what drug best approximates the short-lived stimulant effect of seeing a tweet get lots of Likes and RTs?

@eiaine but i think some nose coffee would do the job as well

@exitfiat WOAH cool!!! brb going to a find a doctor willing to diagnose me for " myocardial infarction, trauma, endotoxic septicemia"

@eiaine dopamine. Getting it into the brain is a trickier process though. IV ain’t much fun.

@drgo i feel like modern medicine should have invented a pill for that by now? Like, i need the equivalent of methadone. but for twitter

@eiaine agreed. Or at least modern designer drug culture should have come up with something g. Methamphetamine would be about right except it lasts too long.

@drgo what if i only take small amounts at a time? will that work, doctor?

@eiaine I suspect it would work better than you’d think. But getting a proper dose and not addicted can be a tricky thing. Meth is a drug in the US pharmacopeia, so long as you are at least 5 years old. Some googling on this taught me something new: you can eat an amphetamine pro-drug and let your liver convert it into a stimulant. Can’t find one good link with both drugs, but here’s a crappy link containing both:

@drgo @eiaine Yup. That's why it's both accurate and inaccurate to say ADHD drugs are just meth: they all turn into basically meth. But the rate at which that happens can be controlled with the pro-drug mechanisms they use in various ways.

@drgo @eiaine From what I've heard ADHD drugs can still be very addictive in spite of all this formulation wizardry. But apparently not in the obvious way: they do in fact work for many people, and that's a very powerful psychological addictiveness in of itself.

@pete @eiaine I’d bet they’d have similar effects in all sorts of mammals. The trick is finding benefit with out abuse or addiction. A bit outside my field, but, I believe it is done all the time.

@drgo @pete @eiaine I’m also probably not the best to answer this question. I literally found out a doctor can prescribe straight up meth to a kid during electronic medical record training…funny the things you learn in medical school. @drbitcoinmd might know more neuropharmacology that me :)

@drgo @eiaine Apparently one of the ways that ADHD etc. can be confirmed is to just see how the patient reacts to drugs like Adderall. In someone with "genuine" ADHD, etc. those drugs often have opposite effects of what you'd expect, eg the "meth" actually leaving the person feeling sleepy.

@drgo @eiaine ...and again, I'm not putting "genuine" in quotes because I'm trying to say ADHD isn't real. Rather, I want to make clear that it's a fuzzy label on a situation specific continuum. Change jobs and someone who would previously fit the criteria of having a problem with ADHD might no longer, and vice versa.

@pete @eiaine in psychiatry, that’s how it is done for everything. Your diagnosis is more of a category assignment and treatments are selecting by using what has shown to work for the largest percentage of people in that diagnostic category. If the drug doesn’t work, you’re now in a new category.

This makes sense for psych because underlying cause for a collection of symptoms is not known.

@drgo @eiaine Exactly. Just look at how good psychiatrists will stress that a condition should actually cause harm to be considered a disorder.

If you have ADHD, but switch jobs to something where long term attention to detail isn't so important, you could easily find that for practical purposes you don't have it anymore. And vice versa.

@pete @eiaine all sympathomimetic drugs share a ton of chemistry. Not all binding highly specific to any one receptor, even outside the sympathetic nervous system.

@pete @drgo @eiaine this is a pharmacologically ignorant take; the method of action is different with meth if it’s eaten, snorted, or smoked, with it becoming more intense and addictive increasing left to right in that list

are you a pharmacist by any chance? can you explain to me how methylphenidate turns into methamphetamine? Can you explain the differences between different amphetamines in technical terms?

@wiggles @drgo @eiaine I mean, I'm not sure that we're in disagreement... I'm saying that the actual low level receptor chemistry may be basically the same. Yet with a very different effect due to how it is being administered.

@wiggles @drgo @eiaine Adderall for example is packed in little time release beads. Just crushing those beads can change how it's absorbed quite a bit IIUC.

@pete @wiggles @eiaine concentration is sort of like fingers on a keyboard. Higher concentration means pushing each receptor type harder; there is a max for any one receptor type, so relative effects from cross reactivity with other receptors changes with concentration. Hence one drug can appear to do different things at different concentrations. Example: I’ve never seen meth mouth on CT in a pediatric patient…

@pete @drgo @eiaine I misunderstood you, apparently. Sorry about that!

@eiaine @drgo There's probably layers upon layers of regulatory mechanisms to prevent dopamine and similar things from going haywire due to chemical imbalances. That'd make manipulating them long-term with simple drugs difficult.

@eiaine @drgo ...and I should say, by "chemical imbalances" I'm not trying to use the trite concept that we often hear depression, etc. described as. I mean to combat the inherent imprecision of biology and genetics, so that organisms function properly regardless. Some of those mechanisms are really basic things, like metabolic rate. That needs to be correct in the face of all kinds of external and internal influences.

@eiaine Not sure. But I liked this, then unliked it so I could like it again. I hope that helps.

@georgevaccaro i'm watching Saylor interview Ross Stevens on youtube right now, oh man what a rush :D


I'm watching it right now, again!

He totally gets it and who knew that folks like this were already making these amazing points to private clients? Where has this guy been?

It's happening.

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