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The effect of amphetamines on kids with ADHD is to improve school performance. The effect of amphetamines on kids without ADHD is to improve school performance

The effect of amphetamines on kids with ADHD is to improve school performance. The effect of amphetamines on kids without ADHD is to improve school performance. The effect of amphetamines on kids without ADHD but who've been diagnosed with ADHD because they're not getting enough exercise is... to improve school performance.

TeMPOraL 6y ago
Amphetamines aren't magic. There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them. The "young unruly boys without enough PE" is a well-known trope, and modern school is very much kid torture - but I'm not willing to say yet that we're medicating children too much, when the world is only slowly waking up to the fact that we've been underdiagnosing ADHD by at least factor of 2 - this stereotype of unruly boys means the Primarily Inattentive subtype of ADHD is being frequently ignored (vs. the Primarily Hyperactive that creates all the stereotypes), that girls suffering from ADHD are not being diagnosed, not to mention adults.
- da_big_ghey 6y ago
  "By high school, nearly 20% of all boys will have been diagnosed with ADHD." Either 1. we are medicate children too much and schooling is very screwed up or 2. 20% of boys defective to extent that they require amphetamines. I am not see third option. I am not believe 20% of boys defective to such extent. So I believe we are medicate children too much. [0]: https://www.esquire.com/news-politics/a32858/drugging-of-the-american-boy-0414/ https://www.esquire.com/news-politics/a32858/drugging-of-the...
  - TeMPOraL 6y ago
    Well, yes. About ~10% of US kids. How about 3: schooling is increasingly good at exacerbating symptoms of a problem that's considered to be strongly genetic[0] (a point curiously omitted in the article you linked) and widespread in the population. And the numbers seem less surprising if you consider that adult life is also good at making the symptoms apparent - except we brush them away with labels like "lazy", "unorganized", "chronic procrastinator", "rude", etc. and let people figure out coping mechanisms on their own, which often include substance abuse, or on the lighter end, self-medicating with coffee and cigarettes. -- [0] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1title https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1... points to "strong genetic influence on ADHD with estimated heritability ranging from 75% to 91%".
  - pseudalopex 6y ago
    20% is how many boys that age were ever diagnosed with ADHD. 89% of children ever diagnosed have a current diagnosis. Only 62% of children with a current diagnosis take any medication.[1] So much fewer than 20% take a specific medication probably. Almost 40% of boys that age need vision correction.[2] [1] https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1417860 https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1... [2] https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=mm6644a12_w https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=m...
    - Dma54rhs 6y ago
      Which are absolutely insane numbers compared to very similar societies all around the world. I doubt there is some sort of truly unique illness doing rounds only in America.
      - pseudalopex 6y ago
        America isn't an extreme outlier. And most of the variation around the world can be explained by different diagnostic criteria.[1] Look for numbers around the world to jump as countries adopt ICD-11. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/
        Dma54rhs 6y ago
        84% of total world wide ADHD meds are eaten in the USA. There is a difference between identifying symptoms and thinking stimulants are the answer or just not paying any attention. Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. It doesnt meant the doctors pain didn't exist in their patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/
        TeMPOraL 6y ago
        I know you don't intend it this way, but it does come across as cruel when confronted with realities. > 84% of total world wide ADHD meds are eaten in the USA. That's of course because US is ahead of the curve in medicine. > Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. This isn't a medical consensus. We just don't push opioids for everything so early. We start with paracetamol and ibuprofen, upgrade to ketoprofen and other NSAIDs in more specialized or severe cases, and continue as needed. But living with pain is not an acceptable answer here either. Stimulant meds work very well on ADHD and are very safe, both short and long-term; it's a much better story than say SSRIs and depression. The main problem here is the combination of stigma (oh no, amphetamines!) and fears of abuse by people not suffering from ADHD (oh yes, amphetamines!) - both of which are in large part fueled by the US War on Drugs, the unending source of pathologies and suffering worldwide.
- hc-taway 6y ago
  > There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them. I was under the impression that this "it works differently on people with ADHD" thing was essentially a pleasant myth. If you've got solid citations that stimulants do somehow work differently on people with ADHD I'd be interested in reading them. My understanding was that the effect is broadly similar, with the only meaningful distinction being that ADHD-diagnosed individuals have been judged as needing those effects, and others have not.
skinkestek 6y ago
The effect of stimulants on the brain is to stimulate it. For those who need it it makes mind-numbingly boring stuff such as homework (as opposed to reading history books or creating elaborate formulas etc etc) less painful. I don't know about you but I personally have seen some examples that have gotten significantly improved lives because of it. If you don't know this stuff first hand, please refrain from making broad statements about it. BTW, I'll give you this: one of the most interesting explanations I saw was that ADHD is very overdiagnosed - and at the same time underdiagnosed. Some people get ADHD meds that shouldn't have, others struggle for years because some people have irrational fear against stimulats. Can we try to avoid moving that needle and instead try to lower the errors on both sides?
- hc-taway 6y ago
  > If you don't know this stuff first hand, please refrain from making broad statements about it. Unless all the kids illegally buying ADHD meds to do better in school when they have not been diagnosed with ADHD (and adults doing the same, for that matter, to do better at work) are doing that for no reason, I'm pretty sure I'm correct that amphetamines improve performance for most everyone, and that distinguishing between ADHD-and-improved-on-meds and not-ADHD-and-improved-on-meds is not trivial. I was replying to a post that read: > If they're on stims in particular, and the meds actually improve their behavior, then the cause most likely isn't insufficient PE time. I object to that being proof of much other than amphetamines making most people perform better in school, without commenting on whether ADHD is a "real" thing (I'm not even sure what it would even mean for it not to be "real", given the state of our understanding and diagnosis of mental disorders). "We gave the kid amphetamines and they improved, must have had ADHD" is dangerously misguided.

TeMPOraL 6y ago

Amphetamines aren't magic. There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them. The "young unruly boys without enough PE" is a well-known trope, and modern school is very much kid torture - but I'm not willing to say yet that we're medicating children too much, when the world is only slowly waking up to the fact that we've been underdiagnosing ADHD by at least factor of 2 - this stereotype of unruly boys means the Primarily Inattentive subtype of ADHD is being frequently ignored (vs. the Primarily Hyperactive that creates all the stereotypes), that girls suffering from ADHD are not being diagnosed, not to mention adults.

da_big_ghey 6y ago
"By high school, nearly 20% of all boys will have been diagnosed with ADHD." Either 1. we are medicate children too much and schooling is very screwed up or 2. 20% of boys defective to extent that they require amphetamines. I am not see third option. I am not believe 20% of boys defective to such extent. So I believe we are medicate children too much. [0]: https://www.esquire.com/news-politics/a32858/drugging-of-the-american-boy-0414/ https://www.esquire.com/news-politics/a32858/drugging-of-the...
- TeMPOraL 6y ago
  Well, yes. About ~10% of US kids. How about 3: schooling is increasingly good at exacerbating symptoms of a problem that's considered to be strongly genetic[0] (a point curiously omitted in the article you linked) and widespread in the population. And the numbers seem less surprising if you consider that adult life is also good at making the symptoms apparent - except we brush them away with labels like "lazy", "unorganized", "chronic procrastinator", "rude", etc. and let people figure out coping mechanisms on their own, which often include substance abuse, or on the lighter end, self-medicating with coffee and cigarettes. -- [0] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1title https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1... points to "strong genetic influence on ADHD with estimated heritability ranging from 75% to 91%".
- pseudalopex 6y ago
  20% is how many boys that age were ever diagnosed with ADHD. 89% of children ever diagnosed have a current diagnosis. Only 62% of children with a current diagnosis take any medication.[1] So much fewer than 20% take a specific medication probably. Almost 40% of boys that age need vision correction.[2] [1] https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1417860 https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1... [2] https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=mm6644a12_w https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=m...
  - Dma54rhs 6y ago
    Which are absolutely insane numbers compared to very similar societies all around the world. I doubt there is some sort of truly unique illness doing rounds only in America.
    - pseudalopex 6y ago
      America isn't an extreme outlier. And most of the variation around the world can be explained by different diagnostic criteria.[1] Look for numbers around the world to jump as countries adopt ICD-11. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/
      - Dma54rhs 6y ago
        84% of total world wide ADHD meds are eaten in the USA. There is a difference between identifying symptoms and thinking stimulants are the answer or just not paying any attention. Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. It doesnt meant the doctors pain didn't exist in their patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/
        TeMPOraL 6y ago
        I know you don't intend it this way, but it does come across as cruel when confronted with realities. > 84% of total world wide ADHD meds are eaten in the USA. That's of course because US is ahead of the curve in medicine. > Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. This isn't a medical consensus. We just don't push opioids for everything so early. We start with paracetamol and ibuprofen, upgrade to ketoprofen and other NSAIDs in more specialized or severe cases, and continue as needed. But living with pain is not an acceptable answer here either. Stimulant meds work very well on ADHD and are very safe, both short and long-term; it's a much better story than say SSRIs and depression. The main problem here is the combination of stigma (oh no, amphetamines!) and fears of abuse by people not suffering from ADHD (oh yes, amphetamines!) - both of which are in large part fueled by the US War on Drugs, the unending source of pathologies and suffering worldwide.
hc-taway 6y ago
> There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them. I was under the impression that this "it works differently on people with ADHD" thing was essentially a pleasant myth. If you've got solid citations that stimulants do somehow work differently on people with ADHD I'd be interested in reading them. My understanding was that the effect is broadly similar, with the only meaningful distinction being that ADHD-diagnosed individuals have been judged as needing those effects, and others have not.

skinkestek 6y ago

The effect of stimulants on the brain is to stimulate it. For those who need it it makes mind-numbingly boring stuff such as homework (as opposed to reading history books or creating elaborate formulas etc etc) less painful. I don't know about you but I personally have seen some examples that have gotten significantly improved lives because of it. If you don't know this stuff first hand, please refrain from making broad statements about it. BTW, I'll give you this: one of the most interesting explanations I saw was that ADHD is very overdiagnosed - and at the same time underdiagnosed. Some people get ADHD meds that shouldn't have, others struggle for years because some people have irrational fear against stimulats. Can we try to avoid moving that needle and instead try to lower the errors on both sides?

hc-taway 6y ago
> If you don't know this stuff first hand, please refrain from making broad statements about it. Unless all the kids illegally buying ADHD meds to do better in school when they have not been diagnosed with ADHD (and adults doing the same, for that matter, to do better at work) are doing that for no reason, I'm pretty sure I'm correct that amphetamines improve performance for most everyone, and that distinguishing between ADHD-and-improved-on-meds and not-ADHD-and-improved-on-meds is not trivial. I was replying to a post that read: > If they're on stims in particular, and the meds actually improve their behavior, then the cause most likely isn't insufficient PE time. I object to that being proof of much other than amphetamines making most people perform better in school, without commenting on whether ADHD is a "real" thing (I'm not even sure what it would even mean for it not to be "real", given the state of our understanding and diagnosis of mental disorders). "We gave the kid amphetamines and they improved, must have had ADHD" is dangerously misguided.