Scott Alexander responds to comments on his post about new telemedicine regulations, addressing various concerns and criticisms raised by readers. Longer summary

Scott Alexander summarizes and responds to various comments on his original post about new telemedicine regulations. He addresses concerns about drug addiction, debates the effectiveness of telemedicine compared to in-person care, discusses the issue of 'pill mills', clarifies his analogy about blind people accessing Braille, responds to criticism of his characterization of Christian doctors, examines which part of the government is responsible for the regulations, and looks at how other countries handle telemedicine prescriptions. Shorter summary

Scott Alexander criticizes new DEA regulations that restrict telemedicine prescriptions for controlled substances, arguing they will harm patients and legitimate practices while failing to prevent abuse. Longer summary

Scott Alexander criticizes new DEA regulations that make it harder for telemedicine doctors to prescribe controlled substances. As a telepsychiatrist, he explains how these rules will negatively impact his practice and patients, especially those who rely on controlled substances for conditions like ADHD or anxiety. He argues that the new regulations, while intended to prevent overprescribing, will mainly create inconvenience for legitimate practitioners and patients while doing little to stop actual abusers. Scott outlines the loopholes in the law and how they highlight its absurdity, predicting that these rules will make telemedicine less accessible and effective in the long run. Shorter summary

Scott Alexander analyzes a study showing Concerta improves ADHD children's attention but not their learning, and speculates on the reasons behind this unexpected result. Longer summary

Scott Alexander discusses a recent study on the effects of Concerta (a long-acting form of Ritalin) on ADHD children's learning in a summer camp setting. The study found that while Concerta improved attention, reduced disruptive behavior, and slightly improved test scores, it didn't significantly enhance learning of the course material. Scott explores potential reasons for this counterintuitive result, drawing parallels to other studies and speculating on the nature of learning and intelligence. He considers factors such as redundancy in teaching, innate intelligence limits, and the possibility of 'difficulty thresholds' for learning. The post ends with a speculative comparison to AI scaling laws, suggesting there might be human equivalents to parameters, training data, and compute in learning. Shorter summary

Scott Alexander examines whether psychiatric conditions result from evolutionary failures or tradeoffs, proposing that most disorders involve a combination of both. Longer summary

Scott Alexander explores the nature of psychiatric conditions, discussing whether they result from evolutionary failures or tradeoffs. He presents evidence for both hypotheses, noting that recent research favors the failure hypothesis. However, he argues that some conditions likely involve both failures and tradeoffs. He uses analogies from justice systems and nuclear war scenarios to illustrate how failures and tradeoffs can interact. The post concludes by suggesting that most psychiatric disorders exist on a spectrum from mostly-tradeoff to mostly-failure, and critiques the neurodiversity movement's blanket statements about conditions like autism. Shorter summary

Scott Alexander examines taxometrics in psychiatry, finding that most mental health conditions are dimensional rather than categorical, and discusses the implications for diagnosis and treatment. Longer summary

Scott Alexander explores the concept of taxometrics, which studies whether psychiatric conditions are categorical or dimensional. He explains the difference between categorical distinctions (like humans vs. rabbits) and dimensional variations (like height), and discusses how taxometric methods attempt to determine which psychiatric conditions fall into each category. The post then reviews recent meta-analyses suggesting that most psychiatric conditions are dimensional rather than categorical, contrary to some expectations. Scott reflects on the implications of this for psychiatric diagnosis and treatment, suggesting a move away from binary thinking about mental health conditions. Shorter summary

Scott Alexander examines the history, chemistry, and efficacy of various amphetamine-based ADHD medications, comparing their strengths and weaknesses. Longer summary

Scott Alexander explores the history and differences between various amphetamine-based ADHD medications. He traces the origins of Adderall to a 1950s diet pill, then compares it to other drugs like Dexedrine, Vyvanse, Evekeo, and Desoxyn (methamphetamine). The post discusses the chemical differences, patient preferences, and effectiveness of these medications, noting that pure d-amphetamine (Dexedrine) seems generally superior to the Adderall mixture. Scott also touches on the controversy surrounding methamphetamine use in ADHD treatment, explaining that the main differences between therapeutic use and abuse are dosage and administration method rather than inherent properties of the drug. Shorter summary

Scott examines the possibility that bureaucracy sometimes serves as an intentional barrier to discourage unnecessary requests, particularly in healthcare, but questions how widely this concept applies. Longer summary

This post explores the idea that bureaucracy might sometimes serve as an active ingredient in plans rather than just being inefficient. Scott presents a hypothetical scenario where insurance companies use bureaucratic hurdles to discourage unnecessary use of expensive medications. He suggests that the time and effort required to navigate bureaucracy can act as a filter, separating those who truly need a service from those who don't. However, Scott expresses uncertainty about how widely this concept applies, noting that it doesn't explain bureaucracy in places like the DMV. He concludes that while this idea might explain some instances of bureaucracy, particularly in healthcare, it shouldn't be overgeneralized. Shorter summary

Scott Alexander reports on weak correlations and inconclusive results from the latest SSC survey on optical illusions and visual perception. Longer summary

Scott Alexander discusses the results of the latest SSC survey, focusing on optical illusions and visual riddles. He admits to being unable to expand on or strengthen his previous findings from 'Why Are Transgender People Immune To Optical Illusions' and 'Can We Link Perception And Cognition?'. While he weakly replicated some previous results, the correlations were too low to be exciting. He found minimal internal structure in the results, with different versions of the same illusion showing low correlation. The post also briefly mentions some pre-registered investigations that yielded uninteresting or negative results, including studies on political conflict theory, autism and categorization responses, and ADHD and ambition. Shorter summary

Scott analyzes survey data to test the claim that rejection sensitivity is a key feature of ADHD, finding limited support and emphasizing caution in adopting such ideas without formal research. Longer summary

Scott Alexander investigates the claim that rejection-sensitive dysphoria is a key feature of ADHD using data from the Slate Star Codex survey. He finds that while people with ADHD do show slightly higher rejection sensitivity than those without psychiatric conditions, it's not as dramatic as some claim, and ADHD actually shows the lowest rejection sensitivity among the psychiatric conditions studied. The post critiques the lack of formal evidence for this claim, discusses potential Forer effects, and emphasizes the need for caution when adopting new ideas about psychiatric symptoms, especially those spread in patient communities without formal research backing. Shorter summary

Scott Alexander examines the risks of Adderall use, analyzing medical, addiction, tolerance, and neurotoxicity concerns, concluding that the benefits outweigh the risks for well-informed patients. Longer summary

Scott Alexander explores the risks of Adderall use, examining medical risks, addiction potential, tolerance development, and possible neurotoxicity. He critically analyzes existing research and shares his clinical experience, ultimately concluding that while there are some concerning risks, they are not severe enough to stop prescribing stimulants to patients who might benefit from them, provided they are well-informed about the risks. Shorter summary

Scott Alexander explains how psychiatric conditions like ADHD can be both over- and underdiagnosed simultaneously, due to statistical quirks in diagnosis and population prevalence. Longer summary

Scott Alexander discusses the counterintuitive phenomenon of simultaneous over- and underdiagnosis in psychiatry, using ADHD as an example. He explains how, even with a highly accurate psychiatrist, it's possible for the majority of people diagnosed with a condition to not have it, while the majority of people who actually have the condition remain undiagnosed. This is due to the interplay between disease prevalence, self-selection for evaluation, and the inherent limitations of diagnostic accuracy. The post demonstrates this concept using a hypothetical scenario with ADHD, and then suggests that this phenomenon likely applies to other conditions such as depression and pain medication prescriptions. Shorter summary

Scott Alexander argues that biological solutions to societal problems may be more effective and easier to implement than social interventions, challenging common perceptions about mutability of human characteristics. Longer summary

Scott Alexander challenges the stereotype that the Left believes human characteristics are socially determined and mutable, while the Right believes they are biologically determined and fixed. He argues that society is actually very difficult to change, while biological factors can often be more easily addressed. He provides examples such as drug abuse, obesity, and poor school performance, where social interventions have largely failed but biological solutions (like banning lead or vitamin supplementation) have shown promising results. The post suggests that we should not dismiss biological explanations and solutions to societal problems, as they may be more tractable than purely social approaches. Shorter summary

Scott Alexander presents and humorously critiques a series of strange psychiatric drug advertisements from the 1960s and 1970s, highlighting their peculiar imagery and messaging. Longer summary

Scott Alexander shares a collection of psychiatric drug advertisements from the 1960s and 1970s, highlighting their peculiar and often creepy nature. He comments on various aspects of these ads, including the evolution of psychiatric terminology, the relationship between drug therapy and psychoanalysis, and the bizarre imagery used to market antipsychotics. The post humorously critiques the ads' visual elements, puns, and implied messages, while also noting how they reflect changing attitudes in psychiatry over time. Shorter summary

Scott Alexander explores a thought experiment based on the Asch conformity experiment to examine the strength and flexibility of personal beliefs and societal norms. Longer summary

Scott Alexander discusses a thought experiment inspired by the Asch conformity experiment, where one imagines being told that their beliefs are completely wrong according to everyone else in the 'real world'. He explores how this experiment might affect various beliefs, from personal convictions to societal norms, using examples like slavery in the antebellum South and vegetarianism. The post suggests that this thought experiment can be a powerful tool for examining one's beliefs, understanding moral progress, and even as a motivational technique. Scott also reflects on how this experiment might reveal which beliefs we hold most strongly and which we might be more willing to doubt or change. Shorter summary