But meth already is being sold to the public. At pharmacies and with a prescription, not to the general public in convenience stores.
I don't think that people hate seeing others having fun, but rather its the demonization of drugs in the post war era to quell social movements that has now entrenched a deep hatered to substances not blessed back then that is the bigger issue.
Maybe you mean Adderall? I've read methamphetamine is sometimes prescribed, but my understanding is it's extremely rare.
There is a real problem with some drugs that become physically addictive. A person can fairly easily drink alcohol or take adderall regularly without suffering physical withdrawals. I'm not so sure this would be the case with heroin, for instance. I don't think in those instances the drugs were demonized to quell social movements, but because they were substances that too easily consumed people's lives.
Methamphetamine is much less frequently prescribed than other forms of amphetamines for ADHD, but I wouldn't say "extremely rare". And there's very little evidence it's any more addictive or harmful than normal amphetamines.
I also think you're conflating addiction to dependency or withdrawal symptoms. Physical withdrawal symptoms are extremely common with stimulants - then again, they're common for basically all other drugs too. Adderall, caffeine, hell, even Tylenol all have withdrawal symptoms. If you're a daily coffee drinker, going a day without will likely cause a splitting migraine and some personality changes for a day or two! Many OTC nasal sprays for hayfever are known for having ferocious withdrawal symptoms, but they aren't addictive or abusable.
People who abuse stimulants take a dose vastly higher than any therapeutic dose. The effects end up being very different. You mention heroin, but heroin itself was originally marketed - for years! - as a non-addictive alternative to morphine, and was sold as a cough suppressant. Many people used it; most didn't get addicted. Cocaine was a fairly common additive to drinks for years; Thomas Edison was famously a fan of https://en.wikipedia.org/wiki/Vin_Mariani (as were two popes and numerous other famous figures).
There's nothing magical about heroin. Prescribe a therapeutic dose of a strong opioid, and maybe 1% (the data here is bad, but most studies cluster around this point) of your patients will get addicted and start abusing it (by taking a vastly higher dose); the other 99% will not. We keep demonising drugs, seemingly almost at random, but it doesn't seem to have much to do with the nature of the drugs.
Thanks for this thoughtful reply. I should probably not have commented on frequency of meth prescriptions, my only reference point is that it's never been brought up to me by my doctor and don't know any friends who take it for ADHD.
Regarding withdrawal symptoms, it's again anecdotal on my end. I have been taking prescribed adderall for ADD since I was a teen. When I do go off it for a prolonged period of time, I don't notice withdrawal so much as a mood shift and a decline in productivity. I'm more or less comfortable being lethargic and lazy when I'm off it, but I take it because I think it makes me better at being a person (ability to focus for one, but also just taking the time to do menial but important every-day tasks I might otherwise let go by the wayside, for example).
I think this speaks to your point though, that in correct dosages the withdrawal in (pharmaceutical grade) drugs can be safely mitigated.
On a slight tangent, I'd like to point to the ongoing opioid crisis. I wonder if the reason it occurred was not only because doctors made the drug readily available, but because so many people were told by their doctor--a generally trusted authority--to take larger doses? If it were only accessibility that led to the crisis, there may be some truth to the idea that some drugs are true public health hazards.
Apologies for rambling a bit, I'm somewhat on the fence about this topic, and I know this is a complicated issue to unravel.
The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested.
Note that the rate of opioid prescription in the US had dropped by nearly 50% since 2012 [1], while the overdose rate has more than doubled [2]][3]. Meanwhile the same crackdown that has led to a huge decline in prescriptions has also led to a decrease in the amount prescribed, to the extent that there is strong evidence it is harming patients because doctors are so afraid of losing their license they are unwilling to prescribe the correct therapeutic dose to patients.
A study in JAMA recently found that when doctors reduce the dosage of pain medication prescribed to long term opioid therapy, it leads to a threefold increase in suicide attempts and a 69% increase in overdoses[4]. In other words, the federal guidelines adopted to try and ensure that the drug was less readily available from doctors and prescribed in smaller doses seems likely to have cost a significant number of lives.
There don't seem to be easy answers, and the driving forces behind (and possible solutions to) the massive increase in overdose deaths in the US remain elusive. But at a minimum a simple model of "it's caused by doctors giving people prescriptions for painkillers" seems to not be supported by evidence at this time.
> The opioid crisis is a difficult topic, but the role of legal opioids in it is highly contested.
No, it really isn't. US doctors were massively over-prescribing very strong opioids and telling patients that these were not addictive.
This meant that communities were flooded with clean, pure, strong, opioids. This supply was legal. The fact that it subsequently got diverted into the misuse supply chain doesn't alter the known facts of the opioid crisis - that there was massive over-supply of legal meds.
> And there's very little evidence it's any more addictive or harmful than normal amphetamines.
Well, I won't say "just try and compare" because recommending to try that would be a devil's advice but the difference is huge and I don't need any scientific paper to confirm that. For a person having actual ADHD amphetamine can be a reasonable tool to manage it sustainably, at the same time meth would at least cause rapid tolerance build-up leading them to increase dosage very fast and face all sorts of health issues. You also won't be able to return to amphetamine soon after having tried meth, the former is going to have almost no effect until your brain chemistry actually recovers.
Start reading from "There's a lot of confusion around the difference between amphetamine and methamphetamine."
Most relevant quote:
"Moreover, there are no known neurobiological differences in action between METH and AMPH that would account for the [supposedly] greater addictive, rewarding, or psychomotor properties of METH."
Oh my, that's hilarious, in a twisted sort of way. I was aware that meth was prescribed, but I guess I had no reference point for how prevalent it might be.
I'm on a very similar one, which also has a GoodRx coupon.
In case you're not familiar with the details of psychopharmacology, or are lucky enough to have a more "normal" brain, it's quite common for one to spend a long time with their doctor, doing trial and error with different compounds that are variants on the same structure, even different isomers can have a noticeable effect for the patient.
At one stop on my journey, I was prescribed dexedrine, which I previously had only heard of in the context of the great Paul Erdos.
Sadly, despite my hopes and dreams, there was no noticeable increase in the proliferation of my math output.
I was in a similar boat, and spent a decent chunk of time during adolescence going through that trial-and-error process. At one point we tried Ritalin, which ended up just giving me horrible headaches and causing my grades to plummet. Dexedrine, on the other hand, was much more effective for me, even more so than adderall for some reason. I know Ritalin works for a lot of folks, and I find it pretty fascinating that the same medication can affect different people in such drastically different ways.
Completely tangential, but regarding Paul Erdos, I recall hearing about a story where a colleague of his was concerned about his amphetamine use and offered to pay him a sum of money to go cold turkey for a month. Erdos was pretty adamant that amphetamines were a boon to his math research, so he went cold turkey for a month to prove he could, took the money, and then promptly resumed his usage.
Not sure if it's true or what lessons are to be learned there, but it's a fun story :)
> I know Ritalin works for a lot of folks, and I find it pretty fascinating that the same medication can affect different people in such drastically different ways.
Same!! (Ritalin doesn't work on me either).
On my "journey to what works" the least pleasant, and most amusing in retrospect, was Strattera. Somehow, that medicine cranked up the "impatient asshole" knob in my brain to 11. I was cursing out people on the street for no rational reason, and carrying myself with more confidence than I've ever felt in my life. Things where I would normally have a patience of minutes became seconds. I found myself getting pissed off at dear friends for talking too slowly, interrupting them "can you fucking speed up please?". I quit after 5 days. :)
At the time, my doctor seemed skeptical of the side effect, but a decade later I found documented evidence of it in others. Curiously, the medicine works quite effectively, no side effects, for someone who shares half my DNA. Brains are weird!
Tangentially, I've heard a variant of that Erdos story too! Clearly it must be true. ;-)
> even different isomers can have a noticeable effect for the patient
Case in point - L-methamphetamine is or was used in Vicks inhalers in some countries, notably the US, as it has none of the euphoriant effects of D-methamphetamine but it does still cause vasoconstriction, which can help with a blocked nose!
I knew I was taking an amphetamine derivative but I had no idea my ADHD prescription was literally the same as meth. of course, I'm taking a tiny daily amount. No wonder they give me such a hassle about filling my script when I'm traveling!
What percent of methamphetamine addicts would actually have qualified for a Desoxyn prescription before they started using? This health site [0] says 16,000 prescriptions for Desoxyn are written in the US each year, contrasted to the 12 million Americans who abuse meth.
Prescription meth use is much different than recreational use. Dosages are way larger, and so is method of administration. This makes enormous difference.
Consider dextrometorphan. This is a common over the counter cough medication. It can also be used recreationally - but the recreational dose is 30 times the therapeutic dose. Amphetamine is similar: methheads are not swallowing a single pill of Adderall, like medical users are.
I don't think that people hate seeing others having fun, but rather its the demonization of drugs in the post war era to quell social movements that has now entrenched a deep hatered to substances not blessed back then that is the bigger issue.