Both act as triple monoamine releasers, releasing the most norepinephrine followed by dopamine followed by serotonin.

The methyl group attached to the amine basically just helps it cross the blood brain barrier better and makes it more resistant to enzymatic destruction. This means it is a couple times more potent dose-per-dose and lasts longer. It's nothing like the difference between methanol and ethanol, where one will kill you and the other is fine to drink. That IMO a rationalization people with ADHD make to convince themselves their prescribed amphetamines are somehow qualitatively different than big scary meth--just like the rationalization that amphetamine acts magically different in people with ADHD (it calms everyone down in low doses, it just might not provide the same working-memory deficit correcting effects as there is no deficit). In fact, in most of Europe, amphetamine itself is what you find on the streets, not meth.

Bingo

This still blows my mind: https://www.goodrx.com/desoxyn

Meth is apparently prescription meth.

Why does it blow your mind?

Imagining a doctor writing a script for meth is pretty amusing, and maybe if that’s not a cool enough drug, they can hand out some crack or something.

Why is it amusing? Because you think it has no therapeutic value?

I don’t see the point in playing obtuse here.

Not playing obtuse, trying to get you to say why you think it's so crazy.

Section 3 of this 2019 paper has stats on meth (desoxyn) prescriptions https://www.medrxiv.org/content/10.1101/2022.05.23.22275471v...

> Methamphetamine is a highly addictive psychostimulant and controlled substance that has detrimental health consequences for chronic users

I mean, there's that.

That statement is true of all amphetamines.

Look, this is what I'm driving at, you appear to have some illusions that methamphetamine is significantly different than other amphetamines, or has some higher toxicity profile, more addictive, IDK I'm trying to get you to tell me your biases.

At that point, we can go look at the clinical literature and see what the evidence is.

Yes - why, as your own source says, are amphetamines prescribed at 4,000 times the rate of methamphetamine? Is there no reason for that? Why does the medical system have such a bias?

Many reasons, that's a different discussion.

Note that you've gone from this statement, to acknowledging that they are regularly prescribed.

> Imagining a doctor writing a script for meth is pretty amusing, and maybe if that’s not a cool enough drug, they can hand out some crack or something.

I assume in a country of 300 million people, every prescription drug is probably prescribed to someone. I’d say what I take issue with is “regularly”. I’ve known many people who have prescriptions for amphetamine, and zero who ever got a prescription for methamphetamine (though certainly some took it anyway).

The 4000:1 prescription number would seem to corroborate my impression that it is quite rare.

Cocaine, like methamphetamine, is a Schedule II controlled substance under US law, so has accepted medical uses.

As with meth, typical medical applications of cocaine don't involve smoking it (source: Wikipedia).

Legitimate US suppliers for smokable cocaine do exist, however, e.g.,

https://www.sigmaaldrich.com/US/en/product/sigma/c8912

In stock and available for shipping today* **!

* “This order may require review prior to shipping.”

** “DEA License Number required at checkout.”

I've taken substances of various schedules legally and otherwise before, and I've never heard of a doctor writing a prescription for methamphetamine. I really wonder if they have it in stock at my local pharmacy.