[nikkwong]

I could see someone making the exact same arguments that you're making about caffeine: you need to increase the dose over time, it's habit forming, people are not the same when they're not on it, etc; but many would argue that they drink coffee successfully for entire lifespans and are better off for it. You're demonstrating a 'spiraling out of control' reaction that happens when people habituate to stimulants but—well, I'm not sure how many cases this actually occurs in.

Stimulants may be used by individuals with true deficiencies in an effort to get to baseline. Many people who start using stimulants in their 20's and 30's report being able to express healthy, practical behaviors that they couldn't summon themselves to express before: cleaning the house, making it to meetings on time, paying attention in conversations. The caution that you're expressing is warranted with any substance, but I'm sensing a bit of fearmongering which I think could possibly stop individuals from trying a substance through which they could possibly receive benefit.

[dweymouth]

I drink coffee every morning and have for pretty much my entire adult life. People might be better off for it because coffee in moderation is healthy and has various bioactive compounds in addition to caffeine that can reduce risk of some diseases... but I don't think the caffeine itself has any cognitive benefits for me at all compared to if I were to never drink coffee. It's just an addiction I'm completely adapted to, and skipping a morning coffee just means I'm a bit extra tired and sluggish through the day. Maybe dopaminergic stimulants are different, especially for people with true ADHD, and they can maintain an effect over time even at a dosage plateau.