Rise of pill-popping tech execs | Hacker News Reader

Rise of pill-popping tech execs

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54 pointswhalesalad41 comments

Lies, damn lies, and statistics…

> 4 in 5 tech execs are taking medications ("controlled substances"), and among that cohort 1 in 2 use them "every day or nearly every day."

Would it be surprising to anyone to find out that ~40% of tech leaders are neurodivergent? Programmer and related jobs are at the top of every list of suggested careers for people with ADHD.

> 1 in 3 used controlled substances such as amphetamines and sleeping pills specifically to cope with work stress and long hours.

What a poorly worded question. Why not ask specifically: do you abuse amphetamines to work longer hours? Do you abuse opiates, ketamine, cannabis, or benzos to “wind down?” Do you use benzos occasionally for work related panic attacks?

They’re being extremely weaselly by grouping all controlled substances together here. Would it concern anyone to find out that 33% of tech leaders smoke weed occasionally to relax?

And what’s the overlap between the 40% of daily users and this cope cohort? I suspect it’s vanishingly small, but they won’t provide that data, because they’re pushing an agenda here.

> 1 in 2 self-reported as qualifying as heavy drinkers (3-7 drinks per day)

There is a world of difference between the bottom and top end of that range. It’s the difference between an unhealthy habit and straight-up alcoholism. Conflating the two further reveals the overwhelming bias of this article.

3 a day seems like a reasonable threshold for heavy drinking. That's a lot. I'm pretty amazed that 50% are heavy drinkers. Not sure why there's a max in this range though; they should have just said 3 or more.

Some of your other concerns have more to do with this article's representation of the survey than the survey itself: https://apn.com/wp-content/uploads/2023/06/APN-Tech-Execs-Mi...

Same reason many people in sales are heavy drinkers - they wine and dine and entertain people to convince them to give them money, usually to their detriment, which is easier to stomach by all if they're drunk.

I would personally be surprised if tech leaders are anywhere near as likely to be neurodivergent as tech workers in general. Too many MBA types and money chasers in tech over the last couple of decades and they're all going after these leadership positions - these people are nothing like typical IT folks.

> I would personally be surprised if tech leaders are anywhere near as likely to be neurodivergent as tech workers in general.

There are disturbing links between "business leaders" and psychopaths - a topic well discussed during the period of the 45th [1], but it's been around way before that worst case entered politics [2].

The problem is that stock markets appraise actions that need a ruthless, cold-hearted arsehole to execute... most infamously mass layoffs of workers despite the company being wildly profitable or giving them so little spare time that they're forced to piss in bottles. This is not something an individual with a healthy mind would order.

[1] https://fortune.com/2021/06/06/corporate-psychopaths-busines...

[2] https://www.forbes.com/sites/victorlipman/2013/04/25/the-dis...

Excellent point. I agree these types of leaders are neurodivergent, just in a very different way from how most tech workers are.

And what’s even better is our culture in-turn celebrates sociopaths as successful role models.

By "appraise," did you mean "reward"?

Snakes in Suits: When Psychopaths Go to Work is a 2006 non-fiction book by industrial psychologist Paul Babiak and criminal psychologist Robert D. Hare. The book describes how a workplace psychopath can take power in a business using manipulation

Stimulants and people in power go together, but that doesn't mean they are neurodivergent. They could just like drugs.

3 drinks a day every day is absolutely alcoholism. 1 drink a day every day is probably a hard-to-stop habit.

3 drinks a day everyday is not healthy. If you’re on 3 a day you’re on the train to 7 a day and alcoholism.

I said 3 a day is unhealthy. I’ve been there in my early 20s. It’s not good. You will get fat. It’s definitely risky that it will continue to escalate. And yet I knocked it off before anyone would ever label me as an alcoholic, before I’d think I had any business going to a meeting. And honestly, coffee has proven much harder to kick than my minor drinking “problem.” Scare quotes because it was a problem, but it barely registers on the scale of what most people consider a drinking problem.

These are usually reported as averages, not floors. I’m interpreting it as “21 drinks per week.” “At least 3 drinks every single day” is a much more serious problem IMO.

7 drinks a day is a fifth of vodka every other day. That’s at the point where you’re likely driving drunk regularly, and need to spike your morning coffee to stop the shakes.

I’d be less annoyed if they just said “3 or more drinks a day.” Putting the 7 there is designed to frame the problem as more severe. Imagine if the range said “3-17 drinks per day” instead. Then it would be too obvious what they were doing.

This is all oddly specific.

Amphetamines are beneficial drugs for many people, and the status quo is that anyone can get a legitimate prescription for them by doing little more than asking. It's just a matter of finding a psychiatrist and explaining you have symptoms of ADHD. There are no physical symptoms, so it's impossible to verify one way or the other. Some might say that means that a drug seeking patient can "trick" their prescriber. But I'd argue the entire field of psychiatry is a "trick," and that effectively, if you think you have symptoms of ADHD, then you may as well have it.

If you want to try treatment (amphetamines), then you should have a right to do that. As it stands, you already de facto have this right. But you need to do this whole song and dance with finding a doctor, paying the fees, and getting the pills. Yes, online telemedicine has made this easier to "abuse" (see above: it's not possible to abuse a diagnosis that is fundamentally based on perception of deviance from the mean). But even prior to online psychiatry, it was easy to legally procure such medication with a little extra effort.

We should dispense with this charade and focus on safe and effective treatment of symptoms for those who want to try it. The goal of a prescriber should therefore not be to gatekeep access to the medication, but to manage its dosage and monitor patients for positive outcomes from healthy usage of the medication.

We should have easy to obtain or even OTC Vyvanse or some similar stimulant that is abuse resistant. (Vyvanse is turned into amphetamine in the liver, rate limiting absorption.) It would probably help a lot of people and at the same time reduce the number who get into dangerous street stims like meth.

Low dose time release Vyvanse would probably be no worse than a lot of caffeine or these energy drinks full of megadoses of taurine and stuff.

Amphetamine is actually not that dangerous if taken at reasonable doses and not abused. Street meth is impure, uncontrolled in dose, and delivered without proper packaging.

If you’re interested in Vyvanse then check out this interview of its creator Dr. Robert Oberlander: https://youtu.be/x9WmEVRxebE

I'm way too ADHD to hold an engineering job without medication. I'm also quite sensitive to amphetamines. Vyvanse gave me terrible insomnia, and the extended time release worsened the psychiatric side effects (depression, social anxiety, paranoia) when taken in large enough doses to aid focus (which were always pretty low in absolute terms).

Vyvanse basically ruined my life in high school in part because my psychiatrist was afraid to prescribe those pesky abuse-prone IR amphetamines, but I felt I had to keep taking them because it was my only way to succeed academically. Having also been a heavy caffeine user over the years, I think Vyvanse is in an entirely different ballpark.

I'm now managing my ADHD effectively by taking low doses of Adderall on an as-needed basis (average of probably 90 days per year, <10mg per day). Minimal insomnia, minimal depression, no paranoia.

SSC's article is the best concise discussion of ADHD and medication I've ever come across: https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

Anecdotally I have the same problem - I was really well managed with adderall IR but now I’m on vyvanse because of the shortage. I think the problem is it never fucking wears off - sounds good on paper but the cumulative effects of dehydration, not eating as well, and not sleeping as much really take a toll on you. Plus while it technically lasts longer, for a lot of that tail end it’s barely effective at managing ADHD (acute tolerance, depletion and tiredness) while still messing with sleeping/eating/hydrating.

I honestly think adderall IR should be legalized too if we’re going to legalize vyvanse - just put it behind the counter like Sudafed.

This stuff was legal, widely used, and widely available in many countries (Germany, the US) for multiple decades and it didn’t collapse their societies. If you read about it, generally the only times it caused problems was armies and such ran out - what people experience right now with all the shortages that wouldn’t exist if it were treated like Sudafed. Sounds like it’s scarily addictive given that, until you realize we’d also have a lot of problems if we ran out of coffee or caffeine.

I prefer IR (raw dexamphetamine) because its predictability makes me feel more in control of its effects, even if they are more volatile, with the temporary "high" for the first hour followed by a gradual dulling over the next few hours. But at least I can be relatively certain of when it will end. Whereas XR might be more consistent throughout the day, but the total duration is variable and depends on factors like how much food I ate or how much acidity was in my drink.

I only tried XR for a few weeks during my initial titration period years ago, but that's how I remember it. I've been on IR dexamphetamine for ~10 years now at varying levels of dosages depending on current life goals. Overall it's been worth it, but there are tradeoffs with dulling of personality and risk of misdirected focus (see my comment history). It's not conducive to long term relationships, and once I "settle down" I might reevaluate my usage of it, but for now it's the obviously right choice. I'm not 100% productive every day, but I'm significantly more consistent than I was without it.

Yeah I went from Vyvanse to XR to IR over the last 7 years and am happy with IR. I feel as though my ADHD symptoms are mitigated appropriately and the side effects are virtually non existent. Vyvanse was great for productivity but I felt like an absolute laser-focused robot and was not at all pleasant to be around.

I'm ADHD and I respond terribly to amphetamine (or Vyvanse). On low doses I become more irritable (or in my wife's words "an asshole"), and the one time I took a higher dose (at the instruction of my psychiatrist because I wasn't getting a therapeutic effect at the lower dose), I had a manic episode and was awake for 36 hours straight.

Finally settled on Focalin as working for me, but every time we changed insurance companies I had to spend a few hours on the phone proving to them that amphetamine doesn't work, while paying out-of-pocket until they are convinced.

> 4 in 5 tech execs are taking medications ("controlled substances"), and among that cohort 1 in 2 use them "every day or nearly every day."

Is not what the survey said.

The survey said (direct link: https://apn.com/wp-content/uploads/2023/06/APN-Tech-Execs-Mi... ):

80% are taking medications but doesn’t say only controlled medications.

It then says 48% take controlled substances daily or every other day.

It also states 31% have increased their controlled substances as a direct consequence of AI, which I find suspect.

We should also consider the baseline [0]. If this is a problem in America, it's not one that's isolated to the tech sector:

> In 2019, 19.2% of U.S. adults received any mental health treatment in the past 12 months, including 15.8% who had taken prescription medication for their mental health and 9.5% who had received counseling or therapy from a mental health professional.

That was for 2019. I expect those numbers increased significantly during and after the pandemic.

[0] https://www.cdc.gov/nchs/products/databriefs/db380.htm

To me, it's not clear if the survey is using "medication" interchangeably with "controlled substances".

As you point out: the section heading reads "medications" but all the subpoints read "controlled substances". I'd wager it's intentionally ambiguous, for hype points.

At the bottom of the third page, it shows which responses it pooled together, one of which is “SSRI” (not a controlled drug generally) (but then provides examples that are not SSRIs, like Wellbutrin, an NDRI), another is “other”.

But it doesn’t state the question.

Just bad “science”.

I had the same thought, but can't imagine what else it is.

I'd like to think that if these people were on cocaine, we'd at least see some of the creative irrationality that led to the more-fun aspects of the 70s and 80s. Who's making anything awesome just for the sake of doing it? Who's commissioning assassinations of business rivals? Which startup founders are trying to save their failing business by pivoting to drug smuggling?

Were it weed, they'd be more chill and empathetic. They're not. Musk constantly looks like his blood pressure is through the roof. He's probably done it once or twice for spectacle (e.g. all the 4/20 stuff and that podcast) but is doing rails of Adderall the rest of the time. It explains him sleeping under his desk like that's some kind of sign of hard work. All I see is a demented bridge troll going through an Adderall crash.

Shrooms? LSD? They'd be chill, happier, and trying to pivot the core business in entirely new directions every week. At least one of them would have had an epiphany and actually tried to make the world a better place. There's also no creativity to be found. Our architecture consists of baby's first shapes. Our car colors are every shade of baby shit. America (and the internet) has never been more sterile. Reddit has always looked like a corporate portal.

I'm convinced it's all Adderall for all of these people, and the ambiguity in verbiage comes from it not all being legally obtained. It's not prescribed medication at that point, it's just a controlled substance they are in unlawful possession of.

With the amount of aspirin and ibuprofen that is sold, I would love to see a similar story on how much folks pop standard pain medications. I'm always baffled at the impressively large sizes those bottles come in. And since I don't know the shelf life of them, I'm very doubtful that the bottle I bought a decade ago is the one i should still be using. (I'm not doubtful enough to care when I have a bad headache, of course...)

The expiration date on most medications functions differently than the expiration date on something like food. It's more about effectiveness than it is about safety. It's the date that the manufacturer can guarantee full potency of the drug. After this date, the drug may have lost some potency. However the vast majority of drugs are still effective, even 15 years after the expiration date [1], if they've been stored correctly. There are some exceptions which either degrade quickly or can gain toxicity post expiration (e.g., nitorglycerin, insulin, liquid antibiotics, biologics), but something like ibuprofen would generally be safe even years after expiration though it may be marginally less effective.

[1] https://www.health.harvard.edu/staying-healthy/drug-expirati...

The actual study can be downloaded.[1] Causes of stress:

- 77% say layoffs have negatively impacted their health.

- 74% say improvements in AI and the thought of being replaced by a computer have negatively impacted their health.

Those are much larger numbers than expected.

"The total sample size was 501 tech leaders (director level and above) in the U.S. aged 18+ in tech firms with 1,000+ employees. The survey was conducted between April 27, 2023 to May 15, 2023 by independent market research consultancy, Censuswide."

[1] https://apn.com/wp-content/uploads/2023/06/APN-Tech-Execs-Mi...

What processes/procedures are in place to prevent polls like this from being completely fabricated? Why should I trust this data any more than a tobacco company's studies showing it's perfectly safe to smoke cigarettes?

That's a good question. How did they get over 1000 "director level" people to participate? That's not a group that's likely to opt in to some survey, or even be reachable by cold calls. They probably cold-called a list like this.[2]

[1] https://censuswide.com/about-us/

[2] https://www.spanglobalservices.com/data/director-level-execu...

People do drugs. It's just becoming less taboo to talk about it. Putting humans under the influence of daily booze and speed in charge of the biggest and most populated ships that steer our society.. yeah. We can see the results. It's not new though. It's part of how we got here. I know the article isn't in judgement or is but walks a linguistic line that's razor thin to technically not be directly judgmental. They do frame the drugs like they are illegal when probably they are prescribed. It's reporting the fact that execs are comfortable disclosing and maybe the drug specifics are changing a bit. Not the booze and speed, but the addition of ubiquitous ketamine or LSD or whatever, but judgement of drug users by puritans is so fucking counter productive. I really appreciate those in those positions who are willing to talk about it even though they are only doing the disclosure for "I work so hard and am under so much stress that I'm high as fuck all the time" clout/flex. We have such a skewed understanding of what drugs are and what they do, I think it's a net good that they are self reporting.

> 3 in 4 say that recent layoffs, and the future risk of AI replacing their roles, have negatively affected their health.

I'm glad the execs also have this fear; it shouldn't just be ICs and contractors who are afraid.

I think we've all known execs who appear to add very little value, who have a very shallow understanding of the areas they oversee, and who seem to repeatedly create the appearance of success off of other people's work in order to move to a new role to start the cycle again. I'm not saying we're yet ready to replace them with LLMs, but perhaps we're not so far away either.

I would love to also know how many tech execs meditate to extend creativity.

We have long since endeavored to push the boundary on creativity and performance - from pills to sensory deprivation tanks, to extreme adventure to BM like experiences.

You can club a wide range of things under pills. Supplementation is an essential part of health and without concrete stats and evidence this is just sensationalism.

Would be super interested in knowing though - How much of the community here leans in on pills vs supplements vs meditation?

One of Matt Levine's recent columns was about this topic too: https://www.bloomberg.com/opinion/articles/2023-06-27/silico...

How does it compare to execs in other industries and the public at large? Sharing isolated numbers is pointless. It very well could be that tech execs take _less_ "controlled substances" than their counterparts in finance, law, politics, education, medicine...

Yep, this is a good thing. Those placed at highest leverage burning at max engines during their productive time is ideal for society. Good stuff.

If these people are tech execs, then presumably they are extremely productive members of the economy. What does it matter what they do in private? If you’re an avid unicyclist it should have no bearing on your appearance of respectability unless you’re skipping work to unicycle or unable to work because of unicycle injuries.

> If these people are tech execs, then presumably they are extremely productive members of the economy.

First of all, executives rarely are productive members of the economy - the value is created by the exploitation of those below them in the ranks.

> What does it matter what they do in private?

Because what they do as a consequence of snorting cocaine and whatnot has consequences on society at large - mass unemployment events, destroying everything around them with their sheer scale (such as Walmart is infamous for), or ruining entire neighborhoods, even entire cities like AirBnB did.

In the spirit of friendly discussion, would you be able to acknowledge that the leaders of company being unproductive and exploitative is not a mainstream theory of the economy? Would you be able to acknowledge that you are equating riding unicycles outside of work with economic recession and urban decay? To be frank I found this comment disturbing because it is arguing against me from a line of reasoning I do not hold.

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