Showing posts with label add/adhd. Show all posts
Showing posts with label add/adhd. Show all posts

Thursday, May 4, 2023

ADD/ADHD Article in The Atlantic and Medical Malfeasance

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The Atlantic has an interesting article about Adderall and ADD/ADHD in which it reveals that the medical community failed to even recognize adult ADD or take it seriously as a disease until 20 years ago, if that. And of course Adderall may be over prescribed today as a result, or is it?  After all, amphetamine is a recognized human performance drug with some well known side effects, why shouldn't people be using it whether or not they have ADD?  

As the article makes clear, the medical community is guilty of gross malfeasance in this area, and I think it is very reasonable to resent being required to go to these wankers as one gateway of many to get the most important known medication available for this disease/syndrome/whatever.

 
 

Sunday, February 26, 2017

Facebook Discussion About Whether ADD/ADHD is a Fraud

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This is a transcript of a Facebook conversation I had with Robit Hairman about ADD/ADHD in response to an article he posted about how ADD/ADHD is a fraud. My response was treated with contempt by Robit, so I let loose with a full dose in response. I have retained some of the FB formatting to try and keep some of the flavor of my response. I believe that ADHD denial is another form of science denial on the part of Americans. At the same time I have no doubt that the disorder may be over-diagnosed.

But it is not a fraud.

Michael Wahrman
Michael Wahrman So every five years or so, some asshole comes out with an article about how ADHD is not real. But it is real. And the medication works. But the medication is nearly impossible to get because of stupid laws put in place by the Nixon administration. You may not like that, but that is just too bad. Oh by the way, thousands of doctors think that ADHD is real. I suppose you deny Climate Change is manmade as well?
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Michael Wahrman
Michael Wahrman Since I have been publicly humiliated for daring to discuss some experiences with ADHD and medication here on this forum, let me go further and share with you a little bit of what I think I have learned after living with this disease all my life and studying it for 20 + years after being diagnosed. I should mention that I am not a Dr. of Medicine, although I hope to be a Dr. of Philosophy in a few years if that matters. First, the track record of psychiatry in diagnosing this and other "mental" disorders (that is, for the most part I am referring to physical disorders that affect cognition) is not great. They have to rely on a lot of patient-reported states of mind in many cases, and there is no definitive blood test for depression or ADHD. Second, various classes of psychiatrists do not talk to each other, or maybe do not respect each other, and in the case of adult ADHD this affected people getting diagnosed and treated for decades. Third, there are excellent tests in child psychiatry for ADHD and if you have a child you suspect may have ADD/ADHD, I hope that these tests are used before a diagnosis is made. I have only been through these tests once, and they were hilarious and very convincing. Ask for more details if you like. Fourth, it was only my first doctor, the highly recommended Dr. Koch of Greenwich Ct who ever used these tests, none of the others have. It is not a coincidence that the others are adult ADD/ADHD doctors but Dr. Koch treats both types of patients. Fifth, I can tell you from personal experience that not all ADHD doctors are drug mad who prescribe at the first sign of anything wrong, on the contrary, the doctors I have used are anti-stimulant and prescribe them as a last resort. As someone who has tried all on-label medications for this disease and most of the off-label ones, I can tell you that for those with my class of the disorder, it is only the stimulants that reliably and significantly work. (The others may indeed be sufficient for those with a minor case of this disease). Sixth, which leads us to the next problem .... (end of part 1)
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Michael Wahrman
Michael Wahrman (beginning of part 2), Sixth, there is no objective way to judge in advance which medication is sufficient or effective or in what dose for the patient, at least not to my knowledge. If you are like me, you will find the hit and miss approach used by doctors to be both annoying and time consuming. In fact, I only found the best medication for my particular version of this problem more or less by accident (in the same way I was diagnosed by a friend not a doctor, originally). Seventh, once you do find the appropriate medication, if you are lucky enough to do so, good luck in getting the Dr to prescribe what you need in a reliable and cost effective manner. I repeat, Drs do not like to prescribe stimulants as it puts them at risk of losing their license. And why on earth would they want to lose their license merely because it helps the patient? Eighth, I have no doubt that this as well as many other "psychiatric" diseases are or may be overdiagnosed, and powerful medications prescribed. Sadly it is up to the parent to figure out if this medication is appropriate or not, as the patient, if a child, may not be able to. Now in the case of adult ADD/ADHD, this is quite straightforward believe it or else. Particularly in the case of ADHD but also with ADD to a lesser extent, the effects of medication in the appropriate dose are not subtle, not in the least. And in the case of the adult, it is extremely likely that the patient has self-medicated all their life to try and get relief in the absence of diagnosis and treatment. (end of part 2)
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Michael Wahrman
Michael Wahrman (beginning of part 3) Ninth, I can tell you, and Robits contemptuous response to my comment above demonstrates, that many people, perhaps most people, do not take this disease seriously. They either do not believe it exists, or that it is serious, or that the medication is required, or some other version of contempt. The fact that millions of Americans will tell them differently has no effect on their preconceptions. But let me tell you, for people like me, and I can not tell you how many there are, the disease is non trivial and the medication is non optional. If you do not believe that, then you are not going to care about the rest of this testimony. It will be dismissed by you with some off hand gesture or ("aww"). And so, tenth, you would not believe how difficult it is to get this medication legally. And we are only talking about legal medication here, not illegal self-medication. I could go on for pages about the hurdles you have to go through and not be exhaustive and you would probably not believe me anyway (most people dont). So if I have any credibility here, let me say that anyone with a serious version of this disease will spend an unknown amount of time per month getting the medication and in many, many cases not get sufficient or reliable medication for years on end. But you probably dont care because you do not believe that this is a real and serious disease, now do you? (end of part 3)
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Michael Wahrman
Michael Wahrman (part 4) Tenth, do I believe that this disease is probably overdiagnosed? Yes, I do. Psychiatry is a screwy business, subject to fads and other influences (including a very corrupt Pharma business) and the free market (what a stupid concept to apply to medicine). To all parents, I would tell you to insist on the tests I went through when I first formally diagnosed. Believe me, they are not subtle. And if your child is only ambiguously diagnosed, then dont worry about it. Its not severe. If it is a clear diagnosis, then trying a low dose of stimulant (or if you prefer the more ambiguous non-stimulants) is not going to kill anyone, and if it works or sortof works, then it will be obvious within hours. This is less true for ADD than ADHD, in the former case, one must rely more on personal testimony of the patient, but even then there are informal tests one can apply. In the latter case, the symptoms of ADHD respond very well to low dose stimulants and one can see results within hours (or even minutes in some cases). Eleventh, the good news is that the primary stimulants prescribed for ADD/ADHD are trivial to get off of. They are no where near as addictive as say, coffee or cocaine. There is the problem that people can get dependent on them for psychological reasons as these are human performance drugs, which is why Dextroamphetamine has been used by our armed forces in WW2 and afterwards. (The Germans used methamphatamine btw, a drug I have no experience with). Twelth, I do not write about my personal experiences because it does me any good. It has been used against me whenever I have, or I have been subjected to abuse or contempt. I do it to help my friends and others who may have this disease and do not know what is going on and may not realize that there is a solution. Therefore you should say thank you for the time I have taken to give you the benefit of my experience and research. You are very welcome.
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Saturday, January 23, 2016

Non-Stimulant Treatment of ADHD


We are taking an extended sabbatical from stimulant treatment for my severe ADHD and anxiety disorders. There are several reasons for this, but two of them are (a) dealing with the controlled substance laws in this country is an incredibly annoying process, filled with the worst kind of quasi-legal bullshit designed to make the process disagreeable and I am looking forward to a break, and (b) it is only fair after 20 years of treatment with stimulants to see what else works or does not work.

If it does work, then it will make things like travel both inside and outside the country much easier.

There is no good time to change medication in this disease, there are only less-bad times, and this is probably one of them.

I can't say that I am very pleased with the medical system in this country. And no, none of this is likely to be covered by health insurance, assuming I even get health insurance with Obamacare.

For those who care enough to learn more, and I doubt there are many of you, here is a link to an excellent discussion of the non-stimulant alternatives. There is something that is mentioned at the top of the article which I would like to emphasize because so many of my friends and people at large do not want to hear it. For this disease, stimulants are by far the best to treat this disease. They are all controlled susbstances.


I admit that being open about the treatment of this disease has never done me any good and can only do me harm, as I am an easy target, but it was a goal of this blog to be open about these matters in the hope that my experience may help others.

The downside of this experiment is that I may experience anxiety disorders, panic attacks, tell people what I think, and seek out stimulants off-label due to craving not satisfied by the non-stimulant medication. Should that happen I will probably return to stimulants quickly.

There is some hope that if I had a stable place of employment doing work I loved with people I liked that then many of these perceived problems would go away and the medication, which will be necessary for the rest of my life, would stabilize.

Tuesday, December 16, 2014

The Plausibility of Getting Medication in Mexico


In order to clear up a misunderstanding... the interest in getting medication in Mexico is not predicated on a desire to save money nor it is to avoid getting proper prescriptions.  It is because DEA and Ca. restrictions on certain medications make it impossible to get these medications under various circumstances (e.g. the pharmacy will not sell them to you) even with legitimate prescriptions.   

One function of the Internet which can be said to be socially neutral is to share information among people who have a common interest, whether that interest is sailing, jihadist terrorism or getting legitimate medical help in a region of the world. This feature is certainly of positive value some of the time, but it is also of (culturally dependent) negative value other times. Clearly we do not see advice on blowing people up as positive, but those who seek to right what they see as wrongs do.

In that spirit I am going to discuss what I think I know about getting the medications I need to treat ADHD in Mexico. One of the few advantages of living in Hell is that I am near the border of Mexico. Its an hour away.

This note is not intended to aid people figure out how to get recreational drugs or anything of the sort. It is intended to be a personal journal of my attempts to get legitimately prescribed medications for a disorder that for reasons known to the DEA are difficult to get in this country.

I also happen to believe that American adult citizens of good standing should be permitted to be able to choose what they take in their bodies without the consent of doctors or government as long as they are of proper age, and do not do stupid things like drive motor vehicles under the influence. Which of course they do every day of the week under the influence of the most dangerous drug of them all: alcohol. But that opinion of mine is not relevant to this and related posts. This post is solely about getting properly prescribed medications that are not disbursed in this country for a variety of regulatory stupidities.

There is a lot of misinformation about getting meds in Mexico on the Internet and I am probably adding to it. As time goes by I will add links to the useful sources I have found. So far, I have not tried any of this and I have not been to Mexico for years. This information comes entirely from reading dozens or hundreds of posts on the Internet and forming my own judgement. No doubt I will try some of what I discuss here if for no other reason to satisfy my curiosity. Repeat, none of the following is personal experience.  And I despise giving what appears as advice without direct personal experience, but here we are.  Any numbers quoted are numbers found on the Internet and are likely to be “internet numbers” which is to say not true, or only somewhat true.

First notes, and then tentative conclusions.

Americans going to Mexico to get medication is a vast business. There are numbers like 40 million visitors per year just for this purpose. There are numbers such as $200M a year in pharmaceuticals bought by Americans and carried back across the border. Remember, these are internet numbers, taken with a grain of salt.

There are at least a thousand pharmacies in Tijuana that exist to service this business. These pharmacies fall into two classes. Only the much more rare first class handles what we would call controlled substances. The more common second class of pharmacies handles the more common and uncontrolled substances.

The vast majority of purchases fall into a few classes: older people seeking to save money on the medications they need to survive or not be in pain and who are looking to ease the appalling costs added to medications in American in order to extract more money from innocent victims. As you might imagine our government is outraged that sick and poor people would try to get the same deal that large corporations get by going offshore, and do anything to stop it. But for some reason the border guards will permit these prescription, but non-controlled or scheduled substances back across the border if they are carried by the person they are for and are for personal use. I know very little else about what is involved in getting these medications and they are of no interest to me, at least not yet. The other major group of purchasers are young men looking for Viagra at a discount or other appalling date rape drugs which are apparently easily available. There is also a big business in self medicated antibiotics and people stock up on these. This is the sort of behavior that makes doctors in this country and their paid servants, the politicians, mad with rage and they do whatever they can to stop it. There is another category of people who are seeking medications not yet available in this country but are available in Europe. Mexico seems to follow the European approvals.

Many of these medications are made directly in Mexico in factories run by the major pharmaceutical companies. There is a lot of discussion about what is and what is not of adequate quality. My feeling is that this should not be a major concern unless you are doing things like cancer drugs or heart disease drugs. In my case it is not a concern. The medication will work in the manner that I expect or I will not repeat the experience. If it doesnt work I am no worse off than I was before.

Generally speaking your American prescriptions are not good over there. Mexico has their own system of prescribing medications and if you are interested in so-called controlled substances you will need a Mexican doctor to write you one. This is apocryphally not too difficult it is said. See notes below. A photocopy of an American prescription or empty prescription bottles *may* be of use in demonstrating that you are of good will and it *may* be useful in talking to a licensed Mexican doctor in getting a prescription for what you need. On a personal note I plan to take with me photocopies of a relevant prescription and an empty bottle or two just in case they turn out to be useful.

It is apparently common for a person to go to a pharmacy, be directed to a doctor, and get a prescription for what they need for what we would consider a nominal sum, e.g. $20 or $30 US. Again take this all with a grain of salt.

The doctor may wish to break the prescription down to small amounts and suggest you go to separate pharmacies.

Coming back across the border seems to be the following. You are supposed to declare anything you buy of this type. If you do not, and they find them, you are guilty of a misdemeanor and what you bought are likely to be confiscated. If you do declare and they are for personal use, generally they let you through. If you are carrying so much that they think that you are going to resell them, then they will confiscate. It is not so clear to me that any of this applies to controlled substances, but if they are small amounts for personal use, and you have copies of legitimate prescriptions or American bottles, then it is believed they let you through. I consider this a major flaw in the whole scheme because it is very likely that the behavior may depend on who is manning the station and what the enforcement flavor of the month is.

You will need a passport.

Tentative conclusions:

For non-controlled substances that are not health critical, such as heart disease, this is likely to be a way to save substantial money and has no apparent risks.

Those who use medications that are health critical need to be more careful and you can find discussions on the internet of how to do so.

Carrying an American prescription and or empty bottles may be helpful in getting the medication or coming back across the border, or it may be totally a waste of time.

You will need a Mexican prescription for anything that is controlled in Mexico. This includes most but not all of the controlled substances in this country. For ADHD, anything useful is controlled in both countries.

Coming back across the border is a dubious activity that may be helped by the medication being for your personal use, and having proof of legitimate American and Mexican prescriptions. It is critical that this medication be for your own use and not for resale. Failing to declare these things is a crime, do not do it, it will get you into trouble.

You will need an American passport.

Plan to spend all day on this activity, at least the first time you try it.

In conclusion, I am leery of the whole process. It is an ambiguous venture, not quite tantamount to drug smuggling but perhaps one of those odd holes in the control of trade materials across the border. But we are told we live in a world of globalization and that it is ethical to destroy American livelihoods by using slave labor in China, a vicious dictatorship, so why shouldn't Americans try to get a little savings by going to Mexico.

The hypocrisy of our system is rampant, overt, and starting to get annoying.