[koolba]

> There are now also online telehealth services that don't hide the fact that this is one of their services. You pay their (cash only, please) fee and they'll make sure you get your letter. The same thing is happening with "emotional support animal" letters.

This used to be a thing with medical marijuana as well (maybe still is?).

The answer is for schools to grab their share of this money by selling each of these accommodations directly, or perhaps via some kind of auction. Acceptance to such a school will be the “basic economy” of attendance. If you want to pick your seat, you can pay to upgrade.

[FireBeyond]

> This used to be a thing with medical marijuana as well (maybe still is?).

Yup. A few years ago in California, go to a weed store in Napa. "Oh, you need a medical card" "Oh, sorry". I get handed a business card, no worries, just call this doctor here, it'll be $x (can't remember) and you can get a medical card and just come back in. I had my medical card within 5 minutes on the phone on the sidewalk outside the store.

Was having stress related ED issues a fews ago. Hit up Hims, fill out the questionnaire. Physician reviews it in our online chat. "If these are your answers, I would not be able to prescribe for you. If your answer to Q3 was x, Q5 was Y, then I would. Would you like to review your answers before re-submitting?"

[mapt]

Conversely, you get the cancer patients like my mother, who waited until her second cycle of chemo to explore cannabis, which is apparently the best antinausea medication we have, with the right strains embarrassing the best that the pharmaceutical industry has to offer. She was told that medical card approval needs to go before a state board and it takes 1-2 years; She's be dead or off chemo by then, so we gave up. It ended up being the latter.

A few years later, we've got a "walk-in clinic" a neighborhood over which advertises how easy/fast it is to get cannabis cards specifically; By this time there is no approval wait.

A few years later, recreational is legal.

[latexr]

The deeper I read into this thread, the more it verifies the Key and Peele sketch.

https://www.youtube.com/watch?v=_8JtnUpkP0s

[Spooky23]

Or just operate so that everyone gets the academic benefits.

My roommate in the 90s was ahead of the curve, he memorized the Cosmo quiz “do you have ADD” went to the student center, got a script that he sold or snorted, and got to take his test in a comfortable room at a time scheduled centrally.

Just randomize assignments to rooms all over campus.

[lazide]

That’s actually impossible (everyone gets the same benefits).

You’re talking about a lottery, which randomly distributes them - which is only fairer in the sense it’s unpredictable, not that anyone that actually needs it would get what they need.

It’s typical gaming of the system, and shortly it’s going to have to switch to punishing those gaming it or it will spiral even more out of control.

[Spooky23]

You’re overthinking it. The accommodation is a quieter room with a more generous time limit. Just provide that and use a lottery to distribute slots. I had classes that had take home finals.

My son runs into the phony accommodation game in middle school. The latest BS is to get a dyslexia diagnosis, which lets you have more time and take a 90 minute break (where they look up the answers). 9 kids discovered that they have this condition in 8th grade. Performance impacts eligibility for placement in some programs in high school.

If the kids didn’t know it, I wouldn’t have an issue with it. But they do, and abusing accommodations and gamification of zero integrity behavior undermines society in a small way.

[polotics]

Oh wow snorted? Did you keep in touch how well is he doing now? I suspect he's not doing so well with the brain damage and the likely switch to other substances.

[walletdrainer]

Snorting adderall does not typically cause brain damage, and the list of substances rich white kids (I’m guessing here) would typically upgrade to is pretty much just cocaine.

Typical cocaine use also does not result in meaningful harm.

The financial industry chugs along just fine despite approximately everybody using these drugs.

I’ve used cocaine regularly at social events since I was a teenager. The vast majority of people I know, whether they’re 25 or 65, will not say no when offered. In my whole life I’ve known two people from my circles to have developed an actual coke problem, and I know a lot of people.

At this point coke is just the cigarettes of the upper classes, but likely less harmful.

[Aurornis]

> Snorting adderall does not typically cause brain damage

"Brain damage" isn't a binary yes-or-no thing that happens to you.

It's not even clear that regular as-prescribed usage of amphetamine is without some harm potential. With regular doses and route of administration it's obviously limited or negligible, but someone insufflating (snorting) it routinely is exposing their brains to much higher concentrations and much faster onset.

Note that dopamine itself is toxic when metabolized normally, but your body is equipped to mostly handle that. Using drugs that disrupt dopamine flows in high doses can overwhelm the systems designed to keep dopamine metabolism from doing damage.

> Typical cocaine use also does not result in meaningful harm.

The works "typical" and "meaningful" are doing a lot of work here. One of my friend groups has a lot of ER nurses. They see a non-trivial number of people coming to the hospital from casual cocaine use. These cases are generally waved away as other conditions by drug users (e.g. heart attacks, etc) and therefore they don't "count" in some people's minds. Yet it's a common finding for them on blood workups for people, including young people, arriving with cardiovascular problems.

> The vast majority of people I know, whether they’re 25 or 65, will not say no when offered.

Significant drug users often don't realize how much of a bubble they're in. Also, the goalposts for having a drug problem tend to be moved around a lot when everyone you know is using drugs regularly. Typically, being unable to say no when offered a drug is a sign of having a problem.

[walletdrainer]

I think we can probably agree that people using cocaine at social events once or twice a week are generally not the problem users.

Similarly, I don’t think you could reasonably suggest that someone who has a couple of glasses of wine during such events has a drinking problem.

> Significant drug users often don't realize how much of a bubble they're in. Also, the goalposts for having a drug problem tend to be moved around a lot when everyone you know is using drugs regularly. Typically, being unable to say no when offered a drug is a sign of having a problem

Personally, I’d consider someone who uses cocaine on a daily basis to have a problem. I’d also like to suggest that it’s pretty hard to have a cocaine problem and not use cocaine on a daily basis.

OTOH, someone who infrequently shoots up cocaine probably isn’t addicted but would be engaging in some seriously risky behaviour unless they’re able to very precisely measure their dosage. I’ve never heard of anyone doing that though, it’s certainly not a common activity among the upper socioeconomic classes.

> The works "typical" and "meaningful" are doing a lot of work here. One of my friend groups has a lot of ER nurses. They see a non-trivial number of people coming to the hospital from casual cocaine use. These cases are generally waved away as other conditions by drug users (e.g. heart attacks, etc) and therefore they don't "count" in some people's minds. Yet it's a common finding for them on blood workups for people, including young people, arriving with cardiovascular problems

To my knowledge there exists no evidence that anything less than massive cocaine use could result in new cardiovascular issues. Of course it may trigger an existing condition, but someone who has a heart attack during normal casual use of cocaine would probably be prone to have one during exercise also. The stress on the heart from cocaine usage is not particularly different from fairly normal day-to-day activities of people who do not use cocaine.

[habinero]

My "I do not have an actual coke problem" shirt is generating a lot of questions answered by my shirt.

[AngryData]

Yeah, somehow despite everyone doing cocaine at even the highest positions for many decades without any real problems, and the plethora of medical research about the effects of cocaine and how minimal all its long term side effects are and how low addiction rates really are, all below common alcohol, people still act like cocaine is this super serious life-ruining drug. The only significant life-ruining part of cocaine is law enforcement's reaction to it, unless of course you have a lot of money in which case you can just pay to lawyer your way out of it.

The biggest danger to cocaine? Using cocaine to stave off the over-dose effects of other longer-lasting drugs, and then running out of cocaine before you run out of the other drugs and then dieing from alcohol poisoning or opiate over-dose. Cops and politicians will pretend cocaine killed those people, but anyone who knows jack shit about drugs or gets to see the actual toxicology report knows better.

[Spooky23]

We talk every once in awhile, I actually thought about it because I bumped into him at a conference recently.

He was one of those people who are able to contain their hedonism and self-abuse to their frat-boy era. Now, he’s a grey-ish beard tech dude with an awesome wife and family.

[elsjaako]

Why would snorting be so much worse than just swallowing the pill? The goal is to get the chemicals in the blood. Snorting apparently works quicker, giving you a stronger but shorter lasting effect. But the difference is not night and day.

A lot of people do recreational drugs while at college and go on just fine. George W. Bush, for example, is alleged to have taken cocaine.

[Aurornis]

> Why would snorting be so much worse than just swallowing the pill? The goal is to get the chemicals in the blood.

When a pill is swallowed it is gradually released into the bloodstream. Some drugs are also partially degraded by the digestive system, meaning you don't get 100% into the bloodstream. For some drugs, as much as 90% or more can be destroyed in the stomach, but this is accounted for in the dosing. Your stomach contents also go through your liver, which does first-pass metabolism depending on the drug and can reduce overall concentrations.

When someone snorts a drug, it bypasses all of that. It has easy access to the brain. It spikes the concentration the brain sees far in excess of what you would get from taking the drug orally.

This spike is where the damage is amplified. A sudden spike to very high values can overwhelm the brain's protection systems, for example.

Dopamine degradation produces neurotoxic metabolites. The brain is normally decent at cleaning these up, but when you consume drugs that spill that dopamine out at excess rates and disrupt its storage in vesicles then you can also overwhelm the brain's ability to clean up safely.

The sudden spike also causes rapid downregulation of the affected receptors, leading to deeper withdrawal effects that can last for a long time.

The sudden spike is also more euphoric. Combine that with the deeper withdrawal and it's why taking a pill through the nose is far more addictive than taking it orally.

[walletdrainer]

> George W. Bush, for example, is alleged to have taken cocaine

And basically any big name in the financial industry has almost certainly used loads of cocaine. They’re mostly not suffering any horrible consequences.

But of course there’s a world of difference between cocaine use and addiction. An addict might start their day with a line, every day, but that’s far from typical use.

[freedomben]

It's not really worse, but you can get a lot more in your bloodstream a lot quicker, so you've got to be careful with the dose.

Snorting will also shoot your tolerance through the roof, so taking it orally will no longer be as effective. Definitely not a road I recommend going down

[storf45]

I think that’s a good argument against using cocaine.

[miki123211]

Poland recently had the famous "receptomats", mostly for medical mariuana, but also a bunch of other things people wanted.

You'd pay online and quickly receive a PESEL (local equivalent of an SSN) + a 4-digit prescription code, which is all that is needed to redeem a prescription there.

[hrimfaxi]

> The answer is for schools to grab their share of this money by selling each of these accommodations directly, or perhaps via some kind of auction. Acceptance to such a school will be the “basic economy” of attendance. If you want to pick your seat, you can pay to upgrade.

I don't think you can charge more for accommodations for the disabled.