What is the best dose for Adderall
A neuroscientist explains why crystal meth and the ADHD drug Adderall are almost identical
This article focuses on the similarity between methamphetamine and the US drug "Adderall", which is popular with Hollywood stars, for example. Dr. Carl L. Hart's work focuses exclusively on the scientific analysis of the drug and its effects on the drug human body and the human brain. Dr. Hart's biography 'High Price' is controversial among German drug experts because some claim that Hart played down addiction, psychosis and tooth decay. Tim Pfeiffer-Gerschel of the German Monitoring Center for Drugs and Drug Addiction agrees with Hart's claim who said it was problematic to refer to crystal meth as "the worst drug of all time" or to speak of "nationwide epidemics" as it could destroy consumer confidence in drug education programs.
This article was written in collaboration withThe Influencereleased. The Influence reports on all aspects of the human relationship with drugs.
The long subway ride from Washington, D.C. airport after Silver Spring was unusually pleasant. I had taken a small dose of methamphetamine about an hour earlier. It was my 40th birthday — October 30, 2006 — and I was on my way to a conference funded by the US National Institute on Drug Abuse (NIDA).
A friend had a prescription for the substance and gave me a few tablets because he knew I was an amphetamine expert without ever having taken any of them myself. I sat on the train and felt wide awake, mentally stimulated and euphorically peaceful.
And when the effects wore off after a few hours, I thought, "That was nice," went to work out and enjoyed a productive two-day conference. Well, maybe I didn't really enjoy it - after all, it was a NIDA conference. But I did no insatiable cravings for drugs or the urge to take more. I also had no strange behaviors — I was definitely far from the "meth head" stereotype.
So where does this typical image people have of this drug come from?
Perhaps it has something to do with the public "awareness campaigns" designed to discourage people from using metamphetamine. These campaigns usually show, in an explicit and detailed way, some poor young person who tries the drug for the first time and then engages in atypical behaviors, such as Prostitution, stealing from parents or attacking strangers in order to get enough money for the next dose. At the end of such advertisements, for example, the words: "Meth — not even once" appear. We have of course all seen the infamous "Meth Mouth" pictures, in which extreme tooth decay is falsely portrayed as a direct result of meth use.
These media campaigns do nothing to prevent or reduce the use of the drug. They don't even provide real facts about meth. The only thing they do is spread false beliefs.
In a society so influenced, it is hardly clear to anyone that methamphetamine has almost exactly the same effect as the popular ADHD drug d-amphetamine (dextroamphetamine). In the US, this drug has been approved for some time and is sold, for example, in the form of the drug Adderall; it is a mixture of amphetamine and dextroamphetamine salts.
Yes I know. I have to explain a claim like this in more detail.
I don't mean to say that people who take Adderall should now worry that they will fall prey to an inevitable and destructive addiction, I mean to say that we should see methamphetamine more like d-amphetamine. Both methamphetamine and d-amphetamine are drugs that are FDA approved in the United States. Methamphetamine is also approved for the treatment of obesity and d-amphetamine for the treatment of narcolepsy.
I would like to be honest at this point and admit that I myself once thought methamphetamine was much more dangerous than d-amphetamine, although the chemical structure of the two substances is almost identical. In the late 1990s, when I was a PhD student, I was told that the extra methyl group in methamphetamine made it more fat-soluble (that is, it gets into the brain faster) and that it made it more attached than d-amphetamine - and I believed that without hesitation .
It was only after I had my PhD for several years that this belief was dispelled by evidence. This evidence came not only from my own work, but also from that of other researchers.
In our study, we brought 13 men who took methamphetamine regularly into the laboratory. We gave each man either a dose of methamphetamine, a dose of d-amphetamine, or a placebo on different days. The study was carried out double-blind. We repeated the process with each person over the course of several days, with multiple doses of each agent.
Like d-amphetamine, methamphetamine gave our test subjects more energy and increased their ability to concentrate. In addition, subjective feelings of tiredness and cognitive disorders, which are usually caused by exhaustion and lack of sleep, were reduced. Both drugs increased blood pressure and heart rate. These are undoubtedly the effects that explain why the armed forces of several countries, including the United States, continue to use d-amphetamine.
When we gave our test subjects the choice between a dose of one of the drugs and various amounts of money, they chose d-amphetamine as often as they chose methamphetamine. These regular methamphetamine users could not tell the difference between the two substances. (It is possible that the extra methyl group actually increases the fat solubility of the methamphetamine, but that this effect is too minor for human users to feel the difference.)
It is also true that the effects of smoked methamphetamine are more intense than the effects of a tablet containing d-amphetamine. But this intensity comes from the dosage form and not from the agent itself. Smoking d-amphetamine has almost the same effect as smoking methamphetamine. The same would be true if someone were to pull the two remedies through their nose.
As I left Washington and returned to New York, I reflected on how I had previously been involved in deceiving the public by exaggerating the dangers of methamphetamine. For example, in one of my previous studies to document the drug's highly addictive potential, I found that given a choice, methamphetamine users would get a methamphetamine dose of 10 milligrams a dollar about 50 percent of the time preferred cash.
In 2001 that indicated to me that the drug was addictive. But what it really showed was my own ignorance and bias. Because, as I found in a later study, if I increased the amount to $ 5, consumers would have taken the money almost every time - even though they knew at the time that they would not get the money until a few weeks later, after the Study, would get.
MOTHERBOARD: Glorification 2.0: The hardcore crystal meth scene on Tumblr
All of this should teach us how much media bias can affect even scientific research into drug use.
For me, it took me nearly 20 years and 20 scientific publications on drug use to identify my own bias about methamphetamine. I can only hope that it won't take as long and as much research again before the public again understands that common ADHD drugs that countless people take on a daily basis are essentially the same as the drug meth.
And I hope that knowing this leads to the fact that people who use meth are no longer judged so much and instead treated with more empathy.
Dr. Carl L. Hart is a professor of psychiatry at Columbia University. He also has the book High Price: A neuroscientist's journey of self-discovery that challenges everything you know about drugs and society written.
Cover photo: Dr. Carl L. Hart | Photo courtesy of The Influence
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