
Adderall Addiction: The Last All-Nighter - jedwhite
http://opinionator.blogs.nytimes.com/2013/03/04/the-last-all-nighter/?hp
======
JohnBooty
The comments to this article mainly focus on the medical benefits and side
effects of Adderall.

I don't want a larger truth to get lost here...

While I've been prescribed Adderall for part of my adult life, and feel
Adderall has benefited me, I'd like to say that there's _far_ more to
successful ADHD treatment than medication:

    
    
      - Proper environment
      - Getting enough exercise
      - Getting enough sleep
      - Support and understanding from loved ones 
      - Strategies/systems that allow frictionless organization
    

While nobody here is explicitly characterizing it as such, please... nobody
fall into the common trap of thinking that successful ADHD treatment is just a
bunch of pill-popping.

(Unfortunately, many psychiatrists _do_ treat ADHD treatment as nothing but
pill-popping. Mine does. There's a good chance yours will. If you're seeking
ADHD treatment I'd urge you to do your own homework and read up on ADHD life
strategies and consider seeing a therapist in addition to a psychiatrist.
Whether or not you decide to go the medication route, those strategies will
really benefit you. Good luck!)

~~~
espeed
You're absolutely right.

John Ratey (<http://en.wikipedia.org/wiki/John_Ratey>), the professor of
psychiatry at Harvard Medical School who wrote _Driven to Distration_ ,
recently published a book called _Spark: The Revolutionary New Science of
Exercise and the Brain_ ([http://www.amazon.com/Spark-Revolutionary-Science-
Exercise-B...](http://www.amazon.com/Spark-Revolutionary-Science-Exercise-
Brain/dp/0316113506)).

 _Spark_ details how high-intensity cardio (like sprints or interval training)
put your brain chemicals in balance in part by generating BDNF
([http://en.wikipedia.org/wiki/Brain-
derived_neurotrophic_fact...](http://en.wikipedia.org/wiki/Brain-
derived_neurotrophic_factor)), which as Ratey describes, it's like "Miracle-
gro" for the brain.

Last year my stress levels were getting out of control from working too much.
At the time I was running at least two miles every day so it's not like I
wasn't exercising. But then one day I changed from running a couple miles to
running 50-yard sprints, as fast and as hard as I could push myself. The first
day I only ran four sprints, but I felt euphoric the rest of the day -- the
best I had felt in years. So I tried it again a couple days later, and sure
enough it worked again -- I felt amazing.

So then I had to find out why this worked -- why a few sprints were so much
more effective than running several miles. I started Googling and eventually
found Ratey's book -- it explains the entire biochemical process of what's
going on and why sprinting works.

It's an eye-opening read. Each chapter covers how high-intensity cardio
affects things like stress, anxiety, depression, ADHD. I have ADHD but haven't
taken anything for it in years (since I was in college), and I can attest that
sprints not only fixed by stress levels, but my ADHD symptoms were almost non
existent.

Here's a key point that Ratey makes throughout the book that completely
changed my perspective on things -- he says that instead of thinking of
exercise as something you should do to look good and build a healthy body, you
should instead think of exercise as the key to building a healthy brain:

"We all know that exercise makes us feel better, but most of us have no idea
why. We assume it’s because we’re burning off stress or reducing muscle
tension or boosting endorphins, and we leave it at that. But the real reason
we feel so good when we get our blood pumping is that it makes the brain
function at its best" (<http://www.sparkinglife.org>).

In the book's introduction he goes on to say, "Building muscles and
conditioning the heart and lungs are essentially side effects. I often tell my
patients that the point of exercise is to build and condition the brain."

In fact the brain exercise routine he recommends is similar to a weight
workout routine, in that you have to push yourself hard one day, and then take
a day off to let your brain recover, just like in weight training. Another key
is when you sprint, always put everything you have into it. Run as fast and as
hard as you can so you are constantly pushing your body and your brain past
their limitations -- this is the key to growth.

~~~
scott_s
Nitpick: "high intensity cardio" is kind of an oxymoron. "Cardio" is used to
mean training which mainly uses the aerobic system. That is, longer term,
lower intensity, training that you can sustain over a long period of time
because you are going at a pace that your body can turn carbohydrates into all
the energy you need.

Sprinting is _anaerobic_ training, as is most strength training. It's high
intensity, you can't sustain it over a long period of time, and it makes
different energy demands on your body than aerobic training does.

[http://en.wikipedia.org/wiki/Aerobic_exercise#Aerobic_versus...](http://en.wikipedia.org/wiki/Aerobic_exercise#Aerobic_versus_anaerobic_exercise)

With that said, I much prefer anaerobic training. It's more fun, for me. And
if you do intervals over a long enough time, you're also increasing your
aerobic capacity.

~~~
dworrad
It won't increase your aerobic capacity... It will raise your lactate
threshold. The only way to increase your aerobic capacity is to spend a large
amount of time exercising at an aerobic heart rate.

~~~
scott_s
It depends on how much rest you're getting inbetween your intervals. If the
rest is short enough that your heart rate never goes back down to normal, then
you're also working your aerobic capacity.

When I train jiu-jitsu, I do several rounds of live rolling. Usually something
like 4 6-minute rounds with a minute rest inbetween. The hard part of live
rolling is the anaerobic part: quick spurts of high intensity. How fast you
can recover from them, and how often you can sustain doing them over time
determines how well, athletically, you will do. But this is also a 30 minute
period with an elevated heart-rate, and you never are fully rested inbetween
your anaerobic bursts. So, it is also an aerobic workout.

Despite not doing much explicit cardio training, I still have the cardio
capacity to run decent distances with decent times, on the rare occasions I
do. That's because I am training my aerobic system even though most of the
exercises are anaerobic. (I once went on a 9 mile run having not gone on a run
in over 6 months, having only done jiu-jitsu training and conditioning during
that time. My lungs were fine. My legs were not.)

~~~
dworrad
You can run easily because your placate threshold has been significantly
increased... doing sprints won't improve your aerobic capacity to any great
degree... just ask Usain Bolt

~~~
scott_s
My point is that I am training _both_ , even though my anaerobic capacity is
the real determinant of the outcome. But inbetween bursts, I am still active,
just at low to moderate levels, and this occurs over a long period of time.

If your sprint workouts involve sprints with very light jogging inbetween then
you will work both.

~~~
dworrad
Many people will tell you that when you go in to "sugar burning" (approx
140bpm+) mode then you are doing very little to improve your aerobic
capacity... Regardless of your heart rate being lower at certain points. Read
about Mark Allen's (Ironman champion) experiences with this. To train your
aerobic system you need to start in the aerobic zone and stay there
religiously. IMHO

------
systematical
There is a smart way to do this and not be a complete moron like the author. I
take adderall a few times a year and have been doing so since my senior year
(2003) in high school and have never come close to this trainwreck. It's a
simple approach: know exactly what you have to do before taking it, eat a meal
before (since you will have no appetite), take them in the early morning (so
you can sleep by night), and finally...don't use them again for at least a few
months. Also have water nearby the entire time since it dehydrates you.

~~~
catshirt
abusing unprescribed drugs makes you a "complete moron", but abusing
unprescribed drugs in moderation makes you well informed. note taken.

~~~
icelancer
Is it abuse if you use them for performance reasons and moderate it properly?
Just because the distributors of the drug say it is abuse doesn't mean it is -
they do not get to decide these things.

~~~
catshirt
this is to my point. who then is the arbiter of abuse? OP?

x pills is fine, y pills is fine, z pills makes you a "complete moron".

~~~
disbelief
Well, when your life starts to fall apart at the seams and you start
exhibiting any one of the behaviours mentioned in OP's article, that's a
pretty good indicator you've reached "complete moron" status.

However I think you're over simplifying the question. Not everyone has the
same response to drugs/substances. Some people can do what systematical does
without any long term side effects because they simply have the willpower,
self awareness, and personality type that allows them to avoid becoming
dependent.

Conversely other people would become dependent and turn into complete wrecks
almost over night. Similar things can be said for alcohol, or any other
"altered stated". It doesn't necessarily mean that the substance itself is the
problem, or that all use is "abuse".

It really comes down to knowing yourself, knowing your own limits, and being
as well informed as you can be.

~~~
systematical
Disbelief is correct here. On the other hand we have a developer at work (with
a prescription) that takes this stuff almost daily. I couldn't live like that,
I enjoy my lunch too much and feeling "normal."

------
rayiner
"Romantically I became schizophrenic, smashing hearts on purpose or falling
head over heels with a one-night stand, exhibiting neediness that disgusted me
— yet I rationalized that becoming a self-loathing depressive could be filed
neatly into my persona as a tortured New York artist, material for stories I
would surely write someday. The problem was, it stopped being a persona, and
became who I was as a person: uninspired, unproductive and miserable."

This sounds like it could just as well be a symptom of New York rather than
Adderall. Or being a lawyer in New York rather than Adderall.

------
taylorlapeyre
As a college student that is constantly surrounded by Adderall and Vyvanse
misuse, this hits close to home. I've had a prescription to similar drugs my
entire life, and it was in 8th Grade that I realized that I didn't actually
need them to function.

The drugs made me unhealthily underweight, constantly antisocial, and easily
aggravated. Nowadays when I look at my peers, I see the same things happening
to them. Some people take two at one time the night before a big test and
don't sleep for days. The worst part is, everybody sees it as normal. Popping
an adderall before a test is as common, easy, and normal as opening a beer to
relax on a weekend.

People don't realize that the 60mg Vyvanse they are taking casually is an
_extremely_ hard drug to take for somebody not fully diagnosed with ADHD.

~~~
throwaway54-762
It's an extremely hard drug for anybody, ADHD or no. Adderall / Vyvanse is
prescription meth[0] (something I've heard from several of my AD(H)D friends).
If the pros outweigh the cons for an individual, great; I wish them the best.
But while I can't find the research I remember to back this up, it's looking
like long-term medication with amphetamines may be ineffective or harmful.

EDIT [0]: Yes, I know that that prescription meth literally exists under the
name Desoxyn, that is not what I mean. See
<https://news.ycombinator.com/item?id=5321949> and
<https://news.ycombinator.com/item?id=5321935> .

~~~
MartinCron
A few years ago, my doctor encouraged me to stop taking Adderall based on the
conventional wisdom that it was likely to cause heart disease. I'll always
remember what he said, _I only prescribe Adderall for depression in my
terminal cancer patients, because I'm not worried as much about their long-
term heart health_

OK, Doc. Let's not refill that prescription, then.

This conventional wisdom has recently been challenged, but I think there is no
great consensus on this issue yet.

[http://www.dailyrx.com/adhd-medicines-were-not-linked-
seriou...](http://www.dailyrx.com/adhd-medicines-were-not-linked-serious-
heart-problems-adults-during-first-few-months)

~~~
throwaway54-762
Oh, the possible negatives I had in mind were brain-related: "diminishing
returns" due to tolerance or other factors after long-term use, and adverse
side-effects of the drug flooding your brain with seratonin and dopamine over
long periods of time (obviously similar to that observed in long-term
methamphetamine use).

~~~
MartinCron
I see. I wasn't a long-term user and was always _extremely_ conservative with
my dosage, so I didn't encounter any of those brain-related issues.

Even with the fact that they are in the same family of drugs, comparisons to
long-term meth abusers doesn't seem quite right.

~~~
throwaway54-762
Every person is different, and meth is definitely abused in higher proportions
more than prescription adderall — I am not contesting that, or attempting to
compare adderall users to meth users.

I _am_ trying to highlight the similarities between the drugs themselves.

------
endtime
Someone close to me has severe ADD and stopped taking Adderall recently. This
person is more productive and organized and even coherent on it. But this has
turned out not to be worth A) the way if affects their mood/social
interactions, and B) the inevitable Flowers For Algernon "mush-brain" feeling
when it wears off in the evening.

~~~
whalesalad
I used to take lots of L-Tyrosine and Magnesium supplements to help restore
the toll Adderall takes on your body. I was on 30 MG of XR daily and would
indeed do the work of 2 or 3 of myself ... but you do pay for it at the end of
the day.

Ever wish you could clone yourself? You can. It's called Adderall. I miss it
dearly. Moving to Sweden has meant that I can't get it any longer. Heading
back to the US in a week to pick up a 5 month supply.

I tried to quit, but to be honest the benefits are simply too great. I often
wonder the number of successful people that are on Adderall or similar drugs
... because I genuinely think some of the amazing things people are doing
these days are impossible as a "baseline human" ... or I am a severely broken
one.

This is a nice post that sums up my thoughts nicely:
[http://backreaction.blogspot.se/2012/08/erdos-and-
amphetamin...](http://backreaction.blogspot.se/2012/08/erdos-and-amphetamines-
check.html)

------
danso
How do people who've taken it for most of their adult life cope with adderall
usage? I mean, how necessary of a drug does it seem to be -- or, to put it
another way, how bad are the withdrawals, compared to antipsychotics,
painkillers, etc?

And if you've lived with adderall usage, do you chronically feel like you have
a reduced appetite and all the other kinds of symptoms? I've heard that
happens for people who take the drug on an occasional/recreational basis, but
I wonder how the side-effects feel for people who are more "on" Adderall than
off of it in their normal lives.

~~~
sneak
Someone very close to me had been on it since she was 12. She's 23 now and
stopped last fall.

Due to her tolerance, she'd been on very high doses for basically a decade.

After stopping, sleeping for 16-18 hours a day was the norm for about a month-
but just getting to that point, first she had to cope with a weeklong
psychotic break.

It causes some serious dopamine desensitization after extended use. Depression
is common among withdrawl symptoms.

~~~
JohnBooty
Wow. Did she stop taking Adderall abruptly, or did she gradually taper down
her dosage?

I find I can easily stop taking it if I taper my dosage. Going "cold turkey,"
however, is kind of hard to imagine.

------
edw519
Hi Kate,

If you're reading this (and I'd like to think so because Hacker News is no
longer a stepchild), 2 things:

1\. It sounds like you've turned the corner on this thing. If so,
congratulations and best wishes.

Oddly, I just posted my feelings regarding drugs and work earlier today.

<http://news.ycombinator.com/item?id=5318320>

2\. You write very well! I look forward to more. Let us know how to follow
you. And keep 'em coming (naturally, of course).

------
logn
I have the power to conjure energy, intense concentration, motivation, all-
nighters, etc all on my own. I call it:
stress+goals+pride+enjoyment+intelligence. Sometimes it's a great asset and
sometimes it runs me into the ground. In my experience a lot of people are
like this (programmers, parents, executives, creatives, lawyers, etc) and we
all find our own ways to cope. For me it was a realization of my own body and
mind (and that I'm normal) and not buying into someone's diagnosis or someone
else's coping strategy.

One of the most reassuring pieces of advice I had during sleepless nights in
high school was from an adult who told me he can't sleep a lot and instead of
tossing and turning he seizes the moment and works, since that's what he's
thinking about anyway. I'm not saying this is healthy advice, I'm saying that
he helped me feel normal by letting me in on his coping strategy. Others will
tell you they drink tea, or workout, or avoid sugar or caffeine. They all work
--for them--and we should take everyone's advice with a grain of salt because
we all have very different minds/bodies/lives. I guess the author here found a
coping strategy that happened not to work for her, so thank you for sharing.

I'll share my strategy: I take trazodone occasionally as needed to sleep. I
let myself get all worked up and be very productive for as long as I think
it's healthy for me. Eventually I get on a weird cycle and this corrects it
for me. There are all sorts of other things I do but there are so many
variables in life, and this is the only one I view as relevant. And who knows,
in a few years I might have to try a new strategy.

Everyone's weird and bizarre and has problems. We should stop stigmatizing
illness, eccentricities, addiction, medication and start realizing that we're
all different and have the potential to be healthy if we find what works for
us. Also don't always try to find the root cause and be pragmatic more often.

Also, I should add that I share these details sort of like people do when they
admit they're gay. It's not without risk, but I hope someone reading this is
helped. And if you think I'm being overly dramatic, this does not apply to you
then, because I'm being way underly dramatic.

------
unimpressive
I remember when I was younger, I could stay up a full 30 hours consistently.

Years later I wondered where that energy went. I thought for a moment that it
was a result of aging or some such, until I remembered that at the time I was
taking medication for ADD.

It's really not healthy to sit and watch TV that long anyway.

------
thelogos
A large part of the blame lays on her.

IMO adderall's mechanism is much more severe on neurons than methylphenidate.
It's very well proven that amphetamine/methamphetamine increases the level of
free dopamine in the cytosol which are prone to auto-oxidation to quinones.
This wreaks all sort of havoc over the long-term.

Methylphenidate(ritalin) and its stereoisomer stay cleanly outside the
presynaptic neurons and only blocks NET and DAT from pumping NE and DA back
inside the cell. Unlike amphetamine, it doesnt disrupt the pH gradient of the
vesicle membrane and cause an abnormal amount of dopamine to leak and
accumulate in the cytosol.

Personally, I would never take adderall/vyvanse/dexedrine.

As a counterexample, let me give you my experience. After being prescribed
focalin, my gpa shot through the roof. This stuff actually improved my health.

How?

Instead of pulling all nighters and procrastinating like I used to, this stuff
allows me to get work done weeks early and go to sleep on time.

I learned calculus in 1 week, bought a piano and taught myself how to play
moonlight sonata 1st mvt and kiss the rain in 3 weeks (working on bach air in
d major at the moment).

Oh yea, I also read the entire lehninger biochem book and bernard milller's
advanced organic chemistry for fun in my own time. Then a whole world of
research papers were discovered through the uni library subscription :>

This stuff allows you to learn at an alarming rate if used properly.

I don't drink alcohol on days of studying because it prevents LTM formation,
you're basically wasting your time studying if you do this. Also I never waste
my time with people while medicated. This stuff can make you socially awkward
and kill your sense of humor. Take it only for the singular purpose of
learning and getting work done.

I took extra care with my health, ate blueberries, avocado, eggs, brocoli,
meat, etc., lots of lycopene, astaxanthin, R-lipoic acid, melatonin and 8
hours of sleep.

Tolerance will go up very slowly with frequent breaks and essentially goes
back to zero with a month break. For adderall, this will take much longer,
some people will even develop permanent tolerance that will never go away.

On days when I dont take focalin, I sit around, sip on a beer and browse HN ;)

~~~
n3rdy
> A large part of the blame lays on her.

I'd say all the blame lays on her.

When you know your gaming a system by either buying a drug from a dealer,
using a crooked doctor to write your prescriptions, taking more than your
prescribed dosage, and _not_ reading the warning label on the bottle every
time you take a dose out of it, its hard to believe that you didn't understand
the consequences of what you were doing.

I'm prescribed adderall and your comment dissuades me from taking it 100x more
than this article does, even more than the warning label does.

Even if you were exaggerating anything, I found more keywords to research from
just the first paragraph than I would get out of 10 of these types of NY Times
articles.

~~~
thelogos
Check out Dr.Sulzer's research. A lot of these studies are very hard to
understand without some organic chem and biochem background.

Reading the abstract is simply not enough feel the significance of these
research.

The other problem is access to these articles through journal subscription is
quite expensive.

I always figure that methamphetamine does some long-term damage, but when they
found melanin accumulation in the neurons by examining brain slices, it was
pretty alarming.

The mechanism of action between amphetamine and methamphetamine is too similar
to rule out the possibility of long-term damage.

It just doesn't make sense to take adderall when dexmethylphenidate (focalin)
gives most of the benefit without ritalin's side effects.

In the long-term, I'm still quite leery of dexmethylphenidate, particularly
how it acts as a releaser at high concentration.

I haven't come across any papers that describe its mechanism of action as a
releasing agent.

This is another reason why I only use it to study and practice piano. As long
as you're learning, it's easy to justify that the benefit outweigh the cost.

------
hxrts
It's unfortunate the author was not able to manage the drug properly. Adderall
is a potent substance that, when used in the correct fashion, can be an
effective aid for those who need it. It's also highly addictive so must be
combined with a healthy lifestyle and coupled to good habits in order to be
kept in check. I would highly recommend that anyone who feels themselves
falling into a routine similar to that described seek a therapist as well as
focus hard on improving their sleep, diet, and exercise routine.

~~~
bduerst
Exactly.

The tone of the article made it seem like the Author was a victim here, when
in reality I think this comment sums it up:

>The writer tells us she was "23" when all this happened, as if to say,
"Really, I was just a kid." But, really, she wasn't a kid. The brain is quite
mature at age 23, but she didn't explore, evidently, the possibility that she
was making a mistake.

~~~
dreamdu5t
Denial is a principal aspect of drug addiction. Even if she quits using, it
will likely take a long-time for her to fully accept that it was all her
fault. Drug addicts will blame every single person but themselves.

------
mortdeus
Ive been taking adderall for a bit over 2 years now, and the important part
about taking adderall is that you are supposed to do things like sleep every
night, eat food during the day, and drink plenty of water, otherwise your
tolerance takes over. This is true for people with adhd as well.

The thing is, if you are taking adderall because it "super charges" you, you
are taking it for the wrong reasons. People with adhd (like myself) have to
take adderall so that we can compete on a level playing field. There is
nothing we can really do to self motivate and study. Without my meds I can not
retain the information that I read. Without my meds I cant motivate myself to
sit down and program because I cant concentrate and conceptualize the model im
trying to write in code.

Adderall can be an invaluable tool for somebody who doesnt stand a chance
without it, but it can take control of somebody who doesnt have a good enough
reason to maintain self control and moderate their usage. The adhd mindset is
a very awkward and uncomfortable feeling. Abusing our medication means we have
to go back into that mindset and it sucks, therefore its easier to not let it
become a craving addiction.

Also the zombie feeling the kid was talking about, is due to the fact that he
is taking too high of a dose. Either that or he would be better off on ritalin
or strattera. Each specific case of adhd is somewhat different and the
underlying cause may be served by a different treatment due to the difference
reactions the drugs have in the brain. (Adderall increases dopamine and
prevents it reuptake. Ritalin, just prevents the reuptake, etc).

------
the_economist
You can boost productivity for a year or two with Adderall, but over a 10 year
period most people will find that they perform better by staying off Adderall
and other stimulants.

And we are all in it for the long run, I think.

After taking Adderall (or any stimulant) for long enough, you need the drug
just to get to your baseline performance level.

Add onto that the unproductive evenings, crashing on days off the pill, mood
swings, likely health repercussions, and the general malaise caused by
intentionally inducing your body into flight-or-fight mode.. It adds up to a
not-so-pretty picture.

If you want to feel like superman for a while, go for it. As for me, I'll
trade short term productivity for low cortisol levels and inner peace.

~~~
overgryphon
Any data to back that 10 year claim?

Equating any and all stimulant usage with unproductive evenings, crashing,
mood swings, and malaise is pretty exaggerated.

~~~
the_economist
I don't have data, just personal experience and observations of people around
me who have used stimulants for prolonged periods of time. Adderall starts off
with 10mgs/day, 20, 30, then 40 to get the same productivity.

I was mostly equating adderall use with that list of effects, not less
stimulants.

------
NateDad
I took adderall for almost a year (under the direction of my GP), for what I
thought might be ADD. It actually did almost nothing for me... Except each
time we upped the dose, I got really dizzy for a day. Other than that, I felt
no better able to concentrate, no better memory. I finally just stopped taking
it because it was a pain in the assignment to get it each month, and it wasn't
doing anything. The only effects of going off it was that my wife said I was
kind of a jerk for a few days.

------
throwaway04583
Going cold turkey off 40 mg of adderall a day and calling it addiction is a
slap in the face to people who have dealt with real addiction. As someone who
has used Adderall at this level and stopped cold turkey and someone who has
also been a heroin addict, stopping adderall cold turkey is a fucking joke
compared to heroin addiction. Alcohol addiction also has the potential to be
unbearably uncomfortable, not to mention deadly.

The author is a poseur, and doesn't realize how lucky she is.

------
rakeshsharmak
Has anyone tried Yoga and/or meditation for ADD? I think it might be
helpful...I am distracted easily and often. However, I find breathing
exercises help me focus.

~~~
mechnik
Yoga and meditation may benefit anyone. There is considerable interest in
mindfulness techniques for ADD treatment. Search for 'mindfulness ADHD'.

------
hcarvalhoalves
The amount of comments here claiming being diagnosed with ADD and taking pills
for it made my head explode. ADD can't be a real condition if suddenly
everybody is diagnosed with it, can it? Because if it is, we have an epidemy
going on.

~~~
georgemcbay
"ADD can't be a real condition if suddenly everybody is diagnosed with it, can
it?"

Sure it can be a real condition, one that is superficially easier to treat by
giving everyone meds rather than admit that the modern "American" society
we've created is full of all manner of unnatural stressors that we haven't
evolved to deal with.

~~~
hcarvalhoalves
Yeah, that's what I'm talking about. The amount of people being prescribed
meds made me scared. I'm from Brazil, and I almost never hear about ADD, let
alone about Adderal.

------
ladzoppelin
Its a good article and I am glad she feels better however what do expect when
you abuse a powerful medication and drink every night.

"The mix of whiskey rocks and a pocket of pills was a potent one. I was now
getting high seven nights a week, every night a delicate balancing act".

Since she kicked the "pills" she now should kick the whiskey before that gets
out of control. The title should probably read "Substance Addiction:The Last
All-Nighter".

~~~
MikeKusold
I would bet that without all the energy that Adderall gave her, she no longer
has the energy to go drinking with friends 7 nights a week.

------
jetti
I have dealt Adderall addiction although in a way most likely different than
most. In my college years I was on tons of medications ranging from mood
stabilizers to anti-psychotics, all in all, I was on 8 different medications
to treat psychological issues I was having. Now those 8 medicines combined to
deliver a mighty powerful punch which made me sleepy all of the time and made
it very hard for me to wake up. The psychiatrist's solution was Adderall.

In the beginning, it was great. I would set my alarm for 4 hours before I had
to wake up and take an Adderall that I had next to my bed and I'd be awake. It
was amazing being able to get to my classes on time. At the same time, if I
got 4 hours of sleep I felt refreshed as if I had 8 to 12 hours.

Things started slipping once I was taken off my medications. All of a sudden I
didn't need the Adderall but I was addicted to being able stay up late. I
never used it recreationally or to be more productive, I was just hooked on
not needing sleep and it was great. I took a few months of re-adjusting but I
was finally able to get back to sleeping normally but it was still hard for
awhile. Why sleep for 6 hours and be tired when I could sleep for 2 less and
pop an Adderall and not be tired at all.

------
brownbat
There are many reports here of people who've taken Adderal without significant
issues, suggesting the key is "active medical supervision" (ie, much more than
the passive doc just handing Kate Miller pills).

In fact, once we have monitoring in place, you might even argue "intelligence
doping" could provide such benefits to society that we should even encourage
it (though only for those who face minimal side effects):

[http://www.becker-posner-blog.com/2008/03/intelligence-
dopin...](http://www.becker-posner-blog.com/2008/03/intelligence-doping--
posner.html)

------
tarstarr
These kinds of articles are often used to delegitimize ADHD as a genuine
condition: it actually can be. People can take Adderall for genuine conditions
and see improvement.

When it comes to the actual diagnosis of ADHD...that's where it gets
interesting. Is everyone on an attention spectrum, and ADHD individuals are
simply at one extreme? Or is there something completely different about these
individuals that can be a single defining marker?

~~~
chrischen
The general understanding is that ADHD is characterized by a spectrum of
attention deficit to an extreme.

The process of diagnosis usually involves a self-questionnaire. In my case I
somehow managed to fail the questionnaire and the psychologist performed an IQ
test.

The IQ test is analyzed to see if you have a processing speed subscore that is
significantly lower than your other subscores (all subscores should be roughly
equal).

------
jjsz
I've never met someone who was diagnosed with ADHD since their early years.
It's always people like the one in this article. I have a few questions to ask
people who have used amphetamines while exercising (cross training, cardio),
having sex, meditating, or anything that raises your heart rate. How does it
feel? Does it feel like running on an empty stomach on a Monday morning after
having slept only 3 hours?

~~~
adderall_9
Methylphenidate (Ritalin) and the amphetamines do wonders for physical work.
You feel fantastic and capable. Amphetamines in particular provide a bit of a
euphoric boost. In general, amphetamines are going to make you feel pretty
damn good, although coming down might be unpleasant sometimes.

I have to caution people to _not_ do exert themselves, as they figure out that
they can go workout at the gym like mad. I'm not sure it's healthy to work out
while on stimulants.

~~~
TheLegace
Ugh, I have hated Methylphenidate, it was really close to ruining my life. It
made me feel angry and depressed. I hated the world and every single moment
after taking it for some time. Even off of it I felt it semi-permanently
affected my brain.

I gave Adderral a shot, but again it is quite an unstable drug. Mostly because
of it's a Dopamine Uptake Inhibitor. And that usually causes unstable Dopamine
levels, meaning less stable mood and thinking.

I fortunately found a Doctor that prescribed new age of ADHD medication.
Although it is not for the weary. Atomoxetine(Strattera) is much more stable,
and much more powerful drug. It doesn't have tolerance issues like typical
drugs. It is a norepinephrine reuptake inhibitor, meaning it enhances the
neurotransmitter that's a precursor to all other neurotransmitters including
Dopamine. This means all your neurotransmitters become enhanced.

Now I say it's a drug not for weary minded, because it's actually very hard to
adjust to it. For the first month you have to take 20mg increments every week
to get your body to adjust to it. At first it makes your incredibly
sleepy(can't even stay awake at any time), but that quickly fades and your
realize that sleep is much easier to schedule when you can get the brain to
feel sleepy(Needed for someone with ADHD).

It also is tough on your liver, unless you eat a decent sized meal you will
most definitely vomit bile from your Liver(I know I have seen it enough). It
gives your incredible nausea and will eliminate your appetite to the point
where it hurts to eat.

I have found that combining it with Marijuanna to be advantageous. Both drugs
complement each other(one to counteract nausea and trigger hunger, the other
to enhance the high you get.

It's one of those drugs that doesn't make your ADHD disappear, but let you
take control of it. But it really is miles ahead of anything, and has changed
my life completely. I have been using it for a year, and the flood gates are
off. Unfortunately I still struggle with a lot of things, but now I have the
ability to correct those learning weakness because I can concentrate.

~~~
jjsz
From what you said atomoxetine is a new age sleeping drug. Not a focusing ADHD
drug.

~~~
Daniel_Newby
Atomoxetine has different effects in different parts of the brain. In the
motivational centers it promotes a sense of tiredness, which tends to wear off
after several weeks. In the frontal lobes it increases the action of dopamine,
promoting focus and persistence.

~~~
jjsz
The proficiency exchange isn't worth it with those side effects.

------
amikahmad
Interesting article on the subject of abuse. It would be more interesting to
find out who the doctor was and if this woman ever received a proper clinical
evaluation or a genome sequence. It seems pretty clear that she was improperly
prescribed Adderall. Though they are cracking down on it much harder these
days due to misdiagnosis and parents who do go pay "expensive upper east side
doctors" so their kids can ace their SAT exams.

It really is sad.

I've been taking the extended release version for over a year now and without
it I would be an unproductive wreck. I went through a full clinical eval by a
neuropsychologist, and had my genome sequenced to verify that I had the
specific mutations that are thought to be responsible for ADHD.

For me it has been life changing to say the least. I grew up in NYC and would
take the uptown train when I was supposed to take the downtown train twice a
week at minimum, I wouldn't realize this had happened until I would end up in
the Bronx or somewhere the train exited the tunnel and allowed light to come
through the windows and bring me back to reality. I would make these errors
due to my brain being off thinking about computers, robots, books, particle
physics, food, girls, music, manga, etc ... rapidly shifting from one idea to
the next, never completely finishing a single thought.

It was hard for me to read. To finish projects. And I never had a job and
instead chose to start my own companies.

I don't quite believe the exercise hype - I was a division I athlete during my
undergrad years, and worked out harder and longer than 99% of the human
population during that time - and I still had difficulty.

I decided to get help after my first year of my master. I was getting
frustrated, unable to complete projects to my liking/standard, and staying up
far later and working far longer to complete anything than many of my peers -
and having just finished designing digital products for one of the top design
firms in the world (really my first true foray into corporate America), while
having trouble sitting down during meetings, and only hearing every third word
that came out of my colleagues mouths, was beginning to freak me out.

so i went in. And worked through the process. I was diagnosed and confirmed
and my life completely changed. Although I had a difficult time with my family
(asian) who looked at me differently and refuse to this day, to talk about my
condition. The pluses still out-weigh the minuses.

Adderall doesn't excite me. It calms me down. I can even sleep better since my
mind is not racing 10000 miles per hour. I'm doing the best work of my life
these days and couldn't be happier as I finish up my master thesis. (something
i cannot imagine being possible had I not talked to someone and gotten help).
I have no side-effects, and just feel "normal" when I'm taking it. And I am
closely monitored by my physicians, all of whom have my best interests in
mind. Sadly, this sort of support and knowledgeable/honest care is not easy to
find.

I think stories like these are both helpful and harmful. Helpful at exposing
the blatant misuse and misdiagnosis, and also harmful because it shows people
that it's still possible to find doctor's who don't give a shit about you and
will just prescribe whatever you ask for. I have people who ask me for the
drug, of course, I don't hand it out for $5 or whatever because it actually
helps me and doesn't turn me into some sort of incredible hulk super human
like the author or other abusers. Patients and doctors should be more
responsible b/c if you don't really had ADHD, then this stuff will mess you up
...

and i have no idea how to end this brain dump because well, it 2am and i'm
sleepy and i have ADHD, I won't take my prescribed dose until 9am, and i have
to talk about the healthcare system during my preliminary thesis defense
tomorrow ... so ya ... later

~~~
kanzure
> I think stories like these are both helpful and harmful.

These things worry me too. For those of us that Adderall genuinely helps, what
do we do if some scaremongers make it (and similar stimulants) inaccessible to
us? Crap. I did the math on it once and it turns out it's cheaper to make your
own meth lab than continue to buy for the rest of your life. Plus, if things
go south, you always have yourself covered.

------
benhebert
The US refuses to admit that the real drug problem are prescriptions. The
effects of prolonged adderall usage have not been studied and I can't imagine
how it interacts with other medications.

It's a schedule II narcotic with a high similar to cocaine. Keep your kids off
of it.

~~~
throwaway04583
I realize you're probably trolling, but just in case..

The 'high' of adderall is not even remotely similar to cocaine.

~~~
danneu
Cocaine and amphetamine result in the same flood of the same
neurotransmitters. Cocaine has no surprises for anyone that's ever been
cracked out on instant release speed. Except maybe making them go "...is this
it?"

Lots of overlap between the two, especially when comparing pharmacophores. For
instance, the peptide transcript called the "cocaine- and amphetamine-
regulated transcript (CART)"[1] might be a good example.

Not to say that you personally haven't had different experiences with the
substances. There's just substantial chemical/physiological overlap between
the substances while there's much less demographic/prescription/intended-
effect overlap.

[1]:
[http://en.wikipedia.org/wiki/Cocaine_and_amphetamine_regulat...](http://en.wikipedia.org/wiki/Cocaine_and_amphetamine_regulated_transcript)

~~~
throwaway04583
I have had substantial experience with both of them, and while the effect is
similar, the feeling is not. In my experience, cocaine has a stronger euphoric
component than d-amp. Adderall makes me logical and emotionally detached,
while cocaine makes me feel like I'm on top of the world.

I think the reason for using the substance could be coloring my opinion of the
experience, since I use adderall to get work done, and when I use cocaine (not
often, maybe once or twice a year. I did a decent amount of blow when I was
doing opiates heavily), it's almost always in a social setting.

I will grant that the pharmacological effects are very similar.

------
logical42
This kinda reminds me of that movie, 'Limitless'.

------
hakaaaaak
To others in similar situation, either considering it or on it, or just taking
some other stimulant like caffeine, or are just tired all the time:

* If you have ADD and it is working for you and you are happy, ignore this shit and do what you need to do.

* If you have ADD and take it, but you don't like how you feel while you are on it, talk to your doc and have him/her help wean you off of it or find a different dose or med.

* If you are fat or not but don't get enough exercise, please get exercise and stop eating fast food and drinking any kind of soda (diet is just as bad). I am overweight now and have been normal weight before when I've exercised regularly and it made a big difference both cognitively and with energy, etc. I need to do that again. I learned the hard way not to diet though. It worked but it is true what they say; you gain it back +10 lbs (or more).

* Replace soda with coffee or tea, even if you hate them. I really hated them. I feel much better not drinking diet sodas constantly. Try to eliminate caffeine if you can.

* Try eliminating/limiting aluminum (drinking from cans, using hair products with aluminum, etc.). (May be unnecessary, but lower your Alzheimer's risk.)

* Try taking daily vitamins (Centrum, etc.), Fish/cod oil pills. Consider taking a baby aspirin each day if you are 40+. Don't overdose on daily recommended intake, even when sick! Some things can be really bad. Don't overdose on ginko, etc. either!

* There is nothing wrong with wanting to be your best, but you'll be your best when you aren't cheating and hurting yourself, and that is as good as you need to be. Even if you think you will get shot or people will die if you don't take stimulants, you can stop and it will be better- for everyone.

* Talk to an ENT about sleep apnea. Losing weight is key no matter what, maybe stop drinking water and eating before bedtime, and no blue light or monitors or T.V. for a few hours before your 8-9 hours sleep. But after you do all that, if you snore or don't dream regularly and feel like crap and hate your job, get help.

If you are like me, you have done a lot of this because you think you deserve
it. I feel on a regular basis like I don't deserve to have what I have and
that I'm a failure. In many ways, I am a failure; but mostly because I'm doing
it to myself. I eat too much. I don't exercise. I hate my job. I think I
should die. I feel like I need the food so my brain won't get distracted by
being hungry. I feel like I don't have time to exercise. I feel like it is my
fault that I hate my job. But, all that is crap. I need to take care of
myself, and so do you! Just go on a short walk tomorrow, and the next day, and
the next. Eat 1/2 as much as normal if you eat too much. Drink less caffeine.
Talk to your doc about changing your meds or anything at all that you're
worried about. Get a hobby and get outside more. Make friends that do healthy
things. Get a job where you can live healthier and work a normal workweek.

------
michaelochurch
This made me sick. I don't know what's worst: the author's self-absorption,
the victimization tone, or the fact that her colleagues had to do similar
unhealthy shit in order to compete with her. It stinks the whole way.

Using drugs to gain an unfair advantage over other people at work has
unhealthy emotional side effects? Am I to be surprised by this?

~~~
nikatwork
> the fact that her colleagues had to do similar unhealthy shit in order to
> compete with her

You are asserting that the law firm's long working hours were caused by her
med use. Do you think you might have that backwards?

> the author's self-absorption, the victimization tone

She had a substance abuse problem. She's warning others that it's a slippery
slope. Show some compassion.

~~~
AnIrishDuck
> You are asserting that the law firm's long working hours were caused by her
> med use. Do you think you might have that backwards?

It probably becomes a vicious cycle / race to the bottom. You take more drugs
to work longer hours and compete with your colleagues, who start taking more
drugs so they can work more hours to have the edge over you...

~~~
nikatwork
The long working hours of many law firms existed before the widespread
availability of adderall. Drugs have absolutely zero to do with it. They are
merely a symptom of the underlying workaholic culture.

~~~
etrain
I had a friend whose grandfather was a hot shot lawyer at one of the largest
international firms of his day in the 60s/70s/80s. She told me that he was a
speed addict for close to 20 years. Long story short he got into a situation
where he had to quit cold turkey and did, successfully.

Substance abuse to get ahead is nothing new. Drugs are not as new as we
pretend they are, and it's been common practice to abuse them for personal
gain probably as long as they've been around.

~~~
Tyrannosaurs
I've worked for a couple of the bigger law firms in the UK and I've never come
across drug use (of this type).

Drugs may enable and perpetuate this behaviour today, at least in some
countries, but I don't think there's much of a case that they caused it. At
least if they did it arose in places like the UK without that assistance.

From my experience the root is far simpler - greed. They dangle the
possibility of partnership with all it's attendant wealth and status in front
of the bright young things and watch them scrap it out and burn out. I have a
friend who made partner with one of the magic circle firms and while the
rewards are amazing, I wouldn't swap his life for mine in a million years.

~~~
michaelochurch
_They dangle the possibility of partnership with all it's attendant wealth and
status in front of the bright young things and watch them scrap it out and
burn out._

It used to be that about 5% _didn't_ make partner. It was like getting fired--
in the 1970s, when that itself was rare. It was harder to get an associate
position, but once you were in, you were solid. Also, work hours were not at
the extreme that they are now.

Now, instead of 5% not making partner, it's about 5% who make partner.

That's because some really evil, greedy fucks got in charge and realized they
could replace partnerships with overworked, churn-and-burn associates.

~~~
etrain
> That's because some really evil, greedy fucks got in charge and realized
> they could replace partnerships with overworked, churn-and-burn associates.

Or could it be that there are way too many lawyers being produced every year
and the realities of a highly competitive market have set in?

[http://flustercucked.blogspot.com/2010/07/40-years-of-
lawyer...](http://flustercucked.blogspot.com/2010/07/40-years-of-lawyer-
overproduction-data.html)

------
b6
Adderall IR makes me feel very energetic and motivated, a feeling I like a
lot. But I always seem to use it until it becomes so detrimental to my health
that I feel I have to quit.

Always, my dosage creeps up, my sleep schedule becomes chaotic, I become too
thin and frail. I'm mentally quick, but also irritable. At first I take it to
feel great, but at some point I'm taking it just not to feel as if I'm wearing
a lead suit.

I recently quit again after using for two months. If I get my weight and
health back, I may try Adderall again, but only if I'm sure I can be extremely
strict with myself. People say that taking weekends off can inhibit the
dependence.

~~~
throwaway04583
I would suggest using the XR version if possible. You may need 20-30mg, but I
have found it is much more stable and I don't feel the need to redose all day
long. My friend has an IR script, and he ends up running out early, while I
keep a stable sleep schedule and don't experience the mood swings.

