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Notes -
Have we talked about the Adderall shortage? Going through top Twitter posts on Adderall recently is a wild ride:
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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.
As Adderall is in some degree effective because of the placebo effect, the meme that the pill’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. “Our foreign enemies are artificially reducing the potency of our placebo’s effects potency with claims of non-placebo substance impotency”, 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: “my boy just can’t add ‘er all up in the math classes like those Chinese kids”.)
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 can’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 “this is the cure for my inattention”, but “this is an unreliable thing they may not be effective” — you’re now looking for evidence that it is ineffective rather than evidence of desired changes
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