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

  • @selfMA
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    151 year ago

    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”

    • @corbin
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      81 year ago

      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!

    • Steve
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      1 year ago

      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.

      • @maol
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        61 year ago

        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?

        • @jonhendry
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          61 year ago

          I might be anhedonic because I’ve been using methylphenidate for ADHD since 1992, but I’ve always been somewhat anhedonic. To paraphrase Maria Bamford “Some people really love life. I’ve always been on the fence.” The question “what do you do for fun” has always been a bit difficult for me.

          Of course it’s also hard to find pleasure in many things if you can’t stay with them long enough for the pleasure to really develop.

        • Steve
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          1 year ago

          It’s interesting but maybe my original message was a bit vague. I shouldn’t say anything about my adderall experiences without clearly stating that it was my experience. I’ve never felt like the medicine had a hold on me. I moved to France 7 years ago and it’s not legal here, so I’ve used less potent alternatives without issue.

          My main point was that the desired outcome when I agreed to take the first prescription was focus and it certainly delivered that. For me, it delivered something that feels like a binary interpretation of what focus is. It’s on or off, and when it’s on it can’t be turned off. Which is very different from my interpretation of evolutionary focus which does a great job of filtering for distractions worth paying attention to.

          With that in mind, my indicator for usage being problematic would be if it were frequently taken without a clear need to get something done.