I wonder also how much obesity plays a role in this. Food also acts as a stimulant. It's possible people are eating more to be more productive, to meet the demands of work. All companies seem to have cafeterias full of free sugary snacks and sugary drinks for employees.
I think you're missing the forest for the trees. The free food and snacks provide a quick and easy source of calories, which enables employees to quickly and reliably replenish their energy stores on site. I'm sure less obese nations have companies with cafeterias of their own for the same reason.
What is the forest and what is the trees? The rest of the world getting obese too. There is strong evidence snacking leads to obesity and or a major contributor to it. An extra thousand calories per day from snacks adds up.
This is a really interesting point, thanks for saying this. I absolutely agree with you. Do you happen to have sources for this? I can do my own research but I thought I’d ask in case you already are aware of some.
There is very likely no line that would apply uniformly between people or even the same person in different states of stress and health, regardless of the exact criteria you are optimizing for. Some people find even coffee to be too much at times. But at the end of the day amphetamines have some pretty scary and dangerous long term documented effects especially if the person goes without sleep for like periods of time. It’s not as bad as meth (to the best of my understanding) but both are amphetamines.
At least for me, ADHD stimulant meds taken in the morning don't impact sleep at all; if I have some more around midday, I need to take additional care with my bedtime routine to get my 8 hours (otherwise it takes too long to fall asleep).
Prescription meds are not _anything_ like party drugs, either in dose or in isomer. Comparing them to meth is a reactionary talking point regularly brought up among those upset a previously-underdiagnosed illness is suddenly being treated.
You need to do a little more research here, honestly. The scary side effects of heavy ampethamine use are mostly due to the associated sleep deprivation that it masks. If you work in an office setting or a school, then I guarantee you are surrounded by people who have spent years on a daily dose of these stimulants without any issues.
The main problem with meth, which Adderall solves, is that the supply chain is some hobo in a trailer rather than nice, government-regulated pharmaceutical plants.
Eh, not even. To use the UK as an example (not that any other western country is better):
>A report in Britain’s Sunday Times said a dozen sites inside the Palace of Westminster, which includes the House of Lords and House of Commons, tested positive for traces of cocaine.*
Ha - let's freely dispense amphetamines to all, it'll surely help the economy!
Edit: We're talking about amphetamine based production being non sustainable - by comparing with tea and coffee I imagine you mean that we should expect people to take amphetamines to the same extant they take other stimulants (ie: to wake up, to work longer, to focus, etc). We shouldn't expect everyone to be on stimulants, we should lower the workload.
This has been a problem for years in academia and in medecine - people taking amphetamines and cocaine to be able to compete in their field. Without talking about expectations in other fields - I've seen my fair share of cocaine and speed in kitchens and in service - I don't think it's sustainable.
If you need speed, the workload is too much for one individual. Speed is not a long term solution.
When taken as directed I'd be inclined to agree, but there is definitely a non-negligible likelihood of individuals misusing it and forming a dependence as a result, more immediately so than caffeine.
I think that the bigger issue is that we're masking societal dependence on stimulants by pretending that they're medicine (yes, sometimes they are) and not just uppers.
There's never a chance to resolve any issue with having an honest objective conversation.
Beyond the fact that our society doesn't like those conversations in general, you're never going to have the conversation that needs to be had in this particular case as long as legislators are in bed with the pharmaceutical industry.
I just wish my doctor had explained that getting off of Adderall would be incredibly difficult — not because of any addiction to the high, but because the chemical dependency means that I’ll be absolutely incapable of focusing on work whatsoever for months.
I’ve been very gradually decreasing my dose, but the underlying ADHD hasn’t gone away, and the chemical dependency just makes dealing with it that much harder.
I should have just stuck with coffee. My sleep was terrible, and I could only focus on things I was very interested in, but at least I wasn’t permanently addicted to an expensive, highly controlled stimulant that I have to take every day of my life to remain a basic functioning adult.
I've heard that so many times... I wish it was told that you would pay it after and the negative impact it will have on your life with all you miss when you are hyper focused.
I wasn't aware that stimulants could even reliably create dependence when prescribed to treat an appropriate underlying condition versus being abused. I'm a bit confused: is the dependence you refer to any different than if you were simply unmedicated? That is to say, that your livelihood depends on being medicated? Or that you will have even further reduced focus than normal due to long term usage? The latter is completely novel to me, if that's indeed the case.
I cannot possibly imagine becoming addicted to stimulants. It's a chore to remember to take them. Tolerance builds quickly so I have to take regular breaks (or reduce the dosage) or the effects simply disappear. I treat myself to a "cheat day" every once in a while where I just don't take any and it's always extremely not productive but otherwise fine. I'd love to find an alternative but the alternatives seem strictly worse.
When I was younger I would frequently let my Adderall prescription lapse (because it's such an ironic chore to maintain) and sometimes would go months without any medication without any discernable negative effects.
Yes, my livelihood now depends on my being medicated — if I don’t take a pill, I don’t get work done. No matter how hard I try to force myself to sit down and work.
It’s as if my original ADHD has been dialed up to 100.
If you can go months without Adderall, and struggle to even remember to take it, I seriously doubt you ever had ADHD in the first place.
So people who haven't been diagnosed yet don't have ADHD? I don't understand.
We're in the same boat, I assure you. What I do not understand is that stopping medication makes everything significantly worse. I've been on a lot of different medications and I've never experienced that. Are you at a high dose? It took me a long, long time to realize a lower dose is ideal, but I build tolerance rapidly. Managing this has been significant.
The “significantly worse” part is being completely unable to function at work. If I don’t have to work, I have no problem stopping cold-turkey — I skip taking it entirely on vacations, for example.
That doesn't sound like a dependency in the traditional sense. Being completely unable to function at work is often a symptom prior to acquiring medication, and I'm not exaggerating. Are you saying you were able to work before being medicated?
Are you kidding? You just drink a tiny amount of caffeine to stave off the headaches, and you’re clear of the addiction in a week.
Kicking Adderall cold-turkey can take from six months to upwards of a year, during which you’re uselessly crippled by the combination of your chemical dependency and your underlying ADHD.
Looking around the internet after reading your comment, it looks like people have very different experiences coming off of Adderall. At one point I took a lot of speed for a long time; it took about a week to sleep it off (while eating huge meals) and I was fine. But I have never been able to quit caffeine, the lethargy and discomfort over multiple weeks is just too much for me.
Is the hard part for you overcoming the chemical dependency, or trying to adapt to living with untreated ADHD symptoms? My claim is that people who don't have incapacitating ADHD can get off amphetamines fairly easily (possibly with a taper); it's certainly nothing like trying to quit benzodiazepenes, SSRIs, booze, or cigarettes.
The chemical dependency is being able to work at all. If I go off Adderall now, my ADHD symptoms are about 100x worse than they were before I started Adderall.
Why not? Paul Erdős took it his whole adult life, seemed to do pretty well. Lots of people spend decades on Adderall. And half the white collar economy runs on caffeine. The stigma around long-term amphetamine use is just weird.
Last year, I took "drawing intensive"– a difficult, heavily compressed, very technical, and often frustrating drawing class required for my BFA for a career realignment. I signed up for the night section because I'm a night owl and it fit with my schedule. Unfortunately, my afternoon dose of short-acting Ritalin would wear off right before the class started, but I did a lot of art for pleasure at night, and figured that wouldn't be a problem. I always had plenty of energy, but my focus was shit, so I wouldn't expect myself to be able to focus on algebra or dense reading.
4 weeks of class pass by and I was struggling. I could feel a near complete disconnect between looking at a scene and making marks on the paper. At first I thought it was my inexperience with drawing that precisely, but realized that this disconnect felt an awful lot like some other things I had trouble with before my diagnosis. The next week, I split my afternoon dose up and took half right before class. It was like an entirely different activity. My working memory now held enough data to reason about making the marks on the page after looking and before drawing. A fellow student who I'd never spoken to approached me after class and said "I was watching you work today and it was like something opened up inside of you." I went on to become one of the only students in the class to get an A, and another professor from the fine arts drawing program saw a portrait I did hanging in the hall and told my teacher "make sure you tell whoever drew that they're really, really good."
Don't glibly talk about people treating attention deficits like people downing Dexadrine so they can work all night long. My dose is so small I can take it two hours before bed and still sleep— while I haven't been able to have coffee after 2pm for years— but it completely transforms how my brain functions in some very specific and important ways.
tl/dr: you have no idea what you're talking about so stop being a jackass.
Only in America could you read about a terrible, ongoing opioid crisis impacting millions of families and in the same breath question aloud if our society's inability to feed our amphetamine craving is costing our productivity.
Also, the article isn't really about the US. The question about the correlation (the HN title is the subhead; the title is "What performance-enhancing stimulants mean for economic growth") isn't the main topic of the article, but a framing device for discussing the idea that availability of stimulants contributed to the industrial and scientific progress of Europe and the UK in the 19th century.
The brain is complicated. We don't understand it with the same level of detail that we understand computers. We can't refactor it, or reorganize it or fix bugs in it.
All we can do is these large, scattershot system-level shifts that result from various drugs. Pretty much every drug makes some things worse and some things better. We don't have an understanding or a technology level that would allow it to be any different.
Despite all that, people often find that, on net, certain drugs are a benefit to them more than they are a detriment. Until we live in the bright shiny future where we can understand and remedy the root causes of mental dysfunction, it seems to me it's a good idea to let people get what relief they can in the meantime.
Well, I don't think drugs are the only option. Behavioral therapy works for a lot of people. And there is also just not treating it at all, some people choose to live with the issues rather than deal with the side effects or on effectiveness of drugs/therapy.
This is a fairly hostile take. For many drugs are the only option. More generally, the usual best strategy is to pursue multiple treatments in parallel.
> some people choose to live with the issues rather than deal with the side effects or on effectiveness of drugs/therapy.
Many, many others would be unable to be a normal member of society without medical intervention.
No one is saying drugs are the only option, but they are an incredibly, consistently effective one. By comparison I'm unaware of any behavioral therapy for any underlying condition that is predictably effective anywhere close to "most of the time."
Drugs might be the only effective option, but that still means it is incorrect to say it's the only option. The comment I responded to clearly says that the only thing we can do is try different drugs.
I’d estimate the difference between untreated and treated is about the difference in life path between having an $80k job at 30 years old and a $380k job at 30 years old.
Our society has rather narrow notions of work... we cant figure out how to incorporate those with disabilities... or even make people useful who arent "mainstream". Dopaminergics are a band aid to make "mundane" tasks exciting enough to do... i agree there must be better ways to organize society.
The two issues are similar in that they both have to do with drug use. But it sort of diverges after that. Stimulant usage, abuse, and addiction is really different and minor compared to the rampant death and destruction going on due to opioids right now.
As usual, a bunch of people are commenting on Adderall not being medication but a performance enhancing drug and...
In any other context these people are probably fine with marijuana legalization and libertarian-esque drug policy in general ("What you do with your body is none of my business..."). When it comes to Adderall, suddenly everybody becomes moralizing and sanctimonious.
I was prescribed Adderall as a child and was made to take it twice daily for many years. I had serious problems sleeping due to it and turned from an outgoing and popular student to a solitary and angry child. It isn't good for the development of children to be prescribing them a lighter version of meth. I was fortunate that my parents allowed me to choose to stop taking it before high school.
I don't think anybody is proposing prescribing marijuana to children and forcing them into a lifelong dependency on it. If Adderall is just available, sure, whatever - but a lot of current users of it were initially forced into it without a clear understanding of the consequences.
It's possible to simultaneously believe Adderall is a performance-enhancing drug and be just fine with people taking it.
We live in an odd moment where you can get legal, high-quality amphetamines online by speaking on video chat with a nurse practitioner who will ask a bunch of leading questions and conclude the five minute interview by prescribing you a highly effective stimulant. Just like with marijuana in some states, you have to observe the proprieties and treat it as a medical intervention. And just like with marijuana, there are some people for whom this really is a life-changing medication.
The only area where I'd moralize about Adderall is that we give it to so many kids. There are grade school kids taking a daily dose that would keep me up for three days, and doing so for years. That's beyond messed up. But adults, if they want to, should have at it while they can.
When I first sought a prescription, it took several attempts to find a medical professional who would take me seriously and actually help me understand and tackle the underlying issue. They all volunteered a prescription without batting an eye.
The regulatory situation in the US is truly a mess. In other countries I have had the exact opposite experience, such that it took years of tests to justify a prescription that was laborious to maintain. What's the point of a drug schedule if it can be abused so openly?
It's not just the regulatory situation, but the fact that there is not even a diagnostic standard for adult ADHD. Everybody right now is just winging it.
> It's possible to simultaneously believe Adderall is a performance-enhancing drug and be just fine with people taking it.
I agree, and this was largely my point: if you think it's ok for adults to take drugs just for fun, then you should be ok with them taking drugs for any purpose whatsoever.
I agree. It would seem as if a lot of journalism is about looking for correlations between data and trying to draw spurious conclusions from it as click bait or filler. Nicholas Cage and shark attacks for example. Find A and then maybe it is plausible it was caused by B and then say they are related. Maybe we don't know.
Coincidence? Probably. Lots of other things could have explained the productivity dip. Equally, though, many of America’s most productive people rely on Adderall to get the job done. It often seems like half of Silicon Valley, the most innovative place on Earth, is on the stuff. And surprising things can cause gdp to rise and fall, including holidays, strikes and the weather. What’s more, the economic history is clear: without things that give people a buzz, the world would still be in the economic dark ages.
Maybe we cannot conclude this. I think some of the backlash is due to kids being prescribed Adderall.
Well if we're just going to make wild conjectures, mine is about all the more obvious things: young people were promoted while experienced people retired, in many places the overall workforce has been reduced, work from home has hurt social mobility, night life isn't what it used to be, inflation outpaced payroll, etc.
Focusing on an Adderall shortage is not seeing the forest for the trees. The root cause of a disruption is bound to be the cause of several other disruptions too. Correlation does not imply causation and all that jazz.
It's not debatable that the adderall shortage negatively impacted productivity. It's a productivity enhancer, any shortage is a loss in productivity. It still would even if society was perfect.
The amount it did to productivity as a whole is debatable and I wouldn't even care to debate it--who cares?
If it was your job to make an argument in favor of increasing production limits next time this happens you could tailor data showing a bigger impact anyways.
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[ 3.0 ms ] story [ 151 ms ] threadCould America’s Adderall shortage have harmed its productivity?
I mean, seriously, think about that headline.
If you need a hint at how click baity that is, the article itself helpfully suggests in the second para:
Coincidence? Probably.
Every magazine has an editor in chief. What is it that you're saying about the editor in chief of the magazine that published this article?
Prescription meds are not _anything_ like party drugs, either in dose or in isomer. Comparing them to meth is a reactionary talking point regularly brought up among those upset a previously-underdiagnosed illness is suddenly being treated.
The main problem with meth, which Adderall solves, is that the supply chain is some hobo in a trailer rather than nice, government-regulated pharmaceutical plants.
>A report in Britain’s Sunday Times said a dozen sites inside the Palace of Westminster, which includes the House of Lords and House of Commons, tested positive for traces of cocaine.*
* https://www.washingtonpost.com/world/2021/12/06/british-parl...
Edit: We're talking about amphetamine based production being non sustainable - by comparing with tea and coffee I imagine you mean that we should expect people to take amphetamines to the same extant they take other stimulants (ie: to wake up, to work longer, to focus, etc). We shouldn't expect everyone to be on stimulants, we should lower the workload.
This has been a problem for years in academia and in medecine - people taking amphetamines and cocaine to be able to compete in their field. Without talking about expectations in other fields - I've seen my fair share of cocaine and speed in kitchens and in service - I don't think it's sustainable.
If you need speed, the workload is too much for one individual. Speed is not a long term solution.
There's never a chance to resolve any issue with having an honest objective conversation.
Beyond the fact that our society doesn't like those conversations in general, you're never going to have the conversation that needs to be had in this particular case as long as legislators are in bed with the pharmaceutical industry.
I’ve been very gradually decreasing my dose, but the underlying ADHD hasn’t gone away, and the chemical dependency just makes dealing with it that much harder.
I should have just stuck with coffee. My sleep was terrible, and I could only focus on things I was very interested in, but at least I wasn’t permanently addicted to an expensive, highly controlled stimulant that I have to take every day of my life to remain a basic functioning adult.
I cannot possibly imagine becoming addicted to stimulants. It's a chore to remember to take them. Tolerance builds quickly so I have to take regular breaks (or reduce the dosage) or the effects simply disappear. I treat myself to a "cheat day" every once in a while where I just don't take any and it's always extremely not productive but otherwise fine. I'd love to find an alternative but the alternatives seem strictly worse.
When I was younger I would frequently let my Adderall prescription lapse (because it's such an ironic chore to maintain) and sometimes would go months without any medication without any discernable negative effects.
It’s as if my original ADHD has been dialed up to 100.
If you can go months without Adderall, and struggle to even remember to take it, I seriously doubt you ever had ADHD in the first place.
We're in the same boat, I assure you. What I do not understand is that stopping medication makes everything significantly worse. I've been on a lot of different medications and I've never experienced that. Are you at a high dose? It took me a long, long time to realize a lower dose is ideal, but I build tolerance rapidly. Managing this has been significant.
Kicking Adderall cold-turkey can take from six months to upwards of a year, during which you’re uselessly crippled by the combination of your chemical dependency and your underlying ADHD.
Is the hard part for you overcoming the chemical dependency, or trying to adapt to living with untreated ADHD symptoms? My claim is that people who don't have incapacitating ADHD can get off amphetamines fairly easily (possibly with a taper); it's certainly nothing like trying to quit benzodiazepenes, SSRIs, booze, or cigarettes.
4 weeks of class pass by and I was struggling. I could feel a near complete disconnect between looking at a scene and making marks on the paper. At first I thought it was my inexperience with drawing that precisely, but realized that this disconnect felt an awful lot like some other things I had trouble with before my diagnosis. The next week, I split my afternoon dose up and took half right before class. It was like an entirely different activity. My working memory now held enough data to reason about making the marks on the page after looking and before drawing. A fellow student who I'd never spoken to approached me after class and said "I was watching you work today and it was like something opened up inside of you." I went on to become one of the only students in the class to get an A, and another professor from the fine arts drawing program saw a portrait I did hanging in the hall and told my teacher "make sure you tell whoever drew that they're really, really good."
Don't glibly talk about people treating attention deficits like people downing Dexadrine so they can work all night long. My dose is so small I can take it two hours before bed and still sleep— while I haven't been able to have coffee after 2pm for years— but it completely transforms how my brain functions in some very specific and important ways.
tl/dr: you have no idea what you're talking about so stop being a jackass.
All we can do is these large, scattershot system-level shifts that result from various drugs. Pretty much every drug makes some things worse and some things better. We don't have an understanding or a technology level that would allow it to be any different.
Despite all that, people often find that, on net, certain drugs are a benefit to them more than they are a detriment. Until we live in the bright shiny future where we can understand and remedy the root causes of mental dysfunction, it seems to me it's a good idea to let people get what relief they can in the meantime.
> some people choose to live with the issues rather than deal with the side effects or on effectiveness of drugs/therapy.
Many, many others would be unable to be a normal member of society without medical intervention.
No one is saying drugs are the only option, but they are an incredibly, consistently effective one. By comparison I'm unaware of any behavioral therapy for any underlying condition that is predictably effective anywhere close to "most of the time."
https://news.ycombinator.com/newsguidelines.html
In any other context these people are probably fine with marijuana legalization and libertarian-esque drug policy in general ("What you do with your body is none of my business..."). When it comes to Adderall, suddenly everybody becomes moralizing and sanctimonious.
I don't think anybody is proposing prescribing marijuana to children and forcing them into a lifelong dependency on it. If Adderall is just available, sure, whatever - but a lot of current users of it were initially forced into it without a clear understanding of the consequences.
We live in an odd moment where you can get legal, high-quality amphetamines online by speaking on video chat with a nurse practitioner who will ask a bunch of leading questions and conclude the five minute interview by prescribing you a highly effective stimulant. Just like with marijuana in some states, you have to observe the proprieties and treat it as a medical intervention. And just like with marijuana, there are some people for whom this really is a life-changing medication.
The only area where I'd moralize about Adderall is that we give it to so many kids. There are grade school kids taking a daily dose that would keep me up for three days, and doing so for years. That's beyond messed up. But adults, if they want to, should have at it while they can.
The regulatory situation in the US is truly a mess. In other countries I have had the exact opposite experience, such that it took years of tests to justify a prescription that was laborious to maintain. What's the point of a drug schedule if it can be abused so openly?
I agree, and this was largely my point: if you think it's ok for adults to take drugs just for fun, then you should be ok with them taking drugs for any purpose whatsoever.
https://news.ycombinator.com/newsguidelines.html
The -2.7% in the article is indistinguishable from noise.
Drawing any conclusions from such data is incompetent at best.
Coincidence? Probably. Lots of other things could have explained the productivity dip. Equally, though, many of America’s most productive people rely on Adderall to get the job done. It often seems like half of Silicon Valley, the most innovative place on Earth, is on the stuff. And surprising things can cause gdp to rise and fall, including holidays, strikes and the weather. What’s more, the economic history is clear: without things that give people a buzz, the world would still be in the economic dark ages.
Maybe we cannot conclude this. I think some of the backlash is due to kids being prescribed Adderall.
> without things that give people a buzz, the world would still be in the economic dark ages.
I doubt the economic history is clear on this point.
Focusing on an Adderall shortage is not seeing the forest for the trees. The root cause of a disruption is bound to be the cause of several other disruptions too. Correlation does not imply causation and all that jazz.
The amount it did to productivity as a whole is debatable and I wouldn't even care to debate it--who cares?
If it was your job to make an argument in favor of increasing production limits next time this happens you could tailor data showing a bigger impact anyways.