[throwaway98031]

> Adderall is not the answer as these journalists like to claim though. It's useless for basically anything other than very rare usage and has difficult to manage loss of productivity during withdraw. It has an incredibly fast tolerance buildup. If your work requires steady output instead of rare bursts, it's questionable whether it even surpasses coffee because of these downsides.

The problem here is that Adderall isn't meant to be used in this manner, nor is it meant to provide the user with bursts of productivity or euphoria when dosed properly.

Proper usage, as in ADHD or sleep disorders, involves titrating the daily dose to a point at which the attention and/or wakefulness-promoting effects reach the appropriate therapeutic level over the long term. This process takes in to account the inevitable tolerance that comes with downregulation of the systems that are directly (norepinephrine, dopamine) and indirectly elevated by Adderall usage.

Casual users and abusers, on the other hand, are always chasing the initial rush of drug-induced euphoria and the associated productivity and mood boost that comes in the early phases of treatment. These effects are highly prone to tolerance and downregulation (as intended) and thus can't be maintained without constant dose escalation or taking frequent breaks to pay back the built-up tolerance. Neither situation is sustainable or healthy, which is precisely why Adderall should not be considered to be a substitute for the milder stimulants that people consume casually every day.

Beyond that, Adderall has some potential neurotoxicity issues due to the way it upsets dopamine sequestration in neurons (dopamine has neurotoxic metabolites and the systems that clean up these metabolites can be overwhelmed in certain Adderall dosing schemes). Coffee, on the other hand, is associated with a reduction of certain neurodegenerative diseases.