Throawey comments on Open thread, Sep. 19 - Sep. 25, 2016 - Less Wrong
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Drugs are prescribed based on a cost-benefit analysis. In general, the medical establishment is pretty conservative (there's little benefit to the doctor if your problem gets solved, but if they hurt you they're liable to get sued). In the usual case for amphetamines, the cost is the risk of side effects and the benefit is helping someone manage their ADHD. For you, the cost is the same but it sounds like the benefit is much bigger. So even by the standards of the risk-averse medical establishment, this sounds like a risk you should take.
You're an entrepreneur. A successful entrepreneur thinks and acts for themselves. This could be a good opportunity to practice being less scrupulous. Paul Graham on what makes founders successful:
I'd recommend avoiding Adderall as a first option. I've heard stories of people whose focus got worse over time as tolerance to the drug's effects developed.
Modafinil, on the other hand, is a focus wonder drug. It's widely used in the nootropics community and bad experiences are quite rare. (/r/nootropics admin: "I just want to remind everyone that this is a subreddit for discussing all nootropics, not just beating modafinil to death.")
The legal risks involved with Modafinil seem pretty low. Check out Gwern's discussion.
My conclusion is that buying some Modafinil and trying it once could be really valuable, if only for comfort zone expansion and value of information. I have very little doubt that this is the right choice for you. Check out Gwern's discussion of suppliers. (Lying to your doctor is another option if you really want to practice being naughty.)
Thanks for the links.
I do notice that the idea of trying modafinil does not result in the nearly the same degree of automatic internal 'no' as amphetamines. That would suggest my inhibitions are somehow related to the relative perceived potency, or potential health effects... or I'm disinclined to do something that could signal 'drug abuser', which I associate much more strongly with amphetamines than modafinil. Hm.
I've also been going around and asking the more conservative people in my circle about this situation as well, to try to give a more coherent voice to my subverbal objections. So far I've found that they actually support me trying things, which suggests I really should try to recalibrate those gut reactions a bit.
Upon reflection, I think I could actually get modafinil completely legitimately. I feel a bit dumb for not resolving to do this sooner, given that I was fully aware of modafinil- even to the point of very nearly purchasing some a while ago, before I knew it was schedule 4- and given that I was fully aware of what modafinil was often used to treat. At this point, the choice is pretty massively overdetermined.
Glad I could help :D
Amphetamine is officially more dangerous than modafinil (for good reason), but doctors actually respond worse to patients asking for modafinil than asking for amphetamine because it's weird. The easiest way to get modafinil is probably to start with amphetamine and later ask for modafinil because it's weaker and safer.
That's... pretty goofy. I would hope sleep specialists, at least, would tend to reach for modafinil before amphetamines.
Yes, I'm sure that narcoleptics are referred to sleep specialists who know that it is on-label for narcolepsy. Probably that makes them more likely to prescribe it off-label.
But few people go to sleep specialists. Scott Alexander has written many times about how as a psychiatry resident he sees patients who need a stimulant, but can't take amphetamine. He brainstorms with his supervisor and suggests modafinil and even in this perfect setup, he gets pushback.
But I wasn't talking about sleep problems, which includes the approved use of modafinil. I was talking about using it in place of amphetamine for ADHD, which is further off-label.