I'm in SV proper and I take adderall and have taken modafinil before. People generally don't talk about it. I've met more people who said they used to use it than say that they currently use it.

> is this actually common?

My experience has been that it's trivial to get a prescription of adderall in America. Doctors have tried to give it to me even when I've said that I don't want it. So (I assume) anyone with health insurance that wants it can get it.

> do you need them to survive?

Yes and no. If I were to immediately stop, I think it would take me 6 months to 4 years to redevelop coping strategies to manage work and my own life properly. I grew up taking it, thus it's my primary coping mechanism. Certainly possible, but certainly unpleasant.

I think it's probably the safest investment I can make. The cost of going to doctors and filling prescriptions is mostly in time, but the payback is huge. I think my life would have taken a very different path without adderall.

To clarify, when I say adderall I mean Adderall XR. My experience with other, similar drugs has been much worse.

Here's how various similar drugs affected me:

- Adderall instant release reliably caused psychosis for me (paranoia and hallucination primarily) and the come up and come down were too sharp. It worked, but benefits < costs

- Ritalin works for me, but it's closer to being unmedicated than it is to being medicated.

- Dexadrin works the best but is both easy and tempting to abuse. I think the benefits < costs.

- Vyvanse feels much "dirtier" for lack of a better word. It causes too much PNS stimulation. At lower doses, it's a bit less effective than adderall, at higher doses it just makes me feel bad.

- Modafinil is very different from any of the above. It does what it says it will, but cheating sleep is a losing game (and that's all that it's really good for), with or without drugs. Thus, benefits < costs.

- Caffeine doesn't help with focus much and has a lot of nasty effects.

For various personal reasons (the stigma and laws of foreign countries), I do want to taper off/stop, but it's been extremely difficult. Even with adderall, the modern world is just so crushingly attention-grabbing that I find it hard not to feel mentally exhausted and overwhelmed constantly. Honestly, I think getting rid of my smart phone and not keeping my computer connected to the Internet all day would be better for my health than stopping adderall.

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