21 ms·

Amphetamine use in America's workforce

163 points by rinze 10y ago

nibs 10y ago
ADHD basically means the behavioral symptoms of dopamine dysregulation. A similar thing is happening with serotonin, where people complain of subclinical (or clinical) symptoms of depression and anxiety. Why are our bodies finding homeostatis of neurotransmitters so difficult? Diet? Culture? Sleep? Constant overstimulating media? Drugs? All of them?
- WalterSear 10y ago
  All of them, and also it's more complicated than depression === serotonin dysregulation.
  - nibs 10y ago
    Indeed. Anxiety pretty much == serotonin dysregulation. Depression could be inflammation, mindset, low brain serotonin, low noradrenaline, low dopamine, all of the above, or something else. Low brain serotonin would be a cause.
    - llamataboot 10y ago
      or any and all of those things could be correlates and not causes. correlation and causation get murky in the realm of consciousness and neuroscience.
  - mr_overalls 10y ago
    The serotonin imbalance hypothesis of depression is old, over-simplified: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405681/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405681/
- _98fj 10y ago
  Why do you assume it has ever been any different? Rate of serotonine production for example is coded in two genes. Don't forget that it's not necessarily an evolutionary disadvantage to be slightly depressed or anxious, because you tend to avoid risks. Same with low motivation and an easily distracted mind which can help to conserve energy by finding ways of avoiding tasks.
  - nibs 10y ago
    I guess my use of finding suggests I assume it is different. I am not sure it is. I think a lot of people in time past probably felt the exact same way. It is more that these conditions become a bottleneck to "quality of life" in modern times, now that survival is relatively trivial for most people.
    - eridius 10y ago
      I think it's that, and also the fact that the type of work most of us do these days is pretty different than the type of work we did in times past, and the type of work we do now, especially knowledge work, seems to be more affected by ADHD than menial work.
      - nibs 10y ago
        Great point. I have found that doing simple routine tasks to be pretty rewarding dopamine wise. The way crossing things off a to-do list feels like accomplishment.
        tetrahydro 10y ago
        I agree with your points. I think that the environment plays a role in gene expression, no doubt the environment we live in today is much faster paced than it was as an agricultural society.
    - ams6110 10y ago
      Social media is probably a bit of a factor as well, with the message that everyone else is having fantastic lives in contrast to our own "hanging on in quiet desperation" Even pre-internet, we had a rise of TV shows like "Lifestyles of the Rich and Famous" which gave viewers a daily reminder of how mediocre their lives were in comparison. The notion that everyone's life is (or should be) full of constant excitement, joy, and amazing experiences is false. It is very one-sided. But if that's all you see of everyone else, your own troubles (which are mostly the same troubles everyone has) start to seem abnormal, something that needs to be treated. So you go see a doctor and end up medicating the problem away. And though she's not really ill, there's a little yellow pill / She goes running for the shelter of a mother's little helper / And it helps her on her way, gets her through her busy day
6stringmerc 10y ago
So glad that as I was growing up, my ADHD tendencies were seen more as just an individual issue I'd have to learn to control myself rather than a physiological condition in need of medication. Granted, in my street-wise years I've found stimulants and I get along really, really well, but there's a nagging feeling that I simply don't want to be on amphetamines daily. It might turn my writing into delusional drivel like Ayn Rand, a noted speed addict for decades.
- harveywi 10y ago
  > It might turn my writing into delusional drivel like Ayn Rand, a noted speed addict for decades. Or maybe your writing would start to look like the work of genius Paul Erdős, a noted speed addict for decades.
  - lfowles 10y ago
    Or maybe you'll finally get around to writing in the first place :)
  - 6stringmerc 10y ago
    Math versus fiction are two different beasts.
- eridius 10y ago
  People with ADHD react to amphetamines differently than people without it (at the correct dosages at least; I've never read anything about what happens to people with ADHD that take more than the correct dosage).
  - yelnatz 10y ago
    How do they act differently?
    - lilyball 10y ago
      For people with ADHD, amphetamines basically erases the symptoms of ADHD and decreases hyperactivity, so it doesn't really act like an upper at all (although it does still increase alertness).
Vraxx 10y ago
I think this is a little bit sensationalized at the very least. This excerpt in particular caught me off guard. "Abuse by young professionals is distressingly common—Wall Street traders, software engineers, dentists, nurses, and lawyers, all cracked out of their minds trying to keep up with the competition." Yes, I was diagnosed with ADHD as a child, and yes I have an Adderall prescription. But I'd hardly call myself cracked out on drugs. I think the biggest issue is when people self-diagnose and self-medicate because they are more likely to take dosages that aren't suited for themselves, but that issue exists for many prescription drugs. This piece seems heavily biased towards scare tactics, so I am not inclined to take it terribly seriously.
- semi-extrinsic 10y ago
  I believe it's well-established that Adderall has a profoundly different effect on people like yourself who actually have ADHD, than on those who don't have ADHD. So when TFA talks about "abuse", I understand it as referring to people who do not have ADHD but are obtaining these medications illegitimately. It is unfortunate that the article mixes this up with the (presumably legitimate) increase in ADHD diagnoses.
  - schrodinger 10y ago
    I thought that was a myth that has been dispelled. Do you have any research to back that up?
    - justin_vanw 10y ago
      Yes this is a myth, it has the same effect on everyone.
      - Vraxx 10y ago
        Not trying to disregard this sentiment present in the thread, but I could easily see it having the same physical effects, but how exactly do they quantify how it affects your brain processes and how you feel. Anecdotally, I knew some people who took adderall in college that were not prescribed it and it seemed to cause them to have different behavior than myself. A similar situation, I would imagine, is how alcohol affects people differently. Maybe not physically, but you definitely see a wide range of actions and behaviors elicited among different individuals.
inDigiNeous 10y ago
I can't be the only one thinking that this can not be good in the long run. I still remember my friend who had a prescription for ADHD -medication, and they cut off this medication, and he couldn't do nothing but sleep for 3 weeks almost. What kind of state does prolonged use of amphetamines put the user ? Constantly being pushed to focus on one task, what kind of thought patterns does that create in the long run ? I feel the biggest issue with this is that it's considered okay, like is coffee use, and still coffee and amphetamines are really strong stimulants, but it's so commonplace that we don't even think about it anymore. Are we being just taught by the culture around us to work, work, work .. when we could be taking it more easy, having our thinking be more open, and not so closed and focused on the tasks ahead of us?
- JohnBooty 10y ago
  I was prescribed approximately 25mg daily Adderall for 7 or 8 years, so here's my anecdotal answer to your questions... > I still remember my friend who had a prescription for ADHD -medication, > and they cut off this medication, and he couldn't do nothing but sleep > for 3 weeks almost. Wow. That is really irresponsible of them to cut him off so suddenly. I wouldn't wish that on anybody. I definitely had a "crash" if I suddenly stopped taking it for a day, cold turkey. Would pretty much be stuck in bed. However, if I slowly weaned myself off over a couple of days (25mg-->15mg-->5mg-->0mg) or something like that, it was no problem. Currently I haven't used any in six months. > What kind of state does prolonged use of amphetamines put the user ? > Constantly being pushed to focus on one task, what kind of thought > patterns does that create in the long run ? Now that it's been six months past, I feel no long-term changes whatsoever. Mentally, I'm back to how I used to be before Adderall. There's no denying, though, that Adderall often made me a bit more prone to anger while I took it regularly. I also have to say that Adderall didn't really "push me to focus on one task." It helped my focus and energy somewhat, but I definitely didn't become some kind of extreme monotasker. > Are we being just taught by the culture around us to work, work, work .. > when we could be taking it more easy, having our thinking be more open, > and not so closed and focused on the tasks ahead of us? Absolutely, yes. I think what bothers me about America's workaholic mentality is that it's not even effective. In the long run I firmly believe that we get less work done if we constantly push ourselves to exhaustion. We try to treat our entire work careers like we're university students trying to power our way through an all-nighter. It just doesn't work. I continually remind myself of this... the hard way.
yarou 10y ago
This article is pretty poorly written. First off, methylphenidate is a phenethylamine - not an amphetamine. Its chemical structure doesn't resemble amphetamine. Secondly, Adderall is not simply dextroamphetamine, it is a racemic mixture of both amphetamine salts. There have been studies showing that amphetamine leads to definitive cognitive improvement in the general population. Why restrict it? Human beings have a special relationship with psychostimulants.
- llamataboot 10y ago
  Get back to me about the cognitive improvements after you are curled up in bed with hot and cold sweats, feeling like life will never be normal again, with a bone crushing fatigue that won't quit. Note -- I'm a staunch anti-prohibitionist and I agree that stimulants are useful tools, but they are also dangerous tools with a high potential for abuse and some pretty wicked effects if you push them too far (stimulant psychosis in the short term, pretty nasty anhedonia as well as a bunch of other health effects in the long term) So yes, of course let's decriminalize and legalize - and let's start by acknowledging that lots of well rounded people use amphetamines mostly safely and responsibly (the occasional binge seems inevitable) - but let's also have a rational harm reduction talk about the dangers of stimulant abuse. More than any class of drugs, I think they give with one hand and take away with the other. What goes up must come down after all.
  - ta_339393 10y ago
    It does improve cognition in low doses with very little side effects and no real long term danger unless you already have a cardiac condition. Also there have been studies that show that people on low-dose therapeutic amphetamines are less likely to abuse drugs, including stimulants.
- ta_339393 10y ago
  Actually Adderall is not racemic, since that would mean a 50/50 mix of the dextrorotatory and levorotatory enantiomers. Adderall is 75% dextroamphetamine and 25% levoamphetamine in four different salts.
kome 10y ago
International comparisons would really help a lot to understand the phenomena... I find that there is a tendency by many North Americans to find pseudo-biological justification about everything. In other words: trying to find individual solutions ("my dopamine is so messed up!") to social problems.
- simonsarris 10y ago
  It is at least somewhat culturally local to the US because the US allows direct-to-consumer advertising, which for years pushed the "chemical imbalance" line. Problem is the "chemical imbalance" line is a myth, there's no evidence that depression is caused by a serotonin imbalance or an imbalance of anything else (easily) testable. It was only ever a theory and one that's not very well regarded. See [1], but there are loads more criticizing it. [1] http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020392 http://journals.plos.org/plosmedicine/article?id=10.1371/jou...
- drzaiusapelord 10y ago
  The largest users of anti-depressants are socialist style nations like Iceland, Australia, and Portugal. These countries are run almost the opposite of the US. So there's more than the usual liberal criticisms of how the US is too competitive/not competitive enough or has too easy access to drugs/not enough or whatever applies here. >North Americans to find pseudo-biological justification about everything. Yet the above nations are nowhere near N America. Perhaps this issue is a lot complex than you care to understand. I guess if you want ad-impresions then you must cater to people's ignorance and biases and leave any facts, science, or statistics out of it.
  - kome 10y ago
    Regarding the use antidepressants, the USA beats everybody, according to OECD data: http://static5.techinsider.io/image/56b363792e526551008b4c1d-1200-1183/ti_graphics_antidepressants-chart.png http://static5.techinsider.io/image/56b363792e526551008b4c1d... Also: Iceland, Australia, and Portugal cannot be called socialist by any stretch of the imagination.
bluedino 10y ago
Articles are either "We should be helping people with problems by giving them these medications", or "Doctors are over-medicating everyone. It has to stop!"
- HillaryBriss 10y ago
  Yeah. Sometimes it seems like there's a standard cycle: 1. Drug X works wonders for millions who suffer with Syndrome Z. But these evil politicians and FDA bureaucrats won't let people use it. Call your congressional rep and demand support for HR ABC123 today. Stop the suffering! 2. (2-5 years later) Is Drug X Causing Millions to get Disease Y? Look at this new study released by the highly respected "Famous University". Mortality went up, and, even worse, Drug X is no better than a placebo! 3. Greedy Big Pharma has been pushing pseudo-cure Drug X and it's destroying people's lives. Call your congressional rep and demand support for HR XYZ789 today!
fixermark 10y ago
I can't help but ask myself whether we should be wondering why Americans can't make it without drug-modified behavior, or whether this is better or worse than alternatives such as cigarettes, alcohol, caffeine, etc. Humans in societies have been chemically altering their moods since we discovered mood-altering chemicals. Stress occurs inside and outside civilized workforces, and people take measures to mitigate stress. The real question is: what are the side-effects and how do we mitigate them? (Not to imply that we shouldn't also look into options for de-stressing the American worker, since benefit there can scale significantly. But we do ourselves a disservice by imagining we're the first generation to have an entire culture habitually consuming a physiology-tweaking chemical cocktail)
- nemo44x 10y ago
  Anecdotally I think Europeans are more likely to self medicate with alcohol and cigarettes rather than prescription pills which are more common in the USA. In my experience the culture around having a few drinks after work and even having the occasional cigarette is far more relaxed in the European countries I've been to than just about anywhere in the USA. But as I've said, I have zero evidence that any of this is even true - just my observations however well travelled I am.
  - duggan 10y ago
    In any of the companies I've worked with or visited in my times in the US (SF, specifically), lunchtime drinking was pretty common, and practically unheard of in my European experience. Like yourself, I wouldn't want to extrapolate a broader trend from that, just providing a counter-anecdote. Think on smoking we've probably had a similar experience though. I don't think I even know an American that smokes (cigarettes), let alone seen it at a workplace. In Europe, it'd be weird if there weren't a couple of people in any office that didn't have an obvious habit.
  - not_kurt_godel 10y ago
    > I have zero evidence that any of this is even true - just my observations Observations are evidence. You meant that you had no non-anecdotal evidence.
notliketherest 10y ago
As an aside, I'd be willing to bet there's a direct correlation between Hackernews karma and amphetamine use.
- theandrewbailey 10y ago
  Correlation isn't causation.
- llamataboot 10y ago
  I'd be really interested in an anonymous hackernews drug survey...maybe I'll make one...
_acme 10y ago
Why does this article describe these stimulants as "narcotics"? They are neither opioids nor illegal when prescribed, so it seems like a needlessly provocative, and factually incorrect, description.
- deleted 10y ago
  [deleted]
- chillingeffect 10y ago
  Because the authoritarian state uses an in-language to signal virtue, overstepping denotations. These are the same people who call non-cops "civilians."
  - linkregister 10y ago
    Calling non-cops "civilians" irritates me to no end. Occasionally you'll see journalists using this terminology as well.
  - drjesusphd 10y ago
    My favorite is when they have the nerve to call vets "civilians".
    - mnw21cam 10y ago
      I'm not sure my cat would appreciate having his annual check-up and booster with a non-civilian vet.
    - DiabloD3 10y ago
      Yeah, that never ends well. Vets have a certain ability to destroy someone's entire existence using nothing but words and gigantic balls, leaving nothing but a burning crater in the ground, without having to have any imposing threat of violence (ie, how cops are trained to escalate the situation through intimidation, vets don't need such a tactic).
  - Retra 10y ago
chm 10y ago
A word of caution to those readers who might want to try self-medicating: I have used pharmaceutical grade methylphenidate and amphetamines. The former inevitably led to suicidal thoughts and feelings or worthlessness at the end of the day (i.e. once the dose is gone). This happened to all of my peers who tried it. The effects were mild, but still quite noticeable. And we were healthy (both mentally and physically) young men. My advice is you just get a prescription from a doctor. They are unfortunately quite easy to come by. At least your dosage will be supervised, and you will have someone to talk to about possible side-effects without fear of reprisal.
- lfowles 10y ago
  What kind of doses were those? I'm honestly curious what kind of doses are used "recreationally", since I was titrated over months until the APRN and I found a dose that fit and didn't have alarming side effects.
  - chm 10y ago
    They were Concerta (extended release) 36mg. We also had 54mg capsules once or twice. We all weighed around 140 pounds at the time.
ta_339393 10y ago
As one who takes methamphetamine (generic Desoxyn) for ADHD, I can't help but take issue with the sensationalism in this article. If someone takes the same low dose I do but doesn't actually have ADHD, how could they be considered "cracked out?" simply because they are faking a diagnosis? We know that low-dose amphetamines improve cognition in healthy individuals regardless of whether or not you have ADHD. We also know that amphetamines are very safe at therapeutic level doses and that you can take them your entire life without any problems. We also know that stimulant therapy actually reduces the chances of someone abusing drugs, even stimulants. Why shouldn't all healthy people have a chance to reap the benefits from them? Why should you have to have a disability in order to be able to access the benefits from these drugs? There's just no logic to the way society currently views stimulants. It's safe for me to use amphetamines to help with my ADHD symptoms but if someone without ADHD uses them in the same manor, then it's dangerous.
- joe_the_user 10y ago
  If someone takes the same low dose I do but doesn't actually have ADHD, how could they be considered "cracked out?" simply because they are faking a diagnosis? "Cracked out" or not isn't quite the question. Amphetamines in low doses have measurable benefits in terms of increased ability to concentrate and work longer hours and definite drawbacks in terms of longer term health effects and risks of actual serious addiction. When the job market creates such pressures that a significant portion of workers are working 12 hours days, not receiving particularly higher compensation, and using amphetamines to manage the situation, it seems that employers are repeating the benefits while the workers only get the drawbacks.
  - ta_339393 10y ago
    There are no negative effects on health by taking them at prescribed doses unless you already have an existing cardiac condition or something similar. You can safely take these drugs your entire life without complications. There is a potential for abuse but studies have shown that people on stimulant therapy are LESS likely to abuse drugs, including stimulants.
- 10y ago
marssaxman 10y ago
It is difficult to take this article seriously given the author's repeated references to "narcotic stimulants," a contradiction in terms. It shows that they are getting their whole perspective from law enforcement, which routinely (and quite misleadingly) refers to all drugs as "narcotics" regardless of their effect. The law enforcement establishment has been spewing bullshit for decades, to a degree that has now become embarrassingly obvious, whenever it discusses drugs; if the author of the piece is still taking anything they say seriously, they are either painfully incurious or they are actively participating in the promotion of War on Drugs propaganda.
Houshalter 10y ago
Yet sadly these drugs are still heavily regulated. You need to renew your prescription every month, which is expensive. Doctors look at you skeptically. In some countries they don't prescribe them at all, or only prescribe less effective versions to prevent abuse. And then there are articles like this that appear every so often, telling us that we aren't really sick. Or that people who take these drugs are abusing them like they are just trying to get high or whatever.
- ta_339393 10y ago
  Very good points. They really make us jump through a lot of hoops just to get the medicine we need to live a somewhat normal life, all in the name of preventing drug abuse. I don't believe it actually does anything significant to prevent abuse, those who want to abuse drugs will always find a way. There's so much of a stigma associated with low dose amphetamines and it's completely unfounded. I really noticed this when I switched from dextroamphetamine to methamphetamine (Desoxyn). Since my insurance wouldn't cover the brand name drug, I get the Mylan generic that says "METHAMPHETAMINE" on the label and I could really notice a difference in the way I was treated at the pharmacy. It was like they immediately assumed I was some dangerous drug addict. I'd try to be friendly with them and all I would get is really robotic responses. It's ridiculous that they assume methamphetamine is this much more dangerous or addictive of a drug, it's not. In fact it's the best stimulant I have ever used. Way more effective than dextroamphetamine with fewer side effects. Luckily I have a good psychiatrist that is setup to handle the monthly refills in a sane manor and doesn't treat me like a drug addict when I'm just looking to improve my life.
  - llamataboot 10y ago
    Stigma works the other way as well though. There's plenty of people prescribed strong stimulants that would be just aghast at the thought of someone doing some meth to get a particularly important painting done or something.
deleted 10y ago
[deleted]
aznpwnzor 10y ago
The comments in this thread seem to suggest a reasonable subset of people here partake. Is there any reason you feel the need to? I went to a pretty rough college where I had standard 24 hour straight homework sessions once or twice a week. And I used caffeine maybe once a week at most. I work at a startup where the work culture isn't as competitive as what I feel is the norm, but even listening to friends at there does not seem to be such a ridiculous need for overclocking yourself. I just seem to have never done work that was hard enough to push me to require drugs, and it's not because I haven't done hard work. Most work seems to be either you just put in the 40 hours it takes to solve it or it hasn't been solved.
- Unklejoe 10y ago
  There are a few reasons why someone would abuse Adderall. One of the first reasons that sticks out to me is that it motivates you to get things done, especially things that would otherwise be boring and repetitive. For example, something like fixing formatting errors in 100,000 lines code. As for why you never felt the need to use it, my guess is that maybe you're more secure with yourself than some other people. There's an incredible push to become "successful" these days (partly due to social media I guess), so I can see why some people resort to Adderall to give themselves a leg up. Of course, I’m talking about people who don’t have ADHD and are taking it simply to augment their performance.
- forgetsusername 10y ago
  >Is there any reason you feel the need to? Everyone here is a misunderstood genius with ADHD.
- MichaelGG 10y ago
  But have you tried using amphetamines while working? Perhaps you don't know what you're really capable of. I know people that are fine, happy, productive. But on speed, they are amazed at how much more capable they are. Apart from psychosis or heart issues, why should anyone settle for being less powerful?
  - TheOtherHobbes 10y ago
bumbledraven 10y ago
No mention of modafinil/armodafinil (provigil/nuvigil)?
- adrr 10y ago
  I think those drugs are more used. Its not hard to get, just say you have shift work disorder which anyone putting the long hours probably has.
- mablap 10y ago
  I really want to try modafinil again. I had two tablets over three days: half, half and whole. I could not see a difference between half dosage and whole dosage (200 mg). I couldn't figure out what the effects were, either. Until about the end of the week, when I realized I hadn't taken a sip of coffee in three whole days! That was pretty unusual for me.
- iamchmod 10y ago
  This is a fun article about provigil - http://www.thedailybeast.com/articles/2015/05/27/silicon-valley-s-eating-up-super-ritalin-i-got-the-best-of-it.html http://www.thedailybeast.com/articles/2015/05/27/silicon-val...
hosh 10y ago
A lot of people are taking issue with what's called sensationalism in the article. I think that's ignoring the elephant in the room. Before amphetamines, it was other drugs. The major point is that practice of capitalism in America is founded on a pattern of use and abuse of drugs. This is an elephant in the room because the dearly-held narrative in America is the idea of work hard, get rewarded. What's called a good work ethic here is seen as insane working hours outside of the US. And this ethos is reinforced by the dominance of US interest in the world. Now you add in the Chinese startups working even more insane hours. Is this really what we want our human civilization to move towards? This blind, tunnel-vision obsession over technological progress without actually reflecting on where it is that we are going? Well, at least when you're using drugs that help you focus, these inconvenient ideas can be easily dismissed. Back to work now, y'all.
deleted 10y ago
[deleted]
dsabanin 10y ago
Comments on this thread are insightful, people on amphetamine defending their way of life.
- thisguy666 10y ago
  +1
  - thisguy666 10y ago
    awesome how one can get voted down on hacker news like this. there is nothing incorrect or even mean stated here. you just don't like what is being said about you. the moderators on this site are so screwed up.
iamleppert 10y ago
Does anyone have any adderall or vyvanse for sale?
api_or_ipa 10y ago
I think this quote sums up the article's heavy handed, decidedly outdated view on mental health. > ADHD drug abuse had become so commonplace on college campuses that Wesleyan University, among other prominent institutions, has tried to ban it altogether. ADHD is a diagnosed medical disorder that affects millions of people in America. Why do we still stigmatize it in the modern age?
- taxicabjesus 10y ago
  > ADHD is a diagnosed medical disorder that affects millions of people in America. Why do we still stigmatize it in the modern age? ADHD is a meaningless psychiatric diagnostic [1] of symptoms, not cause. The diagnosis is used to put millions of people in America on maintenance doses of addictive psychotropic drugs. Routine use of amphetamines almost always causes people's mental conditions to worsen, eventually. Tonight one of my regular taxi passengers txt-messaged to ask if I was working. I was exhausted one night, when he was going home from the gay strip club, so I stopped at the coffee shop that was half-way between the strip club and his mother's house. I was like, "so... what's your story?" When the passenger was in high school, he was diagnosed with ADHD. The doctor got him addicted to Ritalin, or one of the other legal prescription amphetamines. At first the amphetamine was great, but then side effects developed. Then he developed some legal troubles, which led to living in a halfway house, with hostile housemates... Anyways... He's a bit of a mess... probably early or mid-30's... his mother pays his taxi fares. He had a job at the baseball stadium, but then he got fired. Last I saw him, he was collecting unemployment insurance. People... people are interesting. This passenger didn't use "ridesharing" because he can't manage his money well enough, iirc. [1] https://www.commentarymagazine.com/articles/the-doctor-isnt-in/ https://www.commentarymagazine.com/articles/the-doctor-isnt-... and https://www.commentarymagazine.com/articles/how-psychiatry-lost-its-way/ https://www.commentarymagazine.com/articles/how-psychiatry-l...
  - SolaceQuantum 10y ago
    >Routine use of amphetamines almost always causes people's mental conditions to worsen, eventually. I've not heard this before..do you have a source? Quite interested.
jrapdx3 10y ago
This is an important topic, not only from the perspective of drug dependency and substance use disorders (SUDs) research, but also re: potentially misleading statements which may discourage use among people who could benefit from stimulant-class medication. I have treated several hundred individuals with amphetamine, methylphenidate and related compounds, primarily for ADHD in adults and adolescents. Everyone should know that ADHD is a very common disorder, affecting >=4% of all adults. It is a disabling condition in many, perhaps the majority, of those who manifest its symptoms. A troubling aspect is that only about 1/5 of sufferers seek treatment, and often treatment is suboptimal for a variety of reasons. Staying on topic, the most effective medication strategies remain the "stimulant" drugs. The article contains errors re: drug effects and history. First of all amphetamine was synthesized well before 1929. What we now call amphetamine was created by a Romanian chemistry Ph.D. candidate, Lazăr Edeleanu, in Berlin, in 1887. It was rediscovered in 1927 by Gordon Alles who was unable to patent the compound because of Edeleanu's work 40 years earlier. Amphetamine was initially marketed in the 1930's as Benzedrine. Significantly the remarkable efficacy of amphetamine in what's now call ADHD was described in 1937, and to this day no other class of drug has been demonstrated to be as effective as the stimulants. As commented here, stimulant class medications have different effects in those who need them. At the optimal dose, ADHD patients are not "amped up", in fact typically feel calmer, thoughts and actions more controlled and deliberate. In people who don't have ADHD may indeed experience "stimulating" effects. Furthermore, ADHD adults perform much better with appropriate treatment, whereas unaffected users experience a boost only with simple tasks. Stimulant use will cause decreased performance on cognitively demanding tasks. While college students are known to seek out amphetamines in order to "study better" for their final exams, in fact it's much more likely to decrement their results, myths notwithstanding. Not to say that drug abuse is not a serious matter. Ethical practitioners prescribe stimulant class medications with great care to assure correct diagnoses and appropriate prescribing practices. No question that not everyone with a license is ethical. I firmly support taking steps to put those deliberately contributing to drug abuse out of business, and into jail. It's imperative to avoid throwing babies out with the bathwater. Stimulant medications are an extremely useful tool when used along with due vigilance for misuse. Patients in my practice were carefully monitored, and were informed drug misuse could not be taken lightly. Over the years there were a few who were deemed too irresponsible to continue treatment with the medication.
snarfy 10y ago
At your work you may not get free food or a lot of breaks, but I bet you get unlimited free coffee. I'm not sure why one stimulant is socially taboo and the other acceptable, even encouraged.
JustUhThought 10y ago
This attitude, painting cognitive enhancers with a broad and critical brush, is not helping things. Cognitive enhancers have the ability to improve persona lives and and society on the whole. But, there is a double standard with all things in healthcare. If you want to fix something, then by all means, take as many pills as you want and don't worry about changing lifestyle choices. Take insulin, for example. Or blood pressure medicine. Society may be harsh on folks that need these medicines, but these folks will have no problem getting the medicine. But, if we want to be better than "fixed", if we want to improve our cognitive performance, to do that in a safe physician guided manner, and have that translate to a better emotional, psychological, and economic future for themselves and their family. The economic benefits are real and shouldn't be limited to those in higher socioeconomic strata. This article shows sleep deprived surgeons benefit from modafinil: http://www.ncbi.nlm.nih.gov/pubmed/21997802 http://www.ncbi.nlm.nih.gov/pubmed/21997802 Modafinil Does Not Serve as a Reinforcer in Cocaine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842996/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842996/ ... Ok, I won't make it one of those posts. But, do some research. We will all be better off if we can drop the FUD rhetoric and treat cognitive enhancers like we treat other drugs, something that can help and hurt. And we need to stop thinking of health care as something we do when something is broken, and start thinking about it as another tool in the toolbox that we can use to improve our lives.
- nommm-nommm 10y ago
  This article is about amphetamine use. Modafinil is not an amphetamine nor is it amphetamine-like.
thisguy666 10y ago
There sure are a lot of people with very little experience with drugs sounding off here. Downplaying the power of amphetamines. hrm.

163 points by rinze 10y ago

nibs 10y ago

ADHD basically means the behavioral symptoms of dopamine dysregulation. A similar thing is happening with serotonin, where people complain of subclinical (or clinical) symptoms of depression and anxiety. Why are our bodies finding homeostatis of neurotransmitters so difficult? Diet? Culture? Sleep? Constant overstimulating media? Drugs? All of them?

WalterSear 10y ago
All of them, and also it's more complicated than depression === serotonin dysregulation.
- nibs 10y ago
  Indeed. Anxiety pretty much == serotonin dysregulation. Depression could be inflammation, mindset, low brain serotonin, low noradrenaline, low dopamine, all of the above, or something else. Low brain serotonin would be a cause.
  - llamataboot 10y ago
    or any and all of those things could be correlates and not causes. correlation and causation get murky in the realm of consciousness and neuroscience.
- mr_overalls 10y ago
  The serotonin imbalance hypothesis of depression is old, over-simplified: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405681/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405681/
_98fj 10y ago
Why do you assume it has ever been any different? Rate of serotonine production for example is coded in two genes. Don't forget that it's not necessarily an evolutionary disadvantage to be slightly depressed or anxious, because you tend to avoid risks. Same with low motivation and an easily distracted mind which can help to conserve energy by finding ways of avoiding tasks.
- nibs 10y ago
  I guess my use of finding suggests I assume it is different. I am not sure it is. I think a lot of people in time past probably felt the exact same way. It is more that these conditions become a bottleneck to "quality of life" in modern times, now that survival is relatively trivial for most people.
  - eridius 10y ago
    I think it's that, and also the fact that the type of work most of us do these days is pretty different than the type of work we did in times past, and the type of work we do now, especially knowledge work, seems to be more affected by ADHD than menial work.
    - nibs 10y ago
      Great point. I have found that doing simple routine tasks to be pretty rewarding dopamine wise. The way crossing things off a to-do list feels like accomplishment.
      - tetrahydro 10y ago
        I agree with your points. I think that the environment plays a role in gene expression, no doubt the environment we live in today is much faster paced than it was as an agricultural society.
  - ams6110 10y ago
    Social media is probably a bit of a factor as well, with the message that everyone else is having fantastic lives in contrast to our own "hanging on in quiet desperation" Even pre-internet, we had a rise of TV shows like "Lifestyles of the Rich and Famous" which gave viewers a daily reminder of how mediocre their lives were in comparison. The notion that everyone's life is (or should be) full of constant excitement, joy, and amazing experiences is false. It is very one-sided. But if that's all you see of everyone else, your own troubles (which are mostly the same troubles everyone has) start to seem abnormal, something that needs to be treated. So you go see a doctor and end up medicating the problem away. And though she's not really ill, there's a little yellow pill / She goes running for the shelter of a mother's little helper / And it helps her on her way, gets her through her busy day

6stringmerc 10y ago

So glad that as I was growing up, my ADHD tendencies were seen more as just an individual issue I'd have to learn to control myself rather than a physiological condition in need of medication. Granted, in my street-wise years I've found stimulants and I get along really, really well, but there's a nagging feeling that I simply don't want to be on amphetamines daily. It might turn my writing into delusional drivel like Ayn Rand, a noted speed addict for decades.

harveywi 10y ago
> It might turn my writing into delusional drivel like Ayn Rand, a noted speed addict for decades. Or maybe your writing would start to look like the work of genius Paul Erdős, a noted speed addict for decades.
- lfowles 10y ago
  Or maybe you'll finally get around to writing in the first place :)
- 6stringmerc 10y ago
  Math versus fiction are two different beasts.
eridius 10y ago
People with ADHD react to amphetamines differently than people without it (at the correct dosages at least; I've never read anything about what happens to people with ADHD that take more than the correct dosage).
- yelnatz 10y ago
  How do they act differently?
  - lilyball 10y ago
    For people with ADHD, amphetamines basically erases the symptoms of ADHD and decreases hyperactivity, so it doesn't really act like an upper at all (although it does still increase alertness).

Vraxx 10y ago

I think this is a little bit sensationalized at the very least. This excerpt in particular caught me off guard. "Abuse by young professionals is distressingly common—Wall Street traders, software engineers, dentists, nurses, and lawyers, all cracked out of their minds trying to keep up with the competition." Yes, I was diagnosed with ADHD as a child, and yes I have an Adderall prescription. But I'd hardly call myself cracked out on drugs. I think the biggest issue is when people self-diagnose and self-medicate because they are more likely to take dosages that aren't suited for themselves, but that issue exists for many prescription drugs. This piece seems heavily biased towards scare tactics, so I am not inclined to take it terribly seriously.

semi-extrinsic 10y ago
I believe it's well-established that Adderall has a profoundly different effect on people like yourself who actually have ADHD, than on those who don't have ADHD. So when TFA talks about "abuse", I understand it as referring to people who do not have ADHD but are obtaining these medications illegitimately. It is unfortunate that the article mixes this up with the (presumably legitimate) increase in ADHD diagnoses.
- schrodinger 10y ago
  I thought that was a myth that has been dispelled. Do you have any research to back that up?
  - justin_vanw 10y ago
    Yes this is a myth, it has the same effect on everyone.
    - Vraxx 10y ago
      Not trying to disregard this sentiment present in the thread, but I could easily see it having the same physical effects, but how exactly do they quantify how it affects your brain processes and how you feel. Anecdotally, I knew some people who took adderall in college that were not prescribed it and it seemed to cause them to have different behavior than myself. A similar situation, I would imagine, is how alcohol affects people differently. Maybe not physically, but you definitely see a wide range of actions and behaviors elicited among different individuals.

inDigiNeous 10y ago

I can't be the only one thinking that this can not be good in the long run. I still remember my friend who had a prescription for ADHD -medication, and they cut off this medication, and he couldn't do nothing but sleep for 3 weeks almost. What kind of state does prolonged use of amphetamines put the user ? Constantly being pushed to focus on one task, what kind of thought patterns does that create in the long run ? I feel the biggest issue with this is that it's considered okay, like is coffee use, and still coffee and amphetamines are really strong stimulants, but it's so commonplace that we don't even think about it anymore. Are we being just taught by the culture around us to work, work, work .. when we could be taking it more easy, having our thinking be more open, and not so closed and focused on the tasks ahead of us?

JohnBooty 10y ago
I was prescribed approximately 25mg daily Adderall for 7 or 8 years, so here's my anecdotal answer to your questions... > I still remember my friend who had a prescription for ADHD -medication, > and they cut off this medication, and he couldn't do nothing but sleep > for 3 weeks almost. Wow. That is really irresponsible of them to cut him off so suddenly. I wouldn't wish that on anybody. I definitely had a "crash" if I suddenly stopped taking it for a day, cold turkey. Would pretty much be stuck in bed. However, if I slowly weaned myself off over a couple of days (25mg-->15mg-->5mg-->0mg) or something like that, it was no problem. Currently I haven't used any in six months. > What kind of state does prolonged use of amphetamines put the user ? > Constantly being pushed to focus on one task, what kind of thought > patterns does that create in the long run ? Now that it's been six months past, I feel no long-term changes whatsoever. Mentally, I'm back to how I used to be before Adderall. There's no denying, though, that Adderall often made me a bit more prone to anger while I took it regularly. I also have to say that Adderall didn't really "push me to focus on one task." It helped my focus and energy somewhat, but I definitely didn't become some kind of extreme monotasker. > Are we being just taught by the culture around us to work, work, work .. > when we could be taking it more easy, having our thinking be more open, > and not so closed and focused on the tasks ahead of us? Absolutely, yes. I think what bothers me about America's workaholic mentality is that it's not even effective. In the long run I firmly believe that we get less work done if we constantly push ourselves to exhaustion. We try to treat our entire work careers like we're university students trying to power our way through an all-nighter. It just doesn't work. I continually remind myself of this... the hard way.

yarou 10y ago

This article is pretty poorly written. First off, methylphenidate is a phenethylamine - not an amphetamine. Its chemical structure doesn't resemble amphetamine. Secondly, Adderall is not simply dextroamphetamine, it is a racemic mixture of both amphetamine salts. There have been studies showing that amphetamine leads to definitive cognitive improvement in the general population. Why restrict it? Human beings have a special relationship with psychostimulants.

llamataboot 10y ago
Get back to me about the cognitive improvements after you are curled up in bed with hot and cold sweats, feeling like life will never be normal again, with a bone crushing fatigue that won't quit. Note -- I'm a staunch anti-prohibitionist and I agree that stimulants are useful tools, but they are also dangerous tools with a high potential for abuse and some pretty wicked effects if you push them too far (stimulant psychosis in the short term, pretty nasty anhedonia as well as a bunch of other health effects in the long term) So yes, of course let's decriminalize and legalize - and let's start by acknowledging that lots of well rounded people use amphetamines mostly safely and responsibly (the occasional binge seems inevitable) - but let's also have a rational harm reduction talk about the dangers of stimulant abuse. More than any class of drugs, I think they give with one hand and take away with the other. What goes up must come down after all.
- ta_339393 10y ago
  It does improve cognition in low doses with very little side effects and no real long term danger unless you already have a cardiac condition. Also there have been studies that show that people on low-dose therapeutic amphetamines are less likely to abuse drugs, including stimulants.
ta_339393 10y ago
Actually Adderall is not racemic, since that would mean a 50/50 mix of the dextrorotatory and levorotatory enantiomers. Adderall is 75% dextroamphetamine and 25% levoamphetamine in four different salts.

kome 10y ago

International comparisons would really help a lot to understand the phenomena... I find that there is a tendency by many North Americans to find pseudo-biological justification about everything. In other words: trying to find individual solutions ("my dopamine is so messed up!") to social problems.

simonsarris 10y ago
It is at least somewhat culturally local to the US because the US allows direct-to-consumer advertising, which for years pushed the "chemical imbalance" line. Problem is the "chemical imbalance" line is a myth, there's no evidence that depression is caused by a serotonin imbalance or an imbalance of anything else (easily) testable. It was only ever a theory and one that's not very well regarded. See [1], but there are loads more criticizing it. [1] http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020392 http://journals.plos.org/plosmedicine/article?id=10.1371/jou...
drzaiusapelord 10y ago
The largest users of anti-depressants are socialist style nations like Iceland, Australia, and Portugal. These countries are run almost the opposite of the US. So there's more than the usual liberal criticisms of how the US is too competitive/not competitive enough or has too easy access to drugs/not enough or whatever applies here. >North Americans to find pseudo-biological justification about everything. Yet the above nations are nowhere near N America. Perhaps this issue is a lot complex than you care to understand. I guess if you want ad-impresions then you must cater to people's ignorance and biases and leave any facts, science, or statistics out of it.
- kome 10y ago
  Regarding the use antidepressants, the USA beats everybody, according to OECD data: http://static5.techinsider.io/image/56b363792e526551008b4c1d-1200-1183/ti_graphics_antidepressants-chart.png http://static5.techinsider.io/image/56b363792e526551008b4c1d... Also: Iceland, Australia, and Portugal cannot be called socialist by any stretch of the imagination.

bluedino 10y ago

Articles are either "We should be helping people with problems by giving them these medications", or "Doctors are over-medicating everyone. It has to stop!"

HillaryBriss 10y ago
Yeah. Sometimes it seems like there's a standard cycle: 1. Drug X works wonders for millions who suffer with Syndrome Z. But these evil politicians and FDA bureaucrats won't let people use it. Call your congressional rep and demand support for HR ABC123 today. Stop the suffering! 2. (2-5 years later) Is Drug X Causing Millions to get Disease Y? Look at this new study released by the highly respected "Famous University". Mortality went up, and, even worse, Drug X is no better than a placebo! 3. Greedy Big Pharma has been pushing pseudo-cure Drug X and it's destroying people's lives. Call your congressional rep and demand support for HR XYZ789 today!

fixermark 10y ago

I can't help but ask myself whether we should be wondering why Americans can't make it without drug-modified behavior, or whether this is better or worse than alternatives such as cigarettes, alcohol, caffeine, etc. Humans in societies have been chemically altering their moods since we discovered mood-altering chemicals. Stress occurs inside and outside civilized workforces, and people take measures to mitigate stress. The real question is: what are the side-effects and how do we mitigate them? (Not to imply that we shouldn't also look into options for de-stressing the American worker, since benefit there can scale significantly. But we do ourselves a disservice by imagining we're the first generation to have an entire culture habitually consuming a physiology-tweaking chemical cocktail)

nemo44x 10y ago
Anecdotally I think Europeans are more likely to self medicate with alcohol and cigarettes rather than prescription pills which are more common in the USA. In my experience the culture around having a few drinks after work and even having the occasional cigarette is far more relaxed in the European countries I've been to than just about anywhere in the USA. But as I've said, I have zero evidence that any of this is even true - just my observations however well travelled I am.
- duggan 10y ago
  In any of the companies I've worked with or visited in my times in the US (SF, specifically), lunchtime drinking was pretty common, and practically unheard of in my European experience. Like yourself, I wouldn't want to extrapolate a broader trend from that, just providing a counter-anecdote. Think on smoking we've probably had a similar experience though. I don't think I even know an American that smokes (cigarettes), let alone seen it at a workplace. In Europe, it'd be weird if there weren't a couple of people in any office that didn't have an obvious habit.
- not_kurt_godel 10y ago
  > I have zero evidence that any of this is even true - just my observations Observations are evidence. You meant that you had no non-anecdotal evidence.

notliketherest 10y ago

As an aside, I'd be willing to bet there's a direct correlation between Hackernews karma and amphetamine use.

theandrewbailey 10y ago
Correlation isn't causation.
llamataboot 10y ago
I'd be really interested in an anonymous hackernews drug survey...maybe I'll make one...

_acme 10y ago

Why does this article describe these stimulants as "narcotics"? They are neither opioids nor illegal when prescribed, so it seems like a needlessly provocative, and factually incorrect, description.

deleted 10y ago
[deleted]
chillingeffect 10y ago
Because the authoritarian state uses an in-language to signal virtue, overstepping denotations. These are the same people who call non-cops "civilians."
- linkregister 10y ago
  Calling non-cops "civilians" irritates me to no end. Occasionally you'll see journalists using this terminology as well.
- drjesusphd 10y ago
  My favorite is when they have the nerve to call vets "civilians".
  - mnw21cam 10y ago
    I'm not sure my cat would appreciate having his annual check-up and booster with a non-civilian vet.
  - DiabloD3 10y ago
    Yeah, that never ends well. Vets have a certain ability to destroy someone's entire existence using nothing but words and gigantic balls, leaving nothing but a burning crater in the ground, without having to have any imposing threat of violence (ie, how cops are trained to escalate the situation through intimidation, vets don't need such a tactic).
- Retra 10y ago

chm 10y ago

A word of caution to those readers who might want to try self-medicating: I have used pharmaceutical grade methylphenidate and amphetamines. The former inevitably led to suicidal thoughts and feelings or worthlessness at the end of the day (i.e. once the dose is gone). This happened to all of my peers who tried it. The effects were mild, but still quite noticeable. And we were healthy (both mentally and physically) young men. My advice is you just get a prescription from a doctor. They are unfortunately quite easy to come by. At least your dosage will be supervised, and you will have someone to talk to about possible side-effects without fear of reprisal.

lfowles 10y ago
What kind of doses were those? I'm honestly curious what kind of doses are used "recreationally", since I was titrated over months until the APRN and I found a dose that fit and didn't have alarming side effects.
- chm 10y ago
  They were Concerta (extended release) 36mg. We also had 54mg capsules once or twice. We all weighed around 140 pounds at the time.

ta_339393 10y ago

As one who takes methamphetamine (generic Desoxyn) for ADHD, I can't help but take issue with the sensationalism in this article. If someone takes the same low dose I do but doesn't actually have ADHD, how could they be considered "cracked out?" simply because they are faking a diagnosis? We know that low-dose amphetamines improve cognition in healthy individuals regardless of whether or not you have ADHD. We also know that amphetamines are very safe at therapeutic level doses and that you can take them your entire life without any problems. We also know that stimulant therapy actually reduces the chances of someone abusing drugs, even stimulants. Why shouldn't all healthy people have a chance to reap the benefits from them? Why should you have to have a disability in order to be able to access the benefits from these drugs? There's just no logic to the way society currently views stimulants. It's safe for me to use amphetamines to help with my ADHD symptoms but if someone without ADHD uses them in the same manor, then it's dangerous.

joe_the_user 10y ago
If someone takes the same low dose I do but doesn't actually have ADHD, how could they be considered "cracked out?" simply because they are faking a diagnosis? "Cracked out" or not isn't quite the question. Amphetamines in low doses have measurable benefits in terms of increased ability to concentrate and work longer hours and definite drawbacks in terms of longer term health effects and risks of actual serious addiction. When the job market creates such pressures that a significant portion of workers are working 12 hours days, not receiving particularly higher compensation, and using amphetamines to manage the situation, it seems that employers are repeating the benefits while the workers only get the drawbacks.
- ta_339393 10y ago
  There are no negative effects on health by taking them at prescribed doses unless you already have an existing cardiac condition or something similar. You can safely take these drugs your entire life without complications. There is a potential for abuse but studies have shown that people on stimulant therapy are LESS likely to abuse drugs, including stimulants.
10y ago

marssaxman 10y ago

It is difficult to take this article seriously given the author's repeated references to "narcotic stimulants," a contradiction in terms. It shows that they are getting their whole perspective from law enforcement, which routinely (and quite misleadingly) refers to all drugs as "narcotics" regardless of their effect. The law enforcement establishment has been spewing bullshit for decades, to a degree that has now become embarrassingly obvious, whenever it discusses drugs; if the author of the piece is still taking anything they say seriously, they are either painfully incurious or they are actively participating in the promotion of War on Drugs propaganda.

Houshalter 10y ago

Yet sadly these drugs are still heavily regulated. You need to renew your prescription every month, which is expensive. Doctors look at you skeptically. In some countries they don't prescribe them at all, or only prescribe less effective versions to prevent abuse. And then there are articles like this that appear every so often, telling us that we aren't really sick. Or that people who take these drugs are abusing them like they are just trying to get high or whatever.

ta_339393 10y ago
Very good points. They really make us jump through a lot of hoops just to get the medicine we need to live a somewhat normal life, all in the name of preventing drug abuse. I don't believe it actually does anything significant to prevent abuse, those who want to abuse drugs will always find a way. There's so much of a stigma associated with low dose amphetamines and it's completely unfounded. I really noticed this when I switched from dextroamphetamine to methamphetamine (Desoxyn). Since my insurance wouldn't cover the brand name drug, I get the Mylan generic that says "METHAMPHETAMINE" on the label and I could really notice a difference in the way I was treated at the pharmacy. It was like they immediately assumed I was some dangerous drug addict. I'd try to be friendly with them and all I would get is really robotic responses. It's ridiculous that they assume methamphetamine is this much more dangerous or addictive of a drug, it's not. In fact it's the best stimulant I have ever used. Way more effective than dextroamphetamine with fewer side effects. Luckily I have a good psychiatrist that is setup to handle the monthly refills in a sane manor and doesn't treat me like a drug addict when I'm just looking to improve my life.
- llamataboot 10y ago
  Stigma works the other way as well though. There's plenty of people prescribed strong stimulants that would be just aghast at the thought of someone doing some meth to get a particularly important painting done or something.

deleted 10y ago

[deleted]

aznpwnzor 10y ago

The comments in this thread seem to suggest a reasonable subset of people here partake. Is there any reason you feel the need to? I went to a pretty rough college where I had standard 24 hour straight homework sessions once or twice a week. And I used caffeine maybe once a week at most. I work at a startup where the work culture isn't as competitive as what I feel is the norm, but even listening to friends at there does not seem to be such a ridiculous need for overclocking yourself. I just seem to have never done work that was hard enough to push me to require drugs, and it's not because I haven't done hard work. Most work seems to be either you just put in the 40 hours it takes to solve it or it hasn't been solved.

Unklejoe 10y ago
There are a few reasons why someone would abuse Adderall. One of the first reasons that sticks out to me is that it motivates you to get things done, especially things that would otherwise be boring and repetitive. For example, something like fixing formatting errors in 100,000 lines code. As for why you never felt the need to use it, my guess is that maybe you're more secure with yourself than some other people. There's an incredible push to become "successful" these days (partly due to social media I guess), so I can see why some people resort to Adderall to give themselves a leg up. Of course, I’m talking about people who don’t have ADHD and are taking it simply to augment their performance.
forgetsusername 10y ago
>Is there any reason you feel the need to? Everyone here is a misunderstood genius with ADHD.
MichaelGG 10y ago
But have you tried using amphetamines while working? Perhaps you don't know what you're really capable of. I know people that are fine, happy, productive. But on speed, they are amazed at how much more capable they are. Apart from psychosis or heart issues, why should anyone settle for being less powerful?
- TheOtherHobbes 10y ago

bumbledraven 10y ago

No mention of modafinil/armodafinil (provigil/nuvigil)?

adrr 10y ago
I think those drugs are more used. Its not hard to get, just say you have shift work disorder which anyone putting the long hours probably has.
mablap 10y ago
I really want to try modafinil again. I had two tablets over three days: half, half and whole. I could not see a difference between half dosage and whole dosage (200 mg). I couldn't figure out what the effects were, either. Until about the end of the week, when I realized I hadn't taken a sip of coffee in three whole days! That was pretty unusual for me.
iamchmod 10y ago
This is a fun article about provigil - http://www.thedailybeast.com/articles/2015/05/27/silicon-valley-s-eating-up-super-ritalin-i-got-the-best-of-it.html http://www.thedailybeast.com/articles/2015/05/27/silicon-val...

hosh 10y ago

A lot of people are taking issue with what's called sensationalism in the article. I think that's ignoring the elephant in the room. Before amphetamines, it was other drugs. The major point is that practice of capitalism in America is founded on a pattern of use and abuse of drugs. This is an elephant in the room because the dearly-held narrative in America is the idea of work hard, get rewarded. What's called a good work ethic here is seen as insane working hours outside of the US. And this ethos is reinforced by the dominance of US interest in the world. Now you add in the Chinese startups working even more insane hours. Is this really what we want our human civilization to move towards? This blind, tunnel-vision obsession over technological progress without actually reflecting on where it is that we are going? Well, at least when you're using drugs that help you focus, these inconvenient ideas can be easily dismissed. Back to work now, y'all.

deleted 10y ago

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dsabanin 10y ago

Comments on this thread are insightful, people on amphetamine defending their way of life.

thisguy666 10y ago
+1
- thisguy666 10y ago
  awesome how one can get voted down on hacker news like this. there is nothing incorrect or even mean stated here. you just don't like what is being said about you. the moderators on this site are so screwed up.

iamleppert 10y ago

Does anyone have any adderall or vyvanse for sale?

api_or_ipa 10y ago

I think this quote sums up the article's heavy handed, decidedly outdated view on mental health. > ADHD drug abuse had become so commonplace on college campuses that Wesleyan University, among other prominent institutions, has tried to ban it altogether. ADHD is a diagnosed medical disorder that affects millions of people in America. Why do we still stigmatize it in the modern age?

taxicabjesus 10y ago
> ADHD is a diagnosed medical disorder that affects millions of people in America. Why do we still stigmatize it in the modern age? ADHD is a meaningless psychiatric diagnostic [1] of symptoms, not cause. The diagnosis is used to put millions of people in America on maintenance doses of addictive psychotropic drugs. Routine use of amphetamines almost always causes people's mental conditions to worsen, eventually. Tonight one of my regular taxi passengers txt-messaged to ask if I was working. I was exhausted one night, when he was going home from the gay strip club, so I stopped at the coffee shop that was half-way between the strip club and his mother's house. I was like, "so... what's your story?" When the passenger was in high school, he was diagnosed with ADHD. The doctor got him addicted to Ritalin, or one of the other legal prescription amphetamines. At first the amphetamine was great, but then side effects developed. Then he developed some legal troubles, which led to living in a halfway house, with hostile housemates... Anyways... He's a bit of a mess... probably early or mid-30's... his mother pays his taxi fares. He had a job at the baseball stadium, but then he got fired. Last I saw him, he was collecting unemployment insurance. People... people are interesting. This passenger didn't use "ridesharing" because he can't manage his money well enough, iirc. [1] https://www.commentarymagazine.com/articles/the-doctor-isnt-in/ https://www.commentarymagazine.com/articles/the-doctor-isnt-... and https://www.commentarymagazine.com/articles/how-psychiatry-lost-its-way/ https://www.commentarymagazine.com/articles/how-psychiatry-l...
- SolaceQuantum 10y ago
  >Routine use of amphetamines almost always causes people's mental conditions to worsen, eventually. I've not heard this before..do you have a source? Quite interested.

jrapdx3 10y ago

This is an important topic, not only from the perspective of drug dependency and substance use disorders (SUDs) research, but also re: potentially misleading statements which may discourage use among people who could benefit from stimulant-class medication. I have treated several hundred individuals with amphetamine, methylphenidate and related compounds, primarily for ADHD in adults and adolescents. Everyone should know that ADHD is a very common disorder, affecting >=4% of all adults. It is a disabling condition in many, perhaps the majority, of those who manifest its symptoms. A troubling aspect is that only about 1/5 of sufferers seek treatment, and often treatment is suboptimal for a variety of reasons. Staying on topic, the most effective medication strategies remain the "stimulant" drugs. The article contains errors re: drug effects and history. First of all amphetamine was synthesized well before 1929. What we now call amphetamine was created by a Romanian chemistry Ph.D. candidate, Lazăr Edeleanu, in Berlin, in 1887. It was rediscovered in 1927 by Gordon Alles who was unable to patent the compound because of Edeleanu's work 40 years earlier. Amphetamine was initially marketed in the 1930's as Benzedrine. Significantly the remarkable efficacy of amphetamine in what's now call ADHD was described in 1937, and to this day no other class of drug has been demonstrated to be as effective as the stimulants. As commented here, stimulant class medications have different effects in those who need them. At the optimal dose, ADHD patients are not "amped up", in fact typically feel calmer, thoughts and actions more controlled and deliberate. In people who don't have ADHD may indeed experience "stimulating" effects. Furthermore, ADHD adults perform much better with appropriate treatment, whereas unaffected users experience a boost only with simple tasks. Stimulant use will cause decreased performance on cognitively demanding tasks. While college students are known to seek out amphetamines in order to "study better" for their final exams, in fact it's much more likely to decrement their results, myths notwithstanding. Not to say that drug abuse is not a serious matter. Ethical practitioners prescribe stimulant class medications with great care to assure correct diagnoses and appropriate prescribing practices. No question that not everyone with a license is ethical. I firmly support taking steps to put those deliberately contributing to drug abuse out of business, and into jail. It's imperative to avoid throwing babies out with the bathwater. Stimulant medications are an extremely useful tool when used along with due vigilance for misuse. Patients in my practice were carefully monitored, and were informed drug misuse could not be taken lightly. Over the years there were a few who were deemed too irresponsible to continue treatment with the medication.

snarfy 10y ago

At your work you may not get free food or a lot of breaks, but I bet you get unlimited free coffee. I'm not sure why one stimulant is socially taboo and the other acceptable, even encouraged.

JustUhThought 10y ago

This attitude, painting cognitive enhancers with a broad and critical brush, is not helping things. Cognitive enhancers have the ability to improve persona lives and and society on the whole. But, there is a double standard with all things in healthcare. If you want to fix something, then by all means, take as many pills as you want and don't worry about changing lifestyle choices. Take insulin, for example. Or blood pressure medicine. Society may be harsh on folks that need these medicines, but these folks will have no problem getting the medicine. But, if we want to be better than "fixed", if we want to improve our cognitive performance, to do that in a safe physician guided manner, and have that translate to a better emotional, psychological, and economic future for themselves and their family. The economic benefits are real and shouldn't be limited to those in higher socioeconomic strata. This article shows sleep deprived surgeons benefit from modafinil: http://www.ncbi.nlm.nih.gov/pubmed/21997802 http://www.ncbi.nlm.nih.gov/pubmed/21997802 Modafinil Does Not Serve as a Reinforcer in Cocaine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842996/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842996/ ... Ok, I won't make it one of those posts. But, do some research. We will all be better off if we can drop the FUD rhetoric and treat cognitive enhancers like we treat other drugs, something that can help and hurt. And we need to stop thinking of health care as something we do when something is broken, and start thinking about it as another tool in the toolbox that we can use to improve our lives.

nommm-nommm 10y ago
This article is about amphetamine use. Modafinil is not an amphetamine nor is it amphetamine-like.

thisguy666 10y ago

There sure are a lot of people with very little experience with drugs sounding off here. Downplaying the power of amphetamines. hrm.