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> Basically, are they "well-adjusted"? This is so easy to game. People read the diagnostic criteria online and echo it back to their doctor for a prescription

> Basically, are they "well-adjusted"? This is so easy to game. People read the diagnostic criteria online and echo it back to their doctor for a prescription. Their proof of needing adjustment can be little more than pointing to their grades and attributing their less than stellar academic performance to the list of ADHD symptoms they memorized online. EZ way to get yourself a stimulant subscription. This was particularly common during the pandemic when you could do it entirely online without actually meeting a doctor in person. I saw a lot of people explicitly advocating this sort of deception to get stimulant prescriptions; all described it as very easily done. I tend to think those drugs should be legal OTC, so part of me thinks "so what?" But the problem is that right now it isn't legal OTC, so the system is giving a leg up to anybody willing to lie to a doctor, while honest people have to make do with lesser PEDs like caffeine.

falcolas 4y ago
Someone being able to fake an illness does not signify that the illness does not exist. You can fake chronic back pain, migraines, suicidal tendencies, and so on. That doesn't make any of them any less real.
- MichaelCollins 4y ago
  I'm responding to the claim that it's easy for doctors to falsify a false claim of ADHD from somebody who's drug seeking and has been coached online to say the right things to the doctor. This doesn't seem to be the case. ADHD may be real, but doctors seem to have a hard time distinguishing people who actually have it from people who just want the drugs and know what to tell the doctor because they watched a bunch of instructional videos about this sort of deception on tiktok. The 'test' for ADHD boils down to "evaluat[ing] traits, strengths, and difficulties, and to what extent they impact functioning as a person in society. Basically, are they "well-adjusted"?" It's not as though the evaluation is some chemical analysis in a lab, anybody so inclined can be coached to pass this evaluation by telling their doctor the right things.
  - falcolas 4y ago
    Again, this is not unique to ADHD. None of those other things I mentioned can be detected by a chemical analysis either. And morphine is as big - if not bigger - problem than amphetamines.
    - MichaelCollins 4y ago
      Nobody claims this is unique to ADHD.
      - sizzle 4y ago
        And without any data on drug seeking behavior it’s a moot point, could be such a small percent of people who make it past detection, have no criminal records, pass 6 month urine screen that MUST show negative to a panel of illicit drugs + positive for amphetamine markers. Doctors are afraid of losing their licenses for prescribing controlled substances without covering their ass (e.g. illicit drug panel screen) and err on the side of caution. It’s hard to make it past these hurdles and aren’t on other controlled substances, you are still rolling the dice of getting blacklisted in their systems if you ever get caught selling or testing positive for weed or opioids, etc.
kortex 4y ago
Gp wrote: > "By what process can someone reasonably determine that they are NOT neurodivergent?" You are talking about the opposite detection criteria, false positive vs true negative. I was speaking to "neurodivergence is not falsifiable". You are speaking to "one can fake neurodivergence, esp. to get prescriptions", which, of course, that is definitely a thing. Of course, if you fake to the doctor that you don't have symptoms, well duh, of course they won't diagnose you. That also has nothing to do with falsifiability. You won't get a correct diagnosis by lying - doctors aren't psychics. At its very most reduced form, falsifying neurodivergence as a hypothesis means basically demonstrating a single counter-example exists. Can we find someone who made it through high school, learned good study habits on their own, did average to well in college, held down a job, paid the bills, folded their close, made friends and raised a family, all without counseling, special classes, medication, self-medication, masking, hyper-extending themselves (beyond just "working hard"), or burning themselves out just to make ends meet? I think so. Neurodivergence, ADHD, and ASD are falsifiable diagnoses - a true negative result can be obtained.

falcolas 4y ago

Someone being able to fake an illness does not signify that the illness does not exist. You can fake chronic back pain, migraines, suicidal tendencies, and so on. That doesn't make any of them any less real.

MichaelCollins 4y ago
I'm responding to the claim that it's easy for doctors to falsify a false claim of ADHD from somebody who's drug seeking and has been coached online to say the right things to the doctor. This doesn't seem to be the case. ADHD may be real, but doctors seem to have a hard time distinguishing people who actually have it from people who just want the drugs and know what to tell the doctor because they watched a bunch of instructional videos about this sort of deception on tiktok. The 'test' for ADHD boils down to "evaluat[ing] traits, strengths, and difficulties, and to what extent they impact functioning as a person in society. Basically, are they "well-adjusted"?" It's not as though the evaluation is some chemical analysis in a lab, anybody so inclined can be coached to pass this evaluation by telling their doctor the right things.
- falcolas 4y ago
  Again, this is not unique to ADHD. None of those other things I mentioned can be detected by a chemical analysis either. And morphine is as big - if not bigger - problem than amphetamines.
  - MichaelCollins 4y ago
    Nobody claims this is unique to ADHD.
    - sizzle 4y ago
      And without any data on drug seeking behavior it’s a moot point, could be such a small percent of people who make it past detection, have no criminal records, pass 6 month urine screen that MUST show negative to a panel of illicit drugs + positive for amphetamine markers. Doctors are afraid of losing their licenses for prescribing controlled substances without covering their ass (e.g. illicit drug panel screen) and err on the side of caution. It’s hard to make it past these hurdles and aren’t on other controlled substances, you are still rolling the dice of getting blacklisted in their systems if you ever get caught selling or testing positive for weed or opioids, etc.

kortex 4y ago

Gp wrote: > "By what process can someone reasonably determine that they are NOT neurodivergent?" You are talking about the opposite detection criteria, false positive vs true negative. I was speaking to "neurodivergence is not falsifiable". You are speaking to "one can fake neurodivergence, esp. to get prescriptions", which, of course, that is definitely a thing. Of course, if you fake to the doctor that you don't have symptoms, well duh, of course they won't diagnose you. That also has nothing to do with falsifiability. You won't get a correct diagnosis by lying - doctors aren't psychics. At its very most reduced form, falsifying neurodivergence as a hypothesis means basically demonstrating a single counter-example exists. Can we find someone who made it through high school, learned good study habits on their own, did average to well in college, held down a job, paid the bills, folded their close, made friends and raised a family, all without counseling, special classes, medication, self-medication, masking, hyper-extending themselves (beyond just "working hard"), or burning themselves out just to make ends meet? I think so. Neurodivergence, ADHD, and ASD are falsifiable diagnoses - a true negative result can be obtained.