Scott Alexander explains how the vastly higher doses taken by recreational drug users compared to psychiatric patients lead to misconceptions about drug safety in clinical settings. Longer summary

Scott Alexander discusses how recreational drug users consume substantially higher doses of drugs compared to psychiatric patients, which leads to misconceptions about drug safety in clinical settings. He provides examples of ketamine and amphetamines to illustrate this point. For ketamine, psychiatric doses are around 280 mg/month, while recreational users consume about 90,000 mg/month. Similarly, for amphetamines, Adderall patients typically take 20 mg daily, whereas methamphetamine addicts use the equivalent of 1000 mg oral amphetamine daily. Scott argues that many concerns about drug side effects in clinical settings are based on studies of recreational users, and that these concerns may not apply to patients taking much lower doses under medical supervision. Shorter summary

Scott Alexander examines and expresses skepticism about a theory that attributes high-dose melatonin supplements to patent avoidance, while reflecting on the challenges of evaluating such claims. Longer summary

Scott Alexander discusses a theory about why melatonin supplements are often sold in doses much higher than recommended. The theory, proposed by Dr. Richard Wurtman, suggests that supplement manufacturers used higher doses to avoid paying royalties on a patent for lower doses. Scott expresses skepticism about this explanation, citing reasons such as the unusualness of patenting only up to a certain dose and the fact that many supplements are sold in high doses. He also notes that some companies do sell melatonin at the recommended dose without legal issues. Scott reflects on the challenges of evaluating such claims, balancing expert knowledge against rational skepticism. An update clarifies that the patent likely influenced initial supplement production but has since expired, though high-dose traditions persist. Shorter summary