ADHD drugs almost certainly means adderall which is pretty heavily abused as a recreational drug, especially on college campuses. It's relatively easy to acquire a prescription and it's an amphetamine.
Both of those articles are discussing the use of Adderall as a study aid, not a party drug. I think folks in this thread are objecting to its depiction as the latter specifically, not the fact that it is heavily used on college campuses in general.
> In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram.
> My friend pulled two blue pills out of tinfoil and handed them to me. An hour later, I was in the basement of the library, hunkered down in the Absolute Quiet Room, in a state of peerless ecstasy.
Anecdotal but where I go to school (a top university) people often will drink then take adderall since it focuses you while you're drunk so you don't seem as drunk but can still have fun.
I highly doubt however that it's more popular then molly and I know it isn't as popular as weed, which is still the recreational drug of choice. This might be skewed as coming from a good university hard drugs aren't as popular as some other schools, but I think it's enough to debunk a baseless claim.
Ask Hacker News for what goes on at parties and you are going to get skewed results. Yes, people use this to party. But no, I don't think you are going to find a ton of a paper trail for this in journals.
Huh. Family with a history of ADHD. My father, me, son. Medication for my son makes an unbelievable difference. For me with a moderate therapeutic dose, huge difference as an adult. Took meds in school as well. Dad, ended up addicted to meth and alcohol and never did much with his life. They didn't know about ADHD when he was young.
The difference in knowing the enemy and practicing against it is a big deal. To get ADHD meds as an adult I had to spend a lot of time with a psychiatrist and I did machine based testing that is very difficult to fake. Some doctors don't care and just write scripts. It is increasingly risky for doctors to do so though, so most refer you to a psych first.
I will note, at the low to moderate therapeutic doses I use (often skipping several days) it is far from some sort of epidemic of abuse like what the author portrayed. And honestly, even if you don't have ADHD, so, what. It is safer than meth. Alcohol is way, way worse than therapeutic doses of amphetamines. (Therapeutic means relatively low and controlled dosing)
I think I would honestly rather see amphetamines a little overprescribed than have true ADHD sufferers go without treatment. Of all the drugs psychiatrist prescribe, amphetamines for ADHD sufferers have the largest observable therapeutic effect, bar none. We aren't talking just among ADHD. Of all mental illness amphetamines for ADHD sufferers produces a huge clinical effect unlike any other drugs like anti depressants. For those of us that it really helps it is not a game. This article read like scaremongering with no real talk of the actual impact of prescription amphetamine use and abuse. There is no real data to back it up. There is no doubt most people who think they ha e ADHD as an adult don't have it, but at the same time there is no evidence presented that 1.) It is causing harm at any scale and 2.) How overdiagnosed it actually is, but by god we need to do something about this amphetamines...
Kids addicted alcohol in college probably don't graduate. Kids scrounging a few addy probably just write the most interesting papers about neoclassical bullshit the history of humanity ever witnessed.
Edit: Just want to add that people with ADHD are hugely overrepresented within alcoholics and drug abusers. When we don't get the advice and help we need many self medicate. ADHD is a mental illness, just like depression, and other mental illnesses. With addictive personalities being common among ADHD suffered due to how our brains manage dopamine, it is no surprise. It is a huge waste of human potential.
Thank you for sharing. I know the general problem with depression is not directly how the brain manages it's dopamine, but a lot is not understood about depression. Like ADHD it is a cluster of underlying causes that manifest in a similar manner. If your brain has trouble releasing dopamine, amphetamines are going to help. ADHD brains just don't let go of their dopamine effectively. Amphetamine stimulants come in and hit the dopamine stores with a jackhammer. The net result is that mundane stuff becomes more pleasurable. It actually does far less for people who don't have ADHD, but it obviously had an effect. Also, we don't really know what the long term effects are. I suspect if you exercise regularly and cycle on and off to ensure no dependency the side effects are low. We have good reason to suspect this with some folks using Dextroamphetamine (Adderall) and Methylphenidate (Ritalin) for 10-20+ years with no large side effects observed.
It doesn't matter if people are abusing drugs, it matters whether it is immoral or poor for them or not, it depends on what drugs are being abused and if they're bad, since adderall is a general performance enhancer and humans see significant benefits then such activities should be considered permissable, people cannot be held back in their lives because their doctors disagreed on their behalf, people cannot be held to the tyranny of underqualified 'professionals'.
short version: ADHD 7-8x less chance of graduating college with a degree, 10% of dropping out of high school, 30% of repeating a grade(8-12 or maybe k-12), E.F. deficits overpower High I.Q. very easily. As economy of time > economy of information.
I always find it funny how people overblow the side effects from amphetamines and other performance enhancing drugs. Somehow these are "bad" because they are illegal. Just like how marajuana was "bad" but now its suddenly "okay" because it's legal.
I have ADD - and an adderall prescription helped me get through alot of the bullshit for my bachelors degree. I can concentrate on things that interest me, but universities make you take a ton of unrelated courses and I just lost interest almost instantly on work.
So for one year (my senior year) I had a prescription ranging from 15-30mg XR (30 was too high so I dropped down).
In retrospect, I was able to quit cold turkey with minimal sides after graduating - got my heart scanned out of curiosity and its fine, cholesterol is fine, etc. etc.
I think most drugs are safe if:
1. Used in the right doses for the right duration .
2. Only used on otherwise healthy individuals (this is an important one in the world of "everyone is equal") - I would not take adderall if I was obese since it is a stimulant and does increase BP / HR.
I take Vyvanse, so not directly the same. In fact I'm not sure if it and Adderal have the exact same effects on BP since they work differently.
I'm definitely considered obese at 6'4" and 280lbs, but there's been literally no movement of my BP up or down since I've been on it. To agree with your point though:
1. Every physical I've ever had has had my vitals in good ranges (minus the weight)
2. I get strenuous physical excercise at least 4x/wk so I'm a spry tub of love
I was worried about any possible issues with BP/HR during lifting sessions if I took it before workouts in the morning so I avoided it for a while until my doc reassured it should be fine. As with anything if I felt off, just back down the activity and don't do it tomorrow. I'd say if anything it allows me to run longer on the treadmill or elliptical because I don't get so god damn bored and ready to do something else.
The difference in the brain for Adderall v. Vyvanse comes down to the concentration of which enantiomoers are (how much of which mirror image of amphetamine there is). It's all amphetamine, it all affects the same receptors. The real difference comes down to how long it stays available. Vyvanse sticks around in the blood longer than "plain" amphetamine, but amphetamine crosses into the brain much faster. Both of those are because the liver has to first cleave off the extra molecule tacked onto the amphetamine that makes it Vyvanse. That can only happen so fast, and until it does it's too big to cross the blood/brain barrier or get otherwise disposed of.
You're right. However, the article's list of adverse affects are pretty laughable. You also just pulled numbers out of thin air. There are lots of anecdotes in this thread, and doctors seem pretty ok prescribing an FDA approved medication - so, aside from "it's being overprescribed" what is the downside?
Either these drugs are somehow getting approved without monitoring provisions required, or 1% is much higher than the rate of negative side effects in reality.
All of my post is anecdotal, but it sucks that some people abuse the system just for drugs. With that disclaimer out of the way lets begin:
From what I gather it (Adult ADHD) is also very hard to distinguish from bipolar disorder. It took 18 months of moving around with anti-psychotics and other drugs to treat my "bipolar disorder" before my doctor realized that it was ADHD and we found almost immediate results from the treatment.
It sucks that the diagnosis seems to be so easy to get for some people and they're doing it for the adderall. In my case it helped me significantly, moving up in my career and ultimately bringing me out of an almost decade long depression with myself. I hope that people who actually need help get it, and to put it simply, screw the others who make it hard for people to be properly diagnosed. My diagnosis took so long because of the known abuse to get the drugs, from what I gathered in conversations with my doctor, and she was reluctant to consider that diagnosis until she was absolutely sure of it.
I'm sure some people abuse prescription amphetamines to their detriment, but is damages the credibility of the definition of "abuse" to include all the people who game the system for the sake of performance enhancement.
Personally I disagree that it would discredit it. These people are, in effect, taking advantage of a system to use medication for personal gain and not towards treating an actual mental illness. I would think that is abuse. They're causing an already broken system to be further legislated and controlled for people who need it.
I agree that it may be the wrong word to use but since it personally affected me my opinion will be skewed.
There are plenty of people in the pharma business creating medications for performance enhancement. It isn't exactly natural for 80 year olds to have 4 hour boners.
I personally don't see the dangers of even mild recreational use, and performance enhancement is definitely not recreational as dosage has to be kept low, and strictly controlled.
In medical terminology, substance abuse has a well known definition covering addiction, increasing use, and use to the detriment of mental, physical or social well being.
Someone getting a performance benefit from a drug is not abusing it, whilst they are using it within the safe parameters defined by their doctor.
Sleep deprivation, not eating a breakfast, etc... can affect your concentration. Prior to start treating ADD-like symptoms with medication just try improving those things and see if that works for you.
Alas if you actually have ADD, you wouldn't be able to stick to such a rote and uninteresting plan. Being unable to consistently do things that aren't mentally invigorating is a key part of the failure in the executive directive centers of the brain that ADD is known for.
This is akin to telling a depressed person to try and do things that make them happy---they can't because being unable to find the motivation to do anything is part of a depression diagnosis.
Diagnosis is part of the problem. Without taking a brain scan, there's no way to know for sure that you have ADD.
In fact many people do have ADD, but have 'grown out of it' because their coping mechanisms, and life choices make it largely a non-issue as to success in their adult lives. That said, they would have made different choices, and spent less time 'coping' if they didn't have to.
I completely agree, I am just saying that ADD is not the only reason of why a person can perceive a chronic inability to remain focused. Sometimes bad habits can impact your ability to focus, that's all. Then, my advice is by no means substitution for medical advice.
I think of ADD as Amphetamine Deficit Disorder. In a practical sense, "ADD" is the disorder that afflicts people who function better when given amphetamines. Personally, I feel that anyone who wants to take amphetamines should be allowed to.
I think that inability to concentrate is a common pathway for essentially all diseases that afflict man. Anything a disease does to draw your attention to itself is affecting concentration, because you are not able to concentrate on whatever you want to concentrate on. In some cases, this is insidious and you are not aware of the disease as such; it affects your concentration and you don't understand why. In some cases, you might only know that you can't concentrate. Amphetamines will tend to help, because they allow you to concentrate harder on what you want to concentrate on, regardless of the actual etiology of whatever is distracting you.
Small informational bit - ADD is not only "I have problems concentrating on boring things". It's also "I can't automatically connect today's actions with tomorrow's consequences" and "I can't stop focusing on this one thing even though I need to focus on something else".
Note the "can't" in those; it's not a preference or a weakness, it's a straight up inability.
I don't think it's ever a binary question of can versus can't. I think that the disease manifests as a source of internal distractions that are hard to ignore. Think of pain. Imagine trying to take a test while someone was jamming a knife into your foot. I'm conjecturing that other distractions work in a similar way to pain.
It has been noted that amphetamines are capable of relieving pain. That makes sense if you conceive of pain as a distraction that forces you to pay attention to it. Amphetamines allow you to concentrate harder on something else.
There are most likely different forms of ADD or "ADD," and perhaps there is a form of ADD that acts directly on the brain's attention mechanism. We don't know anything about how the brain's attention mechanism works, so the idea that it can be broken is pure speculation.
I suspect that this person has never encountered someone who actually has ADHD, with meds and without. I was lucky enough to be diagnosed early on. Right around Kindergarten I was taking Dexadrine which helped until Adderall came along.
For me there's a huge difference between the two. Without the meds, my concentration drifts. If I'm at home, I may be aware of an issue that needs attention, but lack the energy and focus to carry it out. I'll start watching a video, get distracted, and drift off there, then over there, and so forth.
Out in public it manifests as an occasional intense craving for sugar, though it's possible that's just me. At the peak it can be intense uncontrollable energy (the H part), as well as frequent "why did I come in here" or "I forgot to do this". It comes in getting distracted from a task and forgetting to ever come back to it.
With the meds, it's much different. I have a sharp focus. I can throw on a whole music cd and let the tracks all play out without feeling the need to jump around or to switch to a different album. Just me and the code that I need to do, or solving any other problem tasks.
In public I'm able to control myself better. I don't have to think of doing something before doing it as much, resulting in a better flow.
This isn't a matter of a diet either. I don't snack on fatty foods, and I don't have soda to drink at home. My current doctor has me take an EKG every year to make sure that it's not playing poorly with my heart.
There's a huge difference between "I get distracted from time to time" and having a constant difficulty getting tasks accomplished and lacking the motivation to complete small tasks from start to finish (getting interrupted and forgetting to go back at all).
I suspect this person has never encountered someone with actual adult ADHD. Consider also that in the past, many of these people would have just been called crazy and left at that.
Either I and everyone I know have ADHD, or the symptoms you listed seem pretty benign, and affect almost everyone in the human race.
It reminds me of the Scientology episode of South Park.
"Do you ever make remarks... that you later regret?"
"Would you rather give orders... than take them?"
"Do you ever whistle... just for the fun of it?"
"Does life sometimes feel vague... and confusing to you?"
---------------
"Well, I hate to tell you, but you're completely miserable and totally depressed! Well, there's really no question that you're a perfect candidate for [Scientology|Adderall]. All we'll need to get started is $200."
>symptoms you listed seem pretty benign, and affect almost everyone in the human race.
The difference is that for those with ADHD those symptoms are not benign and have a major negative impact on their life. Saying that it's not real or important because everyone feels that way sometimes is like saying there's no such thing as severe allergies because everyone sneezes sometimes.
The article seemed to be mostly about adult-onset ADHD, which the author asserts is rare or non-existent - it would be noticed and diagnosed as a child/teenager, or evaluation would reveal that it had been ignored/untreated.
I'd wager that Allen Frances has met many adults with ADHD - but probably not many (if any) who started showing symptoms only in adulthood.
The article does very little to distinguish between adult onset, adult diagnosis, and continued diagnosis.
I found what seems to be the longitudinal study Conners referred to.[1] The authors present evidence that "adult ADHD" is a verifiable condition with symptoms similar to childhood ADHD but apparently unrelated.
Another anecdote from someone on HN, which probably biases pretty hard for people who have had success medicating ADHD. I dropped out of a bottom tier state school at 19 studying CS with essentially a 0.0. In my mid 20s I was diagnosed with ADHD by a GP and a psychiatrist and got a second opinion from a second psychiatrist who said the first two were wrong. I stopped medication because of sentiment like that expressed in the article. A year or two later I decided I didn't like what I was doing, and wanted to return to school. I saw a second GP and got rediagnosed and prescribed. I'm now studying CS at a top 5 university with a 4.0.
My personal opinion is that there is more harm from the negative stigma associated w/ ADHD prescription than good, but you can imagine I would be biased given my narrative.
First off any medical advice from Huffpost is bullshit. Second the author here and the doc cited are pompous idiots. ADHD is real in children and adults and evidence of it can be seen with brain imaging (https://www.sciencedaily.com/releases/2017/02/170216105919.h...). Maybe they should conduct their work with some hard science/evidence instead of a checklist based on opinion? Ooooh.... and cry me a river, some big pharma company paid for a vacation for you and then took something you said and bent it to sell some drugs. Wake up! They sell drugs and so do you doc! I have ADHD and meds are the difference between total personal ruin and successfully running a company for me... and many other people. Every one of these clickbait bullshit articles that descend into moral arguments about ADHD do real harm to actual people with a quantifiable disability. Rule 1 of being kind that you teach a child is not to pick on people for things they can't change. I can't change that I have ADHD, other people with it cannot change that. We live in a world made by people with what the book "Delivered from Distraction" called "Attention Surplus Disorder." Supposedly the people who aren't sick are the ones who can sit still at a desk and then a cubicle their whole life doing what they are told. If that's being well I'm so glad I'm "sick."
Psychiatry is such an embarrassment, in the US and UK at least. So many otherwise reasonably intelligent people believe in the concrete reality of "diagnoses" that are merely descriptive at best, and delusional at worst. The number of parents who are led to believe that their child "has" "dyslexia" or "ADHD" is astonishing; and the ramifications in terms of extra time in exams, free laptops etc are absurd. One form of evidence for these assertions is the lack of cultural replication: I don't have citations, but I understand that many of these concepts do not have parallels in other languages/cultures where one would would expect replication if these really were biological phenomena. I guess people will always see shapes in clouds, but when it comes to serious matters like education, the rational, scientific side of our society needs to be kind but firm in stamping this stuff out. But when will it finally happen -- perhaps not until we've also got over the idiocy of religion, and the idiocy of the "postmodernism"-influenced humanities?
This wasn't a rant, it was a perfectly serious comment. Think of the people you know with spurious bipolar disorder diagnoses and who have been wrongly prescribed lithium and antipsychotics and all the rest of it. You know it's not real science.
Talking about about “overdiagnosis” without addressing underdiagnosis is, frankly, scientific and clinical malpractice. Untreated ADHD, which is underdiagnosed in adults (especially in women) can be a debilitating condition and there's ample evidence about this from peer-reviewed medical journals (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195639/, among others). Self-medication with effective medication isn’t even really possible because amphetamines aren't regular prescription drugs -- they're controlled substances, so diagnosis tends to be a necessary condition to get access to effective meds.
The “overdiagnosis” moral panic leads to parents not being OK with the idea of their children being diagnosed with ADHD or shudder be on effective medication like adderall or ritalin, or people (of all ages) thinking/internalizing the idea that they can’t ~~really~~ have ADHD and that they’re just “lazy” or “flaky” or “apathetic” or whatever other shitty terms are used for people with executive dysfunction. It also makes doctors more suspicious of people seeking treatment ("if it’s overdiagnosed it must be rare, so some of the people I see as a doctor have to be be faking it, by pigeonhole principle"), which actually causes harm to people who need access to medical care -- finding a doctor who’s OK prescribing is such a pain when you’re ADHD and have run out of meds.
I've had enough bad experiences with psychiatrists for a lifetime and I've absolutely no inclination to defend psychiatrists, their clinical practice, or their DSM. There indeed are people who are diagnosed with ADHD who don’t have it / don’t benefit from medication. However, the “overdiagnosis” meme (https://www.ncbi.nlm.nih.gov/labs/articles/17709814/) and other forms of ADHD denialism cause real harm to people who actually end up needing critical access to controlled substances which are impossible to legally get without the appropriate diagnosis. Regardless of how psychiatrists draw the lines of diagnosis, there's plenty of evidence that there actually do exist plenty of people with chronic and debilitating attention / executive function dysfunction that do experience amelioration when they take a regular dose of stimulants.
Furthermore, this isn't a straightforward discussion about the effectiveness of some given pharmaceutical -- this is a moral panic that explicitly seeks to use the criminal law to curtail access to medication, regardless if it has been shown safe and effective:
> The Drug Enforcement Agency is doing its best to contain the epidemic
One thing that's missing from this narrative - recreational Adderal users tend to use dosages which are in the 40-60 mg range per hit.
ADHD users tend to be in the 5-30 mg range, often in extended release form. Most neuraltypical people won't even notice any difference in concentration or energy from such small dosages.
I am at the 15mg end, and the energy hit is not even enough to affect my sleep if I make a mistake and take one at night (it's happened). A single coffee, on the other hand, is enough to keep me up for a few extra hours.
I'm someone who has struggled with concentration issues my entire life. I used to bemoan that I grew up in the time before medication existed to treat the condition, since my inability to concentrate has caused some particularly negative consequences in my life. But recently I had a profound realization about my concentration issues. I attended a 10-day meditation training course where, in addition to meditating most of the days, all my distractions (cell phone, computer, books, etc) were taken away from me. The first few days were extremely rough. I went through withdrawal symptoms that were really an extreme version of my concentration issues since my mind felt the need for distraction and there was nothing to sate that desire. But at the end of those 10 days, I had a brief period where I had absolutely no difficulty concentrating. It was such a stark contrast to my life before then, that it was particularly notable.
But addiction to distraction isn't like addiction to alcohol or drugs. Short of a radical "into the woods" plan, you can't go cold turkey on modern life. And since I've reintroduced my modern devices into my life, my concentration issues have returned. But it's been important for me to have realized the true cause of those issues because dialing back on TV, computing devices and everything else I use to divert my attention can cause short-term relief when things get really bad. Turning my cell phone off and spending the entire day hiking outdoors can really help.
Based on my own experience, I wonder whether our practice of medicating attention deficit issues is really just a horribly misguided attempt to treat the symptoms rather than the underlying cause. Life has changed so rapidly within the course of the past couple of generations and I don't think there's been enough attention paid to the effect that it has on our bodies, minds and health. I firmly believe that, in time, we'll look back at this period and our computing devices and other modern distractions and view them in the same way that we view asbestos insulation or lead paint...incredibly effective at accomplishing their immediate goal but with devastating health consequences that we only recognized years after they were introduced.
I'm curious whether this rings true with others, especially those who've had concentration issues. Have others tried a "digital detox" and has it helped? Or is ADHD something different from what I've experienced and that medication really is the only way to treat it?
ADHD-er here. I have a 2-sigma attention span in the shitty direction. It's a massive impairment. I've titrated my dose, and I've stayed at 45mg Adderall/day for the past 3-4 years, which is quite high for someone who has been careful not to develop a tolerance.
Every month, I have to spend a day (or five) dealing with the nightmare that is filling my prescription so that I can function like a normal human being.
THE RULES:
0. For ADHD people such as myself, being forced to go a day without meds is like being forced to go a day without your favorite text editor. It's not fun. In addition, I don't feel safe driving then. If I want to go someplace without meds, I'm taking a cab.
1. Adderall is classified by the DEA as a schedule II stimulant. Some other schedule II drugs: cocaine, opium, morphine. If you opt for a paper prescription, it usually has security features like microprinting, watermarks, or holograms. You're going to be asked for an id (or three) when you fill the prescription. After all, you might as well be getting a prescription for cocaine.
2. There are no refills on your prescription, ever. You have to get a new prescription every month, which means calling in to your clinic and reciting all of the details. Nurses are not allowed to copy-paste these details, so you can bet your ass that I've dealt with a number of typos over the years. Sorting out typos usually takes a few business days.
3. A doctor must sign each prescription.
4. Some doctors flat-out refuse to sign prescriptions that they didn't prescribe. That's totally reasonable, except it means that you need to call in for a new prescription on a day when your prescribing physician is in the office. That means that you need to either learn their work schedule, or call in at least 3-5 business days before you need to fill your meds.
5. Most insurance companies will not allow you to fill your medication even one day early -- if you want to do that, you're paying the sticker price yourself. For my dose, the sticker price is $500-600.
6. In some states...
- if you send a prescription to a pharmacy, then it MUST be filled there, and may not be transferred.
- pharmacies may not answer questions over the phone about whether medication is in stock. They might be able to answer in person.
- pharmacists may not call other pharmacists or access any sort of database to find out whether there is any pharmacy in the area with medication
- if there is not enough medication in stock, then the pharmacy may partially fill your medication with the available stock, but you void the unfilled portion of your prescription. Your insurance will probably not allow you to fill your meds early, even if the pharmacy is out of stock and you choose to fill a partial prescription.
Remember that you can't bring your prescription somewhere else, or call in advance to inquire about stock. So you have to remember to ask the pharmacist about their stock before you hand the prescription over, in case they don't have enough stock. That gives you the opportunity to blindly search the neighborhood for a pharmacy that has them in stock. Remember, you can't call about any of this, so you're going to be doing quite a bit of travelling.
7. Some pharmacists are antsy about filling a prescription for drugs in the same category as cocaine. I've met pharmacists who will insist upon verifying the prescription with your prescribing clinic. If you try to fill your meds when your prescribing clinic is not open, tough luck. Come back tomorrow.
8. Because of the effects that large-ish daily doses of amphetamines may have on one's heart, most doctors that I've met will insist on meeting with patients every few months to check your blood pressure, heartrate, etc. That is, your prescription is not getting filled unless you make a clinic visit every few months. Because I actually have ADHD, the conversation usually goes something like this:
"Are you having trouble sle...
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[ 3.3 ms ] story [ 132 ms ] threadAlso, https://en.wikipedia.org/wiki/Rosenhan_experiment
Is there any well documented evidence for this? It certainly contradicts my personal observations.
Edit: good article about the subject in general https://www.nytimes.com/2016/10/16/magazine/generation-adder...
> In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram.
> My friend pulled two blue pills out of tinfoil and handed them to me. An hour later, I was in the basement of the library, hunkered down in the Absolute Quiet Room, in a state of peerless ecstasy.
I highly doubt however that it's more popular then molly and I know it isn't as popular as weed, which is still the recreational drug of choice. This might be skewed as coming from a good university hard drugs aren't as popular as some other schools, but I think it's enough to debunk a baseless claim.
The difference in knowing the enemy and practicing against it is a big deal. To get ADHD meds as an adult I had to spend a lot of time with a psychiatrist and I did machine based testing that is very difficult to fake. Some doctors don't care and just write scripts. It is increasingly risky for doctors to do so though, so most refer you to a psych first.
I will note, at the low to moderate therapeutic doses I use (often skipping several days) it is far from some sort of epidemic of abuse like what the author portrayed. And honestly, even if you don't have ADHD, so, what. It is safer than meth. Alcohol is way, way worse than therapeutic doses of amphetamines. (Therapeutic means relatively low and controlled dosing)
I think I would honestly rather see amphetamines a little overprescribed than have true ADHD sufferers go without treatment. Of all the drugs psychiatrist prescribe, amphetamines for ADHD sufferers have the largest observable therapeutic effect, bar none. We aren't talking just among ADHD. Of all mental illness amphetamines for ADHD sufferers produces a huge clinical effect unlike any other drugs like anti depressants. For those of us that it really helps it is not a game. This article read like scaremongering with no real talk of the actual impact of prescription amphetamine use and abuse. There is no real data to back it up. There is no doubt most people who think they ha e ADHD as an adult don't have it, but at the same time there is no evidence presented that 1.) It is causing harm at any scale and 2.) How overdiagnosed it actually is, but by god we need to do something about this amphetamines...
Kids addicted alcohol in college probably don't graduate. Kids scrounging a few addy probably just write the most interesting papers about neoclassical bullshit the history of humanity ever witnessed.
Edit: Just want to add that people with ADHD are hugely overrepresented within alcoholics and drug abusers. When we don't get the advice and help we need many self medicate. ADHD is a mental illness, just like depression, and other mental illnesses. With addictive personalities being common among ADHD suffered due to how our brains manage dopamine, it is no surprise. It is a huge waste of human potential.
I have ADD - and an adderall prescription helped me get through alot of the bullshit for my bachelors degree. I can concentrate on things that interest me, but universities make you take a ton of unrelated courses and I just lost interest almost instantly on work.
So for one year (my senior year) I had a prescription ranging from 15-30mg XR (30 was too high so I dropped down).
In retrospect, I was able to quit cold turkey with minimal sides after graduating - got my heart scanned out of curiosity and its fine, cholesterol is fine, etc. etc.
I think most drugs are safe if:
1. Used in the right doses for the right duration .
2. Only used on otherwise healthy individuals (this is an important one in the world of "everyone is equal") - I would not take adderall if I was obese since it is a stimulant and does increase BP / HR.
I'm definitely considered obese at 6'4" and 280lbs, but there's been literally no movement of my BP up or down since I've been on it. To agree with your point though:
1. Every physical I've ever had has had my vitals in good ranges (minus the weight)
2. I get strenuous physical excercise at least 4x/wk so I'm a spry tub of love
I was worried about any possible issues with BP/HR during lifting sessions if I took it before workouts in the morning so I avoided it for a while until my doc reassured it should be fine. As with anything if I felt off, just back down the activity and don't do it tomorrow. I'd say if anything it allows me to run longer on the treadmill or elliptical because I don't get so god damn bored and ready to do something else.
There's 99 out of 100 people like you saying "it's ok!". But there's the thousands of people who are left screwed up.
What you think is completely irrelevant. It's a numbers game, not a personal anecdote game.
How would this comment read if you'd got your heart scanned and it wasn't ok?
From what I gather it (Adult ADHD) is also very hard to distinguish from bipolar disorder. It took 18 months of moving around with anti-psychotics and other drugs to treat my "bipolar disorder" before my doctor realized that it was ADHD and we found almost immediate results from the treatment.
It sucks that the diagnosis seems to be so easy to get for some people and they're doing it for the adderall. In my case it helped me significantly, moving up in my career and ultimately bringing me out of an almost decade long depression with myself. I hope that people who actually need help get it, and to put it simply, screw the others who make it hard for people to be properly diagnosed. My diagnosis took so long because of the known abuse to get the drugs, from what I gathered in conversations with my doctor, and she was reluctant to consider that diagnosis until she was absolutely sure of it.
I agree that it may be the wrong word to use but since it personally affected me my opinion will be skewed.
In medical terminology, substance abuse has a well known definition covering addiction, increasing use, and use to the detriment of mental, physical or social well being.
Someone getting a performance benefit from a drug is not abusing it, whilst they are using it within the safe parameters defined by their doctor.
This is akin to telling a depressed person to try and do things that make them happy---they can't because being unable to find the motivation to do anything is part of a depression diagnosis.
In fact many people do have ADD, but have 'grown out of it' because their coping mechanisms, and life choices make it largely a non-issue as to success in their adult lives. That said, they would have made different choices, and spent less time 'coping' if they didn't have to.
I think that inability to concentrate is a common pathway for essentially all diseases that afflict man. Anything a disease does to draw your attention to itself is affecting concentration, because you are not able to concentrate on whatever you want to concentrate on. In some cases, this is insidious and you are not aware of the disease as such; it affects your concentration and you don't understand why. In some cases, you might only know that you can't concentrate. Amphetamines will tend to help, because they allow you to concentrate harder on what you want to concentrate on, regardless of the actual etiology of whatever is distracting you.
Note the "can't" in those; it's not a preference or a weakness, it's a straight up inability.
It has been noted that amphetamines are capable of relieving pain. That makes sense if you conceive of pain as a distraction that forces you to pay attention to it. Amphetamines allow you to concentrate harder on something else.
There are most likely different forms of ADD or "ADD," and perhaps there is a form of ADD that acts directly on the brain's attention mechanism. We don't know anything about how the brain's attention mechanism works, so the idea that it can be broken is pure speculation.
For me there's a huge difference between the two. Without the meds, my concentration drifts. If I'm at home, I may be aware of an issue that needs attention, but lack the energy and focus to carry it out. I'll start watching a video, get distracted, and drift off there, then over there, and so forth.
Out in public it manifests as an occasional intense craving for sugar, though it's possible that's just me. At the peak it can be intense uncontrollable energy (the H part), as well as frequent "why did I come in here" or "I forgot to do this". It comes in getting distracted from a task and forgetting to ever come back to it.
With the meds, it's much different. I have a sharp focus. I can throw on a whole music cd and let the tracks all play out without feeling the need to jump around or to switch to a different album. Just me and the code that I need to do, or solving any other problem tasks.
In public I'm able to control myself better. I don't have to think of doing something before doing it as much, resulting in a better flow.
This isn't a matter of a diet either. I don't snack on fatty foods, and I don't have soda to drink at home. My current doctor has me take an EKG every year to make sure that it's not playing poorly with my heart.
There's a huge difference between "I get distracted from time to time" and having a constant difficulty getting tasks accomplished and lacking the motivation to complete small tasks from start to finish (getting interrupted and forgetting to go back at all).
I suspect this person has never encountered someone with actual adult ADHD. Consider also that in the past, many of these people would have just been called crazy and left at that.
It reminds me of the Scientology episode of South Park.
"Do you ever make remarks... that you later regret?"
"Would you rather give orders... than take them?"
"Do you ever whistle... just for the fun of it?"
"Does life sometimes feel vague... and confusing to you?"
---------------
"Well, I hate to tell you, but you're completely miserable and totally depressed! Well, there's really no question that you're a perfect candidate for [Scientology|Adderall]. All we'll need to get started is $200."
The difference is that for those with ADHD those symptoms are not benign and have a major negative impact on their life. Saying that it's not real or important because everyone feels that way sometimes is like saying there's no such thing as severe allergies because everyone sneezes sometimes.
https://www.youtube.com/watch?v=rD9qK8-sMGQ
I'd wager that Allen Frances has met many adults with ADHD - but probably not many (if any) who started showing symptoms only in adulthood.
I found what seems to be the longitudinal study Conners referred to.[1] The authors present evidence that "adult ADHD" is a verifiable condition with symptoms similar to childhood ADHD but apparently unrelated.
[1] http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.20...
My personal opinion is that there is more harm from the negative stigma associated w/ ADHD prescription than good, but you can imagine I would be biased given my narrative.
The “overdiagnosis” moral panic leads to parents not being OK with the idea of their children being diagnosed with ADHD or shudder be on effective medication like adderall or ritalin, or people (of all ages) thinking/internalizing the idea that they can’t ~~really~~ have ADHD and that they’re just “lazy” or “flaky” or “apathetic” or whatever other shitty terms are used for people with executive dysfunction. It also makes doctors more suspicious of people seeking treatment ("if it’s overdiagnosed it must be rare, so some of the people I see as a doctor have to be be faking it, by pigeonhole principle"), which actually causes harm to people who need access to medical care -- finding a doctor who’s OK prescribing is such a pain when you’re ADHD and have run out of meds.
I've had enough bad experiences with psychiatrists for a lifetime and I've absolutely no inclination to defend psychiatrists, their clinical practice, or their DSM. There indeed are people who are diagnosed with ADHD who don’t have it / don’t benefit from medication. However, the “overdiagnosis” meme (https://www.ncbi.nlm.nih.gov/labs/articles/17709814/) and other forms of ADHD denialism cause real harm to people who actually end up needing critical access to controlled substances which are impossible to legally get without the appropriate diagnosis. Regardless of how psychiatrists draw the lines of diagnosis, there's plenty of evidence that there actually do exist plenty of people with chronic and debilitating attention / executive function dysfunction that do experience amelioration when they take a regular dose of stimulants.
Furthermore, this isn't a straightforward discussion about the effectiveness of some given pharmaceutical -- this is a moral panic that explicitly seeks to use the criminal law to curtail access to medication, regardless if it has been shown safe and effective:
> The Drug Enforcement Agency is doing its best to contain the epidemic
ADHD users tend to be in the 5-30 mg range, often in extended release form. Most neuraltypical people won't even notice any difference in concentration or energy from such small dosages.
I am at the 15mg end, and the energy hit is not even enough to affect my sleep if I make a mistake and take one at night (it's happened). A single coffee, on the other hand, is enough to keep me up for a few extra hours.
But addiction to distraction isn't like addiction to alcohol or drugs. Short of a radical "into the woods" plan, you can't go cold turkey on modern life. And since I've reintroduced my modern devices into my life, my concentration issues have returned. But it's been important for me to have realized the true cause of those issues because dialing back on TV, computing devices and everything else I use to divert my attention can cause short-term relief when things get really bad. Turning my cell phone off and spending the entire day hiking outdoors can really help.
Based on my own experience, I wonder whether our practice of medicating attention deficit issues is really just a horribly misguided attempt to treat the symptoms rather than the underlying cause. Life has changed so rapidly within the course of the past couple of generations and I don't think there's been enough attention paid to the effect that it has on our bodies, minds and health. I firmly believe that, in time, we'll look back at this period and our computing devices and other modern distractions and view them in the same way that we view asbestos insulation or lead paint...incredibly effective at accomplishing their immediate goal but with devastating health consequences that we only recognized years after they were introduced.
I'm curious whether this rings true with others, especially those who've had concentration issues. Have others tried a "digital detox" and has it helped? Or is ADHD something different from what I've experienced and that medication really is the only way to treat it?
Every month, I have to spend a day (or five) dealing with the nightmare that is filling my prescription so that I can function like a normal human being.
THE RULES: 0. For ADHD people such as myself, being forced to go a day without meds is like being forced to go a day without your favorite text editor. It's not fun. In addition, I don't feel safe driving then. If I want to go someplace without meds, I'm taking a cab.
1. Adderall is classified by the DEA as a schedule II stimulant. Some other schedule II drugs: cocaine, opium, morphine. If you opt for a paper prescription, it usually has security features like microprinting, watermarks, or holograms. You're going to be asked for an id (or three) when you fill the prescription. After all, you might as well be getting a prescription for cocaine.
2. There are no refills on your prescription, ever. You have to get a new prescription every month, which means calling in to your clinic and reciting all of the details. Nurses are not allowed to copy-paste these details, so you can bet your ass that I've dealt with a number of typos over the years. Sorting out typos usually takes a few business days.
3. A doctor must sign each prescription.
4. Some doctors flat-out refuse to sign prescriptions that they didn't prescribe. That's totally reasonable, except it means that you need to call in for a new prescription on a day when your prescribing physician is in the office. That means that you need to either learn their work schedule, or call in at least 3-5 business days before you need to fill your meds.
5. Most insurance companies will not allow you to fill your medication even one day early -- if you want to do that, you're paying the sticker price yourself. For my dose, the sticker price is $500-600.
6. In some states... - if you send a prescription to a pharmacy, then it MUST be filled there, and may not be transferred.
- pharmacies may not answer questions over the phone about whether medication is in stock. They might be able to answer in person.
- pharmacists may not call other pharmacists or access any sort of database to find out whether there is any pharmacy in the area with medication
- if there is not enough medication in stock, then the pharmacy may partially fill your medication with the available stock, but you void the unfilled portion of your prescription. Your insurance will probably not allow you to fill your meds early, even if the pharmacy is out of stock and you choose to fill a partial prescription.
Remember that you can't bring your prescription somewhere else, or call in advance to inquire about stock. So you have to remember to ask the pharmacist about their stock before you hand the prescription over, in case they don't have enough stock. That gives you the opportunity to blindly search the neighborhood for a pharmacy that has them in stock. Remember, you can't call about any of this, so you're going to be doing quite a bit of travelling.
7. Some pharmacists are antsy about filling a prescription for drugs in the same category as cocaine. I've met pharmacists who will insist upon verifying the prescription with your prescribing clinic. If you try to fill your meds when your prescribing clinic is not open, tough luck. Come back tomorrow.
8. Because of the effects that large-ish daily doses of amphetamines may have on one's heart, most doctors that I've met will insist on meeting with patients every few months to check your blood pressure, heartrate, etc. That is, your prescription is not getting filled unless you make a clinic visit every few months. Because I actually have ADHD, the conversation usually goes something like this: "Are you having trouble sle...