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Cryptocurrency also makes ordering illegal drugs via the mail much easier... uh oh.

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Well, one way in which it has changed the world is making ransomware easier and more profitable.

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Folding Ideas has a great video on NFTs called "line goes up" where he says that NFTs are not revolutionary, it's the 1% trying to get as rich as .01% are

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Agree completely. Even in line goes up he is a little overly conspiratorial and a little too eager to see basic human failings and greed as the machinations of his supposed political enemies.

But despite all that it is a great outline out of the basic fundemental flasws with the crypto world, and particularly with "smart contracts" which were always one of the things that most drove me up the wall when people were exicted about them.

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deletedNov 16, 2022·edited Nov 16, 2022
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The ballad of MurderGhandi.

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I think the most surprising thing for me was that “In line with most tech companies” is a great euphemism for “yes, everyone was on stimulants”. And just how matter of fact the article is about software engineering being fundamentally incompatible with the human mind.

And like… I can’t focus very well at my software engineering job, to the degree that I basically relate to all the discussions of people with ADHD now (it wasn’t an issue before college). And I don’t really have particular problems with anything else (chores, writing, massive amounts of DMing). Just my job.

I know a few friends on Adderall, but I thought they were the minority. I don’t know how to feel if it’s really that common. I’m honestly still skeptical of the claim, just because I don’t want to believe it.

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Nov 16, 2022·edited Nov 16, 2022Author

I'm probably exaggerating a bit here, and I've added a clarification to that effect to the post. I really don't know the real number. Maybe a job for an ACX survey.

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founding

ACX readership is _definitely_ not a representative sample of... anything really, but in particular of strange medication use.

When I try to think of examples in the tech people around myself, the people who come to mind were influenced in some degree by knowing me. (And I'm actually pretty conservative - never even tried recreational drugs above weed)

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I'm very dubious. I know tons of programmers, and none of them seem to be taking stimmies, other than a morning coffee and an afternoon espresso, with is pretty mild stuff.

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I've been a software engineer for about 18 years, and I did not take stimulants for 16 of those years. I started taking them about 2 years ago, but only because of depression which I suspect was induced by the COVID pandemic, rather than because of my profession.

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I think the trend is in the same direction. Three years ago I'm confident none of my close tech friends were taking stims. Now at least two of them are. Anecdata only but consistent with the idea that this is becoming more common.

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Not sure about stimulants, but on multiple occasions, my husband and I have been surrounded by a big group of colleagues and learned that we were the only ones not on some sort of prescribed psychoactive medication, mostly antidepressants and anti anxiety meds. It was honestly a little alarming to have a room full of people start comparing notes on that.

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Same. It may be higher than the general population, but it's not everyone, or even >50% from my anecdata. One thing to consider is the average tech age and the supposed recent huge increase of stimulant use in college. Considering the graduated in the last 10yrs population, use may be around average.

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I guess I'm one of the lucky few. I have been a programmer at big companies since 1982, delaying retirement because I enjoy it so much. I haven't taken more than coffee, and I'm not aware of any peers taking stimulants.

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But would you know? People can hide these things.

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Sure, I guess. But most of them, for the past 20 years? It's not like I've been their boss, and some of them have been pretty good friends. I'm sure there's some fraction of the people I know in general that have weird hidden personal problems. I'm just dubious that it's most or nearly everybody.

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I am with you here. Coffees sure.

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Maybe it's more common in a start-up culture environment? I also know may programmers, and none admit to taking stimulants, but none of them work at start-ups.

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I have the same experience, but I assume most people would NOT tell their coworkers about this, so it seems pretty unknowable.

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I knew a few, but only among the ones I was close enough to that we discussed our various medical problems. No one was leaving bottles on their desk or casually talking about it in the hallways.

I used Adderall (generic) myself, for a bit, back when my incipient PTSD was misdiagnosed as my previously-sub-clinical ADHD getting worse. It was useful, but I didn't like it. I noticed an increasing inability to switch from lower-priority tasks to higher-priority tasks, as if whatever I happened to be focused on at the moment was much more important than it actually was.

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That's my main problem with stimulants in general and amphetamine in particular as well. It works great — if I can start doing what I need to be doing. But mostly I just keep doing whatever I was doing when it kicked in.

Yes, this has resulted in four-hour masturbation sessions; and brother, let me tell you: you don't know shame until you finish after four hours of doing the most useless and — heh — masturbatory activity possible, having accomplished nothing *and* not even really enjoyed it after about minute 15, and that post-orgasm clarity hits you...

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Maybe it's more common in the SF Bay area, or in start-ups, or among the pseudo-nerds who read Wired magazine and are desperate to be part of the Next Big Thing.

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On the flip side, I know a ton of hackers who are very definitely all taking some sort of prescription stimulant. I am sure I could name ten without working too hard at it, and could potentially hit as many as two dozen if I really strained at it.

It may well be that the people who have ADD don't talk about it with people who *don't* have ADD or ADHD, which is why it seems to be this significant divide in the comments on the topic.

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Would you tell us what city are you in, what age these hackers are, or what market sector they work in? I expect there are difference along those lines.

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Well, it's not a localized phenomenon, so city is sort of useless, though I'll say this is people all over the world, from Dubai to Czech to Germany to Holland to the US.

Age group would be like, 30 to 60. Market sector is generally infosec or something related; insofar as it is possible for one to professionally be a "cypherpunk", a lot of these people are doing that. There's often a lot of strangely coincidental overlap in groups of people I know, so I hesitate to declare absolutely that it was 100% of these people, but it was probably pretty close, that all of these people will be folks I know because I was going to events like Defcon. (At the Alexis Park, putting me firmly in the *middle* of that age group above... ;) ) So, crypto, cryptocurrencies, computer and network security, penetration testing, sysadmins. That sort of thing.

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> The human brain wasn’t built for accounting or software engineering.

That’s why the evolutionary response is autism and why it is particularly prevalent in the Bay Area… That said, I find it hard to believe people who make their living from their brains will gamble with their moneymaker. The only stimulant I take is theobromine, a.k.a. chocolate.

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The invention of software engineering is too recent for an evolutionary response to have happened.

I think to steelman what you're saying, we probably have autism for "other reasons", and coincidentally, high functioning autism happens to be pretty good for software engineering.

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I think you probably mean "that's why people with autism can be more successful in the By Area," rather than implying that there is natural selection for more autism.

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I don't think there's any reason to believe caffeine or amphetamine is a gamble of that fashion. See, e.g., Erdõs, if the giant avalanche of studies confirming this hasn't convinced you for some reason.

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To give you another reference point, I'm a mediocre programmer, and I feel like true focus is something I experience a few times a day when I'm trying hard and things come together. It's not the norm for me. There's a boot up process of loading things into my working memory and getting my my motivational framework aligned that can be interrupted, or might never come together if the conditions aren't right. (Or if I'm being lazy. Or if I'm doing things I know throw me off like checking Twitter.)

Is this the kind of thing you're talking about?

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I am a programmer as well. I do take prescribed stims, and even with them I would say true focus is something I experience about once a week. I would love to do it a few times a day.

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I know how I would feel: mad that the government is gatekeeping such a useful tool from everybody.

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Wait she finds out about psychedelics.

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I've been in software for more than twenty years, and have never worked at a place where taking stimulants was common. I can only recall one anecdote about a place where doing so was standard practice. If Scott actually thinks speed is common in tech companies, I suspect the influence is from some other circles he travels in, not tech specifically.

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Anecdotally, I work at a FAANG and know for a fact all of my coworkers just (~2 yrs) out of college use stimulants, at least periodically. I only know this because they told me. I think you might be surprised how hard it is to tell, but also I'm sure it's much more common in this recent generation.

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To be clear, by "stimulants" you mean things stronger than coffee or tea, right?

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Yes I mean things like Adderall.

To add to this. I worked at a non-FAANG company before this and if anyone was taking stimulants there they weren't telling me about it.

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He did mention that he might have a bit of selection bias. My guess would be that his selection bias is higher than he thinks.

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Where are you located? That probably matters. Probably less common in some countries and also less common at conventional business software places.

Modafinil is incredily effective for me. You do have to make sure you drink a lot of water. But the impact is much more intense and much more useful than caffeine.

Maybe some kinds of tech either don't attract people who benefit heavily from something like Modafinil? I can do good work if I get in the zone without Modafinil but Modafinil helps get you in the zone and zeroes out lots of distractions.

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I'm in Canada, working for what I guess I'll call a FAANG-aspiring company. I was at an actual FAANG in Canada for three years and in Silicon Valley for eight years back in the 00s.

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What about all the people grinding leetcode and CS knowledge for months just to pass programming interviews, are the vast majority of them doing it "naturally" - no stimulants except the odd cup of coffee?

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Don't know about "all". Some version of your description fits tens of my friends and acquaintances and, at times, fitted me to some extent. I'm aware of a single person on this list taking stimulants. They were taking them for perfectly non-job-related reasons, way before entering the CS/ data/... world. Scott's description is completely unrecognizable to me - I've been in tech for decades now, including Valley start-ups, and have seen essentially zero use of stimulants. Slightly more in academia (including the occasional Aderall before tests), but still almost zero, and almost entirely in undergraduates. I suspect either Scott or I (and so many other commenters!) live in a bubble. I further suspect it's Scott.

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To be clear, I have zero knowledge about the world at large using Adderall. If your links have anything to do specifically with the use of stimulants in tech, I missed it. The word "tech" is absent from both links. All I'm saying is that Scott's characterization of tech as one big stim-party (and that being common knowledge!) is entirely alien to my experiences.

Also, it's a bit strange to put both links together - and then to imply (or at least so I read you - otherwise, what *is* the point you're making? That some people somewhere are using Adderall more? Or at least more relative to supply - numbers are entirely absent from both links?) that the shortage is mostly due to a surge in demand. The second link talks of the supply-side woes and of quotas being reduced.

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I think the point I was looking for is, it seems to be a very popular PED. (I have unfortunately mislaid my links about similar tenure track drug abuse.) Why not in tech?

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A. The claims I was responding to were that it happens in tech *above and beyond the baseline*. You can write "in tech, many people drink water/ have two ears" and be technically correct - but it would be a weird choice. So "why not in tech" is the wrong question. "Why in tech more than in many other areas" would've been better but we don't know that it's at all true.

B. "Why not in tech" may still have pretty reasonable answers. If there's a surge in Adderall demand, it must be relatively recent, hence "surge". Then tech would be selecting for people who achieved much/ worked hard/ studied well/ formed habits/ etc. before said surge. I would also expect risk aversion and conscientiousness to be mildly anti-correlated with stimulant usage and to be strongly present in tech. Perhaps Scott/ John/ you are talking about subcultures such as crypto/ fintech - not much I can say here.

And I'm reporting my own experience - those are friends, people I worked and studied with (including leetcode), not "I heard of them vaguely once". Is my experience consistent with "vast majority" of substance abusers or whatever? Yes, but it's much more consistent with low prevalence, at least for my generation.

Could there be a tech drug epidemic incoming? Sure, that's possible. Particularly if popular Substack writers and their commenters make it seem like everybody's taking stimulants all the time ;)

C. Tenure track - I'd be happy to see that link. Again - I've been exposed to the academic world all my life. Are there stress, tragic cases, highly salient examples of drug abuse? Yes. Are they more prevalent in academia than in other walks of life? I'd like to see the numbers.

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I want to note how pejoratively stimulants are discussed, both in the second article you linked and to some degree in this conversation.

E.g.

“Adderall is prescribed for ADHD, which was once diagnosed only in the prepubescent. Now adults are discovering they have ADHD. Or occasional ADHD. Or work-at-home ADHD.”

Imagine saying the same things about antidepressants. “Now people are finding they have work-from-home depression.”

It seems pretty wild to me to suggest that a spike in prescriptions for a psychiatric drug around December 2020 was due to… avarice and a need for performance enhancement?

The much more obvious explanation would be that a lot of borderline-ADHD people were able to make it in a relatively free and open society, and then when their lives were massively disrupted they weren’t able to get by anymore.

That’s when I got diagnosed. My wife and I both have full time jobs and a then-four-year-old son. When the pandemic hit, schools shut down, childcare of any kind was illegal, and our jobs expected us to work remotely. It was the most attentionally-demanding, work-laden period of my life by far. And when time gets short and workloads get high, your other coping mechanisms often stop working.

Obviously my experience is not general, but I’d love to see some consideration that Adderall prescriptions are not all attempts to get a competitive advantage.

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In my experience, ADHD isn't a thing that keeps me from focusing; in fact, it MAKES me focus. Just not always on what I should be focusing on.

It prevents me from rationally controlling my task-switching--or, arguably, it makes it rational to task-switch in a way that makes it hard to work with people who task-switch easily.

I think my ADHD is a memory problem, not a focus problem or a boredom problem.

1. It imposes a heavy overhead on task-switching. Whenever I task switch, I'll forget forever any ideas I had related to what I was doing unless I write them down; it will take me a long time to load up my memory again with what it needs to resume the task; and I might never remember to resume the task.

2. It imposes a heavy cost on NOT task-switching when I discover something new that needs doing--if I don't drop what I'm doing, and do the other thing right away, I might never do it.

3. I don't have an internal alarm clock. Other people tell their minds, "Remember to go to the meeting at 2pm," and at 1:50, an internal alarm clock raises "go to meeting" into their consciousness. I have to either think about the meeting constantly until the time of the meeting; or set an external alarm. If my alarm goes off at 1:50, and then I notice a program has crashed which I need to run during the meeting so I can get the results that day, and I take 30 seconds to restart it, I might not to remember the meeting. The fact that I remembered the meeting at 1:50 will not make me remember it at 1:51 if I did something else in the minute between.

When I'm coding, I'm usually hyper-focused on it for many hours.

I don't think being bored with something is a result of ADHD. Being bored is more-likely a result of being too smart or not smart enough to find a thing interesting. But then, ADHD may not be a single disease, but a syndrome.

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Constant boredom has been perhaps the most salient symptom for me. And it looks like there’s a correlation in the literature: https://www.psychologytoday.com/us/blog/the-engaged-mind/202104/boredom-could-help-you-understand-what-its-have-adhd

My extremely crude and incorrect way of thinking about this is that my brain is wired more toward “explore” than “exploit”, ie there’s a much higher threshold of engagement necessary to get my brain to think “I should keep doing this” rather than “I should go do something else”. And it seems like dopamine is a core part of shifting toward “exploit”.

But as you say there are many different presentations / parts of the brain that can cause similar symptoms!

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I think there are two theories getting conflated here for why stimulant use might be common in the tech world, and I want to add a third that I’m surprised no one else has offered.

1. Particular places may have a culture of stimulant use. Maybe this is common in startups to handle a high workload (and the high stress position that your company might fail if you don’t work harder), but I’ve been in the tech industry for 15 years (mostly at a FAANG) and never encountered it. But I doubt anyone would question that some places undoubtedly do have such a culture, like the subject of the article, where there was clearly no attempt made to hide the selegeline or adrafinil.

2. Scott’s idea that boring jobs require stimulants, programming and accounting are unusually boring jobs, thus people in these jobs are more likely to seek and benefit from stimulants. I don’t find this argument convincing. Programming is one of the most fun and engaging jobs a person can have. When people talk about flow states they often mention coding, and every programmer I’ve discussed it with knows and enjoys this state as well. Contrast with, say, working in a lab, where you have to do the same things over and over and record the result. When you’re programming you’re invariably solving a new problem.

This brings me to my suggested explanation:

3. People with poor attention are drawn to computers and programming. In my experience there are two life stories of programmers: either you chose it in college as a well-rounded career (excellent choice!) or it chose you when you were young and wanted to play video games and make your own video games and network two computers to play video games with friends and draw fractals and host a website and so on.

Programming is great for people with poor attention spans because it gives immediate feedback. Make a change, run it, make a change, run it, ad infinitem. As someone with poor attentional control myself, I ended up in this industry precisely because it was the work I could get lost in and enjoy.

It was only when I had kids and advanced in my job to the point where I was no longer coding that I realized I needed help. I’m doing double shifts of design / coordination at work, plus childcare at home. Stimulants have helped me feel less bored and frustrated as I do all the less-intrinsically-engaging tasks I have to take on now.

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>Programming is one of the most fun and engaging jobs a person can have

I think this is a statement that has a lot to do with it. I'd say there are two kinds of programmers - ones for whom this statement holds true, and others, like myself, for whom it does not. The thing is the distribution of people who have the mindset and skills to become competent programmers is split pretty evenly over these subgroups.

People who enjoy the job and derive satisfaction from it can focus pretty well and do good work. Others feel like the job is pulling teeth, but keep at it because the pay/status is good comparatively. I think that second group is a lot more likely to use stimulants to combat the drag of going to work because switching jobs to something more tolerable is such a pay cut.

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That certainly makes sense. It would be really interesting to get some data distinguishing software engineers on two axes:

Takes / does not take stimulants

Thinks coding is / is not a relatively fun job activity

Then we could see whether it’s the people who enjoy coding who are more likely to take stimulants (which would point to ADHD as a driver of both) or the people who don’t enjoy coding (which would point to boredom / job dissatisfaction).

Of course, my theory probably has an unfair advantage - which is that if two people go to two psychiatrists and one says “I’ve had trouble paying attention all my life, it’s why I’m a programmer” and the other says “I have trouble paying attention when programming, I don’t find it engaging” the former is much more likely to be diagnosed with ADHD and given stimulants while the latter is less so. AIUI there’s some expectation that ADHD develops early and affects at least two major areas of life (work, school, home).

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Funny. I'm a programmer and my experience is mostly the opposite. I have trouble with chores, errands, writing, reading, paperwork, etc, but a clearly defined coding problem is easy for me to focus on.

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Was this part of what led you to become a programmer? That was my experience :)

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Probably, but I got into programming when I was young so I don't rightly remember. It's definitely part of why I stick with it.

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It doesn't match my experience either. Maybe its a FAANG thing?

If it is, it is seriously making me second guess working there if I had the chance. The idea of a workplace where the majority of workers are required to be on stimulants is nightmare inducing. (Exceptions made for genuine shift work which requires inhuman circadian schedules.)

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One of my colleagues once told me a story about working in a place where speed use was common. She said workers on speed did indeed work very quickly, but the speed really shot their judgement all to hell, so they could produce pages and pages of work without realizing it was complete nonsense.

I have this crazy idea that it might be best to have mixed pods of maybe four workers on speed and one supervisor who is clearheaded and can get the speeders back on track when they go off on a tangent.

But holy hell it would be dehumanizing.

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Like that bit in Herodotus where he's talking about how the ancient Persians made decisions: if they come up with an idea when drunk, they wait until they're sober and see if it still makes sense then. And crucially, if they come up with an idea when sober, they then get drunk to see if it still makes sense when blitzed out of their gourds.

Something something system 1 vs. system 2...

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I work at a FAANG and at large companies the culture can vary widely the further you travel in the org chart, so my experience may not be representative. But there’s definitely not a strong pressure to maintain strong work output; in fact, there’s a major focus on ensuring that people have a good life balance and are going at a sustainable pace.

Does this mean people aren’t on speed? Of course not. But it’s not part of the culture or necessitated by high expectations.

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I work for a big tech company, and if the people around me are on Adderall they're not telling me about it. I'm not, haven't asked, and don't seem to be falling behind anyone else.

Though there was a weird poster by the cafeteria a few months ago that was some sort of advertisement for a charity that was against black-market pills that were laced with all sorts of things. The odd part was that it treated pill addiction as perfectly normal ('$DEAD_KID was normal, sometimes took Adderall to work hard, or took Xanax to chill...') and didn't seem to have any awareness that maybe dosing kids up with black-market pills might be a bad idea. Like..."don't get prescription medicine anywhere but the pharmacy" seemed to me to be a pretty basic bit of common sense, but I guess not.

I didn't add a note saying "Why not just give your kids speed and opium directly?", but I was briefly tempted.

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There IS a big difference between using drugs to achieve life goals vs when they become the life goal themselves. The former is drug instrumentalization, the latter is addiction.

It’s weird that people are so broadly unaware that there are different possible relationships with drugs (I myself only discovered this term a few years ago) despite the fact that like 80% of the population has a relationship to caffeine that is obviously not addiction (and I would characterize as drug instrumentalization).

E.g. this journal article starts with:

Most people who are regular consumers of psychoactive drugs are not drug addicts, nor will they ever become addicts. In neurobiological theories, non-addictive drug consumption is acknowledged only as a "necessary" prerequisite for addiction, but not as a stable and widespread behavior in its own right. This target article proposes a new neurobiological framework theory for non-addictive psychoactive drug consumption, introducing the concept of "drug instrumentalization." Psychoactive drugs are consumed for their effects on mental states. Humans are able to learn that mental states can be changed on purpose by drugs, in order to facilitate other, non-drug-related behaviors. We discuss specific "instrumentalization goals" and outline neurobiological mechanisms of how major classes of psychoactive drugs change mental states and serve non-drug-related behaviors.

https://pubmed.ncbi.nlm.nih.gov/22074962/

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Please don't begin abusing drugs.

Except coffee, it's the greatest drug in the world (https://www.youtube.com/watch?v=OTVE5iPMKLg) and if you learn about the distinctions, you can seem very cultured to your friends!

DISCLAIMER: The fact that I come from a traditional coffee-exporter country has no bearing at all in my coffee recommendation

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Were there any mainstream media stories critical of their use of performance enhancing drugs (which SBF and others seem to have been quite open about on Twitter) before the crash? It seems that would be a red flag worth looking into when reporting on SBF and FTX - but probably didn't fit the narrative of the boy wonder next Warren Buffet story journalists wanted to tell.

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Nov 16, 2022·edited Nov 16, 2022

I've been working in tech for a long time. I've never (in my life) taken anything like adderall. At most, I have some caffeine (but I don't even like coffee.)

After reading this: I'm curious about how this type of thing would affect me. Can anyone describe the difference? (How much of it do we think is placebo effect?)

Edit: To clarify my "placebo" comment. I don't think the stimulants have _no_ effect. But I'm wondering if _some_ (maybe more than half) might be due to knowing you took a pill that supposed to help you concentrate.

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Nov 16, 2022·edited Nov 16, 2022

Stimulants are not placebos. Caffeine has such bad side effects at such low doses that you really can't just do doses of caffeine that are comparable to therapeutic doses of amphetamines and then compare the mental effects. Your review of this experience will mostly be "when I used that much caffeine I was jittery and my stomach hurt and later all my muscles were sore."

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Wait caffeine makes your muscles sore? I really should try quitting coffee

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Only if you take enough to make you very jittery and have noticeable muscle tension. Not if you're just having your daily coffee that you hardly even notice doing anything anymore.

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I think that, if you take the same amount of coffee every day, all it does is prevent withdrawal symptoms.

You would have to take a dose larger than your usual to become jittery.

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It’s often said that daily coffee just staves off withdrawal, but it’s not quite true - you develop tolerance to its effects at the A2a receptor, but not it’s effects at the A1 receptor. Even in tolerant individuals caffeine retains a wakefulness-promoting effect.

https://examine.com/articles/science-behind-caffeine/

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I've tried modafinil and the effect is definitely not a placebo. Usually I struggle a lot with distractions/procrastination/low energy, on moda I end up working so intensely I often forget to eat. Problem solving is also easier, because you mind feels clearer/more powerful. I suspect I'm already low on the distribution for conscientiousness/focus/executive function, in school (assuming that's roughly representative of the general population) I'd say I worked about as hard as the average student, maybe less, but in more selective environments, uni/jobs etc., I definitely felt below average, so probably I get more benefits from stimulants than most people would. Even so I think they can easily double some people's work output, with improved quality.

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Interesting. Is there something OTC that I can take to try? Or is this prescription-only?

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It's prescription only, but pretty easy to buy online.

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It's OTC in many countries.

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You order them from India (unpatented generics, and it avoids some regulation or another). Check r/Nootropics for the best websites to buy from that delivers to your country.

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Also check the laws in your own country! I think in lots of places it's legal to import for personal use even though you can't buy it without a prescription, but check very carefully that that's true for your own jurisdiction

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As Scott mentions, Adrafinil is a slower way to take Modafinil, and last I checked (a few years ago) it was available in regular US online stores.

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And is unscheduled (legal to possess without a prescription) in the US, unlike Modafinil which was schedule IV (last I checked, a few years ago)

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Have you ever had enough caffeine to notice an effect from it? The stimulant effect is certainly real, and caffeine is just the legally and socially accepted milder end of the spectrum.

I take 100 mg caffeine pills 3x/week (plus l-theanine, a very well-known & highly recommended nootropic combination that balances caffeine's energy & alertness with calm focus), and I have also had a prescription for 10 mg Adderall. For me, with my level of tolerance and sensitivity to both substances, the Adderall felt roughly like taking two of the caffeine pills: nothing crazy, no unpleasant side effects, but very definitely a significant boost in mood, energy, and executive function.

If you're curious, the safe and easy way to explore is to buy caffeine + l-theanine capsules on Amazon, probably the lowest dose you can find (probably 100 mg caffeine), and take one. If you don't notice an effect, take two the next day or the day after that. Take them first thing in the morning or your sleep may suffer.

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I have experimented with it, and I definitely do not have ADHD, so I can tell you the effect it has on someone taking it for investigational or recreational purposes. You know how once in a while a dull task like cleaning your kitchen just turns out to be really satisfying, and you keep going and do extra things, like taking things out of cupboards and throwing away the out-of-date stuff and wiping down the cupboard shelves? OK, well if you take adderall before you do a routine kitchen cleaning, you're way more likely to get on a roll like that. And if you sit down to write an email or a blog post or whatever, the same sort of thing will happen. You will find it easier to focus, and more enjoyable to do. Your ideas will flow more freely and there will be fewer of the kind of moments where have that feeling of, "I can't think of what to say next. I wish I didn't have to do this." For me, anyhow, adderall did not induce a feeling of jitteriness or being hyper. It just felt like having a really good, productive day. So I enjoy it a lot, but am careful not to do it very often.

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Sure seems like an awful lot of things de facto require stimulants for success now. Compulsory education (for boys anyway), coding, professional gaming and sports, financial trading...or even in mundane occupations and daily routines, who doesn't get started with a caffeinated beverage? (Much more fun when also mixed with amphetamines, too. Espresso + dexadrine led to some...memorably long uptimes. Glad to have kicked that habit.) Perhaps there's a more systemic price to be paid for the general overclocking of humanity, beyond potential acute failures like this one.

(Can't resist 8: Based on your expertise and years of training, Dr. Alexander, do you agree that __injecting__ bleach would on net be more harmful than drinking it?)

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For what it's worth, I don't have autism, I avoid caffeine during my work week (take it in the afternoon on Fridays to shift back to my natural nocturnal rhythm to be able to keep my mood from crashing from too many diurnal days), don't take any other stimulants, and I still work fine as a software engineer. I have somehow gotten hired by Google; like many people there think about themselves, I too think maybe Google made a mistake in hiring me, but this is the end of year two and they're not even considering it yet, so apparently one can land and hold a high-paying job in IT without being on stimmies.

To be fair, I have done mighty little coding so far, but that's an accident of the things I've been working at at Google, my previous jobs were very coding heavy, and I still code a lot in my spare time. Going by experience, if I *were* coding, I'd be focussing quite naturally, it's an easy activity to get lost in for me, but I'd describe it as an aesthetic experience more than a problem-solving experience, i.e. I take a lot of enjoyment out of how good code reads and looks.

That said, I also *do* seem to have some kind of weird reward function in my brain! For example, I love fixing bugs, refactoring things and writing documentation, whereas my understanding is that most of my colleagues prefer not doing those things and instead writing new features, which honestly sounds dreadful to me for complicated reasons (but flippantly and self-deprecatingly summarised boil down to that I don't want to make decisions in a void; this is an over-simplification, but I didn't want to leave anyone reading this comment hanging *completely* as to the underlying mechanism).

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founding

I too dislike writing code for new features and 'making decisions in a void' seems like a fairly apt description of (at least one reason) why it's aversive to me too. Interestingly, I have no basically no problem with new features for my own personal projects or things like 'code challenges'. I think a lot of the aversion is because of the ambiguity and uncertainty regarding what exactly satisfies an MVP for a feature or how correctness versus speed/pragmatism is _expected_ or desired by my superiors/supervisors. Fixing bugs, refactoring, and writing (internal or technical) documentation are all things where the 'reward function' is MUCH easier (for me) to discern.

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Heh, I feel the same way about bugs and refactoring. Also performance improvements.

New features are OK if there's rapid prototyping and a constant feedback loop. What I don't like are the times where all the planning happens up front (even if I'm involved), and then implementation happens later on a detailed schedule, with a final rollout. In my experience, there's always stuff that's harder to do than anyone planned for. And that sort of advance planning never seems to be thorough enough, and misses things that should be covered and covers things that are unnecessary. I hate the position of being halfway through coding something and having to tell people that this is going to take longer than expected, and ought to have some more things added, and some of their pet details are superfluous and ought to wait until an update.

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founding

Yes, low-latency feedback and feedback _loops_ are ideal. I haven't been dealing with lots of advance planning (unless it's my own) but I very much dislike 'murky models' of other systems with which I'm integrating or, even worse, one's internal to the very system I'm working on/in/with. Even bugs can be awful to fix when 'correctness' is murky enough!

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Ugh, yeah. I hate those situations where there's no clearly optimal solution, and all the potential solutions involve balancing lots of factors that everyone assigns different priorities to, and there's always a majority against any specific solution, but no majority for anything at all.

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I don’t drink caffeine unless I really need it(a couple times a year). Maybe I have natural high levels of these traits people want, but I also kind of suspect constant reliance on substances degrades their natural functionality.

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I am not qualified to talk about the pharmacological aspects of the article, but I did simplify the financial aspect of FTXs fall:

https://jorgevelez.substack.com/p/ftx

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I found this article extremely helpful. Thanks for writing it!

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Excellent write up, thank you. So this was basically a bank run on a brokerage that decided to act like a bank.

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founding

Something this makes me wonder is if Jane Street or other non-exploded trading firms have far more capable and systematic psychiatrists on staff to manage the drug cocktails their teams are on

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My experience in a small corner of industry was that the systematic trading firm did not actually manage what drugs their staff were on. This was probably a mistake, since some people obviously had untreated ADHD and contributed less or less consistently as a result.

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They have better risk management which is a fancy way of saying they’re more intentional about access control and monitoring exposure.

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>But if you’re already a cryptocurrency trader, maybe it only takes a tiny amount of risk-curve-shifting to turn you into a cryptocurrency trader who makes riskier trades.

Can we stop pretending that risky trades were SBF's main fault instead of committing fraud?

>Please don’t rush out to abuse drugs just because you read about them in an article on how they contributed to a $10 billion bankruptcy.

Yeah, that's what the annual nootropic survey is for.

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Nov 16, 2022·edited Nov 16, 2022Author

"Can we stop pretending that risky trades were SBF's main fault instead of committing fraud?"

I don't think I'm pretending anything. I'm writing an article about how psychopharmacology contributed to the crash. He was on a medication that purportedly causes risk seeking, not a medication that causes fraud. Obviously then there is a causal chain from "lost lots of money" -> "fraud to conceal that".

Also, trivial warning (1% of a ban) for tone.

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The fraud may not need to stem from losing the money to stem from the psychopharmacology. Presumably at least part of the reason people don't commit fraud is that "it's a bad idea," either because they don't want to get caught or because risk-averseness also applies to the risks of violating social norms/moral intuitions.

That comes from an introspective intuition that if I were more risk-averse I'd engage in less immoral behaviour, and vice versa.

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Hm. I feel like "pathological gambling" and "hypersexuality" are more specific and common dopaminergic side effects than "become a bad person", but I can't really explain why that should be. I bet I would understand this if I knew more neuroeconomics.

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If the accusation was he just took the money for himself I’d agree. But it’s more like, he tried to get everything back by gambling with other peoples money. Legally that doesn’t sound very different, but “problem gambler” seems like a more important factor in the later explanation.

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Is "becoming a bad person" an acknowledged side effect of any medication?

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I think you would be more technical and careful in how you describe it - some of them worsen temper, some can make you addicted and then you do bad things.

I don't think there's any medication whose effect is as close to the common-sense concept of "bad person" as eg antisocial personality disorder is.

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Would something like Acetaminophen's reduction of empathy of others' pain[1] count?

Presumably having less empathy would mean you'd take more risks that affects others, although I guess it's still not strictly evil, and is more like recklessness.

Thinking about it, considering how something like MDMA/metta meditation makes you much more empathetic/sympathetic; loving; generous; etc, surely there must be a drug that does the opposite?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/

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Well, you could say that engaging in fraud is just a variety of risk-taking . The risk is getting caught, and/or suffering from a guilty conscience. If you don't have a very powerful conscience, then the risk is just getting caught. So IF SBF didn't have a very active conscience, it actually does seem to me that committing fraud would be in pretty much the same category as making risky trades -- maybe there will be a good outcome, maybe a bad -- and an upper on board might shift the needle a bit on how you evaluate the chances of different outcomes.

But that model only works if suffering from a guilty conscience isn't a danger for the person. Was it, for SBF? I know very little about him, but here's some demographic reasoning based on my life experience: Young males who graduate from high-prestige schools, then become traders, then set out to become the best in the world at something (in this case, the world's most effective altruist) are not usually very high on compassion and conventionality, & those are the things that underlie attacks of conscience.

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This seems a bizarre response given you general positions on things. People who commit fraud are not “bad people” in some categorical way different from the various other behavior spectrums you subscribe to.

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Disinhibition should not interfere with honesty, I would expect. I don't know how much of honesty and lying is understood neuroscientifically. The case has been made that deception and countering it created the evolutionary pressure to develop a human brain. Drugs that induce paranoia or delusion may be understood as promoting self-deception, deceiving others still is something different.

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Nov 19, 2022·edited Nov 19, 2022

.

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Nov 16, 2022·edited Nov 16, 2022

Do the drugs also cause dishonesty in addition to risk taking? Why not talk more about the culture of FTX and the role it played? Most businesses don't encourage drug use.

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Scott is quite deliberately only focusing on the psychopharmacology angle here, as that's where he feels he has relevant new points to make.

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It's only illegal if you get caught, and stimulants make it seem like something that happens to other people.

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FWIW, I'm sufficiently isolated from news that I didn't actually know there was fraud involved. And Scott didn't actually mention it anywhere in the article. I'm not trying to say you should write like a newspaper with big explanations of the context at the top for people like me who apparently live under rocks, but I feel like it's fair to not find the link to fraud <i>obvious</i> when you don't mention it.

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I'd guess that people are wary of libel accusations. Given that crypto is famously under-regulated, FTX may have technically not broken any laws, but if what they freely admitted to having done happened in normal finance instead, it would be fraud ten times over, so that's a pretty fair characterisation.

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IIUC, he is definitely under suspicion of committing fraud, and various other financial crimes. That it was done via crypto-currency isn't really significant. Whether he is actually guilty is, of course, another question.

And, again, IIUC, the regulations would probably only be for the purposes of allowing regulators to inspect the books even when a crime is not suspected. Think of them as trip-wires rather than additional crimes. (Though, of course, blocking access by the regulators would be an additional crime.)

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Yeah, IMHO most of the blame here lies not so much at the feet of the bunch of amateurs that the FTX gang seems to be, but at the banking regulators failing to do their jobs, and the sophisticated investors failing to do due diligence.

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There's a lot of allegations flying around and on first glance it sure *looks* like fraud, but it's hard to say until the investigation is done and any criminal charges are pressed. The fraud *appears* to be "took clients' funds and threw them into the gaping money pit in an attempt to make the money back, cover their losses, and then repay the clients" but don't quote me on that. What started it was a run on FTX when people wanted to cash in and FTX seems not to have had the liquidity to cover that.

In general it's a complicated mess of "how much was the Wild West approach to crypto trading and how much was breaking an actual law we can point at?"

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founding

I too have been confused about the 'fraud' but I _think_ it's pointing at (the alleged) instances of FTX transferring user deposits to Alameda to cover the latter's losses. That seems like a fairly 'non-central example' of fraud, but it makes sense (to me, now).

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Easy to miss the fraud part even if you read the news. NYT and Washington Post stories on FTX were strangely positive with very little mention of the crimes and a lot about over ambition.

I don't think it's as simple as him donating lots of money to the Democrats so he gets favorable coverage but comparing how FTX has been treated with other tech companies has been strange.

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"A kid from a good family" seems to be the likeliest explanation for the general kid-gloves approach, but actively promoting correct politics certainly helps too, which has become uncommon in big tech lately.

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Committing fraud seems a pretty good example of taking an extreme risk to me.

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That's the only problem only if you're pretty amoral to begin with. I wouldn't commit fraud even if it was zero risk. Because it's wrong. So you can shift my risk-taking curve as much as you like, and I might very well try to beat the BMW bike to the top of the hill when there really isn't room and die in a fiery crash, but I sure as heck wouldn't be found screwing people out of their life's savings.

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Obviously neither of us really knows what went on in SBFs and other people's head at the time. Is it not conceivable that they started out by thinking dipping into customer funds is no big deal, it's a victimless crime if it had worked out? Maybe they even did it in the past and it worked. Reading the stories about other famous blow ups it sort of comes in dribs and drabs, a little lie here, a little unethical behavior there, not some conscious "let's all commit fraud" decision. The rationalizations probably come easy, especially if chemically assisted.

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Nov 16, 2022·edited Nov 16, 2022

Sure. Like I said, they had to be pretty amoral to begin with. I wouldn't do the rationalization at Step 1 on account of the shade of my mother would immediately rise out of the floor in a towering rage and beat the snot out of me. Lying to people is wrong even if they never find out.

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It seems to be a common failure mode though, when people are entrusted with pots of money by others, and they are either in the business of trading/gambling on stocks or get into it privately. They make quick money at the start due to beginner's luck, think they've found the secret of easy money, plunge, lose their shirts, and try to dam the leak by 'borrowing' some of that money lying idle in their charge. Just borrow it, for this sure thing that will pay out big, and I can put it back with nobody noticing and no harm done once I make my losses back.

Of course they lose it, so they need even more urgently to find some way of getting funds fast in order to cover what they 'borrowed' and that leads to more 'borrowing' and more speculating until it all blows up.

It does seem to be the lure of "since I have to manage this money, eventually I come to think of it as 'my' money in a sense, and it seems very silly to let it lie there idle when I could be using it to make a profit for all of us".

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I think a lot of people who have never been in a certain kind of situation don't understand how little "morality" has to do with it. It seems hard to test that theory though.

You can't exactly put the people claiming "I would never!" in a relevant situation.

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I agree. Every workplace I have been in has some kind of bad behavior that is sanctioned. Usually it has to do with not really sticking to the standards that are mandated by law. And the places I have worked have mostly been psychiatric settings, so sloppiness about patient care and confidentiality had real, direct effects on vulnerable people. And yet the people being sloppy were not bad people. Mostly they were smart and caring. But they were also tired and busy. So they did what most people do: They followed, not the rules in the book, but the unwritten rules that everyone else did.

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How many opportunities to commit fraud with a billion-dollar payout and zero risk have you actually been presented with?

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Nov 16, 2022·edited Nov 16, 2022

None whatsoever. But I think the question is per se a disputatious gotcha with little applicability to the real world. I don't need to stand exactly in Sam Bankman-Fried's shoes to have a reasonable theory about what I would do if I were he, the same way we don't need to stand exactly in Heinrich Himmler's shoes to have a reasonable theory about whether we'd send all the Jews to Treblinka.

In general, to understand these situations we extrapolate from what we *do* know about ourselves, and we back that up by comparing our other behavior and choices with those of the person in question, to see how similar we are in general, and finally we check to see whether the relatively few other people who *have* stood in similar shoes all did the same bad thing to get an idea of the population-averaged probability of being bad. So far as I can tell this all yields pretty good results -- at least, I have rarely been surprised these past few decades in how I (or people I know well) will react (ethically) to novel situations. I am obviously not saying I *don't* have ethical weaknesses -- I'm only saying I know pretty well by now what they are, and aren't.

So first I know from long experience how much I generally value money vis-a-vis my ability to sleep at night with a clear conscience, and the answer is: not much. I could certainly have more money at various points in my life if I cut some ethical corners. Not a billion dollars, but not $100 either. I haven't done it. Would I do it if the reward were $1 billion? I doubt it. I don't really have that much interest in $1 billion in wealth, indeed it seeems to me it would be tedious and unpleasant, saddling me with all kinds of responsibilities and attracting the nastiest sorts of parasites. There's a lot I could so with it, a la Elon Musk, but I don't have his drive and ambition, I'm OK with where I am. I'd be much more impelled to consider the chance of $1 million, which would let me retire a little earlier and do a few other things. But I already know I wouldn't trade my satisfaction in my character for the modest extra bump in convenience and comfort that would mean. Maybe it's only because I'm old enough that I can no longer fool myself into thinking I'll live forever, and being happy with who I am is much more important than having a nicer car. My car is nice enough already anyway.

Secondly can compare my general nature and general actions with these folks, and when I do, the mismatch is grotesque. The more I learn of their lifestyle, the weirder it seems to me. There's a whole collection of stuff there that I would never even start doing -- the publicity show, the Manichaen urge to Change The World right now and comfort with cutting corners in the interest of speed, the drugs, the funky personal lifestyle -- and to be brutally frank a lof ot this kind of reeks to me of a real self-esteem problem. I can imagine that someone who has a big self-esteem problem, and is very smart, might indeed want to pull the mobiest financial hack ever, because maybe it will finally sate that internal hunger. But I already know I'm not that kind of person. For better or worse[1], I don't have self-esteem problems.

And, thirdly, there are certainly a number of people who *have* had the opportunity to pull billion-dollar frauds and we find that -- hardly any of them do. When one of them does, it's a shocker. So that tells me that the a priori probability that I'd act dishonestly is low, because most people don't. Combine that with what I additionally know empirically about myself from the above, and I conclude the probability is extra low.

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[1] I mean, I'm sure there are plenty of people who think I *should* ha ha, but I don't care about them.

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"So far as I can tell this all yields pretty good results -- at least, I have rarely been surprised these past few decades in how I (or people I know well) will react (ethically) to novel situations. I am obviously not saying I *don't* have ethical weaknesses -- I'm only saying I know pretty well by now what they are, and aren't."

I feel similarly to you, so I'm going to complicate things a bit.

Part of The Lord's Prayer (used a lot by Catholics ... maybe by others as well) goes like this: "lead us not into temptation, but deliver us from evil."

Because, I think, avoiding having the choice/option to do the wrong thing is a huge help. Much like an alcoholic NOT keeping liquor at home.

To illustrate, I will present Temar Boggs. When he was 15 years old, he noticed a 5 year old being kidnapped and took off on his bicycle to stop the kidnapping. After quite a car chase on the bicycles the kidnapper gave up trying to elude him (and a friend) and let the child go free. Temar (and his friend) were heroes [and I don't think this was staged though I can't rule out the possibility].

Three years later Temar went to prison for armed robbery.

I wonder if the folks who knew Temar when he was 15 would have been surprised at his behavior three years later. Maybe?

But its basically the same kid an I feel that with a different set of friends the older Temar might well have grown up as a law abiding member of his community.

I wonder how often that holds for lots of folks who screw up big time. It is simple to just conclude that they are bad/immoral/amoral/whatever. And some of them might be. But I think for a bunch if the opportunity for crime hadn't be there (or the opportunity had required much more effort) they'd have lived their lives never knowing that they might have gone the wrong way.

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I think lots of people have a high opinion of their moral character when it's not particularly tested.

That's not to say that you would do crime if you were in SBFs shoes -- I think many people wouldn't -- but I do think that it's hard to say for sure unless you've been in at least remotely similar places.

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Nov 17, 2022·edited Nov 17, 2022

Maybe. But so far I'm not convinced that the "places" these people were in were very "remote." It all reads like market-timing, check kiting, embezzlement, gambling the shopping money, and then doubling down by gambling the mortgage money when you lose, and having a lot of team pep-talks and popping uppers to boost your spirits when the squalid reality peeps through every now and then. Pretty ordinary types of human decadence and moral failure.

I mean, the numbers are much bigger. If I try a little market timing, I do it with $5000 instead of $5 billion. If I kite a check it's for $150 and not $150 million. But I'm not persuaded that's a difference that is sufficiently important to completely change the situation, make it utterly incomprehensible to anyone not in the very same shoes[1].

If a man is willing to commit murder, I don't think we're completely at sea with the question of whether he's willing to commit a million of them. If he's willing to steal a bike, I don't think we are completely in the dark about whether he would steal a luxury car.

Indeed, my experience is that people who have character and self-discipline exhibit that in small and great matters pretty equally, without regard for the number of zeros in what's at stake, because its the nature of the person that matters -- what he values, how he sees himself -- much more than the size of the table stakes.

A person who won't lie to his wife about where he's been, even when it's embarassing, also won't cheat on his income taxes or sell nuclear secrets to the Russians. Conversely, people who do lie and cheat and steal and cut ethical corners in great big ways seem to do it in small things as well.

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[1] Actually, saying "you don't know what it's like to be me! You might do the same!" sounds more like weaseling denial and egoistical self-justification, which alas fits impression I'm getting that there was no small amount of "as Supermen it would be silly and wasteful to consider ourselves bound by the mundane inflexible moral strictures imposed on mere mortals."

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Nov 16, 2022·edited Nov 16, 2022

In defence of the defence attorney, even lawyers have their own ethical rules. If his client says she didn't drink the bleach, he's not allowed to make up his own, better case.

You also should consider doing expert testimony again; you had basically the definitive expert witness experience of being cross-examined on something with a counter-intuitive answer that you don't have to hand. Taking an honest crack at it is the best you can do in the circumstances, so well done!

It's also worth bearing in mind that judges have all heard the same thing hundreds of times, so are aware it's mostly a parlour trick.

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Scott wrote previously that getting institutionalized in the US is very disadvantageous because you get the bill for it. If the person doesn't have the right insurance, it will be very devastating and will make his life more complicated. It is no wonder why the patient wanted to argue in the court against the order.

Maybe it wasn't in the US but in Ireland where people generally don't have to suffer from lack of insurance. Then it doesn't apply. In any case, he shouldn't feel bad about what happened in the court. He told honestly what he thought about the situation and the judge considered it. Sometimes things go as you expect them to and sometimes not. It is not up to you. No one is going to think that you are a bad doctor based on lawyer's words.

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I thought modafinil was primarily used for narcolepsy

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I don't know about "primarily". It's certainly a popular use.

About ten years ago, lots of people thought that modafinil had some sort of high-tech magic bullet effect on orexins, sleep related chemicals that would help with narcolepsy. More recently, people have figured out that it's probably just a stimulant, albeit one that has relatively few side effects and lasts longer than usual. It still works fine for narcolepsy, because lots of stimulants do, but I think it's getting more commonly used in generic stimulant roles.

Some people say that relative to eg Adderall, modafinil is better at keeping you awake and Adderall at keeping you focused. I don't know if that's true or just a side effect of the way the drug was originally marketed.

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As a narcoleptic and a “focus worker”, having been prescribed each at various times, I would say that both have fairly similar wakefulness effects, especially if taking extended release Adderall, but the difference in increased focus under Adderall was noticeable; however, Adderall seems to taper off in efficacy over time where Modafinil/Armodafinil remain relatively consistent in effect over time.

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For me Modafinil has an anti-addictive effect if anything. Not sure how I'd feel about more conventional ADHD drugs. Like I do not at all feel a desire to be on it all the time, it is an entirely instrumental desire. "I'm about to do a pretty high pain type of programming better take Modafinil".

Even when I used it to play EVE, doing 100 characters of maxed out Planetary Interaction specifically, it wasn't something I looked forward to or needed.

I understand that Adderall is supposed to be much more addictive.

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I would also note that not one neurologist I’ve worked with nor any literature I’ve read prior to your comment has suggested that Modafinil would have any impact on the orexin/hypocretin issue and only that it was another type of stimulant to use in attempt to address the symptoms.

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Anecdotally, a friend of mine who's definitely not me reported that even low doses of modafinil were very reliably taking away almost all of the euphoria from GHB taken at the same time, while no other common dopaminergic substances (including, IIRC, Adderall, Ritalin and cocaine) did anything of the sort, which sort of hints at some significant differences in the mechanism of action. But, again, totally anecdotal.

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It is a rather different type of stimulant. On the other hand, I don't know why one should use any stimulant while under the effects of GHB. At least for narcolepsy, one is for daytime and one is for nighttime.

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GHB is frequently used recreationally, in which case its sleep-inducing effects are a hindrance rather than a benefit. Stimulants take care of that problem.

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I think Adderall also has a strong nominative determinism effect for tech.

Adder All.

Concerta or Vyvanse sound like something music/art students take to practice.

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"Don't worry, I have a cunning plan!"

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Now the theme song is stuck in my head.

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It is, at least, an accurate description of my experiences with modafinil and methylphenidate.

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Scott, I just have to say, I love how you write disclaimers. They're great.

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Re: footnote #5

I feel like there's kind of obviously a class of people who wear opposite-sex clothes for reasons other than identifying with the opposite sex, and "transvestite" is a perfectly-fine word for this class of people.

To the extent it's considered an "offensive" term now, the reason AFAIK is literally just "transvestism's existence is very mildly inconvenient for the SJ narrative, so SJ has decided to cancel everyone who acknowledges it". Certainly this isn't a case of "we came up with a new word, if you aren't with the current fashion you're bad" - there is no new SJ-approved word for transvestism, *all* of them (crossdresser, trap, etc.) are now "slurs", it's just been cut out of the accepted language as an expressible concept in the exact mold of Newspeak.

(I stress again, the existence of transvestism isn't even *that* inconvenient for the SJ narrative! You can totally believe transvestism is a thing and also transgenderism is a thing! It just slightly complicates the explanation!)

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Are there still a lot of transvestites, or did they get absorbed into general transgender?

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Ordinary gay drag certainly still exists.

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In the US, there are lots of them. My source is my dad is super incredibly gay and loves to hang out with big groups of gay men many of whom wear women's clothing and all of whom love going to in-person shows that are mostly about men wearing women's clothing.

Elsewhere, some places have different cultural ideas around this stuff that apparently cause people to be crossdressers at much higher rates and transgender at much lower rates.

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But they presumably don't think the are women or would expect people to seriously consider them to be female when they wear women's clothing?

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Lots of gay men dress up in drag for fun -- it has nothing to do with wanting to be women.. Then there are males who truly feel they are female in some important way, and dress as women to manifest femaleness. And there are also straight men who dress in women's clothes because it's a turn-on. Lots of variety out there.

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Your dad's gay? My mom was a lesbian. Gives you a different perspective, right?

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Eddie Izzard has shifted from calling herself transvestite to trans, and has requested she/her pronouns.

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I've never met/heard of any that identify themselves that way in recent years, no.

There are certainly people who cross-dress recreationally for dag shows and the like, and people who cross-dress as a fashion statement or w/e, but I don't think those things carry the sort of pathological/compulsive context that was the essence of our past understanding of 'transvestism'.

And there's definitely a lot of fetish porn around sissy/forced feminization kinks that involve men wearing/being forced to wear women's clothes. But it's not clear how much of that is weird confusion around humiliation/submission kinks getting filtered through toxic masculinity, or how much of it is actual unacknowledged transgenderism being sublimated through the not-shameful-because-it's-supposed-to-be-shameful avenue of porn consumption.

So maybe there are some people in that kink scene that conform more to our past understanding of the context for 'transvestism', but only the most shameful/sexual version of that context.

AFAIK, people like Eddie Izzard who openly identified as transvestites and cross-dressed consistently in daily life, were all absorbed into either trans or non-binary.

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"But it's not clear how much of that is weird confusion around humiliation/submission kinks getting filtered through toxic masculinity, or how much of it is actual unacknowledged transgenderism being sublimated through the not-shameful-because-it's-supposed-to-be-shameful avenue of porn consumption."

Aren't you somewhat glossing over Blanchard's hypothesis? I know it's not politically correct to acknowledge it, and my own experiences suggest it's not 100% correct, but it can't be dismissed as 100% incorrect, either.

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I'm sure there's some truth to this, but it's not true that "all" of them are now slurs. Haven't seen any discourse against drag, for one, and for a new coinage, there's "gender-non-conforming"/"gnc".

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Nov 16, 2022·edited Nov 16, 2022

The second is not specific to transvestites; it's lumping them in with genderqueer, so it doesn't acknowledge that transvestism is a thing on its own not necessarily related to genderqueer.

Drag, possibly. My exposure to SJ has dropped a lot the past few years, so I can't speak for certain about that one; "drag queen" is still definitely a thing, but I think calling one "a man in drag" (even if accurate) might draw the Eye of Sauron.

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Outside of SJ circles there are some women who are miffed at men putting on "womanface" and portraying rather regressive stereotypes of female behaviour.

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I don't know where you got the idea that "crossdresser" is a slur, but it isn't. It's the preferred word for people who dress in clothes associated with the opposite gender for non-identity, non-performance, non-fashion/expression reasons.

(Performance is drag, identity is trans, and fashion/expression is usually butch or fem/femboy or maybe "crossdressing" as a verb.)

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'Transvestite' comes across as a bit old fashioned to me, but not weird in a 1970s-psych-textbook kind of way the way 'transvestism' does. Idk who'd be offended at 'crossdresser' or 'drag', though 'trap' is firmly in the slur category for a lot of people.

I guess the most commonly used modern term is 'femboy'? :P

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I would have thought "transvestism" and "transvestite" had basically the same connotations since they're the same Latin root construction and merely a different grammatical suffix to specify person vs. phenomenon - like "racist" vs. "racism".

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yeah I'm not saying it makes any etymological sense, it's just the vibes I get from the training data I've seen ¯\_(ツ)_/¯

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This is common though - think of how different “Democrat Party” and “Democratic Party” sound, or “Jew” versus “Jewish person”.

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Your analogy's bad. "Transvestite" and "transvestism" aren't different words for the same thing using different-but-related constructions; they're words for different-but-related things derived from the same construction.

Synonyms have a lot of room to acquire separate nuances; because they can be substituted, the choice of which synonym to use tends to acquire signalling value (the different nuance of "Jewish person" vs. "Jew" essentially boils down to signalling "I am all-in on the Blue Tribe's Whorfian language games" vs. "I am not"). But you can't substitute "transvestism" for "transvestite"; one means the phenomenon and the other a person displaying said phenomenon.

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>I guess the most commonly used modern term is 'femboy'? :P

The general term for this whole category is "gender non-conforming", usually shortened to GNC. Which itself is a sort of superset of "non-binary" which includes people that don't explicitly use that label.

Femboys/bois are definitely GNC and often NB, as are drag queens/kings.

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Calling all drag queens/kings "definitely GNC" would be controversial, since that set includes (1) trans drag performers who are traditionally feminine/masculine in their identified gender, (2) performers who are traditionally-masculine/feminine in their private lives and wear drag only as a costume for performances and professional events, and arguably (3) bio queens/kings whose only gender-nonconformity is their participation in an art form associated with the opposite sex.

You could make an argument that they all transgress gender roles in some way, but so did Robin Williams, Hilary Swank, Rudy Giuliani, all the women who've played Peter Pan, all the men who played women in premodern stage performances, and anyone who's ever dressed up as an opposite-sex character for Halloween. In all those cases we don't generally treat gender-role-transgression as a characteristic that the person has; its just a thing that they've done.

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I think I can handwave away (2) as unambiguously being an *act* of GNC'ity, even if they aren't GNC all the time, but the degree to which they consider it a pillar of their life/identity is relevant to that. For (1), IME even most binary trans people are *somewhat* GNC and play around with gender, but fair. The mere existence of (3) is contradictory enough to how most people define drag that I can't comment on it.

I can think of at least four Robin Williams movies off the top of my head that directly touch on GNC'ity, so henceforth I will be thinking of Robin Williams as a GNC icon.

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FWIW I was taught that transvestism is a thing and also transgenderism is a thing and they are different things both worthy of respect and tolerance in high school health class in 1990. The distinction isn't even new.

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>there's kind of obviously a class of people who wear opposite-sex clothes for reasons other than identifying with the opposite sex

See also Aella's "Everyone Has Autogynephilia"

https://aella.substack.com/p/everyone-has-autogynephilia

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The thing is we don't have words for other types of people who wear specific types of clothes. There's no medical-sounding terms for 'denimites' or 'sundression' or w/e.

'Transvestism' is historically a medical-ish diagnosis and referred to mental condition that went well beyond just liking to wear a type of clothing sometimes. And to the extent that it had those deeper connotations, they mainly came from transgender people who *were* expressing a deeper issue with how society viewed them, and we now understand our pt understanding of transvestism was innacurate to those people.

Basically, take the misunderstand of transgender people out of our historical understanding of transvestism, and there's nothing of much substance left to the word that would justify keeping it around. Something like 'cross-dressing' or 'drag' or other non-medical-context-and-weird-history words are much more appropriate for the people who just like to sometimes wear those clothes for whatever reason.

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'sans-cullotisme' ;-)

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Fascinating/awesome write up! This whole debacle feels like a crossover episode of silicon valley and 30 Rock with Chris Parnell aka Dr Spaceman (spe-ch-men) being in three episodes as the company psychiatrist/performance coach

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Thank you for the gift of that YouTube Dr. Spaceman binge! I can't believe how much more likeable Chris Parnell is here, compared to Archer or Rick and Morty. Come to think of it, he's like an IRL Krieger in 30 Rock.

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"And to think, we used to solve questions of paternity by dunking a woman's head under water, until she admitted she made it all up."

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This is 👀. Somewhere along the line the concept of primum non nocere got lost.

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I think it got subsumed into expected utility calculation and the reality of life under capitalism.

Like, I have an ADHD diagnosis, and a bottle of prescribed amphetamines. I don't need them to function normally, and only take them when I need to crunch on a project at work, maybe 1-3 pills a week. They definitely have negative short-term side effects when I take them, and may have negative long-term side effects for all I know.

A very long employment history confirms that when I do this, I can hold down a high-paying and satisfying job, and perform well enough that I am not constantly worried about my performance and if I am about to lose my job. When I do not do this, my performance suffers, I am constantly worried about losing my job to a degree that interferes with enjoying the rest of my life, and I do actual lose those high-paying and very intense, demanding jobs at the rate of about 1 every 1-2 years.

So what is 'do no harm' here? Certainly if I wasn't trying to hold these high-paying jobs, my life would be better with no medication. Certainly my life is better with medication and being comfortable in a high-paying satisfying job than it would be if I were constantly losing high-paying jobs or working a boring low-paying job.

How should a doctor calculate 'harm' in that situation?

And more importantly, what happens when the guy who wants my job realizes he can't compete with me when I'm on speed and he's not, and he goes to his doctor saying *his* life would be better off with meds so he could take my job? What happens when a significant portion of the people in high-paying jobs are each individually telling that to different doctors? What are the doctors supposed to do?

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I wasn't responding to the types of clinical concerns which you are raising and comes up for patients and their physicians daily. It was more related to the boundary circumstances outlined in the FTX article in the Times. The clinical issue is the one Scott raises and you raise - if one has an ADHD diagnosis its easier from a standard of care standpoint. That said our diagnostic criteria and predictive criteria are not so precise.

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The office was only on Adderall because of cowards who know Desoxyn is the best treatment for ADHD and refuse to prescribe it.

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founding

Is it also the best for low impact ADHD? (Just use a smaller dose?)

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> this is a violation of the Goldwater Rule that psychiatrists aren’t supposed to publicly assess famous figures

Would this article fall under that rule? You're not giving a psych evaluation of him, but would speculating about how his medication might have affected his risk tolerance, count as "publicly assessing" him?

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author

I'm not sure, it doesn't really have clear boundaries and wasn't written with pharmacology in mind. I would like to think this article continues to stand if we replace him with some random other person who took these same medications, and that that matters.

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From the perspective of a layman reading it, I feel like this article is fine. It isn't about SBF, it's about stimulants and SBF is merely a reason people currently want to read about the effects of stimulants

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What a wonderful S.A. (i.e. "an essay as outstanding as a post by S.A.S."). I am grateful to live in this time. No cocaine for my brain, no emsam and no jhanna, just this. I am high on ACX.

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Good to know it was just good old regular idiocy then. And not drug induced idiocy which caused this.

But seriously, anytime someone is labelled "the next Warren Buffett" they are usually the complete opposite. It is amazing how reliable this seems to be.

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Of course. Following the path of Jack Bogle is boring. Far easier to invent magic beans. That goes for Bitcoin, too. Its only genuine use case is ordering illegal drugs.

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I think people miss the point of Warren Buffett. Sure, he's made a lot of investments and does a good job managing them, but his real insight is to play the long game. He's like a billion years old and built his fortune through slow prudent investing. Nobody in their 20s can be "the next Warren Buffett" by making flashy trades and getting rich quickly - that's the opposite of what he does!

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Yeah that is exactly it. When asked why not more people were doing what he was doing he replied "Nobody wants to get rich slowly".

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It also requires quite a lot of capital. There's a huge difference in buying a few shares of an undervalued company and buying a large chunk of an undervalued company and then being able to unlock that value.

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Yeah to become as rich as Buffett you need outside capital. But if you start with $50k of savings and save up $15k per year if you have a well paying job, and invest it at 15% per year by finding undervalued stocks, you could have $10m after 30 years. I think that could be considered rich.

If you are as good as Buffett and get a 25% annual return, you would have $100m by the time you are in your 60's (if you start young).

Few people end up doing it though, because it takes discipline and patience. And a well paying job of course.

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I think that's buying into the myth that Buffet is selling. He does this work full-time, has likely a lot more access to the corporations and he also can influence the corporations he buys, something a small shareholder can not do. The regular person with a day job is probably far better of with an index fund.

You can read all his letters to the partners in his hedge fund as well as to the Berkshire shareholders, it's pretty interesting reading.

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"Here's the paradox: You recognize that as an individual trader you probably are not gonna be able to make good enough stock picks, consistently, to outperform an index. But you're also greedy, and can't accept the meager 8% annualized return of the S&P." ~ https://www.youtube.com/watch?v=dgisRHEQ2FM&t=252s

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That would also make for quite the boring story. The business press loves it when someone under 30 strikes it rich by selling shares in an unprofitable company, building a profitable company with sustainable growth from the ground up doesn't sound that exciting.

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"Which came first, the idiocy or the drugs?" seems like something that is going to be debated for a long time.

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One data point: I have a relative with Parkinson's. All of a sudden out of nowhere, he lost tens of thousands of dollars gambling. His doctor took him off his medicine (I don't know which one it was), and he stopped gambling--he had never gambled before. He wrote the drug company, and they paid for his losses.

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founding

I'd be very interested in reading about any details of your relative's experience. What did it _feel_ like for them to decide to both start and continue gambling?

I like _betting_ (for very small stakes and almost always about interpersonal disputes regarding 'trivia') but 'gambling' just doesn't make any sense (given the negative expected value). I can't imagine any drug changing that but I'm very curious if your relative has any insight about how that might work.

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I posted this elsewhere, but this longform article had a lot of personal accounts of exactly this effect: https://theamericanscholar.org/the-degradation-drug/

Some describe it as a compulsion that can't be ignored, like seeing food after a 4 day fast, and others as a desire that makes no sense to ignore, because it would be fun and good.

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founding

Thanks! What is describes is pretty terrifying!

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