Your dependency isn’t the problem if you have ADHD and the medication helps you. The actual problem is all the bullshit around getting the drug and the bullshit stigma around it.
The fact the system treats you like a ‘crack addict’ is the problem. Could you imagine how absurd it would be if say, type 1 diabetics got treated like addicts because they depended on insulin?
The system around ADHD drugs is just fucked and needs to change.
The problem is that ADHD medications actually work. They work so well that they are abused by people who don't actually have ADHD. Resulting in more restrictions, even for people who do have ADHD and actually need the drug.
Insulin can't be abused in this way, which probably explains why you can just go and buy it at walmart.
> What would be the worst thing that happened to society if we just manufactured adderall and sold it OTC?
Honestly I agree with you. I think drugs like this should be sold OTC because it's basically just like food. It is a substance you put into your body. Just like psychedelics.
And imagine the lives that would be saved if the drug propaganda did not desensitize everyone to actual help. This is the whole reason "harm reduction" forums exist.
But, you know how it is, where the government doesn't trust anyone to use substances responsibly.
Man, what I would give for a "responsible enough to buy drugs OTC" license or whatever. I get dextroamphetamine on prescription, but I also really like LSD and would love to be able to buy that OTC, legally, so I'd know the supply is safe and I'm not going to jail.
Although, I'm pretty sure certain drugs like heroin compromise judgement to a great degree, which makes it very difficult to use responsibly, but honestly there are more creative ways to deal with this that society just hasn't explored because of the whole "war on drugs" ridiculousness.
The war on drugs has substantially ruined entire generations by convincing people drug abuse can be solved purely by throwing people in jail and through shame.
To think it's taken until ~2021-2022 for a federal administration in the US to finally admit there needs to be better solutions in place, it's absurd! All those deaths could have been prevented.
Yep... drugs are powerful substances that deserve to be treated with respect, but past that, it's possible to use them responsibly. The fact that some substances are just indiscriminately illegal is just... upsetting. Especially since even things like LSD are lumped into that "Schedule I" despite being... extremely safe? Given you're properly informed and prepared for the experience, of course. Only an example, but it's a particularly personal example.
I just think it's a bit sad how "don't talk to me before my morning coffee" and etc. is normalized just because so many people have that problem.
Some people legitimately need the caffeine just like some people legitimately need ADHD medication, but some people became dependent on caffeine when they didn't necessarily have to be.
> Sure. But shouldn't it be left to the individual?
Honestly, if someone chooses to be dependent on caffeine because they know and consent to it, that's fine I guess, though unfortunate. The problem is that caffeine use is so normalized that people seem to have forgotten that one even can become addicted or dependent on it—I would say "glorified" but that's a bit far.
FWIW, I have some friends who are trying to quit caffeine. Not because I told them it was an issue, but because they independently decided that. I am somewhat biased by seeing cases of actual caffeine addiction and dependence, whereas most people only see the benefits of taking it. This is probably how the normalization happens, some people just don't know any better.
>The problem is that caffeine use is so normalized that people seem to have forgotten that one even can become addicted or dependent on it—I would say "glorified" but that's a bit far.
Seems like the solution is better education on the effects of caffeine and not putting it into the same category as drugs and alcohol. So far I'm yet to hear of people who's lives were ruined by coffee addiction.
The fact that it makes you uncomfortable that people are dependent on coffee is kind of irelevant IMHO. We live in a free society. Let people have their coffee if they want it.
Once you get harassed or mugged by someone on coffee withdrawal who needed a fix, then we can talk about regulating it.
> Seems like the solution is better education on the effects of caffeine and not putting it into the same category as drugs and alcohol.
I... regret to inform you that caffeine is literally a drug, stimulant class.
> So far I'm yet to hear of people who's lives were ruined by coffee addiction.
I'm not really sure what your point is here, as I'm not saying caffeine addiction ruins lives, just that it's a thing that could be avoided more than it is now.
> The fact that it makes you uncomfortable that people are dependent on coffee is kind of irelevant IMHO.
>I... regret to inform you that caffeine is literally a drug, stimulant class.
I regret to inform you that not everything classified as a drug is equally bad as all the other drugs, in fact many drugs are useful in certain situations.
It's not black and white, "drugs are bad m-kay", as you want it to be. Which is why coffee is tolerated.
So I don't get your hissy fit on people consuming this particular drug. If you don't want it, then don't drink it, just let others enjoy it, since it has no negative effect on you.
Yup. Adderall is probably better for you than coffee. Especially if you are drinking copious amounts of coffee because you have undiagnosed ADHD and are self-medicating with caffeine (which, again, properly belongs to the category of stimulant medication) without even realizing it.
Regularly consuming large amounts of caffeine while barely feeling any effect (beyond getting jitters / bowel issues) or feeling calmed by it, is actually indicative of ADHD.
So I'm almost 40 now, was prescribed to ADHD meds from around ages 10-28, mainly Adderall as that just worked best.
At 28 I stopped Adderall because I honestly don't care for the side effects, and felt like I had good enough habits to do without it.
That worked for a while, but I was at a job that wasn't too challenging for 6 years (and very underpaid as a result of not being more ambitious/focused)
Switched to another job, ended up getting promoted to lead, then everything came crashing down. Couldn't focus, and as I fell further behind I'd feel more stressed and overwhelmed constantly.
I had been drinking coffee the whole time, but it wasn't helping that much. Irritated my bowels pretty badly though (I ended up needing surgery for a complication of what turned out to be Crohns, though my symptoms are incredibly mild when I'm not drinking over 4 cups of coffee per day).
Finally got back on Adderall after ~10 years unmedicated and was able to just stop coffee. My entire life has improved. I can focus during work hours and even have some free time during the day, since I'm not spending the entire day struggling to get work done.
I can honestly say that Adderall is much more helpful for me, and has minimal physical side effects compared to copious coffee (though I do have mental/emotional side effects, which are honestly less negative than the stress that accompanied being constantly overwhelmed, exhausted, and sleep-deprived)
The process to get my prescription in Canada took almost 2 years (in part because of my poor ability to navigate the labyrinthine health care system due to said ADHD)
But wow, has it already improved my quality of life significantly in the ~1 month I've been back on it. I agree with other posters here that we should just let people get it OTC or allow diagnosed individuals to just get a lifetime prescription
> It's not black and white, "drugs are bad m-kay", as you want it to be. Which is why coffee is tolerated.
You clearly haven't been paying attention to my comments if you think I'm saying anything like "drugs are bad".
I'm saying undue dependence on something that you didn't need to be dependent on, is unfortunate. As in, it's unfortunate how people can accidentally fall into caffeine dependence without knowing what they are getting into, because it's not that people don't think caffeine is evil, it's that people think caffeine is completely harmless.
Of course they're not exactly like food. They are powerful substances that deserve respect and you can't just "eat" them when you are "hungry" like you can with normal food. But I believe they're like food in the way that you deserve bodily autonomy wrt taking them.
Fun fact: Did you know hunger is basically just carbohydrate withdrawal? If you stop eating carbs for around 1-2 days, your hunger will go away. Obviously, if you want to stay that way, you will have to find some way to sustain yourself without carbs, but it's a relatively safe experiment to fast for a few days and see what happens.
It's fun to think of food in that way because actually... food is just a pile of substances! Carbs, fats and proteins.
It's just that food is generally safe to eat when you're hungry, but drugs are especially powerful substances that can be dangerous if misused. But still stuff that you can put into your body, through basically the exact same mechanisms as food.
I'm all for caution and research and responsibility and informed consent and all that—all good things. But I don't think drugs are inherently so much different than food that you don't deserve some level of autonomy with them.
In other words, I think the amphetamines and stuff should be OTC. Like... legalize them all, legalize everything. Not only would this make the supply safer for people who are already taking those substances, since they can be made by reputable, professional companies, but this would help get rid of the taboo around sharing safe dosage and supplement information, which would seriously help a lot of people (harm reduction!).
All the FUD around the war on drugs is just causing harm to the world. It's causing people to go to jail just from putting things into their own body, it's denying people access to safe medical information, it's barring medical professionals from helping people with substances that happen to be illegal, it's denying people a safe supply of their favorite drugs (which usually results in people going to shady sources, not abstaining completely), ... the list goes on.
Yeah, amphetamines aren't food, but it's nice to imagine a world where they're available freely and used responsibly. Unfortunately I'm not sure if that's a possible future.
Some people can use these things responsibly, but probably fewer than the number who think they can and many cannot at all. That's why doctors are there to help guide responsible use. I agree it isn't ideal for the subset of people who can use them well, but there are also further issues: your drug use doesn't just affect you but the culture around you. I think the analogy to food is pretty bad, since no one is born dependent on amphetamines and it is a manufactured product only invented recently (to be fair, too much of our food is also weird synthesised products which are not historically natural, but I dont think you have a strict natural right to frozen microwave dinners either). The analogy with food may work a little better with mushrooms, but also the effect of these is partially due to your body thinking it has been poisoned, so they arent really food either.
> If there is a referendum I am going to vote against this. Amphetamines are not like food, imo.
Would be nice if only people who are against drugs would pay some additional tax to sustain the whole prison-industrial-DEA-complex though. I don't do illegal drugs, but the fact that I'm forced to sponsor that due to other people's self-righteous puritanism is just stupid.
It would also be nice if the people who support softer drug laws paid a tax for all the resulting urban blight, health bills, property crime, violent crime, addiction, mental health issues, death etc. that results from drug use. The fact that I'm forced to live with all of that, often in danger, due to other people's selfish libertine delusions is unjust.
I think the real issue is that all it should take to get a prescription is a confirmation that you know the procedure for administering the proper dose and that you understand the expected efficacy and risks of doing so. It should be a process that could be completely handled by a kiosk. Maybe a drug won't help them, or even hurt them, but so long as they are informed they should have the right to make that decision for themselves. We let people buy peanut butter without demanding a note from a doctor saying they don't have a peanut allergy. Perhaps some things should have a traditional prescription but the burden on the government should be pretty high to prove that it's something so complicated or so dangerous that it would be catastrophic to permit direct sale to the public.
But boy does it come in handy for other things. It’s the best cold symptom medication there is. Need to drive late at night when you should be tired? Pop 5mg and you can actually drive safely for a few hours. It’s a shame we have it locked away.
That said, it’s dangerous to think other people would act like you. People would definitely abuse it (more than they already do). I come down on your idea like I do in most drug legalization questions. Conceptually I think we should be able to do whatever the hell we want to our bodies. Realistically I don’t know if that works for society.
Adderall is a mix of 3:1 dextroamphetamine to levoamphetamine. It is not "plain old amphetamine", also known as racemic or "free-base" amphetamine (equal mix of dextro- and levo-).
I can't take levoamphetamine, and need dextroamphetamine directly. Unsure if that was ever sold OTC on its own.
By plain old amphetamine I meant structurally, rather than a specific stereoisomer mix. Though I guess I had assumed it was 100% dextroamphetamine.
I think Dexedrine was sold OTC in the 50s and 60s, hard to be sure, sources I can find talk about it being popular for use by anyone and everyone, from dieting housewives to truck drivers and athletes, but don't specifically mention it being OTC or prescription.
Charles Whitman was dependent on Dexedrine, and he packed a good supply of it on that last day of his life. Dexedrine and other psychotropic pharmaceuticals have figured prominently in most mass shootings since that time.
Assuming this was true, did most shootings also involve cigarettes? A lot of people smoked at that time, so I would presume there were a lot of smokers doing shootings.
Sounds more like correlation to me than causation.
Yes; just check the label of SSRIs and other drugs when they first came out. Many carried an FDA-mandated, black-box warning of increased incidences of homicidal ideations. Not merely suicidal ideations, homicidal ones. This was largely regarded as a bad idea and detrimental to sales, so it was walked back.
That's tangential at best and I'm not sure it supports the strong claim - "Dexedrine and other psychotropic pharmaceuticals have figured prominently in most mass shootings since that time"
I'm not saying I don't find it plausible, but a warning message on the box isn't exactly the confirmation I was looking for.
You know that feeling that most impressive leaps in engineering and technology in general all happened in the 20th century, especially between 1950s and 1980s, and that we've somehow lost the ability to do big things?
> JFK was regularly using meth. It created a lot of problems.
Problems caused by drug abuse != problems caused by drug availability.
Meth is neurotoxic, we know this now. So are all stimulants, to a degree. I take magnesium supplements with my ADHD meds because it depletes my brain of natural magnesium—I have had blood tests confirm this. But meth can be particularly dangerous, especially due to how addictive it is and how neurotoxic it gets when abused, compared to even the other amphetamines like dextroamphetamine.
All this is not to say that it shouldn't be widely available. Just that proper, responsible usage information should also be widely available. Which it is not.
If people knew how to take meth properly and responsibly, maybe there would be less cases of it getting out of control.
Too bad all people have to go off of is anti-drug propaganda that says all drugs are bad. Leads to them ignoring all advice altogether, even if it could've otherwise helped them.
You’re going to have a curve of abuse. Availability will affect that curve.
Drugs like opioids and stimulants are great in that they work well at masking lots of symptoms, but our bodies adapt to them and the need for them feeds the physical dependence.
The mental abuse factors amplify as well availability. Bookies and sports betting isn’t novel. Legalized betting on smartphones is; so now billions are spent on marketing to vacuum up many billions of dollars of bets.
Humans are wired the way they are wired. Education about risk only benefits people capable of managing the risk - not the people likely to get addicted in the first place.
> Education about risk only benefits people capable of managing the risk - not the people likely to get addicted in the first place.
Sure, but people likely to get addicted are sometimes also in the presence of people who would benefit from a proper drug education in order to help protect the more vulnerable.
Am I saying people will stop using drugs if they stop being illegal? No way, the opposite actually. But if drug use wasn't considered indiscriminately bad, that wouldn't necessarily be a bad thing anyway.
As someone with ADHD that is absolutely correct. I could not properly pursue anything until I had basically decided that trying to find medication was my last resort before suicide.
Man, you know, I've been known to joke about how I have to take medication to remember to take my medication, but it sure as hell beats suicide. Glad you were able to push through and make it work.
> It might still be easier to get MAID (medically assisted suicide) here in Canada than Adderall. What a shitshow
Is there anything a random USAian could legally do to help your situation? I don't have a ton of financial resources, but if having someone in your corner helps, I might be able to do that for you.
I honestly have a pretty strong hunch that a high percentage of the people out there abusing the drug do have ADHD but are undiagnosed and self-medicating, technically needing it as much as anyone else. The difference is that not seeking treatment for things leads people down the road of substance abuse. I think that, more often than not, the situation tends to work out differently for people when approached from a clinical angle.
Oh, I've absolutely heard of people with undiagnosed ADHD who had to take meth or something because their doctor would not help them. It's just that without the help of a medical professional and prescription, it can pretty quickly spiral out of control based on the person's subjective judgement, which is notably impaired when euphoria-inducing drugs are involved (of which meth is a particularly notable example), and said spiralling becomes more dangerous when the drugs are easily neurotoxic (of which meth is also a particularly notable example).
Not to say responsible people don't exist, but rather that without a framework to support them, it's all their own personal responsibility. And there's also preliminary studies showing meth being somewhat neuroprotective at low doses, so if someone is using it purely for productivity, and taking the right supplements, it's possible that they could avoid damaging themselves too much.
But this is all theoretical and basically I don't fully believe in self-medicating for an ADHD case that you could be getting a real prescription for. I do believe in self-medicating using psychedelics and the like because there's no prescription treatment for that (yet), but as soon as you're allowed to ask a medical professional to help, I think you should.
FWIW even once psilocybin clinics become a thing, I'm still going to be taking LSD at home, because home has my toys and my friends, and clinics have neither. But if one day I can be prescribed LSD to take home and use on my own terms, I'd be glad to ask a professional for advice on it, and get a prescription. Just has to, you know, be legal first.
Insulin is abused by some bodybuilders as yet another gimmick in the quest for more size. There are likely other such niche uses/abuses, but that's one that came to mind.
So can gluten. I know (personally) at least one person where gluten acts as an opioid in their body. Don't remember the exact details but they get high from it and also get opioid withdrawals if they stop eating gluten.
Sounds like an incredibly miserable way to live, honestly.
I don't get high off gluten, but I do not tolerate it yet crave it, along with cheese, which contains casein that has the same opioid effect.
My favourite junk food, and one that puts me KO for 3 days is a double cheese pizza.
Makes me depressed and despondent, bloated and my ADHD meds stop being effective (but my usual dose is quite low on purpose). But that's because of my physiology, the opioid effect is in the strong craving, and how lovely the first bite is, and how I hate myself after the first bite, for having succumbed to its allure once again.
Gluten and casein are under-researched. The fact that there is a so called "gluten sensitivity" fad is not a shared hallucination, but some effect we haven't identified or understood yet.
That's interesting. If you were to make a protein shake with casein powder would that have a noticeable effect on you, or is it only when it is in cheese?
Dunno, never had a shake. I know milk has a slightly sedating effect, and I haven't been drinking it by choice most of my adult life. I can digest it pretty well I think.
Some people just hate that ADHD people have a better quality of life with stimulant meds, and want to believe they're just addicts.
There is no reasoning with that kind of people. I just hate they keep the stigma around ADHD and its very effective medication alive so we keep being branded as druggies.
Well, I am sort of a druggie, all things considered. Amphetamines were my gateway drug, they changed my entire perspective on drugs in general. But I think it's okay to be addicted. Just like I am addicted to eating food when I am hungry, or using a heavy weighted blanket when I sleep (~45lbs).
These are all things that I greatly enjoy and do whenever possible. And I think it's okay to enjoy things in life. I also think it's okay to enjoy drugs in life. Because while my meds finally let me relax and stop getting so painfully bored, they don't detract from my life, don't cause any adverse side effects (besides urinary retention, which is basically harmless), and don't even cause any adverse withdrawal symptoms.
I even take them around every 3 days now because sleeping for 15 hours in between feels nice. I don't have any obligations, so why take them every day if I can enjoy some really nice and comfy sleep in between? I don't get enough sleep on my meds anyway, 7 hours is the usual max I can get every night, so catching up is probably healthy too. Not to mention that my meds cause my preferences to flip a bit; I prefer entertainment while off meds, and productivity while on meds, and I want to keep both sides in my life.
I don't think anyone could make a convincing case that this is a bad thing. I am enjoying my life right now, and not harming myself or others, so~
I know addiction, I have been badly addicted to 4 distinct substances/things in my life, and by being respectful and cognisant of the risk of amphetamine abuse, after a year I can say it does not have much addiction potential at therapeutical dose.
Euphoria stops happening the second day you are on meds, and when they wear off there is no feeling whatsoever to redose. I honestly just feel I have done a lot and it's time to rest for the day. I am lucky it wears completely off by bed time, so sleep has been great.
In my experience, caffeine feels 10x as addictive than dexamfetamine.
> Euphoria stops happening the second day you are on meds
It didn't for me. It lasted something like two weeks. And after months it still sort of happens. The euphoria doesn't come directly from the drug, it comes from feeling free and relaxed and in control. From being able to lay in bed and do nothing and feel good about it. Without ever getting bored like what happens all the time without meds.
Boredom isn't supposed to be so painful all the time, but it normally is for me. Being free from that is euphoric regardless of the substance I'm taking, honestly.
I don't have any recent first hand experience with Adderall use, are we honestly at a point where those taking it are treated as crack addicts?
My understanding has always been that plenty of people use it, and if anything that is over prescribed. What exactly have you seen that's so bad it's being treated similar to a schedule 2 narcotic?
Well that I really should have fact checked first, could have sworn it was schedule 3! Societally aive never noticed adderall having the same stigma as crack, but I gotta say I'm pretty surprised it's schedule 2 (or 2N, I don't see any details on what the N distinction means).
Guess the question is whether a person really is at as high a risk for dependence when on Adderall vs. opiods and other schedule 2s.
It's a bit of a long read, but it's very good. The author is a psychiatrist who deals with this sort of thing frequently.
I can't really comment on the relative risk of dependence for Adderall vs opioids, except from my personal experience. A real addict probably wouldn't even (literally) get out of bed in order to take my daily dose of Adderall (25 mg XR).
I've been taking it for almost 10 years now, and in that time, I've had one dosage increase, from 20 to 25 mg. I've accidentally taken it twice in a day, and I can say with certainty that I do not enjoy the experience when that happens. I honestly can't fathom how anyone would want to take the kinds of doses that addicts take. It's not a fun drug at all, as far as I can tell. If I didn't have to take it to function somewhat normally, I wouldn't take it at all.
I know plenty of people buying and selling adderall on the streets, and it’s for recreational purposes. I don’t think insulin quite has that going against it.
Well, insulin doesn't have that going against it because you can just buy it from Walmart. It doesn't require any people on the street.
But the recreational use thing is huge indeed—the fact that adderall is so potent, desirable and dangerous is what earned it a spot on Schedule II. The reason why people are "treated like addicts" is because people think all addicts are the same.
There are different reasons to be addicted to a substance, and not all of them are bad. Say, if the substance legitimately helps you by making your brain function properly, as does ADHD treatment, it should be okay to be addicted. Who wouldn't be addicted to feeling like their brain is finally working properly?
But being addicted to a substance just because it feels good, with no regard for your personal safety or health (i.e. overdosing constantly) is reckless and dangerous, and this is what people think of when they think "addict". This is also, unfortunately, what comes to mind whenever one sees someone enjoying their ADHD medication.
They compare it to the enjoyment of someone who is well and truly fucking themselves with some neurotoxic substance like meth or cocaine—short-lived euphoria that goes away once the drug stops manufacturing good feelings for them, not true satisfaction with their self.
It's sad, really. Though I'm not surprised that people can't see the nuance.
I don't think type 1 diabetes meds are considered overprescribed _anywhere_. ADHD meds definitely are. Even reputable doctors say they are overprescribed.
How large % of the ADHD population could be fixed environmentally, e.g. by just going to the damn gym? How much can be attributed to our modern lifestyles?
ADHD exists, but to say that there's something wrong with "the system" just because 100% of people in society don't take it as a serious diagnosis is a big stretch.
Another big stretch is comparing ADHD with type 1 diabetes. Come on...
> How large % of the ADHD population could be fixed environmentally, e.g. by just going to the damn gym? How much can be attributed to our modern lifestyles?
It's complicated. I think a decent percentage could be helped by going to the gym, because I think the fact that SNRIs help so many people shows that norepinephrine can be the main issue in some cases, and exercise should help with that.
But then there are the cases that can only be helped by stimulants that are DRIs (like me, with dextroamphetamine), and most NRIs actually make things worse (e.g. my body can't handle the levoamphetamine in adderall).
I would love to know the distribution here, honestly.
As for the modern lifestyle, I think the modern tech world is trying to exploit ADHD-like behaviors in everyone. The whole thing about social media trying to maximize dopamine and instant gratification and endless scrolling and etc. is a real thing that happens to try to take advantage of even people who don't have ADHD... but it hits people with ADHD the hardest, because due to their disorder, deviously-crafted social media can actually overshadow the rest of their life.
I'm almost definitely addicted to chatting on Discord for example, ever since the platform first came out, but mainly because it facilitates chatting with my closest friends. I pick a DM and talk to people, and it's very direct, and I don't feel manipulated at all. But that's how it gets you; I know the majority of my time is spent chatting, and the majority of my time procrastinating is spent chatting. The only question is whether my decision is truly informed or not. I think it is.
> How large % of the ADHD population could be fixed environmentally, e.g. by just going to the damn gym? How much can be attributed to our modern lifestyles?
Structural differences in brain chemistry don't get fixed by going to the gym.
People with untreated ADHD are 3x more likely to be in a car accident. Going to the gym won't fix that.
50% of people with untreated ADHD have issues with substance abuse. 50%. Going to the gym won't help with that.
Divorce rates for people with ADHD are up to 2x population averages, a few hours a week lifting weights won't help with that.
> How much can be attributed to our modern lifestyles?
Risk factors for developing ADHD are heavily linked to exposure to the industrial pollutants that are a result from modern society. It isn't the largest factor, but it is a contributing one.
That is going to be the only "modern lifestyle" link you find.
People with ADHD don't just have problems sitting in a chair (that tends to go away as people age anyway), ADHD impacts emotional regulation, the ability to perceive time, and basically all other aspects of executive function.
ADHD isn't just "can't focus", that is just the most obvious symptom. ADHD is, aside from being horribly misnamed, a disorder of the executing functioning part of the brain that is responsible for controlling large swaths of higher order brain functions.
ADHD is both under and over diagnosed. It is under diagnosed in women, minorities, and people who are poor, and those facebook ads advertising 30 minute online questionnaire diagnoses are certainly pill mills, though I would also not call them a diagnosis.
Like most things in life, there isn't a simple yes or no answer.
The fact the system treats you like a ‘crack addict’ is the problem. Could you imagine how absurd it would be if say, type 1 diabetics got treated like addicts because they depended on insulin?
The system around ADHD drugs is just fucked and needs to change.