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

  • @sue_me_please
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    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.

    • Sailor Sega Saturn
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      121 year ago

      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.

    • David GerardOPMA
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      101 year ago

      i am simultaneously going “what”-meme and jesus fucking christ and also i’m not actually shocked

      • @YouKnowWhoTheFuckIAM
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        101 year ago

        If you want to prematurely end your stimulant rush, booze, GHB, or ketamine will do that.

        Ketamine and booze will absolutely not do that, and for the love of God do not take GHB to cool off a rush, what in God’s name are you thinking, you ludicrous phoney

        • @saucerwizard
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          61 year ago

          Are these guys lying about drug use to look cool???

          • @selfMA
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            71 year ago

            “incredibly dangerous drug advice that doesn’t get called out” is practically an orange site specialty at this point. it’s weird that their world-class mods don’t even catch the obvious cases

            • @Evinceo
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              81 year ago

              They give programming advice just like they give drug advice, the consequences are just different.

              • @YouKnowWhoTheFuckIAM
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                This whole situation is making me so glad I stopped taking drugs and never learned to program

                Born too young to be made to learn how to program in school

                Born too old to lose my code monkey job to a literal mechanical code monkey in a mutually disastrous management fuckup

                Born just in time to burn out on drugs and alcohol and watch the machine revolution from home

            • @YouKnowWhoTheFuckIAM
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              GHB aside I wouldn’t even call it particularly dangerous, it’s just blissfully wrongheaded. Ketamine is a dissociative anaesthetic, and it does what it says on the tin: it takes however your mind is at that moment and just brutally lops off all the connections you normally anticipate it having with your body and other bits of itself, with various interesting consequences for mind and body both. Alcohol is alcohol, it’ll depress your euphoria to some extent but it is also in itself sugar and obviously will make you drunk on top of the (significant) remaining effects of the stimulant - rather than calm down, you are far more likely to get outrageously mad and try to punch a stranger, poorly, because already the whole point of abusing most stimulants, euphoria aside, is to turn you into the world’s sharpest spoon.

          • @YouKnowWhoTheFuckIAM
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            61 year ago

            I’m just cackling at whatever this guy thinks ketamine does when you’re already on speed playing jump rope with the traffic, other than “you will lie face down on the pavement for half an hour and conduct a week long interview with satan between the gap in your eyelids”

            • @maol
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              41 year ago

              Ok, yes, he’s making it all up to look cool, but the idea of dorky rationalists mixing pills, booze and ket is really, really funny. If you really want to be good at code, you should be drinking and drugging like you’re Lemmy in 1971…

    • @skillissuer@discuss.tchncs.de
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      61 year ago

      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

      • @jonhendry
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        1 year ago

        I suspect (without evidence) that what a lot of the NT people get from ADHD stimulants is not so much focus but “better alertness than you get from caffeine”. And being more alert by itself would probably help an NT person focus especially when they’re burning the candle at both ends.

        As opposed to needing the extra dopamine in the frontal lobe to kick the executive function into gear to concentrate at all.

        To really test this you’d probably have to get some NT people and some ADHD people, ensure that they’re well-rested, fed with adequate nutrition, exercised a bit, and have them do an incredibly fucking boring task both medicated and unmedicated. (Perhaps take in a 90 minute lecture and do a quiz about the medieval open-field farming system.)

    • @skillissuer@discuss.tchncs.de
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      31 year ago

      i understand that as scott saying that only people with “natural inverse-ADHD” are capable of happily churning code or numbers for 10h daily. which is also bs

  • @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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      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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          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.

  • @jonhendry
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    141 year ago

    Shit like this is exactly why I’m skeptical of FTX boy’s Adderall prescription.

    • David GerardOPMA
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      91 year ago

      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.

      • @jonhendry
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        111 year ago

        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.

  • @saucerwizard
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    111 year ago

    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).

    • acb
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      111 year ago

      In his book on psychedelics, David Nutt suggests that it is likely that the observed benefits of microdosing are just the placebo effect.

      • @saucerwizard
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        61 year ago

        His GABAlabs stuff sounds absolutely fascinating.

    • @selfMA
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      111 year ago

      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)

      • @maol
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        111 year ago

        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

  • Steve
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    This was definitely written on an adderall bender.

    • David GerardOPMA
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      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.

      • Steve
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        91 year ago

        It reads like adderall bravado to me. From the beginning where he’s confident that his patient’s colleagues are already on it.

        • David GerardOPMA
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          I would first presume Scott’s just like that, and just naturally tends to rambling logorrhea on the order of 10k words a week. I certainly wouldn’t post an assumption of any sort of malfeasance on his part, except to the degree even posting this thing that a subculture took as its starting pistol to speed out of their stupid little heads is.

          • @YouKnowWhoTheFuckIAM
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            31 year ago

            As a matter of opinion, I gotta say our brief new friend the other day did give me flashbacks to the one time I interacted with Siskind, even if it’s just that Siskind’s particular style of incoherent personally afflicted grandeur only happens to correlate with how pill heads express theirs

            • David GerardOPMA
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              51 year ago

              I certainly wouldn’t post from England and Wales that a medical doctor was in any way abusing a medication. So I would first presume Dr Siskind is just like this.

              • @YouKnowWhoTheFuckIAM
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                That’s basically what I mean. A fun thing to do in rehab, for example, is to try and figure out who’s still withdrawing and who is just like that

        • Steve
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          61 year ago

          Though I’ve not read anything else of his. So could be his regular bravado. Or he could be on a permanent adderall bender.

  • @Evinceo
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    91 year ago

    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
  • @sinedpick
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    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.

    • @selfMA
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      151 year ago

      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

      • @blakestaceyMA
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        101 year ago

        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

      • @sinedpick
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        81 year ago

        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.

        • Brian David
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          51 year ago

          @sinedpick @self Just referring to your comment (haven’t watched the video) I completely agree that there is a view among some crowds that psychedelic experiences have moral and psychological benefits in and of themselves. Which is definitely not the case, and can lead some people to some real bad places.

        • acb
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          31 year ago

          To be fair, amphetamine is as different from psychedelics (such as LSD and psilocybin) as cocaine is.

          • @YouKnowWhoTheFuckIAM
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            71 year ago

            Yeah, it’s true, if you’re not careful extended reliance on acid and mushrooms can make you an even more annoying megalomaniac

      • @Evinceo
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        41 year ago

        I don’t think people should go to jail because they want to get high. But, separately, taking a pill, especially timed release, shouldn’t be getting you high, and the people who need adhd meds to function I know certainly don’t act like they’re experiencing euphoria.

      • @skillissuer@discuss.tchncs.de
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        11 year ago

        cheesus. dude spends entire hour explaining how chemicals have no political inclination, in particular no leftist inclination and how he absolutely have never done acid ever, for legal purposes and only at the end you learn he’s shilling NFTs

        • @selfMA
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          51 year ago

          I’d be very surprised if that were the case, given this is the description of the $4.20 tier of Chill Goblin’s patreon:

          VERY chill. You just bought yourself a Chilled Gobbo NFG, which is like an NFT except it’s just a picture I have saved on a google gallery. I’ll rename the one you pick with your username so everyone will know EXACTLY who it belongs to. I’m hoping one day Chilled Gobbo NFGs will replace both money and art, by donating at this level you will be helping my dream come true!

          it’s not high parody (heh heh) but it’s pretty clear he’s not an NFT fan

    • @maol
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      41 year ago

      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.

  • @Evinceo
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    11 year ago

    deleted by creator