Comment by anexprogrammer | Hacker News Reader

Comment by anexprogrammer | Hacker News Reader

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Yes! We could replace those flawed and lobbied against restrictions with advice. The market would be free once again to innovate.

Bayer could once again offer Heroin as an addiction free drug. We could get long missed radium cures and snake oil. They could be free to advertise to their heart's content. They can tell us cigarettes are good for us.

The companies can be trusted to have our health at heart. They can spend adequately on SEO to ensure their messages are dominant. Silly government warnings and or indivduals having problems with side effects or Heroin forum posts can sensibly be lost in the far reaches of search.

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Seriously? I can't think of anything more stupid, even though the system is horribly flawed.

Want to go back to food adulteration, and poisons sold as cures? Endless advertorials pushing pointless product? We have an entire vitamins and supplements industry that's pointless (and problematic) for most people.

Go read the history of those regulations and restrictions. I don't want the pre-drug and food adulteration acts world back, thank you very much. How is this the highest voted post?

It was under basically the same regulatory regime that Purdue Pharma marketed Oxycontin 12-hour extended release as a drug unlikely to cause abuse.

It wasn't that long ago that Phen-Phen (sp?) was legally marketed and sold.

We currently allow prescription of extraordinarily strong methamphetamine to children, who often spend their formative years under the influence.

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We still have a long ways to go.

I did say it was flawed.

> currently allow prescription of extraordinarily strong methamphetamine to children

As someone adult diagnosed ADHD and taking "extrordinarily strong amphetamine" from my 40s I'd like to point out they do not affect ADHD sufferers in the same way as neuro typicals. They're used at tiny dosages compared to using recreationally. I would not wish children with the condition to have my hugely damaged teen years because of horribly misinformed popular rhetoric about amphetamines. Using meth is the last resort option when other forms haven't worked.

That popular rhetoric meant I spent an additional 10 years before gaining effective treatment. I had to read and interpret actual papers to get past the media bullshit and gain an informed opinion.

I doubt you can even imagine how much I wish I had been taking "extraordinarily strong", ie correctly dosed, amphetamines from my earliest years. I will add that I'm not in favour of use for weight - many other tactics can work there.

Do you use the term "extrordinarily strong" when you mean "correct dosage" or speaking of paracetamol? Paracetamol is the cause of many deaths unlike amphetamines. Now add the liver damage.

This assumes correct diagnoses. In your case, the cost was lost years of correctable, sub-optimal brain chemistry. To a kid unnecessarily prescribed amphetamines, the cost is a life with a malformed brain.

The issue at hand is how to balance the outcomes. Based on increased prescription rates (600k diagnosed in 1990 to 3.5 million in 2012 [0]), it seems probable to me that we've passed the breakeven point. I bet that increase in diagnoses corresponds with an increase in marketing spend for these drugs, which is another indicator that gives me pause.

You as an adult were able to decide for yourself. Many diagnosed nowadays are young; they do not have the ability to give informed consent to the medication, nor the ability to roll back the effects. Younger brains are more easily harmed as well.

Further complicating the fact is that it requires an assessment of relative importance: is it better to harm by inaction (your situation) or by over-action?

It's really hard to try and fairly balance these and other issues that I'm sure I'm missing. However, thank you for sharing; although uncomfortable, I thought about the issue from a perspective that quickly embarrassingly had not previously occurred.

[0] http://www.nytimes.com/2013/12/15/health/the-selling-of-atte...

It's a big subject and I don't want to to drag too far off topic. So I'll just say prescription rates in 1990 were when the condition was barely recognised and hugely under-diagnosed. Most doctors still believed you grew out of it.

Research seeems to indicate a global prevalence of around 5-10%, settling around 7.8%. So those areas, and there are some, diagnosing >10% are overdoing it. Until we have blood or genetic tests it's too reliant on self-reporting. Even so, many still struggle to get diagnosed or are suspected of just seeking recreational amphetamines.

If it does turn out to be 7%, that's over 22.5m in the US, 4.5m in the UK. It's doubtful all would need or want prescription as not everyone is affected similarly.

I wouldn't have hesitated to push for diganosis if I'd recognised it in my own children (It's strongly determined by heredity).

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