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Comment by EA-3167 | Hacker News Reader

Productivity based on using speed is not sustainable.

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?

I can assure you it’s a chemical dependency.

People drink coffee and tea around the world. Where’s the line, really?

Also coca and khat leaves in different parts of the world.

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.

There’s a pretty big difference between smoking half a gram of meth and taking 5–10 mg of Adderall in tablet form every morning.

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.

"Drugs I use are fine, but I don't use are evil and horrible."

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.*

* https://www.washingtonpost.com/world/2021/12/06/british-parl...

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.

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.

From experience, it is sustainable, but — unlike coffee — the cost is a serious chemical dependency.

Caffeine addiction is way harder to kick than amphetamines.

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.

But we've been using coffee that way for like 1000 years

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