Club Med

Dispatches from the Adderall Epidemic.
compilation

America runs on Adderall. From Silicon Valley to Wall Street, through prep school and grad school, in ad agencies and magazines, many of our most powerful minds are flying on prescription-grade speed. And all these uppers do a lot more than increase productivity. They induce a particular set of behaviors—a passive-aggressive management style, a manic discourse, a sarcastic affect—that can fuse into a culture when the number of users reaches critical mass.

This culture is only becoming more pervasive. The last few years have seen the biggest spike in ADHD prescriptions since Adderall first passed FDA approval in 1996. If Adderall were not considered a productivity drug—economically beneficial, on balance—we would almost certainly be talking about an amphetamine epidemic. And maybe we should be. Adderall’s efficacy for treating ADHD, and its popularity among the Professional Managerial Class, has helped obscure what a strange and deleterious drug it can be. Adderall is highly addictive, the returns it delivers are steadily diminishing, and the risks of heart disease and psychosis increase by the year. In the meantime, it just makes you kind of annoying.

The drastic increase in Adderall use hasn't raised nearly as much uproar as the national shortage it helped cause. The consternation at the peak of the drought was understandable: our country was suddenly lacking one of its key ingredients. Productivity declined by 3%. Twitter started to suck. People raised on Adderall started unwittingly dabbling in meth. At Broadcast, we took this as an opportunity—a kind of pause—to reflect on the impact this pervasive drug has had on our culture. While Adderall use is widespread and normalized among a certain class of Americans, almost no one talks about it publicly. We were curious: What cultural shifts have come out of this incredibly upbeat epidemic? What are the short- and long-term consequences of millions of people getting hooked on speed?

To get to the bottom of this, we asked some of our favorite writers to each explore a particular facet of the culture that has evolved around this powerful drug.

The History of Adderall

How we got ourselves an amphetamine epidemic.
By Daniel Kolitz

There was a time in my life, ten years ago now, when I did almost nothing but take Adderall and write about Adderall. These were complementary pursuits. The more Adderall I took, the more fervently I investigated Adderall—its culture, history, and collision with my life. While an alcoholic writing a history of alcohol might struggle to stay on the ball, in my case substance and subject were perfectly matched. Night after night I brought myself to the verge of a heart attack paging through abstruse FDA documents; mid-morning after mid-morning I went to bed assured of the rightness of my project. I was cornering the facts. I was blowing the doors wide open.

This project was personal to me. I was an early adopter, first prescribed Adderall in the third grade. At the time I felt that it was mostly poison. The come-up was great: there are layers to "Californication" you simply cannot hear unless you are nine years old, flying on pharmaceutical speed, and listening to it on your discman, ideally on the short-bus to Jewish day school. But the drug drained me of the one thing I cared about most: my prankish joie de vivre. No one likes a drugged class clown, except perhaps for that clown's teachers, school administrators, and parents. So I refused to take it. The jokes were more important. Later, a child psychiatrist would tell me that many people who hate Adderall as children wind up liking it in adulthood, after developing the kinds of worldly ambitions for which the drug was intended. He was right. At twenty-three—a postgrad burning for self-advancement—I suddenly couldn't get enough of the stuff. You could almost say it was a problem.

Certainly, taking Adderall all night and drinking to fall asleep and then taking more Adderall to pretend to function at my largely fake job promoting various lifestyle products had its pleasures. But more and more often I just felt haunted and unwell. Even at the height of my mania I knew that this was no way to live. I also knew that I was far from the only person living this way. At hedge funds and media startups, coffee shops and WeWorks, the signs were plain to see: an entire generation grinding its teeth to dust, wrecking its posture, struggling to blink. How had we landed in this weird bind? Who exactly had allowed it to happen?

To help me answer those questions, I contacted preeminent speed historian Nicholas Rasmussen. His classic On Speed: The Many Lives of Amphetamine sheds valuable light on the period, in the 1950s and ‘60s, when amphetamine’s ubiquity as an antidepressant and diet aid helped to usher in America’s first speed epidemic. I was nervous to talk to him, partly because of his book's formidable intelligence and range, and partly because I'd taken a bunch of Adderall about twenty minutes before our scheduled Skype call. The call went poorly, as you can see from this excerpt:

Me

It seems, obviously, that most cases of amphetamine use don't ultimately end in psychosis or heroin addiction, although many do. And that's not to say that widespread amphetamine use isn't a social harm—but sometimes it seems like the consequences might be a bit more subtle or pernicious, especially when it's being taken by, say, a working professional, who might actually be sticking to low doses, and not necessarily escalating and taking ten then fifteen then twenty milligrams...so I'm wondering what you think the downside of amphetamine is when it's used, maybe the word isn't responsibly, but when it's used in relatively low doses over an extended period of time.

RASMUSSEN

I’m sorry—what?

Me

I'm basically wondering, outside of the extreme cases of psychosis or heroin addiction, and escalating usage, what are the downsides of amphetamine use among the general population, if they're taking it in low doses over an extended period of time?

RASMUSSEN

I believe that it's an addictive drug. So for those who don't get addicted—that is to say, those who only use it occasionally—there won't be any particularly great negative consequences. But since most people who are prescribed the drug seem to develop a dependence on it, at least adults, it strikes me as too dangerous to be used in this way.

Me

So, what's the downside of being dependent on a drug like Adderall?

Rasmussen

If you're dependent on amphetamine, you will develop amphetamine psychosis eventually.

Me

Amphetamine psychosis just being defined as taking so much that you kind of go off the deep end, or—

Rasmussen

It is a paranoid psychosis indistinguishable from schizophrenia.

Joke's on Rasmussen: I never went insane. Instead I developed a chronic tension headache that plagues me to this day, half-heartedly dabbled in the opioid epidemic (how else was I supposed to sleep?), and emerged, after ten months, with a strikingly unpublishable 12,000-word melange of memoir, broad-strokes cultural theorizing, and in-the-weeds regulatory analysis. In a way, the essay was a tortured account of the conditions—historical, political, neuro-pharmacological—that allowed for its creation. Reading it for the first time in almost a decade, I ache for the boy who wrote it. I also sympathize with his mission. Because he was onto something. The details of Adderall's FDA approval really are, I still think, a scandal.

*

Adderall’s precursor, Obetrol, was cooked up in a converted Queens garage sometime in the 1950s. Back then, pharmaceutical regulation was laissez faire. Becoming a large-scale amphetamine manufacturer was, more or less, a matter of buying the equipment and getting to work. You had to prove your drug was safe—a low threshold at the time—but no law stipulated that it had to work as advertised. Here’s how William Goodrich, chief legal counsel at the FDA, described the situation:

The way drugs were investigated, a physician from the company would go out in the community with some samples and say to the doctor, "I've got this new drug for so-and-so. Here's some samples. Try it out and let us know how you like it." And they would get back a letter from him: "I tried it out on eight patients and they all got along fine." That's the kind of stuff that was coming in for science.

Goodrich was a virtuous public servant: on his retirement, he was hailed as the FDA’s “most influential figure and guardian of its institutional memory.” In an era when the agency was a public joke, lacking even basic enforcement powers, he made it his mission to harass profiteers—among them, notably, Rexar Pharmaceuticals, Obetrol’s manufacturers. In a complaint to the DOJ, he accused the company of selling high doses of Obetrol with no license, and promoting the drug with the “unsupportable and illogical” claim that it was safer and more effective than other amphetamines (a theme Adderall would pick up a few decades later).

The FDA finally banned Obetrol in 1973 as part of the agency’s broader effort to curb the speed crisis, declaring the drug “ineffective” and “lacking in proof of safety.” In response, Rexar reformulated Obetrol, swapping out the methamphetamine it contained for various amphetamine salts—the soon-to-be patented Adderall recipe—and resumed distribution, albeit in small enough quantities to evade regulatory notice. The drug’s circulation in the 1970s and 1980s is hard to trace, although it had a way of popping up in huge quantities at random doctor’s offices across the country. One news report in the 1980s highlighted the work of Ohio doctor Mattie Vaughn, whose practice was described in a court memo as “nothing more than a thinly disguised drug-trafficking operation,” and who in eighteen months dispensed nearly 140,000 of these new Obetrols to 4,500 patients.

By the early ’90s, the market had largely dried up, Rexar’s owner was dead, and his family had put the company up for sale. A Kentucky-based high school football coach-cum-pain pill entrepreneur named Roger Griggs examined its meager assets and seized on a surprising detail. Almost all of Obetrol’s minimal sales—$40,000 a year—were attributable to a single child psychiatrist: a Dr. Robert Jones based in Provo, UT. Griggs made plans to visit him. Over lunch in Provo, the enterprising doctor reported that he had been prescribing Obetrol to ADHD kids who couldn’t tolerate Ritalin. The results, he claimed, had been spectacular. Griggs was sold. He bought the drug, changed its name (ADD for All: Adderall) and began marketing it at scale with his company Richwood. By the middle of 1994, just a few months into this campaign, 30,000 children were on it.

Unfortunately, Griggs had apparently skipped an important step. He soon received a call from the FDA, informing him that his flagship product had never received the agency’s approval. It was "devastating," Griggs said, to learn their product was technically illegal. Nonetheless, Richwood promptly initiated a marketing campaign in a prominent child psychiatry journal, triggering a warning letter from the FDA restating that Adderall was an unapproved new drug, the continued marketing of which may result "in seizure and/or injunction."

There were good reasons to not approve the drug. Contra its early advertising, there was no evidence it was any more effective than Ritalin in treating ADHD. Its component parts had been generically available for decades. Asking for the “exclusive” right to manufacture Adderall was equivalent to asking for the “exclusive” right to manufacture a combination of peanut butter and jelly. The drug’s chemical makeup and subjective effects were functionally indistinguishable from Dexedrine, which had lost its patent decades ago. Had Adderall been submitted as a completely new drug, rather than as a “supplement” to Obetrol’s 1950s-era application, it would never have been approved—no company would even think to try in the first place.

And yet—after months of mounting tensions—the FDA's tone abruptly brightened, and in a surprise about-face the drug was granted full approval and market exclusivity in January 1996, without a single substantial clinical trial submitted to demonstrate its effectiveness. Why? As New York Times journalist Alan Schwarz reports in his book ADHD Nation, a senator's son had been taking Adderall before the FDA intervened; the senator "pitched a fit" and the agency rushed to approve it. Who that senator was Schwarz doesn’t say, but my research suggests it was Orrin Hatch, who took a curious interest in Richwood’s plight around this time.

Sensing an opening, pharma giant Shire purchased Richwood for $185.7 million in 1997, and from there worked to advance a paradigm shift in psychiatry, one which would posit ADHD as an underdiagnosed scourge tanking the potential of not just millions of children but—once that market was saturated—millions of adults. In the meantime, Adderall has spawned multiple blockbuster sequels: Adderall XR, Vyvanse, and, most recently, Mydayis, a long-release version of Adderall which lasts, incomprehensibly, for sixteen hours.

“We defined the attention deficit disorder market,” Roger Griggs told me, ten years ago, as I struggled to extricate myself from both my dependency on Adderall and the mountain of Adderall-related documents, reports, statistics, and interview transcripts I had frantically compiled. “There was nobody promoting it. We were the first people to do that.” By every conceivable metric, they succeeded. Per the most recent data, prescriptions of amphetamine—a chemical whose alleged therapeutic benefits were more or less entirely discredited at the start of the 1990s—have increased by roughly 2,500% since Adderall went on the market.

*

There is a robust, well-funded ADHD advocacy movement which insists that this is a good thing—that millions of people who would otherwise be struggling to read restaurant menus or walking blindly into traffic are now able, with Adderall, to live healthy, fulfilling, productive lives. And maybe they’re right. User reports are so variable that generalizations are useless: few experiences are more epistemologically destabilizing than scrolling a heated Adderall-related Reddit thread.

I can say that, in my case, Adderall broadened my ambitions to the precise degree that it thwarted any possibility of achieving them. This had something to do with the quality of attention the drug generates, which is, above all, value-neutral. On Adderall, everything is interesting. This is one reason my Adderall essay was doomed from its inception. Whenever I seemed close to wrapping things up, another vital avenue of inquiry would materialize, until I found myself—not entirely without reason—compiling material on minor figures surrounding the Kennedy assassination. Adderall, I eventually had to acknowledge, had destroyed my Adderall essay, and was on its way to destroying me.

The drug’s influence has since escalated dramatically. As the recent shortages have demonstrated, there are hundreds of thousands of people who cannot function without it, owing perhaps to a deficiency of norepinephrine (the leading neurological theory for the basis of ADHD), or (as likely) to a form of iatrogenic chemical dependency, or both, or neither. Does it matter that the US is the only country where this happens? That, however complex the rise in speed use, not to mention opioid use, might appear, these phenomena are effectively mono-causal?

The FDA approved OxyContin just one month before Adderall, and allowed Purdue Pharma to claim it actually countered addiction, thus creating that company’s fatal marketing advantage. Likewise, Adderall was the first new amphetamine granted market exclusivity since the ’60s speed epidemic—inexplicably, the agency granted Richwood a reason to get as many people as possible hooked on amphetamines. If Adderall’s pushers have since evaded Sackler-style comeuppance, this can be largely attributed to the fact that it’s basically impossible to fatally overdose on it. Entire desolated towns can testify to the destructiveness of OxyContin; all that Adderall leaves behind are the phantoms of lives that might have gone otherwise, my own included.

Adderall pills of different shapes, sizes, and colors arranged in a line.

My Party Drug of Choice

The only one at the rave paying this much attention.
By Geoffrey Mak

In my twenties, I thought I could live like a god. I snorted coke by the pool at the Standard Hotel, did pull-ups the first time I popped ecstasy at Berghain, snorted an entire gram of K on a Tuesday night, dropped acid at Documenta, smoked meth from a dealer who fucked me in a bathhouse, passed out the first time I did G and chipped my front tooth on concrete. As you can see, I’ve put myself through a lot, so these days I keep it simple. I rave on Adderall.

One 15mg pill gives me a clean, steady hum that energizes me from midnight to dawn. It never makes a moment something other than it is. I might not get the jolt of energy, as if on speed. I just feel alert. Like I’m the only one at the party paying this much attention to everything.

I’m thirty-five years old and have been raving for ten years. I feel like I just announced, “I’m Geoff, an alcoholic,” because I know about that life. I did the Twelve Steps, found God in the wisdom of the Third Step Prayer, but these days I stick to a harm-reduction regimen with friends who hold me accountable. Addicts are my people. My “Harm Reduction Buddy” and I text each other if we ever have cravings. We don’t convince the other not to do drugs—we just listen. If he calls me, I drop whatever I’m doing. Like the night he called me after he relapsed on meth, I came over and we flushed the syringes and then I trip-sat with him for thirteen hours and we cried in each other’s arms until the sleeping pills kicked in. Real love.

Adderall doesn’t merit a call to my Buddy. This pharma-grade amphetamine doesn’t intoxicate me as much as it infects me with a kind of discerning mania. On Adderall, I can’t tolerate music unless it’s excellent. I hear it all. Hi-hats pattering like fingernails tapping on glass. The terrifying serenity of a kick drum tuned to a minor key.

While ketamine had me riding chariots of fire no matter how shitty the set, Adderall demands an intentional approach. I require a regimen to get into the music. If the beat is slow, I rock my shoulders to my alternating two-step, as if passing an invisible ball in a Z shape across my body. If the rhythm is higher, something like 160 BPM, I rotate my arms, in a pinwheel, ducking my head like I’m in a washing machine. I spin around until I’m dizzy because it reminds me of being high. Grace is a gift from God you know you don’t deserve, and I take what I can get.

Most nights, I hit what I refer to as The Wall: the measure of my soul. Despair comes down and I face the limits of my own interiority. I used to dissociate from this feeling with various powders, but now I confront it, unblinking. Defeated, I get up and walk upon the dance floor. Now it’s just me and the speakers. I don’t ease into it this time—I thrash around, flailing against my body’s aching inertia. People clear away, and I find myself in a circle of my own. Lunging my arms, I can hear my throat lurch in grunts and cries, and sometimes, I am crying. My head swings low, jaw unhooked. This is the moment I know that a party has turned into a rave. Humbled with gratitude, my eyebrows smash together and I turn up, eyes rolled back, mouth open as if ready to receive rain. Lord, relieve me of the bondage of self. I am on this dance floor and this is what I am made of. A freezer burn ripples across my muscles, and it feels like pleasure. I am judging everyone.

Adderall pills of different colors and sizes arranged in a pattern

Tweaking on Main

The drug meant to cure the attention crisis is making it worse.
By Danielle Carr

Decision theorist Herbert Simon coined the term “attention economy” in 1971 to describe an emerging problem of the computer age: information (limitless, inorganic, machinic) consumes attention (biological, scarce). “There is only so much lettuce to go around,” he explained, “and it will have to be allocated somehow among the rabbits.” By the time the term surged in public use, around the Twitter debut year of 2006, we rabbits were beginning to feel seriously out of whack. Like so many strange nouns before it (gender, the nation), the public only started to take notice of the “attention economy” when it seemed to be in crisis.

For Simon, the problem of attention was simple mathematics: infinite need meets scarce resource. As such, attention scarcity might be unfortunate, but it was not pathological, certainly not in a medical sense. Yet by 1980, the American Psychiatric Association had coined the ADHD diagnosis to explain why children were failing to get hooked on phonics. The problem was not, in fact, that the kids were “hyperkinetic” (aka that they couldn’t sit still), but that they suffered from a neurological incapacity to pay attention. By the time ADHD reached quinceañera age, an entire generation of well-insured children had been diagnosed—via tests as rigorous as losing a round of a Chutes & Ladders knockoff called “Stop, Relax and Think”—and put on Adderall, to blockbuster profits.

When people say “disaster capitalism,” they are referring to the dynamic by which capital creates crises for which it then sells solutions. In some cases, the logic hews so closely to its ligaments that it cries out for dissection. By now everyone save for the most orange-pilled #mentalhealthwarriors finds the late-90s child addy prescription boom shady at best. Yet even for those who consider themselves critics of the psychiatric establishment, the idea remains that the crisis of the attention economy was medicalized. In other words, first came the attention crisis, then came the diagnosis that described it as a medical problem, and last came the Adderall boom that was supposed to fix it. By these lights, if Adderall isn’t fixing the attention crisis, it’s because we are trying to cure a non-medical problem (e.g. the natural exuberance of children, or the infrastructural fact of smartphones) with a drug. This analysis fails to grasp the full extent of the problem. It’s not just that we are drugging something that can’t be solved with drugs. It’s that the particular drugs we are using to do so—amphetamines—are making the attention crisis worse.

At this point, no one seriously disagrees with the idea that, as the Internet has become inescapable, the so-called ADHD crisis has escalated. Nowhere has this been clearer than in the latest round of attention panics emanating like a toxic plume from the pandemic. It’s hard to say when, exactly, but sometime in the last four years, something insidious snapped into place. It was the feeling of watching the last remaining escape routes—out of the endless scroll, away from the screen—get sealed off. What used to be a piece of paper is now a QR code. You can’t turn off your phone to work because you need it for dual factor authentication. And so on and so on. What else is there to do in endless Zoom meetings other than be on your phone, anyway?

Reading an early depiction of the Internet, in William Gibson’s Neuromancer (1980), what’s remarkable about the depiction of “cyberspace” is how immersive people expected it to be. It was a place you could go, distinct from “meatspace.” If only. The reality is that now, you are always half on your phone. This means that you can only ever half think, a fact that felt more obscene when you could remember, more clearly, how the other way felt.

This, then, is the architecture of the current attention crisis, which telepsychiatry start-ups like Done propose we solve with more Adderall, and critics propose we solve by rolfing, or something. There is a growing consensus that the attention crisis is, at bottom, caused by the Internet, which has in turn caused the rise of Adderall usage and prescriptions. But what if this story has things the wrong way around? Working backward from the neurochemical effects of the drug, it begins to seem plausible that, in fact, Adderall’s prevalence was the sine qua non of the Internetified attention economy and its perpetual crises.

Let’s begin here: the most online one can be is online on Adderall. Is there anything better? Where does the time go? There is always another tab to open, another reel to watch. In retrospect, it’s hard to think of a single bastion of millennial culture—which is to say, smartphone-cusp Internet culture—whose essential features are not deducible from the premise that everyone involved was gacked to high heaven on Adderall.

It’s not just that the technical architecture of the modern Internet was created by people on stimulants, although that’s also true. (There’s hardly a part of the country more Adderall-sodden than Silicon Valley. A recent study by the University of Michigan documented the prevalence of amphetamine use among programmers and coders.) It’s that Adderall was the living currency of being online, the elevated heart rate that set the culture’s BPM. Can one envision, for instance, a form as essentially millennial as the listicle without the army of twenty-something media writers intently foraging across the Internet, tweaking out of their minds? “Because Adderall is the drug most responsible for getting Gawker editors working at 7:30 AM,” the ill-fated site announced in 2006, “we recommend it without hesitation. Lord knows our loyalty is lifelong.”

By then, language itself was beginning to take on the qualities of a tweaker project. In 2000, literary critic James Wood dubbed an emerging genre of novel “hysterical realism.” It was meant to describe what he saw as a new type of fiction that resorted to paroxysms of erratic and baroque detail in order to veil the lack at its core—the lack being attention at the human scale. “An endless web is all they need for meaning,” wrote Wood, although he might as well have said these novels were, in contemporaneous slang, ‘so random.’ David Foster Wallace’s The Pale King led the way, with its Obetrol-riddled protagonist. At least half of the novel The Book of Numbers was written on “a variety of psychostimulants both legal and illegal,” Joshua Cohen confessed. ​​“I have been reading everything and not sleeping,” says a character on Adderall in 10:04, a novel Ben Lerner wrote after a post-college stint in which he convinced a Californian think tank they could “win” the “culture war” by paying him handsomely to make thousands upon thousands of interlinked Wikipedia pages. Extremely Loud and Incredibly Close? Everything is Illuminated? Tell me you’re tweaking without telling me you’re tweaking.

The further you went downstream from literature toward the blogs, the more the linguistic euphoria thinned out into a pure content production grind. “Performance enhancers are necessary to the level of production the blog economy requires,” one industry veteran explained. “In a given week I may be called upon to produce, on short notice and in fair copy, essays, features, blog posts, Facebook posts, tweets, interviews, how to pieces, listicles, confessionals, city guides, recipes, memoirs, and whatever else will pay enough to cover my scrapple tab.” This flotsam was the phenomenological grist of being online, a loop running in a perpetual present. The Adderall that kept the 2010s VICE blogger churning out content was the same Adderall that made us open the article in yet another tab.

And this is the point: first came Adderall, then came the Internet. We didn’t get on Adderall because the Internet was too good. The Internet was good in the particular way that it was good because we were on Adderall.

There’s a biological reason for this. Adderall is a dopaminergic drug, meaning that it works by increasing the neurochemical signal that makes you want to keep doing whatever it is that you’re doing. Specifically, dopamine signals whether an activity is better or worse than expected: for example, if you get two gumballs from the machine when you expected to only get one, the physiology of the resulting jackpot thrill is caused by increased dopamine signaling. Any drug that floods the brain with dopamine will render the user hyper-vulnerable to getting stuck in repetitive behavioral loops, especially when the reward is unpredictable (the technical term is “variable reward.”) This is why gumball machines aren’t addictive and slot machines are. Amphetamines work by turning whatever you’re doing into a slot machine. If the Internet is the giant casino in which we are all now imprisoned, then dopaminergic drugs hook us deeper into its reward structures—like the ones that have you checking your notifications “one more time,” or opening a browser tab to Twitter through muscle memory that seems hardwired past your best intentions.

The connection between amphetamines and digital behavioral loops is perhaps best illuminated by what psychiatrist Gosta Rylander first described as “punding” in 1970. “The patient becomes obsessed with an activity that, while harmless on its own terms, comes to consume their life,” he wrote. “They become irritable whenever someone distracts them from their preferred behavioral loop.” Current clinical literature describes punding as “non-goal oriented, repetitive activity such as manipulation of technical equipment, handling, examining or sorting through objects, grooming, or hoarding.” These activities offer a soothing flow state reinforced by periodic reward, balancing undemanding stimulation with endless repeatability. “Repetitive Reward Seeking Behavior” syndromes of this kind tend to be observed in people who are taking drugs that flood their central nervous system with dopamine, and are most frequently observed in Parkinson’s patients being treated with dopamine replacement therapy, and amphetamine users.

Punding is an uncanny description of the doom-scrolling that became so alarmingly ubiquitous in the post-pandemic universe of screens. In the words of one young student, “The teacher would be speaking and I’d go blank. I would mute my teacher and go on TikTok and stay there for hours. That’s what sustained my attention.” He and many others are now being treated for ADHD in the steepest short-term rise in attention deficit diagnoses since the disorder was introduced. The excesses of the Covid telepsychiatry boom, the wanton abandon with which teleshrinks doled out amphetamine prescriptions—this is how we got an Adderall shortage.

The trouble with taking Adderall for your Instagram addiction is that, neurochemically, amphetamines hook you deeper into the endless scroll. You can’t fix the Internet attention economy crisis with Adderall, because the Internet was made by people on Adderall, for people on Adderall. The more Adderall you take, the better the whole thing gets (by “better” I mean “worse”). This is the upshot: the very medical fix currently touted as the cure for the attention crisis is, in fact, exacerbating it.

Adderall pills of different shapes, sizes, and colors arranged in a line

An Eccentric Lifestyle

Why I acted weird all those years.
By Leon Dische Becker

Many people I’ve worked with closely over the years (or worse, dated) have told me that I have some of the worst ADHD they’ve ever seen. And they’re right, I tick all the boxes.

  • I can hardly sit still (hence the H).
  • I feel blocked from starting the most mundane tasks.
  • I have awful time management and trouble keeping deadlines.
  • I lose stuff constantly.
  • I cannot multitask because I cannot compartmentalize.

Growing up in Berlin, I had no term to describe this, and assumed that I was just a bit lazy and stupid. But then I moved to America for college and was pleased to learn that I suffered from a learning disorder that could be cured with amphetamines.

My first Adderall prescription felt like an explosion of pure possibility. I could now become a functioning member of society, or even, I thought after knocking back the first 20mg, more than that. I started working all the time, writing and reading more than I ever had. Sure, the side effects were annoying: the way it sapped me of my social graces, and exacerbated my anxiety and insomnia. But these felt like minor crosswinds during an otherwise perfect take-off. Adderall became my only hope—the hope that any one burst of hyperfunction could spring me out of obscurity.

This hope renewed itself daily and kept me from acknowledging all signs that the drug was at best an imperfect fit. Adderall helped me become a writer, but made me an obsessive and indulgent one. It helped me read while impairing my memory. It made me a hard-working but unpredictable employee. It lent me a manic confidence that may have been conducive to meeting certain people, but made me way too annoying to sustain those relationships. Eventually the side effects took over entirely. In the course of one week in spring 2013, I got fired from my job at an obscure publishing house for criminal disorganization, a woman I liked broke up with me for being an asshole, and then I tore my ACL playing pick-up soccer way too vigorously with a team of Yemeni cab drivers. Crippled, lonely, broke, drowning in half-finished essays, I pulled the last card in my deck—my soon-to-lapse insurance—to see a real psychiatrist who might help me understand what had happened to me.

Dr. B. was recommended as a dissident ADHD expert, and he lived up to that reputation by telling me at the end of our first meeting that he wasn’t sure I even had ADHD. “Or rather,” he said, “you have it now for all intents and purposes, because you’ve been medicated for it, but it may not have been your foundational issue.” He explained that anxiety and insomnia could both produce symptoms easily mistakable for ADHD, particularly in concert. Anxiety inspires procrastination. Insomnia makes simple tasks tiring. The trouble with having a bunch of mild comorbidities is that it makes it harder to treat any one of them. There was no medical solution to my problem, it seemed, unless I was willing to take a whole medley of drugs.

Which ones? I asked, ready to go. But that’s not what the good doctor meant. Instead, he wanted me to stop thinking about my life as a series of easy fixes, and try a more sustainable approach, such as meditation (lol). This was as far as we got when my insurance lapsed. During our final meeting, with corrupt resignation, I asked the man trying to get me off Adderall to please just give me one last prescription for it. He handed me the script and dispatched me with a cold “good luck.” Nevertheless, his injunctions stuck with me. Unfortunately, flying on his prescription, I put them towards another manic scheme. If I couldn’t be a good worker and a good person at the same time, I simply had to live a double life.

My new plan was to only do Adderall when I absolutely had to, and to never bring my brazen speed energy to delicate social situations (work calls, dates, friend hangs, family tragedies). This led to strange configurations. If I started dating someone I really liked, I would quit Adderall altogether, until I was so behind at work that I was forced to disappear on a month-long binge. For the duration, I would have to avoid all direct communication. Eventually I would burn out, sleep for 24 hours, and then try to re-ingratiate myself with my pissed-off girlfriend and suspicious colleagues. Over time, my brain became increasingly fried, the breaks from work longer and the catch-up sessions more extreme. In the resulting turmoil, I made a lot of rash decisions: messy break-ups and make-ups with people that deserved better; emotional work emails; falling in and out with good friends. I didn’t tell any of these people what I was doing at the time, and I suspect a lot of them still think I’m a bit nuts.

I can write about this behavior in the past tense now thanks to the recent Adderall shortage. Unable to fill my prescription—scared of the alternatives— I was forced to detox. This couldn’t have come at a worse time. I had just managed to stack up four simultaneous jobs and fell behind in all of them, eventually losing two. But where my productivity lapsed, my social graces began to reflourish. I was finally able to appreciate what a shitty time machine I’d spent the past decade in.

I wish I’d never taken Adderall. I don’t mean to sound ungrateful—it helped me get by in America—but I feel like I’ve donated a slab of my brain to pharmaceutical research. Maybe when we have longer studies of its effects on the human brain and heart, I’ll be part of a class action lawsuit against the drug’s makers. In that way, the American dream still seems well within reach.

Adderall pills of different shapes and sizes, positioned in an alternating pattern.

Adderall House Style

How to know if a writer is on the stuff.
By Amber A’Lee Frost

Shortly after moving to New York, I made a friend I felt comfortable confiding in, and confessed to her that I was intimidated by the hyper-achieving women writers I was pitching alongside. They were Ivy League educated, had read all the "right" books, and published so frequently that I deduced they must possess preternatural energy and focus. My friend gave me three of the most edifying pieces of career advice I’ve ever received:

  1. Elite colleges mostly teach students how to ask other rich people for favors. Watch them and figure out how they do it.
  2. Everyone is lying about having done "the reading." If you do even a third of "the reading," you'll have read at least twice as much of it as they have.
  3. "Amber... all those girls are pounding Adderall."

The secret of their hyper-productivity revealed, I eased up on myself. Still, I was intrigued. I thought Adderall was just the speed we give to children who fidget during math class. I started asking friends and peers if they were privy to this miracle drug. It turned out many of them had been on prolonged, high-dose prescriptions since college, "for the edge," as one girl put it. It's a rational economic decision; they come from a hyper-competitive world where that edge can make all the difference.

Many years later, I got a book deal, and was so terrified I wouldn't be able to finish that I got my own prescription. To this day, I'm still not sure if the drug helped me finish the book, or if it actually delayed its completion with chemically induced detours. There are pitfalls to writing on Adderall, and even in the short time I was using it, I noticed some of the symptoms, in both myself and my writing.

I recognized them because I had begun to keep a mental list of the highly specific tells that a writer was working with the "edge" a long time ago, back when I started editing other peoples' work. Like a psychotic co-author, Adderall changed the way people wrote and what they wrote about, usually for the worse. Its influence stood out on the page in very specific ways.

This is the Adderall House Style. Once you recognize the signs, you’ll start to see them everywhere.

*

The Garbage Palimpsest

Professional writers have to learn to accept some version of the following maxim: you'll never really finish a piece of writing, but at some point, you just have to turn it in. Adderall writers do not know when to stop, and often get caught in a loop of obsessive, seemingly endless revisions. I'm not saying everything written on Adderall is garbage, but what is good often gets buried under tons of it (or excised completely) in a fury of compulsive rewrites.

It usually starts small, a little tweak to this or that paragraph. It might actually be an improvement. Improvement is satisfying. Let's improve some more. Eventually, a decent thesis is appended or even supplanted by convoluted idées fixes, which are inevitably replaced by new, equally torturous ones, the original strength and beauty of the work fading in the rear view mirror. Still, the speedy writer persists, until some poor editor has to hound them to turn it in, sometimes by dishonestly reassuring them that, yes, this totally works.

Perseveration on Minutiae

When they aren't rewriting the entire piece, Adderall writers often become fixated on one tiny detail, rolling it over and over in their mind, again and again, gaining more and more momentum, until they finally lose the plot.

When I was about ten, I watched a man repair a clothes dryer. The drum had stopped cycling, so he replaced the motor with one far more powerful than the factory-installed original. When he finished, he gave it a test drive. It began cycling stronger than ever. Then it got faster. And faster. And faster still, until the whole machine began to shake so violently that it rattled into mobility, lumbering across the floor, and finally slamming into the concrete wall of the basement. This is a brain overflowing with Adderall.

I once edited a writer who spent the better part of a week trying to nail down two sentences before the paralysis of indecision set in and he abandoned the project entirely. For better or worse, granular, single-minded focus to the exclusion of everything else means granular, single-minded focus to the exclusion of everything else; until it means the opposite. If you keep cycling around a small, single point, faster and faster, eventually you lurch out of orbit.

Sprawl

Counterintuitively, Adderall-induced fixations can also atomize your attention span entirely. But when you're jacked up on middle class meth, a total lack of focus is no reason to slow down, much less stop. You go big. You find a new idea to explore, a tangent to build out, more citations, more research, anything to keep going and growing. You might not be a perfectionist, but you are a completist, and the work is never complete until it contains the entire, ever-expanding universe of your ideas. Given too much room to roam, an Adderall article or essay can become overly ambitious, wandering and sprawling out into a totally unreadable (and unpublishable) manifesto that usually ends up foundering under the weight of overload. Adderall might help you annex Poland, but you're not gonna take Russia in winter.

Punchy

I won't deny the historic benefits of hardcore stimulants in the right medium, and speed can be a very effective aid in the timely writing of shorter compositions; "quick and little" does not necessarily mean "bad." Sure, this writing can be careless, vapid and "bloggy," but it can also be concise and sharp. Short-form comedy—i.e. "jokes”—come to mind. The writers' room of what many consider to be the Golden Age of Saturday Night Live very famously ran on blow, and SNL veterans have gone on record to casually identify what I heard one refer to as "a two-bump joke." On high enough doses, and with a long enough timeline, the symptoms of heavy Adderall use are indistinguishable from the symptoms of heavy cocaine use. To wit, a couple of friends of mine were downing Adderall when they wrote the jokes for two eight-episode radio plays, dead-on parodies of NPR-style podcast series like Serial and S-Town. The jokes really land. Uppers keep you punchy, or at least, "in the moment."

Eureka

Sometimes, an Adderall user may experience what they believe to be an epiphany, as if they've been personally chosen from on high to receive a heretofore unknown gospel. The bolt of clarity that strikes them is rarely, if ever, a good idea, but almost always implicitly trusted. Since they are writers, they simply must get it down on the page, for posterity, of course (they owe it to the world).

A friend of mine was trying to come up with something for his blog on the future of civil rights; 30mg later: legalize polygamy.

Hard Pivots

If the epiphany fails to come, Adderall may inspire a powerful wanderlust in the service of a writer’s creative self-actualization. In other words, they start trying on new hats. Adderall House Style sees a lot of hard pivots in form, sometimes mid-project, and most of which are not suited to a writers' skillset or talents. One week, you'll be restructuring Jim's article on the history of the Supreme Court. The next week, out of the blue, he'll send you the 10,000 word sample chapter on his new thriller novel, some alt-lit poetry, or "I've always thought I had a screenplay in me..."

Obviously most writers want to branch out, and maybe Adderall can provide a little Dutch courage to try new things, but when an editor finds herself on the receiving end of an unrequested bulk of obviously hastily produced new material, in an entirely new medium, she probably knows ol' Jim is cranked out of his gourd on the socially acceptable Speed of the PMC.

Telling on Yourself

Writers rarely confess their Adderall usage on the page, but they tend to leave a lot of tell-tale signs. You can't prove it, of course. Sentences like "I had gone three days without sleep" aren't a smoking gun, but they do raise the question; "well, how did you pull that off?" Sometimes it's even more subtle, and you really have to read between the lines to figure out when a writer might (though might not) be writing about an Adderall symptom. I often wonder what would happen if everyone contributing to the cottage industry of body-positive essays, whether fat or skinny in theme—i.e. “I lost weight, but I was always beautiful” or “I gained weight, but I’m still beautiful"—was subjected to a piss test.

Hostility

Have you ever noticed that drugs that suppress your appetite for food so often increase your appetite for enemies?

Adderall writers can be very quick to attack. And, if you haven't noticed the pattern by now, they have a hard time knowing when to stop. Critique becomes invective, invective mutates into vituperation. The resulting work is humorless, nasty and emotionally exhausting. Sometimes, you can observe the Adderall rage rising in real time. You could be editing a book review, maybe from a formerly collegial and mild-mannered adjunct, and see successive drafts become progressively vicious, leaving you to wonder whether the nutty professor has actually read the book or simply discovered the author fucking his mother.

Paranoia

"But what if he did, though?"

Paranoia is a common side effect of prolonged stimulant use, and when you've convinced yourself that someone is out to get you, it makes sense to find, expose and attack them. You rationalize your hostility as reciprocation, self-preservation, and self-defense. Paranoia also manifests in textual analysis.

Freud said there was little difference between the philosopher and the schizophrenic; both see a conspiracy in the text. A writer may convince themselves of these conspiracies by misinterpreting what they believe to be hidden evidence. On the page, this can manifest as outright accusations (these podcasts are all in cahoots to soft-launch fascism with Peter Thiel funding), or "deep reads" (Joker is a dangerous call to arms designed to activate mass shooter incels). Sometimes the conspiracies aren't even malevolent; Business Insider published "43 Talor Swift songs, interpreted from a queer perspective," trawling her lyrics for encrypted confessions of her lesbianism, indecipherable to all but her most insightful fans. Paranoia also tends to self-flatter.

Adderall inspires baseless suspicions and intensifies the desire to decode the uncoded; you can always find sinister signs and patterns if you're looking hard enough.

*

Sometimes there's a perfect storm. And it's never confined to the writing itself.

A few months ago, a former friend of mine (we'll call her "G") announced she was coming over with her bff (“O”) to work on their screenplay. G arrived about an hour late, O a half hour later, both with pupils roughly the size of dimes. O had written a scathing, pages-long email to a friend of G's boyfriend (“A”). It was all A's fault, they agreed.

A was a compassionate, considerate man who had given G and her boyfriend a gift card to a Korean Spa for Chrismukkah. But he became upset and raised his voice when G and O accused him of saying her boyfriend's depression could be cured with exercise after he suggested they go on a walk. A did not believe in mental illness, they decided.

Venting gave way to suspicions, which gave way to theories, then certainties. Soon, A had always secretly disliked O—who had recently transitioned—then, A was a secret transphobe. This escalated until they assured each other that A would probably be violent toward women, if pushed ("I bet you could get him to hit you," O said to G with breathless excitement). They proceeded to call A, secretly recording the conversation, even after I told them that recording a phone conversation is considered illegal wire-tapping in the state of California.

Eighteen hours later, G dumped her boyfriend, but not before O sent out another round of cruel, belabored emails, this time to G's boyfriend and another one of his friends.

Looking back, I should have seen it coming in their screenplay. At some point, I stopped reading their drafts. It was usually a matter of days before G would text me to stop reading, because they hated that draft and wanted me to read a new one. Each draft was longer and more disarrayed than the last. In what they believed to be a brilliant flash of professional strategy, they added a transgender character, thinking this would attract more attention to the project. They might have been right, but the character was a hat on a hat on a hat. The style changed as well, and by the seventh draft, it read like it had been crowdsourced, algorithmically designed with surveys from 100 randomly selected high schoolers. Unprompted, G told me they had started using ChatGPT to write some of the dialogue; I couldn't tell the difference.

About a week later, the Twin Tweakers road-tripped about two hours north of LA for what was supposed to be a short stay at the avocado orchard/vacation home of a wealthy bohemian saxophonist, who wanted their help turning the space into a sort of artists' retreat for bands to come and record their albums. Neither O or G were musicians, nor did they know any musicians, aside from the saxophonist, but of course it was going to work.

It was about a month of radio silence before I heard from G again. She texted me around midnight asking for a "PR consultation" on behalf of O, who they feared was about to be canceled. I told her to call me tomorrow; it was another 24 hours before she texted back. Gushing with gratitude, she thanked me for my friendship, but by then she and O had decided the PR crisis wasn't that big a deal. She apologized for taking so long to respond, but they were still holed up at the avocado orchard. It seems that after their brief flirtation with mean emails, they were once again pivoting in creative medium, a new project in a new genre, one they had never tried before, which made it all the more appealing; they were writing lyrics for an album, and had become nocturnal in the process.

The final time I heard from G, she texted me to say I didn't have to pretend that I respected her. (To be fair, I had started seeing her ex). She demanded a call, and when I declined she insisted she wouldn't record the conversation. I declined once more.

I'm not sure if they're still working on the screenplay; last I heard they were on draft eleven.

*

I probably got lucky; there was a global Adderall shortage. And I was never prescribed very much in the first place, so it was easy to titrate off. I also never had a drug buddy co-writer.

I still have a few pills. For emergencies.

You're free to speculate.

Again, I'm not sure if Adderall was a mistake for me. But I have to assume that at some point, it was a massive headache for someone else.

Thus, I wish to extend my deepest apologies toward anyone who had to edit me during that period. Sorry I was such a crackhead. But I suppose it could have been a lot worse.

A little while ago, I noticed a rare post from G on Instagram. She has bangs now.

Adderall pills of different shapes, sizes, and colors arranged in a line.

The Repression Pill

A powerful way to keep your feelings at bay.
By P.E. Moskowitz

I started taking Adderall when I was fifteen. My parents didn’t want me to—they thought my problems would be better addressed by some good old fashioned therapy. Unfortunately, at that point, I was in too much distress to talk it all out. I needed a quicker fix. For all of it: my questions about my identity, the anxiety it caused me, the lack of attention I had for school, my entire personality. ADHD gave me a name for all those problems and promised a medical solution.

I do not believe ADHD is an inherent thing. Otherwise a large subset of Japan’s population would not be able to function, since all stimulant medication is illegal there. But I do, I realize, believe it is a thing—real in the way most things are real, because we collectively deem it so. Because we have chosen to call a cluster of gas a star and a cluster of symptoms a disorder.

In a cluster, the individual elements are easy to overlook. This appealed to me enormously when I was fifteen. Suddenly the instability in my life—the sort I’m sure any queer kid reckoning with their gender and sexuality feels—was just a symptom of my ADHD. And the proposed antidote seemed to work. Adderall stabilized me by containing me. I would sit in class dead-eyed, brain blank, but happy, because I no longer had to think about it all.

The problem is that, as it turns out, you do have to address it all eventually. The symptoms and their causes cannot be contained for very long. As one year on Adderall became two, then three, then four, my sexuality became more repressed and I became more ashamed of it. My repressed affect started to override my personality. Friends noticed. They were sad I was no longer myself.

Everything would have to come out—the gender stuff and the anxiety stuff and the hating myself stuff and the learning-to-work-within-a-horrible-system stuff. I would have to sort through it all like a crime scene.

I found this out when, at the age of nineteen, I flushed my Adderall down the toilet at college, and promptly went into a state of crisis, because all the feelings I’d suppressed came flooding back. It was a lot less fun and easy than being on stimulants. But it made me healthier. It made me a real person.

And then, after a decade of feeling reasonably happy and free and accepting of my personhood and personality, I surprised my friends, my psychiatrist, and myself: on April 24th, 2021, I got back on the drug. The pandemic and the lockdown had made me feel crazy. I could no longer effectively work. And so, I popped that orange pill for the first time in so many years and felt that familiar simple, chemical relief.

This time, I promised myself, would be different: I would allow the drug to temporarily contain me, to make all the material reasons for my inability to function—the fact that we were living through a deadly time in which every interaction felt laced with fear; the fact that I needed to write to make a living even if I didn’t really want to; the fact that I was so anxious about the state of the world that I could not sit still—feel temporarily irrelevant, just so that I could get some work done. But I wouldn’t allow the drug-as-diagnosis to become me, I wouldn’t allow those material reasons for my distress, my cluster of disparate symptoms, to be explained away.

I take a much lower dose of the drug now than I did when I was a teen, and I take it only three or four days a week. The other days, the non-Adderall days, are harder, more complex; my symptoms more present in my mind. I can’t work as well because I have to face what is bothering me. That’s the point.

Adderall pills of different colors and sizes arranged in a pattern

Fake Addies

The year we all did meth.
By Joshua Tempelhof

One day in 2022, a trusted drug dealer sold me twenty Adderall pills, and I—like a veteran dairy farmer divining from a milk sample that his cows are eating plastic—immediately sensed that something about them was off. These orange 30mgs were unusually crumbly and lacked Adderall’s distinctive saccharine flavor. And the rush they produced wasn’t quite as smooth. But I didn’t have time to be fancy—I had tons of work to do—so I explained my concerns away. They’re probably just old, I theorized, or they’re making them less sweet so they’re less appealing to children.

The next few weeks, I started to feel increasingly contorted. My doorman began looking at me strangely, like he suspected there might be a problem. One evening, I woke up and my hands and feet felt entirely numb. This prompted a street Adderall-fueled research binge into the provenance of street Adderall. Incidentally, this is how I found out about the shortage. Apparently, pharmacies across America had run out of the precious drug for mysterious reasons, and drug dealers had responded by simply making their own, replacing the active ingredient with meth and a bit of caffeine. That explained a whole lot.

Later that year, I wrote about my month of accidental meth in these pages (proclaiming “Fake Adderall Apricot” the Color of the Pandemic, which turned out to be suspiciously predictive of Pantone’s Color of the Year 2024: Peach Fuzz). In response, I received a bunch of DMs from pillheads who were also doing fake addies. They were all people like me, with the kind of rickety insurance and unpredictable income that makes buying pills from a drug dealer preferable to a prescription. Many of them were shocked that they may have been doing meth, while others suspected the whole thing was a psyop. Everyone started doing their own research.

One friend ordered a bunch of Adderall and, during the handover, asked his dealer about the sourcing process. He seemed reassured by the man’s explanation. Yes, the pills were knockoffs (pressed, in the current jargon), but they were good faith attempts to replicate the real thing. This was pleasing to behold—there was a guy in a kitchen somewhere mixing up amphetamine salts and trying to create something wonderful for everyone. Unfortunately, it was probably untrue. Adderall’s component salts were, at the time, even harder to secure than the drug itself. Another friend, who was buying from the same dealer as me, told me it was definitely meth—but this wasn’t a problem for her. She had done meth before and liked it.

As the Adderall shortage became near total, I knew more people doing fake Adderall than the real stuff, even though many of them were now wise to its secret ingredient. Yeah, it’s kinda shitty, seemed the consensus, but aren’t meth and Adderall basically the same thing?

I’ve heard this a lot: Adderall is just rich man’s meth (and meth is just poor man’s Adderall). Unfortunately, that’s a lot like saying that human beings are just fancy apes—true to an extent, but far from the whole story. Certainly methamphetamine and dextro-amphetamine have a lot more in common than sets them apart, but, milligram for milligram, the former is about four times as powerful. While the two chemicals have many of the same degenerative side effects, meth has shown to produce them at a higher rate. And that’s not to account for the gasoline, phosphorous, and ratatouille of other drugs it’s cut with on the street. Ironically, back when Adderall was cheap and plentiful, it was sometimes used to punch up fake meth. Now fake Adderall users were downing the reverse concoction with prescriptive regularity, living as dangerously as addicts on the wrong side of prohibition.

The phrase “gateway drug” has fallen out of favor since the government ludicrously applied it to weed, but it seems a fair description of the Adderall trajectory. In my experience, many of the kids who grew up on Ritalin and graduated to Adderall—a group I affectionately call Generation ADHPV—have come away with a general sense that they like uppers. If you enjoy Adderall, there’s a good chance you may be open to the odd bump of cocaine. And if you’re snorting that slush, you might as well do a bit of gentrified meth. Prescription amphetamines—like their opposite, pharma-grade opiates—have further muddied the blurry lines between medicine and street drugs.

Luckily for all involved, the Adderall shortage has now started to wane. Pharmacies still run out regularly, but the online drug warehouses are close to fully stocked. Drug dealers have started listing “rx addies” on their menus, alongside “pressed addies,” charging three times as much for the genuine article. Hopefully, after pushing fake Adderall on people, they can now wean them back onto the real thing. It is, after all, a more acceptable and slightly healthier habit.

Adderall pills of different shapes, sizes, and colors arranged in a line

What Women Want

A doctor who will prescribe them anything.
By Elena Comay del Junco

If there’s ever another Adderall shortage, and you desperately need to get your hands on some in New York (the first place it runs out), I recommend asking around about Dr. L. Hailed in reviews as a “pill pooper [sic] best friend,” the Upper West Side practitioner is notorious across several boroughs as a rubber stamp court for controlled substances, and he is particularly useful during a drought.

Dr. L only takes walk-ins, first-come, first-serve. Come anytime between 4 and 6 pm on a weekday and you’ll find a couple of women in the little waiting area outside his office: dressed in athleisure, AirPods in, well-highlighted hair pulled up in ponytails, tapping their feet, waiting for their turn to be seen. I have yet to encounter a man in his waiting room; when I first started seeing him, I was puzzled how he’d built up such a gendered customer base.

Some reviewers have complained about the unsanitary conditions in his office, but once you get used to the moldy coffee mugs, all you see are the contours of mid-century glamor. Dr. L is one of the few remaining psychiatrists trained as a psychoanalyst, which is one of the most décor-obsessed professions. When you enter, you’ll find a set of the Standard Edition, some Melanie Klein (certainly no Lacan) on the bookshelves, a nice daybed, some vaguely ethnic art. It turns out, an analyst’s consulting room on West End Ave is the perfect front for a drug dealer.

And he acts like a drug dealer. For an intake fee of $200 (in cash, if that wasn’t obvious) he will prescribe you any medication you want. Visits for refills are $60. The Adderall shortage didn’t slow down his business, because he knows which pharmacies—mostly small independent drugstores on the Upper East Side that sell expensive French shampoos—are in stock at any given time. He says he is blacklisted by Duane Reade.

Reviewers have derided him as “the rudest therapist ever” and they are correct. On my first visit, I put on a little show, assuming I had to convince him of my attention deficit. I said that I had been struggling with focus lately, lied about taking Adderall as a teen and some other things I can’t remember now. Within thirty seconds, he cut me off: “Stop wasting my time and tell me what you want.” I said Adderall. He asked me how many milligrams, I hesitated, he asked again, and I made up a round number.

Despite his transactional brusqueness, I don’t think Dr. L is in it for the money. That desire alone doesn’t explain his favorite tactic, which is to explain everything—inability to focus, anxiety, insomnia, whatever—with the observation that “women think too much.” I guess that’s why they need so much Adderall.

If I had to try to reconstruct it, I would say his reasoning goes something like this: (i) being a woman must suck (ii) therefore, I should give them what they want; (iii) women seem to want lots of Adderall; (iv) I can give them lots of Adderall. And thus, (v), I will give women as much Adderall as they want. QED. It’s circular, to be sure, and though I’m not so perverse as to claim some sort of feminist cred for Dr. L, I still can’t help but find a convoluted sort of altruism among his motives. Whatever they may be, he is doing vital work—narrowing the gender gap in amphetamine prescriptions, one woman at a time.

Adderall pills of different shapes and sizes, positioned in an alternating pattern.

Tapering

Adderall works really well for me. That’s the problem.
By Kendall Waldman

Growing up, my three brothers and I were all terrible students. They got straight Ds (“poor”), while I—their only sister—alternated between As (“excellent”) and Fs (“failing”), and ended up with Cs (“average”). The difference between us was that these demerits didn’t seem to bother them. There was something punk about their relationship to academic performance—it had no bearing on their confidence—while I was secretly trying my little heart out. Every Sunday night, I’d tidy my binders, plan all my lunches, lay out my clothes, and forecast the week in an exhaustive to-do list. Stick to the plan, I told myself, and everything will be different. But by Friday afternoon, everything was a mess again, and I was never quite sure why.

Despite marginally better grades, teachers didn’t see as much potential in me as they did in my tall, charismatic brothers. The boys were thought to be underperforming, so they were referred to psychiatrists who could help them fulfill their potential. This, at the time, was shorthand for Adderall. To my mother’s relief, none of them took to it, and their unopened refills started to accumulate in the back of her underwear drawer. One day I decided to sneak a few pills. Twenty minutes later, there it was: my new favorite feeling.

My usual miasma of impressions crystalized into fully-formed thoughts, delivered with new authority and a clear sense of time. Once a shy people pleaser, I suddenly felt self-righteous, opinionated, bold and exacting. I started visiting the underwear drawer more regularly. Soon I had made such a dent in the stash that it seemed only reasonable to move the rest to my room. Adderall was working for me, though not as intended. Instead of making me a better student, it empowered me to believe that high school was a waste of my faculties. By the time my mom noticed the missing pills, I had already taken them all, and dropped out.

From there, Adderall propelled me through days and then decades. That kind of acceleration gets you places, but doesn’t leave much time to ponder where you really want to go. In my early twenties, I broke into a career as a location scout for network television shows, a job that requires you to be a photographer, salesperson, negotiator, researcher, archivist, and driver all in one. Soon I was working sixty-eighty hours a week on 60-100mg a day, with the resting heart rate of someone being chased by a bear. Whenever I came down, the doubts crept in: Would I have been able to do all this with my original factory settings? How long could I keep it up?

My reliance on the drug started to scare me. Yes, it helped me function, producing the advertised effects almost to a tee. Sadly, the returns were diminishing, the doses inevitably increased, and so did the side effects. Three years into my scouting run, I started to feel metabolically overextended. A disagreeability had settled over my personality like an algal bloom. People had long been saying that I was less funny, less soft. But now those rough edges were starting to crack.

I decided I wanted to quit—eventually—soon, probably. When that didn’t happen, I tried, unsuccessfully, to taper. Getting sober, I realized, would require a lot of downtime. Unfortunately, not working means no money. In other words, I couldn’t afford to quit. It’s no coincidence that my two longest eras of sobriety coincided with me dating a rich man and the government sending out pandemic checks.

Even in those luxurious exceptions, quitting Adderall is perfectly miserable. I should know; I’ve done it hundreds of times. Day one is no problem. You feel smug about leaving the matrix. Silliness and sleep and friendship are back on the menu. Amphetamine remains in your blood up to 48 hours, and that residue serves as phantom strength. It carries you until day three, when the exhaustion sets in, the debilitating kind that comes with viruses.

Sober, I felt slow and glitchy. Every time I struggled to get to work, or couldn’t find the right words in conversation, the old shortcut beckoned: this could be easier.

I scoured PubMed and Reddit and wellness Pinterest for advice on holistic repair, what we know about how to heal the brain from long-term amphetamine use. I found an integrative nutritionist with amazing hair and tasteful filler, some 60k followers and lots of sponsored posts for matcha and nootropics. I listened to a podcast in which she described her experience detoxing, rolling my eyes when she suggested the same things as everyone: high-quality sleep, weight bearing exercise, cardio, tyrosine, mindfulness, adaptogenic mushrooms, intravenous NAD, breathwork, cold plunges, saffron, touching grass.

“Oh yes,” she conceded breathily, “transitioning off stimulants is hard,” but at this point she was feeling “better than ever.”

“How long have you been off of Adderall?” the host asked.

“Forty-one days,” she responded, completely serious. How had she secured all those branded partnerships in forty-one days?

I sometimes wonder what my life would have been like if I had never tampered with my biochemistry. The truth is, I can’t picture it. I would have had to develop so many coping mechanisms that I'd be an entirely different person, with different regrets. For all I know, things could have turned out a whole lot worse.

I now feel about Adderall the way people do about their most infuriating exes: you were so close to being perfect for me. I am not nostalgic for the drug as much as I wish there were a better version of it out there. Imagine: something equally euphoric but impossible to abuse. Something that gets you to work, but also lets you laugh and dream. Until that comes around, I’m taking mucuna pruriens (a velvet bean containing high doses of the amino acid L-dopa) and fish oil, looking for an affordable CBT practitioner and a walking desk. I apologize in advance for any delays.♦

MORE FROM BROADCAST
Change the frequency.
Subscribe to Broadcast