> Adderall and other amphetamines only have problems with long term usage.
My research was done a long time ago. I understood Ritalin to have mild neurotoxic effects, but Adderall et al to be essentially harmless. Do you have a source for the benefits giving way to problems long-term?
Regardless, your overall point is interesting. Presumably, these drugs are (ridiculously tightly) controlled to prevent society-wide harm. If that ostensible harm isn't reflected in reality, and there is a net benefit in having a certain age group accelerate (and, presumably, deepen) their education, perhaps this type of overwhelming regulatory control is a mistake. In that sense, it's a shame that these policies are imposed federally, as comparative data would be helpful.
I went to university at a time that Adderall was commonplace, and am now old enough to see how it turned out for the individuals. At college, it was common for students to illicitly purchase Adderall to use as a stimulate to cram for a test/paper etc. It was likewise common for students to abuse these drugs by taking pills at a faster than prescribed pace to work for 48 hours straight amongst other habits.
In the workplace, I saw the same folks struggle to work consistently without abusive dosages of such drugs. A close friend eventually went into in-patient care for psychosis due to his interaction with Adderall.
Like any drug, the effect wears off - Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years. As I recall, the standard dosages of Adderall cease to be effective after 7-10 years due to changes in tolerance. Individuals trying to maintain the same therapeutic effect will either escalate their usage beyond "safe" levels or revert to their unmedicated habits.
In my experience, Adderall does lose effectiveness but Vyvanse is much hardier. I’ve been receiving treatment for ADHD for about 4 years. My current Vyvanse dose is marginally higher than my original Adderall dose, but I’m considering reducing it down to below my original Adderall dose.
Cognitive behavioral therapy does excel at treating ADHD! But 5 years of therapy is what, 16 times more expensive than 5 years of medication? Maybe more? Not to mention the time commitment.
But adderall and vyvanse aren’t the same drug at all. You cannot directly compare dosages. 50mg of vyvanse is roughly equivalent to 20mg of adderall. As a prodrug, Vyvanse must be processed by the liver for it to function.
You get addicted to modafinil? I've tried it. It doesn't cure ADHD but it is remarkably like if those boomer newspaper comic jokes about coffee were actually real.
But… it's not addictive at all. Taking it made me not want to take it again. I was just like damn, I kind of smell like sulfur now.
> Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years.
Apropos of anything else, 5 years of weekly CBT to get to the same result is a _lot_. 260 hours of therapy that, on my current health insurance would cost nearly $12,000 in copays. And during that 5 years you're still dealing with your ADHD to some heavy extent.
Adderall doesn't particularly have long-term tolerance. If you're developing tolerance to it, you have a magnesium deficiency and should take magnesium threonate supplements. (Not oxide, the cheap ones, that doesn't work.)
And then remember to drink water, exercise and get enough sleep.
Imagine posting “sorry that the facts bother you” and then linking to
- A study with a sample a size < 50
- A study that says that medication improves outcomes over CBT
- A study that says that evidence for CBT improving ADHD symptoms comes from studies with such small sample sizes that the conclusions could be the result of bias
The only way someone could conclude “CBT has the same outcome as medication” from the studies you linked to would be to not read them. The first two don’t really say that and the third one literally refutes that position.
> I understood Ritalin to have mild neurotoxic effects, but Adderall et al to be essentially harmless.
There is no conclusive research on humans, but you have these backwards. Ritalin (methylphenidate) is thought to have less risk for neurotoxicity than Adderall (amphetamine). Amphetamine enters the neuron and disrupts some internal functions as part of its mechanism of action, while Ritalin does not.
Both drugs will induce tolerance, though. The early motivation-enhancing effects don't last very long.
There are also some entertaining studies where researchers give one group of students placebo and another group of students Adderall, then have them self-rate their performance. The Adderall group rates themselves as having done much better, despite performing the same on the test. If you've ever seen the confidence boost that comes from people taking their first stimulant doses, this won't come as a big surprise. These early effects (euphoria, excess energy) dissipate with long-term treatment, but it fools a lot of early users and students who borrow a couple pills from a friend.
> The early motivation-enhancing effects don't last very long.
They lasted me 12 years so far. Same dosage.
> The Adderall group rates themselves as having done much better, despite performing the same on the test.
A feeling of euphoria means your dosage is too high, and people without ADHD probably shouldn’t take these drugs.
If the studies involved people that were on the drugs normally, it’s also not a particularly surprising result. The drugs induce a very real chemical dependency, and you will not feel like yourself or that you are performing when you are off of them.
That is honestly my only complaint. Without the drug, I am essentially a vegetable. If I go cold turkey, I can barely stay awake. However, it’s still a lot better than my life was before.
> Presumably, these drugs are (ridiculously tightly) controlled to prevent society-wide harm.
Maybe I'm misunderstanding what you mean - but I think almost any college student would disagree with this presumption.
> Do you have a source for the benefits giving way to problems long-term?
Although a very long read, I found this to be very insightful:
> It was still true that after 14 months of treatment, the children taking Ritalin behaved better than those in the other groups. But by 36 months, that advantage had faded completely, and children in every group, including the comparison group, displayed exactly the same level of symptoms.
Very much so. Perhaps their training shouldn't explicitly use such language and work to increase that separation - LE training is notorious for teaching cops old and new that anyone/anything "not a cop" is not one of them, and is a threat or has threat potential.
As someone who cycles a lot, I can heartily recommend larger wheels and strong legs if you really need to slice through the traffic at 30mph.
But I do agree that personal electric transportation should be able to travel at >15mph on suitable cycle tracks, seeing as it ain’t that hard for pedal bikes to do those speeds.
I try for the classic "1 gram of protein per pound of bodyweight a day" and I try to limit carbs whenever I have a chance because I already have a habit of eating too many of them.
It's already happening. A story about mistreatment of a dog garners reactions like "how can someone act like that to a fur-baby". Same action toward a person and it's elided over as baseline expected violence. By the same token, quasi-deification of animals has happened for a very long time, and all it takes is a mutation of this idea to spread across popular culture.
That's just because dogs and other pets are used as ersatz babies and are thus afforded the the same level of moral outrage when harmed. We accept base violence against adults but not against small children.
You'll be dealing with AI agents all the way down.
A decade ago, I used one of the hotel aggregator sites to reserve rooms for vacation, and as I call the hotel to double check something on my way to the airport, I find out that I don't actually have a reservation and my room is already occupied. They couldn't do anything about it, as it was the 3rd party aggregator's mistake.
Just getting the aggregator to admit, that no, even though their system says I have a reservation, the hotel confirmed it didn't exist took over an hour. I had to go through several layers of customer service, and I suspect different call centers, until someone called the hotel themselves and issued a refund.
It was miserable and stressful to do from the airport, I would have lost my mind if I had to deal with chatbots for what was already a terrible experience with an automated purchase.
At some level these platforms are the public square and facilitate public discussion. In fact, Google has explicitly deprioritized public forum sites (e.g. PHPbb) in preference to forums like YouTube. Surely there is a difference between declining to host and distribute adult material and enforcing a preferred viewpoint on a current topic.
Sure, Google doesn't need to host anything they don't want to; make it all Nazi apologia if they thing it serves their shareholders. But doing so and silencing all other viewpoints in that particular medium is surely not a net benefit for society, independent of how it affects Google.
“Covid” related search results were definitely hard-coded or given a hand-tuned boost. Wikipedia was landing on the 2nd or 3rd page which never happens for a general search term on Google.
I’d even search for “coronavirus” and primarily get “official” sites about Covid-19 even tho that’s just one of many coronaviruses. At least Wikipedia makes the front page again, with the Covid-19 page outranking the coronavirus page…
“Covid” related search results were definitely hard-coded. Wikipedia was landing on the 2nd or 3rd page which never happens.
I’d even search for “coronavirus” and primarily get “official” sites about Covid-19 even tho that’s just one of many coronaviruses. At least Wikipedia makes the front page again, with the Covid-19 page outranking the coronavirus page…
At this point, private companies have more power than some governments. How long before we are back to company towns with private security forces? We are trading elected officials, who may be corrupt, with unelected officials, who are corrupt by design.
That's certainly no more accurate of the news division of KTVU, a local Fox-owned station, than it is of the the national “News” network with the same corporate parent.
My research was done a long time ago. I understood Ritalin to have mild neurotoxic effects, but Adderall et al to be essentially harmless. Do you have a source for the benefits giving way to problems long-term?
Regardless, your overall point is interesting. Presumably, these drugs are (ridiculously tightly) controlled to prevent society-wide harm. If that ostensible harm isn't reflected in reality, and there is a net benefit in having a certain age group accelerate (and, presumably, deepen) their education, perhaps this type of overwhelming regulatory control is a mistake. In that sense, it's a shame that these policies are imposed federally, as comparative data would be helpful.
reply