[bserge]

I've had cocaine a few times now and while everyone is saying it's euphoric, I keep saying it's the most normal I've ever felt. Not "euphoric", I've done other stuff that felt suuuuper good (in an actual euphoria sense) so I believe can compare.

But normal. The cloud of thoughts gone, I am able to make myself do anything with one thought, I have energy, the aches are gone, the tinnitus is gone, I don't second guess, I don't overthink. I just am and I do. It's amazing. This is what people like Bezos and Musk must be like lol

Amphetamine probably feels like this, too, although many say it's actually quite distinct. The price, (un)availability, very short duration and the comedown are big negatives, sadly.

But yeah, comparing it to caffeine... nah. Can't comment on IV, but I can compare it to insufflated caffeine. It has some similarities, but the important parts are missing. Or maybe I'm just desensitized to caffeine. At least I'm a good fake coke detector lol

[kortex]

> But normal. The cloud of thoughts gone, I am able to make myself do anything with one thought, I have energy, the aches are gone, the tinnitus is gone, I don't second guess, I don't overthink. I just am and I do. It's amazing.

Have you been evaluated for ADHD? This is one of the classic tells. Methylphenidate is structurally and chemically very similar to cocaine.

Vyvanse is definitely the best when it comes to duration and classical stimulants. Modafinil has even longer duration, but it isn't always as effective at targeting ADHD symptoms. Vyvanse is kind of stupid expensive, but you can get a savings card. It would be $330 for me even with a good Rx plan, and the card knocks it down to $45/month. Sounds like you would also respond well to Concerta (extended release methylphenidate). I don't like it because I apparently have the metabolism of a honeybadger and get like 4-6h of otherwise "all day" meds like concerta. I have to split my vyvanse and take it in two doses to get a full day.

> This is what people like Bezos and Musk must be like

My headcannon is both these guys are ADHD and/or on the spectrum, have a doctor's script for vyvanse, adderall, modafinil, and/or whatever else, and have figured out how to ride the tolerance curve properly to maximize productivity.

[inter_netuser]

I have no idea why people like Vyvanse so much. It’s just time release with a fancy mechanism and paranoia around abuse potential of instant release formulations, which work just as well in most, if not all.

However, Ritalin is less neurotoxic than amphetamines that can indeed hike your risks of Parkinson’s (and probably few other things)

[kortex]

Because it's been life-changing for me, and countless others? It's not just time release; that's the old school drugs like Concerta.

The chief problem I have with all stimulants is too fast of an impulse response. It comes on too fast, crashes too fast. For me, for instant release drugs, I experience the following half-lives:

- methylphenidate: 60-90m

- amphetamine salts/dexedrine: 3-4h

- caffeine: 3h

- modafinil: 6-8h

Once a drug reaches about 1.5 HLs (about one Tau/time constant, conveniently), I start fading hard. There is a hysteresis effect: peaking/crashing/re-dosing is not the same as plateauing at some in-between value. Once my brain checks out, that's kind of it for the day.

So what Concerta, Adderall XR, and similar do for me, is give me what feels like two randomly spaced doses of instant release over a 4-6h window. This is unpredictable and thrashes my mental state. It peaks too high and crashes too low. The companies market these drugs based on averaging the plasma profiles of individuals to show a nice smooth curve, but I dug into the literature and this is NOT what you see on an individual level, at all. Concerta just doesn't do it for me.

Vyvanse is way smoother. The plasma peak is already low-pass filtered by the pharmacokinetics of hydrolysis of the lysdexamphetamine. As a result, my subjective experience is basically a 6h plateau. I split my dose to basically get a nice, actually smooth profile over 8-12h with a gentle taper instead of a crash. That also means lower peak plasma conc, and peak plasma is the greatest risk factor in neurotoxicity.

If you actually dig into the literature on neurotoxicity of amphetamines, you basically don't see any until you start getting to the equivalent of 50-100mg IR, and even then it's basically within the noise floor until you get to hundreds of mg per day.

[0des]

Ritalin does damage to DNA, if that counts for anything.

[inter_netuser]

To DNA? as in cancers?

Pls send some studies, very interesting.

[0des]

Sure. The early history of ritalin was the first sign to me that pharmatech industry owns their regulators. Check out the follow up research on 8-hydroxyguanine glycosylase as an indicator of oxidative DNA damage in response to the 2005 nih publications asserting no increased biomarkers, its somewhat surprising on both sides for Ritalin and the popular amphetamine alternative as well.

https://link.springer.com/article/10.1007/s00702-010-0408-5

[kortex]

> The aim of the present study was to examine the effects of drugs (amphetamine, methylphenidate and atomoxetine)

> We observed decreased expression of this enzyme for all applied substances.

Yeah no I'm not buying it. Amphetamine, perhaps, but atomoxetine causing DNA damage? That sets off my "spurious results" detector, hard.

I'll look into it more but I've done deep research into all things psychostimulants and I have not seen any indication of genotoxicity of methylphenidate or atomoxetine. Amphetamine has a slight risk of increased oxidative stress due to making dopamine leak places where it shouldn't, and DA's electronic structure makes it prone to generating singlet oxygen and ROS, but it's typically only observed in really high doses, like the equivalent of hundreds of mgs per dose.

Like, maybe there's some increased ROS due to any drug that boosts DA/NA (oxidizing catecholamines produces ROS in general), but like, "ritalin causes DNA damage" is the wrong conclusion to draw from that.

[realce]

Coke and Amph making you feel "normal" means you 100% have ADD.

[inter_netuser]

Being calm and relaxed on stimulants can potentially mean there is some arousal disorder: sleep apnea, narcolepsy, delayed sleep syndrome, or just chronic sleep deficit. Maybe concussions (mild TBI), amphetamines work for that too. Even depression is possible.

ADHD is just most likely because it’s so common, with sleep apnea being close second. I would rule out ADHD and sleep disorders first.

Potentially also, UARS, which is also form of sleep disordered breathing but not commonly detected with current technology (and also not easy to treat), some physicians do a full nasopharyngeal endoscopy under propofol anesthesia. I believe it’s incredibly undiagnosed and probably accounts for more than 10% of apnea cases, but most patients are thin instead of obese and so nobody suspects apnea-like disorder. If you needed braces or needed corrective jaw surgery UARS should be ruled out.

ADHD can be somewhat objectively measured with some tests like CPT, but that would also often show abnormalities in sleep disorders.

If your measures of attention, and sleep study, along with wakefulness maintenance test, if warranted, are all normal, and your pulse and blood pressure is normal, and by normal I mean very close to ideal 120/80, with hr below 70 - maybe you are just a mutant.

See a good neuropsych that specializes in sleep disorders. Stanford is one of the better centres for that. They will know what to do if it’s not a sleep issue also.

dx of ADHD and good response do not preclude the possibility of other disorders.

you can obtain treatment that way, and investigate other causes later, you may have to wash out from stimulants for a few weeks for the CPT and WMT, and preferably for sleep studies also, because they increase muscle tone and if your sleep issue is due to some neuromuscular issue, stimulants may partially obscure it. (This is still in research, and most physicians won’t tell you this, as it’s not yet standard of care in most places afaik)

[actually_a_dog]

I know this is kind of an obvious follow up to your comment, but, have you been tested for ADHD? You described exactly how my brain reacts to mixed amphetamine salts (AKA Adderall). Caffeine doesn’t really do much for me, either, incidentally.

[tonyarkles]

I was diagnosed last year and the psychiatrist I was seeing worked at a clinic that primarily sees inner city patients with much different health profiles than a mild mannered engineer. This is one of my favourite exchanges from the intake meeting:

“So, the first time you tried cocaine, were you surprised that you didn’t react the way everyone else did? Did it calm you down instead of getting you keyed up?”

“I’ve never done cocaine”

“Look, yes, some doctors might disqualify you for stimulant prescriptions for admitting to past substance abuse, but it doesn’t bother me at all. I actually do some research at $local_university specifically looking at how properly managed ADHD dramatically reduces the chance of substance abuse.”

“Serious, I’ve smoked pot, I’ve done mushrooms, but I’ve never tried coke. Had lots of opportunities if I wanted to, but it didn’t appeal to me”

“Huh! With lots of the patients that come through here, they see me for the first time after casually mentioning to a GP that they’re worried they’re weird when coke doesn’t work right for them!”

[actually_a_dog]

Interesting.

I was diagnosed twice, both times in adulthood. The first time was by a neuropsychologist who did something like 8-10 hours of testing over about 3 days. I’m not even sure if she ever asked me about any sort of drug use.

The second person to diagnose me was a physician at the student health center where I was a graduate student. Believe it or not, he was actually a pediatrician! I think he may have asked me about my caffeine consumption (excessive!), while also being impressed by my shockingly normal blood pressure (almost always between 110/70 and 125/83). I actually think going on Adderall might have lowered my BP overall, due to the increased ability it gave ume to tolerate and problem solve my way through stressful situations.

[randstring]

I've tried cocaine and it would make me feel like the "best" or perhaps much better version of me. Improved, but subjectively not overinflated self-confidence, sharper thoughts, better concentration, high energy and motivation, easier connection to people, without apparent intoxication or affected judgement.

I would agree with you that it makes me feel normal in the sense that's what it seems I should have been. The first time I tried it, I was like "so when I'm gonna feel the effect?" for a few seconds and then I realized I feel it and thought "That's the way it [life] 's meant to be played" :D

[buscoquadnary]

That's exactly how I feel when I take my Adderall. Or at least how I do after a break. I also have ADHD so that probably means you've got it to.

[jasonladuke0311]

Gonna pile on with everyone else and suggest you get tested for ADHD. This is a pretty classic symptom from what I understand. This is basically how I feel with Adderall. I had no idea how "normal" things could feel.

[dotancohen]

  > This is what people like Bezos and Musk must be like

And now you too know the powdery white secret to success.