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Small-Scale Question Sunday for April 9, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Have we talked about the Adderall shortage? Going through top Twitter posts on Adderall recently is a wild ride:

Doc need to either up the dose on my adderall or get me a higher quantity . šŸ˜’ ASAP .

...

I got two really confusing business emails from someone who is normally perfectly coherent.

Then I read about the Adderall shortage.

...

Its been said but the Adderall shortage in the US is so fucked up. I hate feeling like I have to guard myself against the "Adderall is meth" crew to even acknowledge it but it feels so insane that it's just accepted as normal by those in power. Let alone intentionally engineered

...

The current manufactured inaccessibility of adderall is a catastrophic crisis that @POTUS should be directing @HHSGov to address, immediately. Peopleā€™s lives are being ruined, totally unnecessarily.

...

You can tell, also, when someone's cognitive output is the result of adderall - be it essays, code, or just talking to them. It churns out the CalArts style of thought.

We have ourselves a scissor-crisis! This situation lends itself to many people believing that there is a deliberate government effort to sabotage people afflicted with ADHD by the DEA controlling the supply of a necessary and important drug. Meanwhile, it leads to others being pretty concerned that the DEA limiting the supply of amphetamines results in people freaking out and declaring that they can't function without it, and what that says about the overall mental health of the country. Both of these stories are largely consistent with observable facts.

I wonder how many other stimulants are effected? There are many adderall substitutes on the market. I take vyvanse and havenā€™t had any issues filling it throughout this crisis.

This shows just how prevalent drugs are, like for weight loss, performance, or other things. Especially off-label use.

I often wonder about what percent of my peers are taking PEDs like Adderall. (If it enhances performance, it enhances performance. Not going to be too pedantic about the context in which that exact term is usually used). It seems like everyone in tech has ADHD or uses ADHD medication , and the productivity of certain people does make me feel like something is amiss.

It is extra ironic because I haven't met a more ADHD-esque person than me (I'm diagnosed), but I am too scared of the unknown impacts of the prescription, so I have held off on medication personally.

I click the twitter link and half of it seems to be people shitting on Trump for some reason (his truth social stuff being less coherent than usual?), accusing him of being an Adderall addict, of somehow being responsible for the shortage. I live in a very different twitter bubble to these people, clearly.

I feel like we've trained a generation of morons that if they want social approval all they have to do is say something mean about Trump. It's all so tiresome.

Was it ever this bad before? Like, even in Nazi Germany, did people in casual conversation just say "of course the Jews are to blame" every other sentence. Somehow I doubt it. Trump is the word that kills all intelligent thought in at least half the population. It's especially disappointing when it's people who should know better.

Was it ever this bad before?

Worse, if accounts from Mao's China are to be believed. People were bookending their verbal interactions with quotations from Mao, even for things like ordering from a shop. If you haven't read the account of Mao's mangoes, you really ought to.

On 5 August 1968, Mao received the Pakistani foreign minister Mian Arshad Hussain, who brought with him a basket of golden mangoes as gifts for the Chairman. Instead of eating the mangoes, Mao decided to give them to the Capital Worker and Peasant Mao Zedong Thought Propaganda Team ā€¦ that had earlier been sent to the Qinghua University in Beijing to rein in the rival Red Guard gangs. Two days later, on 7 August, the Peopleā€™s Daily, the official news organ of the Communist Party-state, carried a report on the mango gift that included the following extra-long headline in extra-large font: ā€˜The greatest concern, the greatest trust, the greatest support, the greatest encouragement; our great leader Chairman Maoā€™s heart is always linked with the hearts of the masses; Chairman Mao gave the precious gifts given by a foreign friend to the Capital Worker and Peasant Mao Zedong Thought Propaganda Teamā€™.

Yuet Chau then quotes an eyewitness:

Mao gave the mangoes to Wang Dongxing, who divided them up, distributing one mango each to a number of leading factories in Beijing, including Beijing Textile Factory, where I was then living. The workers at the factory held a huge ceremony, rich in the recitation of Maoā€™s words, to welcome the arrival of the mango, then sealed the fruit in wax, hoping to preserve it for posterity. The mangoes became sacred relics, objects of veneration. The wax-covered fruit was placed on an altar in the factory auditorium, and workers lined up to file past it, solemnly bowing as they walked by. No one had thought to sterilize the mango before sealing it, however, and after a few days on display, it began to show signs of rot. The revolutionary committee of the factory retrieved the rotting mango, peeled it, then boiled the flesh in a huge pot of water. Mao again was greatly venerated, and the gift of the mango was lauded as evidence of the Chairman's deep concern for the workers. Then everyone in the factory filed by and each worker drank a spoonful of the water in which the sacred mango had been boiled. After that, the revolutionary committee ordered a wax model of the original mango. The replica was duly made and placed on the altar to replace the real fruit, and workers continued to file by, their veneration for the sacred object in no apparent way diminished.

...via this classic post.

Your post reminded me of the time that Trump supporters staged a violent coup in the Capital. Except the opposite. Because I thought your post was top notch. Unlike the time that Trump said he wanted to kill all the Muslims and gays.

Now you're just repeating your theme in a low-effort way.

I was riffing off the parent's comment that routine interactions were sandwiched between salutes to Mao. Also, this is small-question Sunday. Hard to figure out where it's allowed to be funny here (or attempt to be at least).

To be fair, before Trump there were a ton of people who blamed Obama for every single thing under the sun. It wasn't quite as bad as the Trump situation but it was pretty damn close. This isn't a new phenomenon for our society, unfortunately.

Yeah, there's a reason "Thanks, Obama" became a meme.

Quite possibly. I guess I'm just not exposed to those people, not having any working class friends or family. I also don't need to care about what they think as they have virtually no influence over my life.

It was more ā€˜conservativesā€™ than ā€˜working class peopleā€™ who blamed Obama for everything. Granted that Obama presided over the white working class near-continually shifting right, but these are not quite the same things and the most intense partisanship is usually a college educated game.

As Adderall is in some degree effective because of the placebo effect, the meme that the pillā€™s potency has been artificially reduced by the government does a lot of damage just by being a meme existing. Almost something I would do if I were the psy-op division of another country. ā€œOur foreign enemies are artificially reducing the potency of our placeboā€™s effects potency with claims of non-placebo substance impotencyā€, I would tweet.

I stand by my opinion once commented here that saffron is a viable and superior alternative to ADHD medication, while smelling better and adding a greater flavor to paella than the leading ADHD medication brands.

(Whoever came up with adderall must have gotten a huge bonus. Starts with ADD, ends in all implying comprehensive benefit, and sounds like what your rural mom complains about to the doctor: ā€œmy boy just canā€™t add ā€˜er all up in the math classes like those Chinese kidsā€.)

I'm curious what you mean by 'some degree effective because of the placebo effect'? If you mean it's just a weak drug generally, and that at least 50% of its effect comes from a standard placebo effect, I don't think that holds up. Both because its chemical structure and pharmacology is mostly the same as methamphetamine, just at a much lower dose, and meth's effects are well known, and accounts of Adderall use as well as directly observing behavioral differences of Adderall users don't at all look like accounts of placebos. Generally, while there are things wrong with modern medicine, and IMO adderall bad, it's very easy to not be careful criticizing it and say things that are untrue, and doing so, in the long run, doesn't help your case or cause. (for an extreme example, see the far-right embracing ray peat).

The only thing that comes to mind as placebo-ish is that you need some desire to be productive for it to work, as Adderall will make you focus on something you're already interested in, not magically pick 'productivity' out of the sea of possible actions. So it still depends on user intent, and one could take it and sit down to play video games for ten hours. I don't think the government announcing adderall doesn't work well matters for this - many people have a ton of personal experience with adderall making them more productive that it wouldn't overcome.

To be more specific, that there is a placebo effect for all pills, and pills considered efficacious have the largest placebo effect, so the efficacy of adderall in aided by the placebo effect.

This placebo effect is increased also because of the intentionality imbued in the object. You go to the socially prescribed expert/authority on disease because you canā€™t study well and he tells you that this will cure your issues. He tells you the name of the drug, maybe gives you a pamphlet, and then you pick it up. You take it with the intentionality that this cures your issues, while remembering the problem for which you requested help.

So cutting into the placebo effect will hurt. Patients are no longer thinking ā€œthis is the cure for my inattentionā€, but ā€œthis is an unreliable thing they may not be effectiveā€ ā€” youā€™re now looking for evidence that it is ineffective rather than evidence of desired changes

The situation is worse in that ADHD by its very nature canā€™t be diagnosed objectively(itā€™s just ā€˜difficulty paying attention to the point of impacting your lifeā€™) and has had a recent overdiagnosis crisis.

I want to applaud your accurate use of the term scissor-x. As opposed to using it to merely mean controversial.

I realized it as I was scrolling people's thoughts and simultaneously thinking, "what a moron" while also realizing that I couldn't actually prove that they're wrong and didn't actually disagree with the facts they were laying out. That's probably a pretty good test for whether something is a scissor-x or if it's just controversial.