[N]o other class of medications in virtually all of medicine inspires more baseless fears, intentional disinformation, and wild beliefs as do the stimulants used to treat ADHD.

Interestingly, these fears are almost entirely an American phenomenon that hardly exists elsewhere in the world.

[H]aving ADHD lowers a person’s estimated life expectancy by 12.7 years.


From other articles on the site:
  • ADHD medication use lowers risk of death by 19%, risk of overdose by 50%, and it reduces hospitalizations

  • [T]he risk of substance abuse decreases substantially when [ADHD] patients are treated with stimulant medication

  • SubstantialNothingness [comrade/them]@hexbear.net
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    2 days ago

    I’ll give this one a shot because I wrapped up my responsibilities for the day.

    The most common medication for ADHD afaik is amphetamine. Amphetamine doesn’t just sound like methamphetamine, it is very similar in effects. Meth and similar stimulants were used at high rates up through WWII. Germany, the US, Japan, and presumably many other countries relied on them heavily for their soldiers. Then broken soldiers came home and the use of stimulants among the general domestic populations became “problematic.” Part of this was based in reality - addiction, stimulant psychosis, having energy to oppose the state - and part of it was the need to appear consistent in anti-drug propaganda against other substances such as cannabis.

    An additional factor is that stimulants can be easily be made clandestinely, and that reality is inconvenient for strong states that desire economic control and the dependence of their residents on government-sanctioned revenue streams. Amphetamines are stronger than coffee and yet much easier to produce at home. Cartel financing is extremely effective in opposing orthodox power structures. And to be fair, homebrew amphetamines can be very dirty meaning that there are risks to the user that do not exist when using substances created by official regulated producers.

    We’re probably thinking about the medication from the perspective of medicating neurodivergent individuals to improve their quality of life, and in that sense you are correct that the evidence supports them strongly. However the rules are made by the states, and the states want a monopoly of authority. Such power structures generally care very little about patients as opposed to controlling “human capital.” Their concerns are more about weakening the argument for a war on drugs (which was never about the drugs themselves), individual economic independence and state loss of tax revenue, loss of donations and lobbying from pharmaceutical producers, and similar “risks” that would occur if their population accepted such drugs. The best way to turn individuals against their own interests is propaganda, and so a ton of anti-stimulant propaganda was created post-WWII.

    We are still dealing with the consequences of those choices. The propaganda has pervaded pop culture. It even affects drugs that were never used recreationally such as SSRIs (although they can be criticized from different angles such as questionable efficacy, as opposed to earlier medications [TCAs and MAOIs] for example). As a result we have also become more worried about manageable side effects vs. the deleterious primary effects of the untreated conditions themselves. We are now in a state where “common sense” says that no drugs is better than some drugs even though that viewpoint relies on erasing the consequences of untreated conditions.

    Are these treatments perfect? Are they free of side effects? No. Criticisms along these lines can be valid if properly evidenced. But that’s not in anyway a priority for society at large. It’s not what is really driving the Puritanical anti-drug sentiment imo.

    • ReadFanon [any, any]@hexbear.net
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      2 days ago

      Meth and similar stimulants were used at high rates up through WWII. Germany, the US, Japan, and presumably many other countries relied on them heavily for their soldiers.

      Pervitin!

      There’s an interesting and easy read on amphetamines used in Nazi Germany titled Blitzed by Norman Ohler. You know where to find the ebook but TankieTube has the full audiobook here

      Fun fact: doctors in the US still occasionally prescribe methamphetamine for ADHD. It goes by the trademark name Desoxyn.

      • SubstantialNothingness [comrade/them]@hexbear.net
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        2 days ago

        There’s an interesting and easy read on amphetamines used in Nazi Germany titled Blitzed by Norman Ohler.

        Blitzed is a great reference, it was one of the sources that opened my eyes to the bigger picture iirc

        Fun fact: doctors in the US still occasionally prescribe methamphetamine for ADHD. It goes by the trademark name Desoxyn.

        Because it works lol. I’ve never tried it but it’s clear why it does: One of it’s two metabolites is amphetamine itself. At best you get additional therapeutic effect from the original form and the additional isomer, at worst (since the additional metabolite is not extremely toxic) you just have a prodrug for amphetamine.

        For those whom it might benefit, a prodrug is a drug which does not have the targeted action but whose metabolite is the active chemical itself - these are sometimes used to bypass drug laws but they have other purposes too.

        afaik there are two primary reasons why meth is seen so much worse than amphetamines even though they are both generally legal prescriptions where either is legal:

          1. Meth is what was common so meth was the focus of propaganda and other communications, and
          1. The big one imo: Meth is much, much easier to synth.

        And so meth is relegated to a last-resort therapy in most cases.

        There may be additional factors I’m missing here that aren’t described in the research that I’ve done. There haven’t ever been too many meth users in my social circles and science can often gloss over individual experiences. I don’t mean to say meth is great or even that it’s not bad for most people. I don’t really know. I just know that a lot of the discussion around it is severely distorted which has created some undue prejudices when it is a legitimate therapeutic compound for an illness that plagues significant numbers of the population in Western-styled developed countries where ADHD traits can be strongly discriminated against.

        • ReadFanon [any, any]@hexbear.net
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          2 days ago

          I think methamphetamine is less neurotoxic than amphetamine at the equivalent dosage, although that’s only what I heard - never looked into it to say that I know this for a fact.

          Did you know that Ohler has a new book out called Tripped about psychedelics? It’s also up on TankieTube as an audiobook here although I haven’t read it yet but based on Blitzed I’d assume it’s pretty good.

      • SubstantialNothingness [comrade/them]@hexbear.net
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        2 days ago

        Hah great question.

        I guess it honestly depends on what you have available to you. The reason why I phrased it this way is because:

          1. If coffee is not available then you aren’t working with an intermediate stage. So you’re going to be growing, harvesting, roasting, and brewing the bean yourself.
          1. If amphetamines are not available then reactants are still going to be widely available for the average individual who might be reading this. So you’re going to be making a trip to the store and then you’re going to shake 'n bake and you’re done.

        If you need to produce the lye, etc. yourself then you are right that coffee is easier (depending on your region I guess). But this was not the situation in most countries that developed a taste for speed.

        Maybe I should add to my original comment that there are similar drugs with an effect between those of coffee and amphetamines, for example khat. While khat consumption has a long and storied history it is also more euphoric than coffee (khat releases dopamine directly while caffeine acts on adenosine and has a lesser downstream effect on dopamine) and it has been increasingly banned with the evolution of the modern nation-state.

        • Ithorian [comrade/them]@hexbear.net
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          If I’m not mistaken Khat has to be used super fresh though, like same day it was picked. I don’t know if there’s even anyway to get it in huge chunks of the world.

          • SubstantialNothingness [comrade/them]@hexbear.net
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            22 hours ago

            I think there are some exceptions to that rule, but that it is mostly true.

            Where you can’t get it fresh, there is often a more local alternative available - kratom, coca, betel nuts, ephedra, etc. These too have been facing similar criminalization pressures.

            • SubstantialNothingness [comrade/them]@hexbear.net
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              2 days ago

              I was, yeah. I should have caught that. I have a friend that was obsessed with Inside for a while. I guess I had the same reaction to your profile as I did to first hearing his song - this is just common conversation set to upbeat music, right? (I’m a climate change doomer if you couldn’t tell.) He’s super catchy - I ended up singing along, too.