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ADHD drug treatment and risk of negative events and outcomes
241–250 of 537 posts
Re: ADHD drug treatment and risk of negative events and outcomes
#242The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle.…
Highly relevant reading, from a psychiatrist who prescribes ADHD meds: https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
TL;DR they believe the most responsible thing to do is to give everyone Adderall if they're seeking Adderall, with minimal gatekeeping, because the risk of not giving Adderall to someone who needs it far outweighs the concerns of giving Adderall to someone who doesn't need it.
Re: ADHD drug treatment and risk of negative events and outcomes
#243Canadian here. ADHD diagnosis is one of the few non-socialized parts of our medical system. Because of the abuse potential they charge a fairly steep fee (cad $3k+, with a $2k+ autism assessment addon) to even attempt diagnosis (after screening by your GP — referral required). The intake paperwork alone was perhaps 100 pages of online questionnaires that lead to interviews where they schedule counselling and evaluati…
Where in Canada? I had the complete opposite experience last winter in Ontario. I asked my doctor about ADHD, he had me fill two forms, set up an appointment with a psychologist, who after a couple weeks of appointments was ready to prescribe Atomoxetine (at my request since I wanted stimulants only as a last resort). I paid for nothing in this entire exchange, and the meds are usually covered by an extended drug pla…
Yeah, BC chiming in. Any physician can diagnosis you with ADHD. It’s free, as are all GP appointments.
There is nothing controversial or difficult about getting a diagnosis in this province. And the stimulant-class medications are easy to access and inexpensive if a generic option is available.
Re: ADHD drug treatment and risk of negative events and outcomes
#244My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.
Your hypothesis is contracted by mountains of high quality scientific evidence. ADHD is a well-defined condition and there is an accepted way of diagnosing someone with it that effectively divides those with the condition from those without it. Stimulant medications may help many people to feel and be more productive, but that does not imply that people who meet the criteria for ADHD do not represent an identifiable group.
I highly encourage you to browse the Consensus Statement on ADHD, referenced below. It’s a compilation of 202 facts about ADHD, accepted by a global consensus of experts on ADHD.
Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence‑based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022
Re: ADHD drug treatment and risk of negative events and outcomes
#245My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.
>My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) Of course they do. They're stimulants, that's what they do. Some people just need them to be closer to normal, or whatever's considered normal in post-Industrial society. Modafinil promotes wakefulness in everyone, not just narcolpetics. Anxiolytics calm down everyone, not just the anxious, and psilocy…
ADHD is a well-established, highly heritable neurodevelopmental disorder. Large-scale twin, genetic, neuroimaging, and longitudinal studies consistently show distinct brain, behavioral, and outcome differences compared to the general population. While we don’t yet understand every mechanism or subtype, the condition is robustly characterized and recognized by all major medical bodies. The World Federation of ADHD International Consensus Statement concludes: “ADHD is a genuine neurodevelopmental disorder with a well-documented genetic and neurobiological basis” and emphasizes that claims to the contrary are “contrary to scientific evidence and risk causing harm” [1].
Medical and psychological professionals are VERY confident that ADHD is a real condition—on par with the confidence they have in diagnoses like major depressive disorder or generalized anxiety disorder.
Across psychiatry, ADHD, depression, and anxiety are all among the best-documented psychiatric conditions. There is more skepticism about disorders with fuzzier boundaries (e.g., “personality disorders” or “internet addiction”), but ADHD is NOT in that category.
I believe ADHD is stigmatized in our culture because our modern world makes us all feel distracted at times; therefore, it seems like people with the diagnosis are perhaps getting a “free ride” by blaming their poor behavior on a “condition”. But ADHD is so much more than just having a hard time focusing because of social media and phones. It manifests as a spectrum of extreme challenges that lead over time to sufferers having a significantly harder time navigating life than people without ADHD.
Merely having a hard time concentrating does not make you an ADHD candidate. You must experience a range of symptoms that interfere materially in multiple areas of life.
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Reference
[1] Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., Rohde, L. A., Yang, L., Cortese, S., Almagor, D., Stein, M. A., Albatti, T. H., Aljoudi, H. F., Alqahtani, M. M. J., Asherson, P., … Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022
Re: ADHD drug treatment and risk of negative events and outcomes
#246Earlier quoted context omitted.
I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization. I was on various forms of prescribed amphetimines for years and developed paranoia. It took me a few years to somewhat recover. My family has PTSD about that period of my life. I can’t think or communicate well anymore. Fuck that industry.
> I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization. Funding info is at the bottom of the article, the project was primarily funded by the Swedish government.
Also in that section:
> LZ is supported by ìShizu Matsumuraîs Donation (2024-02228) and KI Research Grants (024-02570). LL was supported by the Swedish Heart-Lung Foundation (20230452), the Söderström König Foundation, and Fredrik och Ingrid Thurings Stiftelse. BD was supported by a grant from the American Foundation for Suicide Prevention (AFSP). SC, National Institute for Health and Care Research (NIHR) research professor (NIHR303122), is funded by the NIHR for this research project.
It may be none of them. It may be all of them. There could be corruption. There could be subtle manipulation. You have no idea how much money there is in the industry. They make things happen.
Some in the medical profession believe that these abused drugs are safe for their patients. Others know better but they still prescribe them. Some pharmacists will tell you that they’re good for your brain because they increase blood flow, because that’s what they’ve been sold by the reps and the studies they’re fed.
Re: ADHD drug treatment and risk of negative events and outcomes
#247Earlier quoted context omitted.
I literally did the thing you’re not supposed to do. my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her. Then I just told my psychiatrist that I have Adderall prescription and she took it over. For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Me…
The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…
> the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse.
I know that I process Adderall differently having ADHD, but I still struggle to see how it's used recreationally. I took it somewhat consistently for over a year for ADHD treatment until I missed an appointment and couldn't get around to scheduling another before my prescription ran out. After that getting back on became more trouble than it was worth. Not once did I ever feel a high from Adderall. My best naps were on Adderall. Not once after dropping it did I ever feel withdrawals or the urge to take more. The only thing I felt while taking it was constant dry mouth and my brain no longer constantly jumped between topics outside of my control.
My brother abuses controlled substances. When I told him I was taking Adderall he warned me to be careful and talked about his issues with it and I just couldn't relate at all. I'm no stranger to addiction. I'm an alcoholic and am addicted to nicotine via fruity vapes. But Adderall? Nothing at all.
Re: ADHD drug treatment and risk of negative events and outcomes
#248The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle.…
Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.
Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)
Re: ADHD drug treatment and risk of negative events and outcomes
#249Earlier quoted context omitted.
Oh yeah, and I didn’t even cover the problem of “I have eight pills left and want to go out of town for two weeks”. They will not let you refill scheduled substances ahead of time like that.
You gotta start skipping a day sometimes or taking 1/2 on some days. Then you'll accumulate a reserve.
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Re: ADHD drug treatment and risk of negative events and outcomes
#250Earlier quoted context omitted.
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> (which has no physical diagnosis criteria, just a subjective checklist), An ADHD diagnosis is not just subjective checklist. There's little regulation, but in order to get federal ADA accommodations in gradschool I had to get a diagnosis that took weeks. First I had a professional IQ exam which took 6 hours and highlighted that certain sub-scores were low indicative of ADHD, in particular working memory. Then there…
> Maybe it's just ableism or puritanical views against the idea of stimulants
It was very widely abused in my college days. There was also a (IMHO justified) concern over whether it was being over-prescribed as a way to deal with problematic behavior in children, rather than actually putting in the effort as a parent or medical professional to get to the root of the issue.
With that said, I do know people who genuinely have either ADD or ADHD, and who struggle to function without some form of pharmacological help in addition to therapy. Limiting their access to stop others from abusing it is unethical, whatever a cost/ benefit analysis might say.