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Adderall is not an identity Wanting a drug isn't the same as needing it

Even Family Guy has a prescription (FOX Image Collection via Getty Images)

Even Family Guy has a prescription (FOX Image Collection via Getty Images)


April 3, 2023   6 mins

It’s 2am here in Pittsburgh, Pennsylvania, and I’ve just finished writing 7,500 words of corporate marketing copy. I then turn my attention to this piece. But my attention is glitching. So I do something I haven’t done since I took the Pennsylvania bar examination in 2007: I take one of my wife’s bright orange 20 milligram Adderall pills. My jumbled thoughts settle and everything, as the Scientologists might say, goes “clear”.

Neither my wife nor I use Adderall with any regularity. A 60-count “break-in-case-of-emergency” supply might last the Bateman family ‘til death do us part. But the same cannot be said for millions of others who are reliant on the drug: since last August, the world has experienced a shortage of Adderall. This is probably tied to manufacturing and supply chain issues combined with rapidly increasing demand — though nobody knows for sure. It has had a particularly acute effect on the US. A high-income country of 330 million people is bound to have an outsized impact on world affairs. But the numbers related to Adderall beggar belief. America consumes 80% of the drug’s global supply. Back in 2013, there were 18 million Adderall prescriptions in circulation in the United States — a number that exploded to 41.4 million in 2021.

These statistics can be partly explained by another equally astonishing set, relating to the condition for which Adderall is prescribed. According to the US Centers for Disease Control and Prevention, 6.3% of US children aged 5-9 have ADHD, compared to 1.5% of UK children aged between 6-8. Some attribute that to differences in diagnostic principles. The criteria used in the US are considerably more detailed, allowing for diagnosis only if at least five symptoms are present, whereas the globally-accepted standard gives more leeway to the clinician, only stating that symptoms should be “sufficient in number” and cause “significant psychological, social, educational or occupational impairment”.

When I asked one therapist why this leads to a much higher number of ADHD diagnoses in the US — rather than the opposite — she pointed to the laws governing education. Here, the Individuals with Disabilities Education Act mandates that schools provide special education services and accommodations to students with ADHD, while in the UK, there’s no specific legislation for ADHD, and schools have more flexibility to support students with diverse learning needs without a formal diagnosis. American doctors know that parents and students need this diagnosis for paperwork purposes, so they, to borrow a line from Jean-Luc Picard, “make it so”.

In other words, an ADHD diagnosis opens a lot of doors in the US. If you know what to say, it’s not hard to get Adderall. And there are plenty of reasons to want Adderall. It significantly improves cognitive function, increases wakefulness, and enhances mood — temporarily turning poor learners into decent ones, and good ones into rock stars. Longer-lasting than other ADHD drugs like Ritalin, Adderall offers that intense “clear” feeling I mentioned, resulting in higher levels of focus, attention, and motivation.

These stimulants can improve, among other things, performance on various standardised tests that (at least for now) still have an outsized impact on admission to the most prestigious academic programmes. Unsurprisingly, there’s plenty of evidence that rich parents and their kids are working with willing doctors to secure easy access to Adderall, and other so-called “smart drugs”. A 2016 study found that 10.7% of high school students who had used Adderall in the past year had obtained it from a doctor. Meanwhile, 13.2% had obtained it from a friend or family member, indicating that these drugs circulate widely in certain academic and social circles — a fact many of us may know all too well.

I’ve watched a number of friends and relatives game the system to receive legal prescriptions for ADHD, visiting physicians and uttering the magic words needed to meet diagnostic criteria. Their motivations varied: one cousin likes to be “amped up” on stimulants at all hours of the day, while a friend from college uses it to improve his performance as an esports athlete. And I’m willing to admit that the drug has benefited me in small and very infrequent doses. But there are obvious ethical concerns here. Adderall, like Ozempic (for weight loss) or testosterone (for muscle building), gives some people an unfair advantage over others.

The US Drug Enforcement Administration acted last month to rein in what some now consider a “Wild West” environment. Adderall prescriptions in the US rose 16% during the pandemic, with telehealth appointments a main driver. The DEA’s proposed rule would require at least one in-person visit to the physician prescribing controlled substances such as Adderall. But it faces stiff resistance from clinicians and users, who argue that remote consultations increased access to life-changing medications. People whose lives and identities are tied up in ADHD have been lamenting that their condition, defined by an inability to focus without Adderall, becomes doubly hellish when they’re required to actually go somewhere to get prescriptions filled; the complaint of one legal aid attorney, representative of thousands of others, was that the “nationwide adderall shortage means I skipped my doses this weekend and fucking fought for my life to do the dishes”.

And yet, the rate at which Adderall is prescribed in the US must mean that the majority of diagnosed cases of ADHD are not life-destroying, merely life-affecting. Moreover, even long-tenured experts on ADHD, including Remembering Ritalin author Lawrence Diller, have serious qualms about the “realness” of the “disease”. In his book, Diller reflects on the various young patients — “Generation Rx”, he calls them — with whom he worked during the Eighties and Nineties, probing the extent to which ADHD is a legitimate diagnosis or an oversimplified, harmful label that could be applied to anyone in certain conditions. “For patients, if ADHD truly exists, risking their health by taking a drug to treat the condition or disease makes a lot more sense
 [but] if it doesn’t exist, then perhaps they’re just using it as a crutch
 and setting themselves up to abuse it,” he writes. Adderall, like other stimulants, presents numerous dangers: side effects that run the gamut from high blood pressure, increased heart rate, panic attacks, psychosis, agitation and irritability. And of course, there’s the horrific feeling of crashing when one doesn’t have regular access to the stimulant.

Diller’s concerns are echoed by my neurologist acquaintance. ADHD, like most diseases of the mind, are “all in one’s head”: the symptoms are not verifiable by any methods beyond the claims of the patient. Physicians have a duty to take these claims seriously, but it’s difficult to gauge the roots of a symptom from the outside. Is lack of concentration, far from being a “disease”, merely a sign that someone is a poor student — a sad but unavoidable fact of life that one must confront in the ordinary course of existence? And if so, would liberally prescribing this now-scarce drug be the ethical thing to do? Or would that be unfair on those who use Adderall to get through the day, rather than excel?

These are loaded questions, but important ones. In response to the Adderall crisis, the media has pumped out nuts-and-bolts policy proposals. A recent New York Times column, for instance, argued for maintaining full telehealth physician availability and boosting Adderall production by shifting regulation and oversight from the DEA — which is primarily interested in drug interdiction — to the FDA — which is more concerned with drug safety and access. There is certainly much to recommend such arguments. The libertarian, “government is the problem” side of me favours wide latitude with regard to drug access, but that doesn’t acknowledge the core cultural questions fuelling all of this feverish pill-popping.

It’s hardly surprising that increasing numbers of people are struggling to concentrate. We are bombarded with stimuli, which naturally leads to difficulty focusing and increased impulsivity in day-to-day life — symptoms of ADHD — and the subsequent prescription of Adderall. If assigned, a diagnosis can become a core plank in an individual’s sense of self; as Freddie deBoer has written for UnHerd, our very online culture encourages people to turn diagnoses into identities. Viewed this way, Adderall’s is a toxic, “ouroborotic” cycle of consumption — the culture fosters the behaviours that result in an ADHD diagnosis, Big Pharma sells you the medication needed to address it, and the various social media platforms that monetise your freely-provided content offer you space to earn attention by #ShoutingYourStigma.

Are you your disease — as a young influencer might proclaim on TikTok — and therefore entitled to Adderall access as some sort of fundamental human right? By extension, is someone who has the attention span of a feral cat that’s locked onto its prey not entitled to this “smart drug”? Or should everyone have access to Adderall, since it’s a tool that might encourage further human flourishing, before we’re forced to insert neural implants and merge with AI? Or should no one, since our “human essence” is sacred and must remain unsullied by chemical interventions?

These are the questions we will need to answer. But for now, all we can be sure of is that fewer people will get Adderall, particularly cheaper generic-brand Adderall, than want it. Those that do will probably be the richest — who may use it to get richer — rather than those who most need it. We can only hope that these dynamics will encourage us to reflect on whether wanting and needing, like our illness and our selves, are inextricably linked, or merely connected because “thinking makes it so”.


Oliver Bateman is a historian and journalist based in Pittsburgh. He blogs, vlogs, and podcasts at his Substack, Oliver Bateman Does the Work

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Andrew Buckley
Andrew Buckley
1 year ago

Just follow the money!
Pharmaceutical Companies need to maximise the patient cohort to cover development costs and then to make a profit. Stretching the diagnosis as wide as possible is the easiest way to achieve this.
ADHD and drugs sold to treat this is only one of many examples. When does sadness become depression? As soon as possible to get those prescriptions written! Remember the craze for anxiolytics (Valium et al)? Same thing, life a bit hard work at the moment? Here; pop a pill.
From the medical viewpoint anything that can be given to reduce face to face time is good for both workflow and income.

Retanot King
Retanot King
1 year ago
Reply to  Andrew Buckley

This is incorrect. Clearly you have not suffered from depression or ADHD to put this to profit making.
Sadness becomes depression when you lose interest in all things.
A business needs to make profit, or it will go under and cease to exist. So I don’t know why you think profit making is unbecoming. How will you pay the cost of capital, the cost of risk, or pay for the value created by the company for knowhow and technology advances. These are all achieved by profit.

Last edited 1 year ago by Retanot King
Retanot King
Retanot King
1 year ago
Reply to  Andrew Buckley

This is incorrect. Clearly you have not suffered from depression or ADHD to put this to profit making.
Sadness becomes depression when you lose interest in all things.
A business needs to make profit, or it will go under and cease to exist. So I don’t know why you think profit making is unbecoming. How will you pay the cost of capital, the cost of risk, or pay for the value created by the company for knowhow and technology advances. These are all achieved by profit.

Last edited 1 year ago by Retanot King
Andrew Buckley
Andrew Buckley
1 year ago

Just follow the money!
Pharmaceutical Companies need to maximise the patient cohort to cover development costs and then to make a profit. Stretching the diagnosis as wide as possible is the easiest way to achieve this.
ADHD and drugs sold to treat this is only one of many examples. When does sadness become depression? As soon as possible to get those prescriptions written! Remember the craze for anxiolytics (Valium et al)? Same thing, life a bit hard work at the moment? Here; pop a pill.
From the medical viewpoint anything that can be given to reduce face to face time is good for both workflow and income.

Simon Blanchard
Simon Blanchard
1 year ago

Very interesting. I admit I was entirely ignorant about this issue apart from noticing an explosion in ADHD related posts in my Instagram feed. I’d begun to suspect that the algorithm had diagnosed me. This (according to my internal logic) explained my use of amphetamine sulphate as younger man. Who knows? But I deleted Instagram. On Adderall; dollars to doughnuts the author is underreporting how often he takes this performance enhancer.

Brendan O'Leary
Brendan O'Leary
1 year ago

Snap with the sudden increase in ADHD posts.
Also the anger and indignation when I queried the delf-diagnosis and even mocked it.

Retanot King
Retanot King
1 year ago

Nothing should be socially wrong with ADHD. It just means your mind wants to do more interesting and more difficult things, and gets bored with the easy and routine stuff. Maybe it is a sign of intelligence?

Alan Bright
Alan Bright
1 year ago
Reply to  Retanot King

Or perhaps that is simply the human condition: getting bored with easy and routine stuff.

Persephone
Persephone
1 year ago
Reply to  Retanot King

Uh nope. ADHD isn’t a sign of intelligence (or stupidity for that matter), it’s independent of intelligence. People debate what is at the root of ADHD but the diagnostic criteria are fairly clear and unambiguous, and they are about having difficulty organizing your thoughts, concentrating on things that don’t interest you very much, executive functioning, and switching from one task to another. Your mind doesn’t “want to do more interesting and difficult things” so much as wanting to fly around in all different directions in a random way that makes it difficult to do anything at all. The question to ask is why is your brain inclined to do that, and what is the best thing for you personally to do about it.
Medication can be part of the answer for some people, but there are a lot of other alternative treatment options as well, options that are safer, but that big pharma can’t make any profit from. Don’t forget that none of the ADHD drugs are licensed for use in adults, or even for long term use in children, and that’s because there are serious concerns about their safety for long term use.
It may not be “unbecoming” for big pharma to make a profit, but I personally think it’s pretty “unbecoming” of them to ensure that they make that profit by suppressing safer, equally effective alternatives to their profit-making medications.

Alan Bright
Alan Bright
1 year ago
Reply to  Retanot King

Or perhaps that is simply the human condition: getting bored with easy and routine stuff.

Persephone
Persephone
1 year ago
Reply to  Retanot King

Uh nope. ADHD isn’t a sign of intelligence (or stupidity for that matter), it’s independent of intelligence. People debate what is at the root of ADHD but the diagnostic criteria are fairly clear and unambiguous, and they are about having difficulty organizing your thoughts, concentrating on things that don’t interest you very much, executive functioning, and switching from one task to another. Your mind doesn’t “want to do more interesting and difficult things” so much as wanting to fly around in all different directions in a random way that makes it difficult to do anything at all. The question to ask is why is your brain inclined to do that, and what is the best thing for you personally to do about it.
Medication can be part of the answer for some people, but there are a lot of other alternative treatment options as well, options that are safer, but that big pharma can’t make any profit from. Don’t forget that none of the ADHD drugs are licensed for use in adults, or even for long term use in children, and that’s because there are serious concerns about their safety for long term use.
It may not be “unbecoming” for big pharma to make a profit, but I personally think it’s pretty “unbecoming” of them to ensure that they make that profit by suppressing safer, equally effective alternatives to their profit-making medications.

Persephone
Persephone
1 year ago

Yup. Oliver Bateman needs to stop abusing his wife’s medication and if he can’t concentrate late at night go to bed. Just because he is abusing drugs that he is not legitimately entitled to doesn’t mean that this is a problem for the rest of the world. And just because he doesn’t need this drug that he is abusing doesn’t mean that no one else does. Just because he doesn’t have ADHD doesn’t mean that no one else does.
However, Oliver abusing his wives’ medications seems like a different issue from a whole lot of people self-diagnosing themselves with ADHD over the internet, getting a prescription somehow that they may or may not need, and then making it part of their identity. I would not be at all surprised if that was happening, because internet contagion seems to be a really big problem with a whole host of mental illnesses that used to be super rare. Tourette’s, cutting, multiple personality disorder, and identifying as trans and or non-binary have all had internet epidemics attached to them, so why would ADHD be spared, especially when it has a popular drug of abuse attached to it.

Brendan O'Leary
Brendan O'Leary
1 year ago

Snap with the sudden increase in ADHD posts.
Also the anger and indignation when I queried the delf-diagnosis and even mocked it.

Retanot King
Retanot King
1 year ago

Nothing should be socially wrong with ADHD. It just means your mind wants to do more interesting and more difficult things, and gets bored with the easy and routine stuff. Maybe it is a sign of intelligence?

Persephone
Persephone
1 year ago

Yup. Oliver Bateman needs to stop abusing his wife’s medication and if he can’t concentrate late at night go to bed. Just because he is abusing drugs that he is not legitimately entitled to doesn’t mean that this is a problem for the rest of the world. And just because he doesn’t need this drug that he is abusing doesn’t mean that no one else does. Just because he doesn’t have ADHD doesn’t mean that no one else does.
However, Oliver abusing his wives’ medications seems like a different issue from a whole lot of people self-diagnosing themselves with ADHD over the internet, getting a prescription somehow that they may or may not need, and then making it part of their identity. I would not be at all surprised if that was happening, because internet contagion seems to be a really big problem with a whole host of mental illnesses that used to be super rare. Tourette’s, cutting, multiple personality disorder, and identifying as trans and or non-binary have all had internet epidemics attached to them, so why would ADHD be spared, especially when it has a popular drug of abuse attached to it.

Simon Blanchard
Simon Blanchard
1 year ago

Very interesting. I admit I was entirely ignorant about this issue apart from noticing an explosion in ADHD related posts in my Instagram feed. I’d begun to suspect that the algorithm had diagnosed me. This (according to my internal logic) explained my use of amphetamine sulphate as younger man. Who knows? But I deleted Instagram. On Adderall; dollars to doughnuts the author is underreporting how often he takes this performance enhancer.

Sam Brown
Sam Brown
1 year ago

Amphetamines are Class A drugs. I am amazed they are dolled out so freely!

Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Sam Brown

The economy likes uppers. If people were super-productive on opioids you can bet we’d be offering free starter prescriptions to every high-schooler in the nation.

John Noonan
John Noonan
1 year ago
Reply to  Nona Yubiz

We have turned doctors into drug dealers. It seems that a lot of kids get prescriptions to this because their personality is being treated. If some classes are boring kids aren’t going to pay attention and then they get diagnosed with a disease. The saddest part is that we are essentially allowing doctors to legally prescribe a legalized drug that is not dissimilar to meth.
I would like the stats regarding how many school shooters are on this or other over prescribed drugs that impact the mind. The rising rates of these shootings definitely correlates with the prescription number increases.

Last edited 1 year ago by John Noonan
John Noonan
John Noonan
1 year ago
Reply to  Nona Yubiz

We have turned doctors into drug dealers. It seems that a lot of kids get prescriptions to this because their personality is being treated. If some classes are boring kids aren’t going to pay attention and then they get diagnosed with a disease. The saddest part is that we are essentially allowing doctors to legally prescribe a legalized drug that is not dissimilar to meth.
I would like the stats regarding how many school shooters are on this or other over prescribed drugs that impact the mind. The rising rates of these shootings definitely correlates with the prescription number increases.

Last edited 1 year ago by John Noonan
Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Sam Brown

The economy likes uppers. If people were super-productive on opioids you can bet we’d be offering free starter prescriptions to every high-schooler in the nation.

Sam Brown
Sam Brown
1 year ago

Amphetamines are Class A drugs. I am amazed they are dolled out so freely!

Warren Trees
Warren Trees
1 year ago

Is it any wonder that many people need drugs just to keep up today? The sheer volume of information we are processing, ever since social media became widespread, is astounding. And after writing a 7500 word piece for work at 2:00 AM, who wouldn’t be a little “glitchy”? Insomnia is also a growing problem for many. Thank goodness we have pills to help us cope with so many problems today, but taking a pill to work, another pill to fall asleep and many, many more to solve any number of alleged “maladies” sounds like a pharma induced dystopia.

Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Warren Trees

It doesn’t “sound” like that: it IS that.

Eugene Shults
Eugene Shults
1 year ago
Reply to  Warren Trees

Those few extra moments of misery probably are worth avoiding shaving 10 to 20 years from your lifespan.
I have that same problem but without stimulants. Spent from 10 PM to 3:30 AM last night diving into a potential solution to something at work. Had to force myself to bed.

Last edited 1 year ago by Eugene Shults
Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Warren Trees

It doesn’t “sound” like that: it IS that.

Eugene Shults
Eugene Shults
1 year ago
Reply to  Warren Trees

Those few extra moments of misery probably are worth avoiding shaving 10 to 20 years from your lifespan.
I have that same problem but without stimulants. Spent from 10 PM to 3:30 AM last night diving into a potential solution to something at work. Had to force myself to bed.

Last edited 1 year ago by Eugene Shults
Warren Trees
Warren Trees
1 year ago

Is it any wonder that many people need drugs just to keep up today? The sheer volume of information we are processing, ever since social media became widespread, is astounding. And after writing a 7500 word piece for work at 2:00 AM, who wouldn’t be a little “glitchy”? Insomnia is also a growing problem for many. Thank goodness we have pills to help us cope with so many problems today, but taking a pill to work, another pill to fall asleep and many, many more to solve any number of alleged “maladies” sounds like a pharma induced dystopia.

Sandeep Karthikeyan
Sandeep Karthikeyan
1 year ago

Well, I would not have been able to finish reading this article, let alone comment, without my ADHD medication, Vyvanse (similar to Adderall). And to be fair and honest, ADHD is much much much more than just the inability to pay attention to everyday normal things in life. It affects multiple areas of one’s functionality ranging from money management, driving, memory, learning, social relationships, substance use, and so on and on. Untreated ADHD can cripple one’s life, and a lot of evidence points out that ADHDers, on average, have shorter lifespans. And in general, there is a higher rate of underdiagnosis of ADHD, particularly among women. I don’t know how to prevent the abuse and misdiagnosis, but that is a lesser concern than how miserably ADHDers’ lives can fall apart without proper ADHD treatment. Yes, there are cardiovascular side effects of stimulant medications. However, the increased heart rate and blood pressure are clinically non-significant. ADHD is too complex a phenomenon to write a commentary article like this.

William Edward Henry Appleby
William Edward Henry Appleby
1 year ago

But you highlight the issue precisely: ADHD is not just the inability to pay attention. But this doesn’t seem to get in the way of a diagnosis. I happen to believe that autism (which is much more than the inability to be social, and sometimes appear to be a bit “nerdy”), is also overdiagnosed. There also seems to be a gender agenda which wants to diagnose more females as autistic, probably because someone things they’re being denied the opportunity to display those few traits that are considered useful about autism, in some cases.

Last edited 1 year ago by William Edward Henry Appleby
Retanot King
Retanot King
1 year ago

Yes, there is a lot of misconception and misplaced stigma by the public regarding depression and ADHD. Depression is reduced to sadness and ADHD is reduced to inattention. No wonder a great part of the population are never diagnosed and continue to suffer.

Persephone
Persephone
1 year ago

The “gender agenda” with autism is that it is being missed in women and girls because women and girls with autism tend to be a lot better at masking than boys and men (due to the way we socialize females vs males in our society), and because the diagnostic criteria are written to privilege male autism (for example male vs female ways of expressing that obsessive interest).
What ends up happening to these undiagnosed autistic girls is that they don’t get the benefit of early treatment, and their efforts at masking lead to developing lots of other secondary mental illnesses which don’t respond very well to treatment because the underlying autism isn’t being attended to. This leads to a lot of unnecessary suffering.

Retanot King
Retanot King
1 year ago

Yes, there is a lot of misconception and misplaced stigma by the public regarding depression and ADHD. Depression is reduced to sadness and ADHD is reduced to inattention. No wonder a great part of the population are never diagnosed and continue to suffer.

Persephone
Persephone
1 year ago

The “gender agenda” with autism is that it is being missed in women and girls because women and girls with autism tend to be a lot better at masking than boys and men (due to the way we socialize females vs males in our society), and because the diagnostic criteria are written to privilege male autism (for example male vs female ways of expressing that obsessive interest).
What ends up happening to these undiagnosed autistic girls is that they don’t get the benefit of early treatment, and their efforts at masking lead to developing lots of other secondary mental illnesses which don’t respond very well to treatment because the underlying autism isn’t being attended to. This leads to a lot of unnecessary suffering.

Retanot King
Retanot King
1 year ago

@Sandeep — very well said. That is exactly my feeling about this article that takes a very negative turn on this serious matter, and is only interested in second or third order matters of less important or significance. The first order matter of the real sufferers who go undiagnosed is not even mentioned.
It is easy for those with good mental health not to understand this debilitating condition.

Last edited 1 year ago by Retanot King
William Edward Henry Appleby
William Edward Henry Appleby
1 year ago

But you highlight the issue precisely: ADHD is not just the inability to pay attention. But this doesn’t seem to get in the way of a diagnosis. I happen to believe that autism (which is much more than the inability to be social, and sometimes appear to be a bit “nerdy”), is also overdiagnosed. There also seems to be a gender agenda which wants to diagnose more females as autistic, probably because someone things they’re being denied the opportunity to display those few traits that are considered useful about autism, in some cases.

Last edited 1 year ago by William Edward Henry Appleby
Retanot King
Retanot King
1 year ago

@Sandeep — very well said. That is exactly my feeling about this article that takes a very negative turn on this serious matter, and is only interested in second or third order matters of less important or significance. The first order matter of the real sufferers who go undiagnosed is not even mentioned.
It is easy for those with good mental health not to understand this debilitating condition.

Last edited 1 year ago by Retanot King
Sandeep Karthikeyan
Sandeep Karthikeyan
1 year ago

Well, I would not have been able to finish reading this article, let alone comment, without my ADHD medication, Vyvanse (similar to Adderall). And to be fair and honest, ADHD is much much much more than just the inability to pay attention to everyday normal things in life. It affects multiple areas of one’s functionality ranging from money management, driving, memory, learning, social relationships, substance use, and so on and on. Untreated ADHD can cripple one’s life, and a lot of evidence points out that ADHDers, on average, have shorter lifespans. And in general, there is a higher rate of underdiagnosis of ADHD, particularly among women. I don’t know how to prevent the abuse and misdiagnosis, but that is a lesser concern than how miserably ADHDers’ lives can fall apart without proper ADHD treatment. Yes, there are cardiovascular side effects of stimulant medications. However, the increased heart rate and blood pressure are clinically non-significant. ADHD is too complex a phenomenon to write a commentary article like this.

David Pogge
David Pogge
1 year ago

I have been conducting clinical assessments of children and adolescents for 35+ years. There are reliable, well validated, and objective ways to measure attention and other mental processes and determine (a) if a person’s attention is significantly worse than expected for their age group, (b) if it is significantly worse than their other mental abilities, (c) if there is evidence of anything else that might explain poor attention (e.g., depression, anxiety, psychosis, etc.), and (d) if their attentional problem is likely to be longstanding and developmental rather than the result of some insult or illness. The tests for these things are very well validated, they are readily available, and they provide an objective basis for determining if someone has a significant attentional problem that cannot otherwise be explained (i.e., ADHD). Unfortunately, those who prescribe stimulants rarely bother to seek such an assessment, and often put people on stimulants who either have no real attention problem or whose attention problem is secondary to another cause and would be better addressed in some other fashion. Too often the so-called ADHD that leads to the prescription is nothing more than the disease of ‘being a little boy’. Until practitioners resolve to use sound methods to diagnose this condition and teachers and parents find ways to raise male children that do not involve chemical manipulation the casual diagnosis of “ADHD” and the promiscuous prescription of stimulants will continue – with all of the attendant harms.

Roddy Campbell
Roddy Campbell
1 year ago
Reply to  David Pogge

What an interesting bunch of tests. Are they available/accessible on the net?

Retanot King
Retanot King
1 year ago
Reply to  David Pogge

It is very difficult for someone not hit by depression or ADHD to feel the devastation that these conditions can bring. And they can strike at any age. The general public has very little idea what adult ADHD is, for example.

Roddy Campbell
Roddy Campbell
1 year ago
Reply to  David Pogge

What an interesting bunch of tests. Are they available/accessible on the net?

Retanot King
Retanot King
1 year ago
Reply to  David Pogge

It is very difficult for someone not hit by depression or ADHD to feel the devastation that these conditions can bring. And they can strike at any age. The general public has very little idea what adult ADHD is, for example.

David Pogge
David Pogge
1 year ago

I have been conducting clinical assessments of children and adolescents for 35+ years. There are reliable, well validated, and objective ways to measure attention and other mental processes and determine (a) if a person’s attention is significantly worse than expected for their age group, (b) if it is significantly worse than their other mental abilities, (c) if there is evidence of anything else that might explain poor attention (e.g., depression, anxiety, psychosis, etc.), and (d) if their attentional problem is likely to be longstanding and developmental rather than the result of some insult or illness. The tests for these things are very well validated, they are readily available, and they provide an objective basis for determining if someone has a significant attentional problem that cannot otherwise be explained (i.e., ADHD). Unfortunately, those who prescribe stimulants rarely bother to seek such an assessment, and often put people on stimulants who either have no real attention problem or whose attention problem is secondary to another cause and would be better addressed in some other fashion. Too often the so-called ADHD that leads to the prescription is nothing more than the disease of ‘being a little boy’. Until practitioners resolve to use sound methods to diagnose this condition and teachers and parents find ways to raise male children that do not involve chemical manipulation the casual diagnosis of “ADHD” and the promiscuous prescription of stimulants will continue – with all of the attendant harms.

Cathy Carron
Cathy Carron
1 year ago

What is not widely advertised about Adderall is that it plays on the cardiovascular system and can bring on impotency. I found that out after my daughter broke up with a really, really nice guy. I was baffled until she revealed somewhat later what the issue was – they say impotency ‘subsides’ after awhile, but not for everyone- about 30% of takers experience some level of this malady; He has been taking the drug since high school, into college and he’s now in his 30’s
..no need to get into more anecdotal details, but I was shocked that this is not more widely known and discussed as a long term consequence of taking this drug. If I were a parent and understood this I would climb mountains to find another cure. So yes, it can change life dramatically for some.
I wonder if Adderall and VIAGRA sales correlate over time?

Last edited 1 year ago by Cathy Carron
Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Cathy Carron

Why should Adderall be any different than anything else? Doctors will sell you surgery, drugs–whatever–and unless you do your due diligence and research you will not learn about long-term consequences, side effects, etc. With rare exceptions.

Eugene Shults
Eugene Shults
1 year ago
Reply to  Cathy Carron

Probably more likely due to excessive porn consumption, imo.

Last edited 1 year ago by Eugene Shults
Retanot King
Retanot King
1 year ago
Reply to  Cathy Carron

There are also a lot of side benefits to Adderall. Such as non-brain neurological enhancement.

Nona Yubiz
Nona Yubiz
1 year ago
Reply to  Cathy Carron

Why should Adderall be any different than anything else? Doctors will sell you surgery, drugs–whatever–and unless you do your due diligence and research you will not learn about long-term consequences, side effects, etc. With rare exceptions.

Eugene Shults
Eugene Shults
1 year ago
Reply to  Cathy Carron

Probably more likely due to excessive porn consumption, imo.

Last edited 1 year ago by Eugene Shults
Retanot King
Retanot King
1 year ago
Reply to  Cathy Carron

There are also a lot of side benefits to Adderall. Such as non-brain neurological enhancement.

Cathy Carron
Cathy Carron
1 year ago

What is not widely advertised about Adderall is that it plays on the cardiovascular system and can bring on impotency. I found that out after my daughter broke up with a really, really nice guy. I was baffled until she revealed somewhat later what the issue was – they say impotency ‘subsides’ after awhile, but not for everyone- about 30% of takers experience some level of this malady; He has been taking the drug since high school, into college and he’s now in his 30’s
..no need to get into more anecdotal details, but I was shocked that this is not more widely known and discussed as a long term consequence of taking this drug. If I were a parent and understood this I would climb mountains to find another cure. So yes, it can change life dramatically for some.
I wonder if Adderall and VIAGRA sales correlate over time?

Last edited 1 year ago by Cathy Carron
Chris Wagner
Chris Wagner
1 year ago

I highly doubt that anyone “needs” Adderall; it sounds like your opening vignette of “aw shucks, sometimes I just *need* Adderall because I work so darn hard” could have been solved with better time management skills. You were merely rationalizing getting your fix.

It’s not really that shocking that Big Pharma companies have created diseases simply to sell medication for it.

What’s shocking is how many people fall for it.

Retanot King
Retanot King
1 year ago
Reply to  Chris Wagner

More conspiracy theory?
There are people who actually suffer from depression and ADHD, and it is not a joke. I am happy to hear that you are mentally so healthy. Consider being blessed.

Retanot King
Retanot King
1 year ago
Reply to  Chris Wagner

More conspiracy theory?
There are people who actually suffer from depression and ADHD, and it is not a joke. I am happy to hear that you are mentally so healthy. Consider being blessed.

Chris Wagner
Chris Wagner
1 year ago

I highly doubt that anyone “needs” Adderall; it sounds like your opening vignette of “aw shucks, sometimes I just *need* Adderall because I work so darn hard” could have been solved with better time management skills. You were merely rationalizing getting your fix.

It’s not really that shocking that Big Pharma companies have created diseases simply to sell medication for it.

What’s shocking is how many people fall for it.

Allison Barrows
Allison Barrows
1 year ago

That first paragraph is a doozy: how much of my resume can I brag about in the fewest number of words?

MĂŽnica
MĂŽnica
1 year ago

Think so? As someone who works in the field, I would say that’s very run-of-the-mill free-lance work.

MĂŽnica
MĂŽnica
1 year ago

Think so? As someone who works in the field, I would say that’s very run-of-the-mill free-lance work.

Allison Barrows
Allison Barrows
1 year ago

That first paragraph is a doozy: how much of my resume can I brag about in the fewest number of words?

laurence scaduto
laurence scaduto
1 year ago

Wait. Hold on. So you mean that all those (younger) people who used to brag about their ability to “multi-task”, all the ones that used to look at me like I had a third eye when I said “Yeah. No. I don’t do that.”; the ones wandering around the city staring at their phones (probably playing some stupid game; Sim Torture Chamber or Bupkis Ballet) – you honestly mean to tell me that now they’re complaining about focus problems?

Retanot King
Retanot King
1 year ago

Video gaming will almost certainly result in ADHD.

Persephone
Persephone
1 year ago
Reply to  Retanot King

100% I have ADHD, and I find my concentration is vastly vastly better if I don’t allow myself to play video games until AFTER I have finished my work for the day. (I also structure my time and take medicinal saffron, and Rhodella). I personally wouldn’t go near any of the commercial ADHD meds, because they haven’t been tested for long term safety in children, or at all in adults and they’ve been linked to early development of dementia, and studies have found that a high dose of good quality saffron works just as well.

Simon Blanchard
Simon Blanchard
1 year ago
Reply to  Persephone

I was hoping you’d mention what some of the alternatives were – although of course I should google it. And I’ve wondered about getting a proper diagnosis and then thought, what’s the point? What would be the practical net benefit? I just accept that it’s likely I have it and cut myself some slack on being surrounded by grand projects, half finished. There’s more to it than that of course but I’ve already overshared!

Simon Blanchard
Simon Blanchard
1 year ago
Reply to  Persephone

I was hoping you’d mention what some of the alternatives were – although of course I should google it. And I’ve wondered about getting a proper diagnosis and then thought, what’s the point? What would be the practical net benefit? I just accept that it’s likely I have it and cut myself some slack on being surrounded by grand projects, half finished. There’s more to it than that of course but I’ve already overshared!

Persephone
Persephone
1 year ago
Reply to  Retanot King

100% I have ADHD, and I find my concentration is vastly vastly better if I don’t allow myself to play video games until AFTER I have finished my work for the day. (I also structure my time and take medicinal saffron, and Rhodella). I personally wouldn’t go near any of the commercial ADHD meds, because they haven’t been tested for long term safety in children, or at all in adults and they’ve been linked to early development of dementia, and studies have found that a high dose of good quality saffron works just as well.

Retanot King
Retanot King
1 year ago

Video gaming will almost certainly result in ADHD.

laurence scaduto
laurence scaduto
1 year ago

Wait. Hold on. So you mean that all those (younger) people who used to brag about their ability to “multi-task”, all the ones that used to look at me like I had a third eye when I said “Yeah. No. I don’t do that.”; the ones wandering around the city staring at their phones (probably playing some stupid game; Sim Torture Chamber or Bupkis Ballet) – you honestly mean to tell me that now they’re complaining about focus problems?

Matt Hindman
Matt Hindman
1 year ago

I remember the days when diagnosing little kids without a care to pump as many pharmaceuticals in them as possible was a thing. Scare the parents and fill the prescriptions. I have never understood what the big deal about Adderall is. I took that stupid little pill for years as a kid and it had literally no effect on me. Then I just said screw it and just said I would not take it anymore. I did not even get any entertaining withdrawal symptoms from going cold turkey. The only noticeable end result of this was siphoning money out of my parents wallets.

Last edited 1 year ago by Matt Hindman
Eugene Shults
Eugene Shults
1 year ago
Reply to  Matt Hindman

I took ritalin in grade school for a year or 2. I have no memories of any effect.

Last edited 1 year ago by Eugene Shults
Retanot King
Retanot King
1 year ago
Reply to  Matt Hindman

Adderall certainly has an impact on the person at 10mg dosage or above. Maybe you were taking a placebo?

Eugene Shults
Eugene Shults
1 year ago
Reply to  Matt Hindman

I took ritalin in grade school for a year or 2. I have no memories of any effect.

Last edited 1 year ago by Eugene Shults
Retanot King
Retanot King
1 year ago
Reply to  Matt Hindman

Adderall certainly has an impact on the person at 10mg dosage or above. Maybe you were taking a placebo?

Matt Hindman
Matt Hindman
1 year ago

I remember the days when diagnosing little kids without a care to pump as many pharmaceuticals in them as possible was a thing. Scare the parents and fill the prescriptions. I have never understood what the big deal about Adderall is. I took that stupid little pill for years as a kid and it had literally no effect on me. Then I just said screw it and just said I would not take it anymore. I did not even get any entertaining withdrawal symptoms from going cold turkey. The only noticeable end result of this was siphoning money out of my parents wallets.

Last edited 1 year ago by Matt Hindman
William Edward Henry Appleby
William Edward Henry Appleby
1 year ago

As the late Ken Robinson said (with heavy irony in case you don’t spot it) in one of his TED talks, about ADHD and the dancer/choreographer Gillian Lynne: “today she would have been diagnosed with ADHD, but back then it hadn’t been invented, so you didn’t know you could have that”

Last edited 1 year ago by William Edward Henry Appleby
Retanot King
Retanot King
1 year ago

That is why many adults are shocked to find out they have been diagnosed with ADHD. They always thought that it’s because of their own lazy ars.

Persephone
Persephone
1 year ago

If you read Pride and Prejudice by Jane Austen, there are a couple of characters who would definitely be diagnosed with ADHD today. (I’m looking at you Lydia and Mrs Bennett).
There are also some characters in Georgette Heyer’s novels (written from the 1920’s to late 1960’s) who obviously have ADHD by today’s standards.
What I’m trying to say is that even though diagnosing this as a mental illness and treating it is a new thing, the phenomena that we currently call ADHD clearly isn’t a new thing as there is evidence of it in novels written 200 years ago.

Last edited 1 year ago by Persephone
Retanot King
Retanot King
1 year ago

That is why many adults are shocked to find out they have been diagnosed with ADHD. They always thought that it’s because of their own lazy ars.

Persephone
Persephone
1 year ago

If you read Pride and Prejudice by Jane Austen, there are a couple of characters who would definitely be diagnosed with ADHD today. (I’m looking at you Lydia and Mrs Bennett).
There are also some characters in Georgette Heyer’s novels (written from the 1920’s to late 1960’s) who obviously have ADHD by today’s standards.
What I’m trying to say is that even though diagnosing this as a mental illness and treating it is a new thing, the phenomena that we currently call ADHD clearly isn’t a new thing as there is evidence of it in novels written 200 years ago.

Last edited 1 year ago by Persephone
William Edward Henry Appleby
William Edward Henry Appleby
1 year ago

As the late Ken Robinson said (with heavy irony in case you don’t spot it) in one of his TED talks, about ADHD and the dancer/choreographer Gillian Lynne: “today she would have been diagnosed with ADHD, but back then it hadn’t been invented, so you didn’t know you could have that”

Last edited 1 year ago by William Edward Henry Appleby
Retanot King
Retanot King
1 year ago

The author gives short shrift to the real and debilitating mental conditions of depression and ADHD. Both depression and ADHD can strike at any age, and are not just reserved for the young. Basically if you have lost interest in all things, and have not gained interest in other areas, that is a sign of clinical depression. If you find it almost impossible to perform routine, boring, uninteresting, even simple things that must be done, and you hit a wall, but at the same time you have a lot of interest in certain mental activities like reading, learning a field or solving a difficult or complex problem, then that is a sign of ADHD.

Retanot King
Retanot King
1 year ago

The author gives short shrift to the real and debilitating mental conditions of depression and ADHD. Both depression and ADHD can strike at any age, and are not just reserved for the young. Basically if you have lost interest in all things, and have not gained interest in other areas, that is a sign of clinical depression. If you find it almost impossible to perform routine, boring, uninteresting, even simple things that must be done, and you hit a wall, but at the same time you have a lot of interest in certain mental activities like reading, learning a field or solving a difficult or complex problem, then that is a sign of ADHD.

Retanot King
Retanot King
1 year ago

Author says: “Adderall. It significantly improves cognitive function, increases wakefulness, and enhances mood”.
This is somewhat inaccurate and only partially the case.
Adderall, an amphetamine stimulant has two functions. Increase the dopamine level in the brain, and also increase nor-epinephrine level in the brain to a lesser extent.
Dopamine gives you motivation and joy/interest in performing a task that is normally mentally difficult for you.
Nor-epinephrine is needed for focus and concentration. Without this, you can’t concentrate on difficult tasks, and the mind will wander to other more interesting tasks.
Adderall does not improve “cognitive function”, i.e. calculating, planning, thinking, problem solving. That is the job of another neurotransmitter, namely serotonin. SSRI is needed for that. SSRI is also effective against anxiety.  Lack of serotonin results in confusion.
Adderall is an NDRI. Although there are plethora of SSRI drugs, very few NDRI drugs are available.

Last edited 1 year ago by Retanot King
Retanot King
Retanot King
1 year ago

Author says: “Adderall. It significantly improves cognitive function, increases wakefulness, and enhances mood”.
This is somewhat inaccurate and only partially the case.
Adderall, an amphetamine stimulant has two functions. Increase the dopamine level in the brain, and also increase nor-epinephrine level in the brain to a lesser extent.
Dopamine gives you motivation and joy/interest in performing a task that is normally mentally difficult for you.
Nor-epinephrine is needed for focus and concentration. Without this, you can’t concentrate on difficult tasks, and the mind will wander to other more interesting tasks.
Adderall does not improve “cognitive function”, i.e. calculating, planning, thinking, problem solving. That is the job of another neurotransmitter, namely serotonin. SSRI is needed for that. SSRI is also effective against anxiety.  Lack of serotonin results in confusion.
Adderall is an NDRI. Although there are plethora of SSRI drugs, very few NDRI drugs are available.

Last edited 1 year ago by Retanot King