My research was done a long time ago. I understood Ritalin to have mild neurotoxic effects, but Adderall et al to be essentially harmless. Do you have a source for the benefits giving way to problems long-term?
Regardless, your overall point is interesting. Presumably, these drugs are (ridiculously tightly) controlled to prevent society-wide harm. If that ostensible harm isn't reflected in reality, and there is a net benefit in having a certain age group accelerate (and, presumably, deepen) their education, perhaps this type of overwhelming regulatory control is a mistake. In that sense, it's a shame that these policies are imposed federally, as comparative data would be helpful.
There is no conclusive research on humans, but you have these backwards. Ritalin (methylphenidate) is thought to have less risk for neurotoxicity than Adderall (amphetamine). Amphetamine enters the neuron and disrupts some internal functions as part of its mechanism of action, while Ritalin does not.
Both drugs will induce tolerance, though. The early motivation-enhancing effects don't last very long.
There are also some entertaining studies where researchers give one group of students placebo and another group of students Adderall, then have them self-rate their performance. The Adderall group rates themselves as having done much better, despite performing the same on the test. If you've ever seen the confidence boost that comes from people taking their first stimulant doses, this won't come as a big surprise. These early effects (euphoria, excess energy) dissipate with long-term treatment, but it fools a lot of early users and students who borrow a couple pills from a friend.
In the workplace, I saw the same folks struggle to work consistently without abusive dosages of such drugs. A close friend eventually went into in-patient care for psychosis due to his interaction with Adderall.
Like any drug, the effect wears off - Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years. As I recall, the standard dosages of Adderall cease to be effective after 7-10 years due to changes in tolerance. Individuals trying to maintain the same therapeutic effect will either escalate their usage beyond "safe" levels or revert to their unmedicated habits.
Maybe I'm misunderstanding what you mean - but I think almost any college student would disagree with this presumption.
> Do you have a source for the benefits giving way to problems long-term?
Although a very long read, I found this to be very insightful:
> It was still true that after 14 months of treatment, the children taking Ritalin behaved better than those in the other groups. But by 36 months, that advantage had faded completely, and children in every group, including the comparison group, displayed exactly the same level of symptoms.
https://archive.is/20250413091646/https://www.nytimes.com/20...
Cognitive behavioral therapy does excel at treating ADHD! But 5 years of therapy is what, 16 times more expensive than 5 years of medication? Maybe more? Not to mention the time commitment.
“Cognitive behavioral therapy matches insulin after 5 years”
(because they die - so they’re no longer counted)
They lasted me 12 years so far. Same dosage.
> The Adderall group rates themselves as having done much better, despite performing the same on the test.
A feeling of euphoria means your dosage is too high, and people without ADHD probably shouldn’t take these drugs.
If the studies involved people that were on the drugs normally, it’s also not a particularly surprising result. The drugs induce a very real chemical dependency, and you will not feel like yourself or that you are performing when you are off of them.
That is honestly my only complaint. Without the drug, I am essentially a vegetable. If I go cold turkey, I can barely stay awake. However, it’s still a lot better than my life was before.
Unlike insulin, which cannot be produced with any sort of therapy, it does seem that ADHD can be significantly improved.
I'm sorry though that the facts seem to bother you so much.
https://pubmed.ncbi.nlm.nih.gov/22480189/
And then remember to drink water, exercise and get enough sleep.
But… it's not addictive at all. Taking it made me not want to take it again. I was just like damn, I kind of smell like sulfur now.
- A study with a sample a size < 50
- A study that says that medication improves outcomes over CBT
- A study that says that evidence for CBT improving ADHD symptoms comes from studies with such small sample sizes that the conclusions could be the result of bias
The only way someone could conclude “CBT has the same outcome as medication” from the studies you linked to would be to not read them. The first two don’t really say that and the third one literally refutes that position.
Fortunately for them, that's often the case. I've seen at least a couple internet arguments with LLM-generated "sources" that didn't actually exist.
Apropos of anything else, 5 years of weekly CBT to get to the same result is a _lot_. 260 hours of therapy that, on my current health insurance would cost nearly $12,000 in copays. And during that 5 years you're still dealing with your ADHD to some heavy extent.