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Comment by westmeal | Hacker News Reader

I suppose, but anecdotally I was told I have ADD by my family physician and was prescribed various stimulants including adderall and ritalin. I only stopped and got on a patch based medication when I was losing weight because of the amphetamines destroying my appetite and I was already a skinny bastard. The only difference I felt on the medication is that I was methed up. This could have been a misdiagnosis but the tests I was given that led to my diagnosis were frankly bullshit. Looking back it seemed incredibly easy and 'hand wavy' for the doc to just shut up the parent and schools and write up a prescription to 'solve the problem'. In my eyes, the only problem I had is that I thought school was a meaningless chore. Should we make children take meth because they don't like the system they're in?

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> Should we make children take meth because they don't like the system they're in?

The flip side of this is that being unable to thrive in the system they're in is effectively dooming them to a substandard, more difficult life. If you think the system is broken, fix it, but ripping off the bandage before you have any sutures on hand is the opposite of a solution.

If I had started on medication younger, I undoubtedly would have done better in high school. If I had done better in high school, I would have gone to a better college, better college, better job etc. On the flip side, had I not gotten medicated in college, I very well could have flunked out.

So, yeah, it's a fucked up that the system doesn't accommodate for people slightly outside neurotypical-ness, requiring stimulant use to thrive, just like it's fucked up that it doesn't accommodate deaf people, making cochlear implants an extremely valuable treatment. But so long as that system is in place, restricting access to harm mitigation from that system because the system is fucked is unquestionably wrong.

The biggest flaw in this line of reasoning is that these drugs aren't inherently calming or causing docility. They are pretty powerful stimulants!

It's quite obvious when a troublesome kid has been misdiagnosed: they act as you would expect a child on stimulants to act. The behavior changes are mostly only useful if the child does have adhd. A non-adhd problem child on amphetamines is a powerful source of chaos.

Adderall and Ritalin are not meth, and the fact that you consider them equivalent demonstrates your harmful lack of knowledge on this topic.

Amphetamines and methamphetamine are closely related. Methamphetamine is actually a derivative of amphetamine.

So - you're wrong. And with that stupid insult you added at the end, you look even dumber.

> Amphetamines and methamphetamine are closely related.

In the field of biochemistry, this is virtually meaningless. A single substitution group is capable of producing wild changes in pharmacokinetics. The left and right-handed enantiomers of these molecules don't even act the same way in the body, and these aren't even positional isomers. The similarities with AMP and MAMP begin and end with being TAAR1 agonists. Off the top of my head, MAMP is also a potent agonist for sigma 1 & 2 receptors, and is generally more promiscuous.

Methamphetamine is a substituted amphetamine, not a "derivative". They're both simple substituted phenylethylamines, another TAAR1 agonist that is extremely prolific in your neurochemistry as we speak, and an incredibly diverse family of monoamines that range from lethal neurotoxin to serotonergic hallucinogen. The difference between the two is often as simple as a single atom moved 2 or 3 substitution points over. When you lack basic domain knowledge, please don't call other people dumb as you try (and fail) to correct them.

Methamphetamine is not a substitution for amphetamine. A substitution refers to the replacement of one atom or group of atoms in a molecule with another atom or group of atoms. A derivative, on the other hand, refers to a molecule that is derived from another molecule by modifying its molecular structure. In the case of amphetamine and methamphetamine, methamphetamine is derived from amphetamine by adding a methyl group (-CH3) to the amphetamine molecule, which modifies its molecular structure.

Amphetamines and methamphetamine are closely related drugs, as methamphetamine is a type of amphetamine. They both work in a similar way by increasing the release and blocking the reuptake of certain neurotransmitters, such as dopamine, norepinephrine, and serotonin, in the brain. As a result, they both have similar effect.

All you're doing is microdosing a terrible drug and calling it treatment. Addicts defend this, not logical healthy people.

Did you write this post with a chatbot?

> Methamphetamine is not a substitution for amphetamine.

I did not say it was a "substitution" which means something entirely different in this context, I said it was a substituted amphetamine. The rest of this comment reads like boilerplate drivel that completely ignores everything I actually wrote.

Still causes psychosis.

>Amphetamines and methamphetamine are closely related.

So are ethanol (vodka) and methanol (poisonous fuel). The difference is exactly the same - one methyl group (CH3).

If you think that it's a small difference, try drinking methanol instead of alcohol, and see for yourself.

(Or, rather, not see for yourself, given the side effects of methanol poisoning).

Prolonged use of amphetamines can lead to addiction, psychosis, cardiovascular problems, and other serious health issues.

This is the bottom line. It’s a drug, it’s not good for you. That euphoria is not treatment, your being drugged. Only addicts defend long term use

Would you say that amputees are addicted to using a chair? Or do you think that would be a bigoted thing to say?

A chair doesn't drug you and put you into psychosis. Not even the good kind of drug either.

Good comment, but Adderall is Amphetamine, not Methamphetamine. Big difference.

Methamphetamine can be prescribed for ADHD under the trade name Desoxyn, but it's less common because the side effects are worse.

Sure, but they said they had been prescribed Adderall and Ritalin, neither of which are Methamphetamine.

Methamphetamine is actually a derivative of amphetamine.... So it's pretty damn close, effects are similar too.

Methamphetamine is a schedule 2 drug and prescribed in the US, though significantly more rarely than amphetamine. Is there a difference between oral consumption of amphetamine and methamphetamine dosed out in correct proportion to the salts in question? Maybe, but certainly not that "big" of a difference.

It's actually a big difference. One feels downright euphoric, according to Desoxyn users. The other is a boring study drug.

https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

>The other is a boring study drug

That's quite the mischaracterization. Stimulants even at low doses increase the dopamine in the brain and lead to a mild high. I don't think I've ever heard anyone ever call Adderall "boring" before either. That's like calling alcohol boring, maybe someone may not like the experience, but they both have immediate and noticeable effects and it's not just "I love studying" either.

Even Scott's article has examples of this, here's a story of a little girl becoming very high from a prescription stimulant:

"A spontaneous report from the manufacturer of Strattera (atomoxetine) described a 7-year-old girl who received 18 mg daily of atomoxetine for the treatment of ADHD. Within hours of taking the first dose, the patient started talking nonstop and stated that she was happy. The next morning the child was still elated."

In my experience people who take adderall while partying do it to stay awake longer to party with other drugs or booze. In practice for most people that “high” isn’t really a thing. At least not with anyone I know who is prescribed it or sometimes takes it recreationally. Meth on the other hand? Yeah that’s going to give you a very noticeable high.

Please browse https://www.reddit.com/r/StopSpeeding/ (probably nsfw) for many stories of people struggling with prescription stimulant abuse. These people aren't taking it because it keeps them up longer for drinking.

I'm not denying that you can abuse prescription stimulants by taking large doses to get high but most people aren't taking 10-30mg a day and experiencing meth like feelings of euphoria. Especially with extended release formulations. It's also much harder to maintain the regular abuse of a prescription stimulant without resorting to illicit acquisition since most psychiatrists avoid prescribing high enough doses to make that feasible.

I can't speak for every person who abuses prescription stimulants but I've met people that do and they always had a meth or other addiction in their past and were either buying from dealers or seeing multiple doctors/pharmacies. It's been a while since I've run into someone with that problem though so I don't even know if the latter strategy is effective anymore. I assume the feds maintain some kind of database these days.

Why are you conflating Adderall with all or any stimulants? Might as well throw in caffeine and sugar as things that "even at low doses increase the dopamine in the brain and lead to a mild high".

Not disagreeing with you wrt atomexetine but really should compare apples to apples.

You're right. I wasn't as careful as I could be, my intention was to cover common ADHD stimulants: adderall, ritalin, vyvanse, etc. Basically any of them that gives you a quick boost of dopamine and are addictive. I'm not a smart psychopharmacology guy, just have a lot of experience with stimulants. Perhaps ask for clarification instead of throwing out 'conflating' next time though?

Adderall is an amphetamine. It's a hard drug. And methamphetamine are closely related. Taking small doses of this, essentially macrodosing, it's not good in the long term.

The long term health impacts of taking prescription stimulants at recommended doses for on-label management of disorders is well understood and extensively studied/documented. There's not a psychiatrist that's not going to take this and other factors into consideration when prescribing it and any decent one is going to discuss medication breaks with their patients they prescribe them to. Prescription stimulants aren't perfect but it's currently the most effective treatment that's broadly applicable and well-tolerated.

A lot of people are critical of prescription stimulants without presenting a comparable alternative that will allow disordered people (particularly adults) to maintain the ability to function, be productive and maintain happiness in our current society with it's expectations and capability requirements.

The alternative is easting healthy organic foods, pasture raised meats, and exercise. Even weed/DMT/LSD is loads better than 'adhd' medication - and might actually change your way of thinking.

Strattera is not a stimulant, not in the same method of action that Adderall or Ritalin is.

Thanks for the clarification, was just quoting from Scott Siskind's article which focuses on Adderall. I was responding to the suggestion that adderall is a mundane drug and doesn't get a person high.

I don't think that would be that hard to disprove, but I was trying to pull a quote from the article they linked.

Wikiopedia says Strattera can lead to increases in dopamine, whether that's relevant to that case I don't know.

It's a pretty huge difference. Desoxyn's focus improvement comes with a full-body euphoric rush, which while fun and all, dramatically increases its abuse potential and addictiveness. Amphetamine, in contrast, is just makes it easier to focus. Properly dosed, there's no rush, no euphoria, just slanted walls on the sides of your train of thought.

The difference is one of chemistry, not law. A helpful analogy is to find another pair of drugs that people are more familiar with where the difference is a single methyl group: caffeine and theobromine (the stimulant in chocolate).

Saying that appropriately dosed amphetamine and methamphetamine don't have a "big" difference is like saying appropriately dosed chocolate and coffee don't have a "big" difference. The difference is clearly massive.

I disagree. In oral usage, when you control for potency, particularly with regard to the stereoisomer composition, amphetamine and methamphetamine are FAR closer in effect (and "side effects") than historically people have claimed.

Pointing to the methyl group is completely missing the point; I am not talking about the absolute chemistry, but the pharmacology.

> Should we make children take meth because they don't like the system they're in?

>take meth

Ah yes, the good old "Adderall is meth" ridiculousness.

Sure, Adderall is amphetamine, and meth is methamphetamine, just one methyl group of a difference - practically the same thing, right?

Just like ethanol (aka vodka) and methanol (deadly poison, makes you blind) - one one ethyl group difference, practically the same thing!

Please stop referring to medication[1] many people rely on as "meth".

Or if you must do so - consider having a shot of methanol next time you go for a drink.

If it's the same to you, then why not?

[1]https://romankogan.net/adhd/#Medication

> In my eyes, the only problem I had is that I thought school was a meaningless chore. Should we make children take meth because they don't like the system they're in?

This is what the problem was for you. It's quite a leap from there to assume that all children on ADHD medications also happen to have the same problem.

For many people with ADHD, the difficulty is beyond "the system they're in". Being regularly late to events, zoning out when talking to someone, living in a chaotic/messy living space etc. (common problems with those with ADHD) will still be a problem in a hypothetical better school system or post-scarcity communism society.

>Looking back it seemed incredibly easy and 'hand wavy' for the doc to just shut up the parent and schools and write up a prescription to 'solve the problem'

Exactly. The diagnosis is a tool for the system to give it a veneer of scientific legitimacy. There is no truth only power. In living memory, being gay was a diagnoseable disorder. In some countries political dissidents would be deemed insane and committed to institutions. Psychiatrists used to hand out lobotomies and electric shocks to anyone they felt like.

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