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349 points pseudolus | 3 comments | | HN request time: 0.618s | source
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01100011 ◴[] No.42478203[source]
A question for older folks: what did drugs do for us? Why did we do them?

For me, drugs were:

- socialization. I met a lot of friends through alcohol & drugs and they became the social glue for my circle. Alcohol & drugs became a large part of my identity.

- a way to cope with boredom. Every day is a party when you're high.

- identity. In my generation, drugs were mostly cool and associated with iconoclasts, artists, etc.

Young people's culture changed. I don't think kids see alcohol, drugs and being out of control as cool anymore. I don't know specifically what changed this. Better social messaging, mass prescribing of ADHD meds, more competitive job markets.. Social media and multiplayer gaming have both ramped up competitive drives for what used to be more relaxing activities. Maybe the current optiate and meth epidemics are more effective as a warning than, say, the crack epidemic was for us?

Kids have tech to glue them together(poorly in many cases, but it does fill the niche). Kids have internet subcultures to define their cultures now. Alternative lifestyles are much more accessible and take much less risk to participate in vs my childhood in the 80s. You don't need drugs to meet people or forge common identities.

Kids are never bored anymore. I suspect there has never been a better time to be a kid in a boring small town. If you have bandwidth, you have culture. You have better shipping, home delivery, cheap imports, etc. Affluence seems more common than it used to be, even in our highly divided economy.

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TomK32 ◴[] No.42478760[source]
The improved treatment, and acceptance, of ADHD is certainly one key element here. I hope we continue to support kids if they show symptoms of any psychological disorder.

Here's a 2018 study following kids into adulthood and questioning them on their substance abuse: https://pmc.ncbi.nlm.nih.gov/articles/PMC5985671/

My brother is one of those really bad cases, while I got my diagnosis just recently; never had more than a slight drinking problem which has almost disappeared since the I started taking medication.

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1. FireSquid2006 ◴[] No.42480385[source]
We can take a good thing too far (and probably are at that point). ADHD is being overdiagnosed and medication is being overprescribed, especially in young men.
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2. TomK32 ◴[] No.42481132[source]
Over-diagnosis would mean we'd see a lot of kids and adults being diagnosed with ADHD despite being normal/typical. Granted ADHD shows in a spectrum of symptoms but I can't find any study that systematically re-tested patients to find over-diagnosis.

There might be clinicians who diagnose ADHD much more freely than others and whose verdict might not withstand the critique of a more experienced clinicians, but that can happen with any other disease, especially when it's still being studied and not every doctor has learned about it during his medical education. Just look at the speciality of psychiatrists near you, you might for 10 times more for depression than for ADHD. Despite both having the same prevalence and depression often being a comorbidity of ADHD.

Over-prescribed medication, well it is a problem because of the myth that Ritalin would help studying but at least here in Austria it there's enough hurdles to get a prescription. And the meds alone won't fix ADHD.

What we know from studies are under-diagnosis in women and the severe effects an undiagnosed ADHD can mean for a person. What we also know from studies is the under-diagnosis of girls, only in adulthood the gender-ratio of late diagnosis is almost even. Please don't talk ADHD down, it's too severe and we have a hard enough life already without being told by others that suddenly everyone has ADHD...

3. Spivak ◴[] No.42481530[source]
I don't think we've hit overdiagnosed, I think we've massively underestimated how many sufferers there are. But assuming you're right, so what?

There's an argument to be made that getting the diagnosis right for kids is imperative because the medication is essentially impressed upon them but for adults, who cares? They're not cheap, the side effects are kinda awful, it's annoying to get the dosing right so you don't build up a tolerance, you have to go to a doctor every time you need your rx renewed. If someone without adhd is going through all that because stimulants help then power to 'em I guess. There's not really a downside, stimulants at the doses prescribed for adhd aren't life ruining.