Reading this great thread on SBF’s bio it seems like his main problem was stimulants wrecking his brain. He was absurdly overconfident in everything he did, did not think things through, didn’t sleep, and admitted to being deficient in empathy (“I don’t have a soul”). Much has been written about deeper topics like naive utiliarianism and trust in response to SBF, but I wonder if the main problem might just be the drug culture that exists in certain parts of EA. Stimulants should be used with caution, and a guy like SBF probably should never have been using them, or at least nowhere near the amount he was getting.
I think we need to be really careful to distinguish self-medication or recreational use from legitimate medical use to [edit: avoid inadvertently criticizing] appropriate medical treatment. The Adderall and Emsam doses referenced in a recent court order are not inappropriate for the diagnoses provided, if the prescriber and patient know what they are doing.
I’m also not aware of any significant risk of medical-level doses triggering erratic behavior, but havent looked at the literature specifically. (I don’t encourage unauthorized use of controlled substances, but also don’t want to discourage those who have mental health conditions from accessing appropriate treatment.)
I disagree that there is some clear ontological distinction a priori between “legitimate medical use” and ‘abuse’/”stimulants wrecking his brain”. I do think different brain types respond to Adderall differently, with some being aggravated (bad fit) and some being calmed down and focused (‘real ADHD’), for instance. I am not an ADHD expert. But the idea that a doctor rubber-stamping a prescription is legitimate in kind from self-medication mostly strikes me as an invocation within social reality. Of course it helps to have professional guidance, often tremendously so, but they also screw things up too sometimes, and sometimes en masse e.g. with SSRIs. For someone like SBF, I could totally buy the hypothetical that he really benefitted from it and it also screwed up (or at least worsened pre-existing) decisionmaking processes. This is a contradiction in what sorts of beliefs we are allowed to hold both due to social norms and the structure of language, not a contradiction in the physical world where these drugs can have all sorts of positive and negative effects, where a real need for increased mental functionality could conceivably trade off against a simultaneous increase in the risk of making rash decisions. A genuinely concerned doctor could be on the lookout for that, but then if the user has the means they can just go to another doctor and get the drugs they want. Are people in severe pain addicted to painkillers?
I would only entertain the OP’s hypothesis as being the main cause if SBF was taking stimulants since childhood up to college days, with the drugs having had a significant shaping effect on his personality. I think it’s an interesting thing to explore further, but hard to disentangle correlation vs causation here. What seems more critical to me is the apparent sociopathic traits, but I am still quite confused about what exactly is going on with his neurodivergence. The Lewis book has been somewhat informative. He clearly does get some amount of addicted to certain types of fast-paced games with lots of uncertainty and evolving rules. I could certainly see stimulants increasing his addictivity and cognitive involvement in these decisionmaking ‘games’ at the cost of responsibility to factors outside the frame of his focus, but I’m not too sure as I could be typical-minding how dopaminergics influences different neurotypes.
Reading this great thread on SBF’s bio it seems like his main problem was stimulants wrecking his brain. He was absurdly overconfident in everything he did, did not think things through, didn’t sleep, and admitted to being deficient in empathy (“I don’t have a soul”). Much has been written about deeper topics like naive utiliarianism and trust in response to SBF, but I wonder if the main problem might just be the drug culture that exists in certain parts of EA. Stimulants should be used with caution, and a guy like SBF probably should never have been using them, or at least nowhere near the amount he was getting.
Is “the amount he was getting” publicly known?
I think we need to be really careful to distinguish self-medication or recreational use from legitimate medical use to [edit: avoid inadvertently criticizing] appropriate medical treatment. The Adderall and Emsam doses referenced in a recent court order are not inappropriate for the diagnoses provided, if the prescriber and patient know what they are doing.
I’m also not aware of any significant risk of medical-level doses triggering erratic behavior, but havent looked at the literature specifically. (I don’t encourage unauthorized use of controlled substances, but also don’t want to discourage those who have mental health conditions from accessing appropriate treatment.)
I disagree that there is some clear ontological distinction a priori between “legitimate medical use” and ‘abuse’/”stimulants wrecking his brain”. I do think different brain types respond to Adderall differently, with some being aggravated (bad fit) and some being calmed down and focused (‘real ADHD’), for instance. I am not an ADHD expert. But the idea that a doctor rubber-stamping a prescription is legitimate in kind from self-medication mostly strikes me as an invocation within social reality. Of course it helps to have professional guidance, often tremendously so, but they also screw things up too sometimes, and sometimes en masse e.g. with SSRIs. For someone like SBF, I could totally buy the hypothetical that he really benefitted from it and it also screwed up (or at least worsened pre-existing) decisionmaking processes. This is a contradiction in what sorts of beliefs we are allowed to hold both due to social norms and the structure of language, not a contradiction in the physical world where these drugs can have all sorts of positive and negative effects, where a real need for increased mental functionality could conceivably trade off against a simultaneous increase in the risk of making rash decisions. A genuinely concerned doctor could be on the lookout for that, but then if the user has the means they can just go to another doctor and get the drugs they want. Are people in severe pain addicted to painkillers?
I would only entertain the OP’s hypothesis as being the main cause if SBF was taking stimulants since childhood up to college days, with the drugs having had a significant shaping effect on his personality. I think it’s an interesting thing to explore further, but hard to disentangle correlation vs causation here. What seems more critical to me is the apparent sociopathic traits, but I am still quite confused about what exactly is going on with his neurodivergence. The Lewis book has been somewhat informative. He clearly does get some amount of addicted to certain types of fast-paced games with lots of uncertainty and evolving rules. I could certainly see stimulants increasing his addictivity and cognitive involvement in these decisionmaking ‘games’ at the cost of responsibility to factors outside the frame of his focus, but I’m not too sure as I could be typical-minding how dopaminergics influences different neurotypes.