> The most commonly prescribed medication for ADHD is pharmacologically essentially the same as meth.
I'm not sure about that. If I remember correctly, the most prescribed medication for ADHD is Adderall, and Adderall is amphetamine salts. Amphetamine and methamphetamine are not the same, though they are close. Also, the difference between a therapeutic dose of amphetamine or methamphetamine and what the regular drug abuser uses is huge.
I'm not at my home computer so I'm not able to pull up citations, but there is a paper I have read in which they gave meth addicts amphetamine-based ADHD medication vs typical equivalent street doses of meth in a double-blind study, and the meth addicts reported them as basically equivalent. I say "basically equivalent" because they were not indistinguishable due to different formulations having noticeably different durations of effect, but the high they produced and the side effects were basically the same. This study was a pretty big deal because it demolished the widespread assumption that the methyl- group makes methamphetamine more neurologically potent.
So yeah, aphetamine (Adderall et al) and meth are basically the same, pharmacologically. The anticipated differences between them in their effect on the body and mind largely aren't real.
Most studies I've seen of methamphetamine for ADHD treatment use 20-40mg doses, sometimes but not necessarily split in two. A google search seems to claim that abusers take up to 50mg at a time. That's not a lot higher than the prescribed dose.
I'm a physician who's prescribed medications for many ADHD adults. Methamphetamine (MA) is legal to prescribe for ADHD and indeed a few patients had best results with it. MA isn't "stronger" than D-amphetamine but may be better tolerated. AIUI the main reason MA is the dominant street amphetamine-type drug is that it's easier to synthesize in clandestine labs vs. classic amphetamine. At equivalent doses the effects are similar.
In any case you're right that there's a big difference in street drug use vs. therapeutic doses. For street drug user a typical daily dose is on the order of 1000mg whereas prescribed doses are with few exceptions 1-2 orders of magnitude below that. MA in particular is in the lower end of the range, I'd say 10-20mg/day (partly due to it being a very expensive pharmaceutical product if in fact it's even being manufactured at present).
Only a small portion of methamphetamine users are using a full gram in a single dose. Perhaps spread over a day or two, but most recreational doses are closer to 100mg
I've seen the same thing as you for methamphetamine and amphetamine being "basically equivalent" but it was a study in rats. However, patients usually rate desoxyn (which is methamphetamine) higher (~10% higher) than either adderall or dexedrine (another amphetamine), and methamphetamine is supposed to be better at crossing the blood brain barrier. I'm not sure if I would call it equivalent/the same but they're very close. Especially this part:
> The anticipated differences between them in their effect on the body and mind largely aren't real.
You're totally right about that. People associate methamphetamine with drug abuse and amphetamine with people taking adderall, but I think it's a case where the dose makes the poison.
For the abusers parts, I've found Simon et al, 2001 "A comparaison of patterns of methamphetamine and cocaine use", that would indicate doses of 500 mg, usually snorted instead of "eaten". As an anecdote, a friend that used to abuse amphetamine consumed around 300 mg a day.
I'm not sure about that. If I remember correctly, the most prescribed medication for ADHD is Adderall, and Adderall is amphetamine salts. Amphetamine and methamphetamine are not the same, though they are close. Also, the difference between a therapeutic dose of amphetamine or methamphetamine and what the regular drug abuser uses is huge.