The worst discussions we have on Hacker News are around healthcare and medicine.
For some reason the community refuses to apply a high of research and rigor to this topic, as if it's lesser than the non-sense we call computer science.
This entire debate is comical, the medical community's approach has been, by it's own admission, to throw various stimulants at ADHD. Methylphenidate, L-Amphetamine, D-Amphetamine, Lisdexamfetamine, etc.
By in large, everyone on this thread is pretending like there is a treasure trove of research demonstrating the superiority of Adderall (a racemic mixture of L & D amphetamine) to Methylamphetamine.
And that's just not true at all, there is a paucity of research on the subject. Meth = Bad because of the Germans and street drug users (who smoke an uncontrolled amount).
I get tired of people that don’t have to deal with ADHD trying to apply some sort of morality to stimulants to treat the condition.
If something else actually worked people would gladly try it. Stimulants have so many downsides and side effects that most would never take it unless it was necessary for them to function. These people are not junkies looking to get high.
Not too surprised to see people say here stuff like “isn’t adderall just meth” dose and delivery methods are completely different.
I've taken substances of various schedules legally and otherwise before, and I've never heard of a doctor writing a prescription for methamphetamine. I really wonder if they have it in stock at my local pharmacy.
Look, this is what I'm driving at, you appear to have some illusions that methamphetamine is significantly different than other amphetamines, or has some higher toxicity profile, more addictive, IDK I'm trying to get you to tell me your biases.
At that point, we can go look at the clinical literature and see what the evidence is.
Yes - why, as your own source says, are amphetamines prescribed at 4,000 times the rate of methamphetamine? Is there no reason for that? Why does the medical system have such a bias?
Note that you've gone from this statement, to acknowledging that they are regularly prescribed.
> Imagining a doctor writing a script for meth is pretty amusing, and maybe if that’s not a cool enough drug, they can hand out some crack or something.
I assume in a country of 300 million people, every prescription drug is probably prescribed to someone. I’d say what I take issue with is “regularly”. I’ve known many people who have prescriptions for amphetamine, and zero who ever got a prescription for methamphetamine (though certainly some took it anyway).
The 4000:1 prescription number would seem to corroborate my impression that it is quite rare.
Method of administration affects the time delay for euphoria. Smoke > Shooting > Eating.
People who do a lot of meth (or drugs outside of a prescription) tend to do as much as they can purchase and/or tolerate.
When you see someone who has a doctor (dealer) that gives them as much adderall as they want, illusions of differences between the two drugs rapidly fade. I'm talking about 100+mg a day, I've seen it happen, still have 50mg adderall pills from the person in the story.
Adderally XR formulations are still a minority of prescriptions.
Talking about methamphetamine as a different molecule is not helpful, as Adderall itself is not a single molecule.
Which I suspect you know, as you mention different enantiomers of thalidomide. However you don't point out that adderall itself is a 3:1 racemic mixture of l and d amphetamine.
The real discussion here is the receptor binding affinity of the various targets of the drugs, and how they compare.
There's a whole section, "Single-Isomer Versus Racemic Formulation", in this recent review article titled "Novel Formulations of ADHD Medications: Stimulant Selection and Management"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412159/
There's no way. I snorted a bump of approximately 50mg, at the most, off of my hand and was completely jacked for 48 hours. It was the most uncomfortable speedy high I've ever experienced. I drank an entire case of beer trying to come down and it did almost nothing. I've gone through a gram of coke in a night, snorted and/or smoked, and it was nothing compared to meth. I'm on 30mg Adderall daily and I can sleep just fine.
I remember thinking "Why would anyone want to feel like this?" Will never touch the stuff again.
For some reason the community refuses to apply a high of research and rigor to this topic, as if it's lesser than the non-sense we call computer science.
This entire debate is comical, the medical community's approach has been, by it's own admission, to throw various stimulants at ADHD. Methylphenidate, L-Amphetamine, D-Amphetamine, Lisdexamfetamine, etc.
By in large, everyone on this thread is pretending like there is a treasure trove of research demonstrating the superiority of Adderall (a racemic mixture of L & D amphetamine) to Methylamphetamine.
And that's just not true at all, there is a paucity of research on the subject. Meth = Bad because of the Germans and street drug users (who smoke an uncontrolled amount).