that time Scott told the rationalists how adderall would turn them into geniuses of finance and even named specific rationalists he thought should get into adderall
that time Scott told the rationalists how adderall would turn them into geniuses of finance and even named specific rationalists he thought should get into adderall
[Previously in series: Antidepressant Pharmacogenomics: Much More Than You Wanted To Know; SSRIs: Much More Than You Wanted To Know, etc. This is all preliminary and you should not take it as a rea…
this btw is why we now see some of the TPOT rationalists microdosing street meth as a substitute. also that they're idiots, of course.
somehow this man still has a medical license
This is up there with the time that rationalists convinced themselves to get addicted to heroin for productivity or whatever.
https://news.ycombinator.com/item?id=34648499
EA appeals to exactly that kind of really-smart-person who is perfectly capable of convincing themselves that they're always right about everything. And from there, you can justify all kinds of terrible things.
I came to the same conclusion after a group of my friends got involved with the local rationalist and EA community, though for a different reason: Their drug habits.
They believed themselves to have a better grasp on human nature and behavior than the average person, and therefore believed they were better at controlling themselves. They also had a deep contrarian bias, which turned into a belief that drugs weren’t actually as bad as the system wanted us to believe.
Combine these two factors and they convinced themselves that they could harness recreational opioid use to improve their lives, but avoid the negative consequences that “normies” suffered by doing it wrong. I remember being at a party where several of them were explaining that they were on opioids right now and tried to use the fact that nothing terrible was happening as proof that they were performing rational drug use.
Long story short, the realities of recreational opioid use caught up with them and they were blind to the warning signs due to their hubris. I intentionally drifted away from that group around that time, so I don’t know what happened to them.
I will never forget how confident they were that addiction is something that only happens to other people, not rationalists like them.
I had opioids (Norco) in the hospital like 3 or so times when I had pancreatitis, and they gave me some to take home just in case. I didn't actually need any at home so left that bottle closed but it took a surprising amount of self control; just because of how good it felt in the hospital.
The stuff is potent and best not messed around with.
i am simultaneously going "what"-meme and jesus fucking christ and also i'm not actually shocked
That thread is gold. Specially love this one where heroin is dismissed because it's not utilitarian enough
EA appeals to exactly that kind of really-smart-person who is perfectly capable of convincing themselves that they’re always right about everything. And from there, you can justify all kinds of terrible things.
i'd normally disregard that outright as adderal talking
What about addiction risk?
The data on this are really poor because it’s hard to define addiction. If a prescription stimulant user uses their stimulants every day, and feels really good on them, and feels really upset if they can’t get them…well, that’s basically the expected outcome.
did I just watch Scott try to reply guy addiction out of existence?
also, all the paragraphs Scott uses to call his patients liars and insinuate that other psychiatrists have guilty consciences are really uncomfy? cause it really feels like a normal response to the situations he’s describing is “boy I’m getting a lot of folks with ADHD and neurodivergent traits and all they seem to want is one treatment for it, maybe I should examine that more closely” and not “look at all these normal-brained fucks with intense problems focusing coming to me for drugs, which I’m certain the other pill-pushers in my industry will give them without question. welp time to not even attempt to establish a therapeutic dosage or even guidelines around how much to take since this is a fun safe party drug”
An ounce of NSFW might help here. There's a very reasonable definition of addiction using ΔFosB modulation. Scott probably doesn't like this because it implies that the concept of addiction is hopelessly overlapping with desires for food, shelter, exercise, social belonging, etc. and totally avoids the difficult subjective task of determining whether a person's addiction is interfering with their daily life; Scott gets paid good money to be judgmental about his patients' lives!
I haven’t read it all yet, but so far he doesn’t seem to recognise the diminishing returns of increasing focus. It took about a year of it before I realised I was regretting things I’d spent days on because I was too focus blocked.
It’s an aspect of medicated adhd that always makes me feel like I’m in simulated focus. Last thing I would expect to be beneficial to someone with healthy ability to stay on task.
That drug science webpage that PJ Coffey linked above notes that:
Long-term amphetamine use is associated with anhedonia; a general difficulty in finding pleasure in life without the drug, which may persist for some time after quitting the drug.
They're specifically referring to recreational amphetamine use here, I think. Needing to use a substance just to make you feel normal? Needing to use higher and higher doses of the same substance to feel the same effect? Aren't those the classic symptoms of addiction, and the drivers of the negative behaviours people associate with addiction?
Shit like this is exactly why I'm skeptical of FTX boy's Adderall prescription.
my view of that is that the judge specifically ordered MDC Brooklyn to give Sam his duly prescribed meds, also fuck MDC Brooklyn. But also, I concur that Sam and Caroline ensured a supply of legally prescribed medications, and tweeted about how much they were into their speed, based specifically on this essay.
My general assumption is that ADHD is both underdiagnosed and overdiagnosed but I'm generally chill about it and not a gatekeeper. But the recent shortages and delays have me a little more on edge about it.
Also I should point out claims around micro-dosing psychedelics are actually pretty sketch…and some of these people claim daily use of lsd - which is impossible (due to receptors getting flooded).
In his book on psychedelics, David Nutt suggests that it is likely that the observed benefits of microdosing are just the placebo effect.
His GABAlabs stuff sounds absolutely fascinating.
daily use is definitely possible! you’ll just get absolutely nothing out of it other than extremely minor but cumulative damage to your heart (which notably doesn’t happen when you’re not doing weird shit with your acid and you give it a fucking week or two off)
not really relevant, but: a quote from an interview with hard-living 60s rock band the Pretty Things:
"..microdosing LSD [is] a practice May thinks may have been invented by a keyboard player who performed with the band in the 70s. “He used to have a little lick of acid every morning while standing on his head, doing his yoga exercises.” And did it help him psychologically, as latterday devotees of microdosing claim it can? “Well, no, not really,” sighs May. “He went pretty loony, to be honest.”"
Source: this article
For those interested, what David Nutt did _after_ he got fired for saying "actually the evidence is that cannabis is less dangerous than alcohol".
As the rare person who is both fully convinced that ADHD is real/treated successfully with stims but who also has decided not to use them anymore, I feel called out.
This article is overly long and not sufficiently informed by the history of stimulant use and ADHD diagnosis, and instead tries to derive history from first principles. I read it a long time ago and I ain't reading it again because fuck that.
If you want a good accounting of the 'what if we're overdiagnosing ADHD' argument, ADHD nation is much better researched than Scott's post, and dives into the history of ADHD as a diagnosis and the era of stimulant use before it was as tightly controlled a substance. l don't endorse it's conclusions, but if you want a background on the topic, it's better than whatever this is.
There's a schism in the online disability rights community between people who favor an extreme flavor of the social model (somewhat advocated in Scott's 'man was not made to program or account' argument) and people who are very adamant that they have an intrinsic disability which must be medicalized.
I think both are a symptom of just how common the diagnosis is and what a wide swath of human behavior it covers, but I'm not sure that's all. My sibling and I both have an ADHD dx and scrip; my sibling still takes it and is basically non-functional without it; I have instead adapted my life to avoid a total lack of executive function creating too many issues.* I do not require stimulants to program for hours, but my sibling has difficulty focusing even with the aid of stimulants. I was diagnosed earlier because I was a rambunctious boy and she was a girl so when she couldn't focus on math class, the way she tells it, they just shrugged and assumed she was bad at math.
- Posting a lot notwithstanding
This was definitely written on an adderall bender.
Messing about with meds for yourself is the sort of thing that gets medical doctors struck off, even if the paperwork is in order, so I would not actually assume that at all. I do think he's dancing on a fine line with essays like this.
It is pretty awesome gear though, you gotta give him that.
Ok. But this part is pretty reasonable:
Think about how wasteful all of this is. We throw people in jail for using Adderall without a prescription. We expel them from colleges. We fight an expensive and bloody War on Drugs to prevent non-prescription-holders from getting Adderall. We create a system in which poor people need to stretch their limited resources to make it to a psychiatrist so they can be prescribed Adderall, in which people without health insurance can never get it at all, in which DEA agents occasionally bust down the doors of medical practices giving out Adderall illegally.
It's absolute bullshit that I can't buy amphetamine at my corner store if I want to. Yes, it's probably bad in the long-run. But I fucking want it.
Edit to add more substance: I also believe without evidence that "ADHD" is a lingering result of the transition of humanity to a sedentary lifestyle, but some are better equipped to deal with it than others. The whole binary of "You have ADHD" and "You don't" is utter nonsense made up by the prohibition state to justify medicating people with amphetamine.
as a long-term supporter of the idea that folk should be able to just get high if they want to, it’s incredibly hard to square my beliefs with the existence of a person like Scott, especially having directly dealt with the outcomes of Scott’s advice amongst folks I have worked with
in general, the capitalist idea that even getting high needs to have utility has led to the normalization of some of the worst drug culture I’ve ever seen, from the can of worms that is lifestyle microdosing to some much worse shit than that
I haven't finished the video yet but wow, that was truly shocking. I used to think that psychedelic experiences nudge people to be "better" in some abstract sense that I will not define, but now I see that what I thought was completely wrong.
Education, not prohibition is still my stance; for every Scott encouraging people to take amphetamine, there should be someone who can eloquently describe how it turns you into a soulless focused monster who disregards everything except the goal of the minute, including pesky concerns such as hydration, nutrition, and social interaction. Just like everything else, it's a tool.
I made the mistake of assuming that my experience with LSD would be the same as anybody else's. Prior to that, I'd known that if you all drink whisky, you all get drunk, you all feel dizzy and you all start slipping around. So I presumed, mistakenly, that everybody who took LSD was a most enlightened being. And then I started finding that there were people who were just as stupid as they'd been before, or people who hadn't really got any enlightenment except a lot of colours and lights and an Alice in Wonderland type of experience.
— George Harrison, quoted on page 179 of the Beatles Anthology
The problem is not that people who don't have health insurance can't get Adderall. The problem is that there are people who cannot get regular healthcare because they don't have health insurance. If you made adhd medication (adderall isn't the only one) available over the counter tomorrow, there would still be deaths, damage, disablement and addiction caused by drug use unless all those users also had access to decent harm reduction based healthcare.