Comment by sph
15 hours ago
For the past 3 years I have replaced my ADHD stimulant medication with nicotine patches and they’ve been great, cheap, and legal in the country I live in now.
Recently I got the urge to try vaping again, bought all the paraphernalia and started vaping like a chimney 24/7. Got light nicotine poisoning as well. After two days, I caught myself compulsively reaching for the vape.
So I threw everything away and I’m back to patches. Took me a week to forget the compulsive hand-to-mouth urge. I now believe intradermal nicotine is the superior method of administration. At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.
> At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.
In my experience: no, you don't. You just arrange your life around the fact that you need to smoke all the time.
I've been a heavy cigarette smoker for 12 years (pack a day min.). When I switched to vaping, I vaped continuously the entire day.
There is no human on earth that can smoke continuously the entire day for very long. A pack a day smoker means smoking one every ~30 minutes circa.
John Wayne is said to have chain-smoked 5-7 packs a day? If you can smoke a cigarette every ~30 mins, that's 2/hour (actually about 1.5 packs/day), but if a cigarette takes 10 minutes to smoke and you chain-smoke, that's 6/hour (4.5 packs/day). So it's doable but John Wayne was significantly out of breath the last 10+ years of his life, perhaps from having an entire lung removed.
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I don't know how they did it but 50 years ago some people did seem to smoke non-stop. Of course they were still an exception. Of course when they cigarettes were dirt cheap you could let atleast a few burn up with just a puff or two off it also. These days they are so expensive from taxes that setting it down and breathing for a second instead of smoking can feel like burning money.
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it also stops being unpleasant once your brain has associated it deeply with the dopamine
if anything, the strong smell and taste sensations makes it even more addictive
I, too, have experimented with the patches over the last year. Nicotine is great in a lot of ways, but whether it's a tool or a crutch depends on both the person and the delivery method.
The patches are different, not just because it lacks that same connection to compulsive and ritualistic activity, but it simply doesn't provide the same quick "hit" that makes smoking far more addictive.
On the other hand, someone prone to addictive tendencies probably shouldn't even use the patches. Even the patches can be a gateway to vaping and smoking for such a person. I have simply never been the type to become addicted to any drug or substance, other than the occasional overeating. This isn't to say that I don't have the potential to get hooked on more powerful drugs, but my innate desire to use them is a lot less than I think is average. Even during times where I've habitually drunk copious amounts of alcohol, I've always been able to realize "this kinda sucks so I think I'm gonna stop" and then I just do without really much struggle other than some brain fog for a few days. Similarly, I sometimes use phenibut, and people talk about how easy it is to become dependent on it and how hard it is to get off it, and that hasn't been my experience in the slightest. Someone without a clear objective around how they use substances like that will be much more likely to end up suffering.
That said, the patches are great for focus and anxiety when used in low doses in moderation. I don't necessarily advise that everyone use them as I have, but I also don't think they're anywhere near as harmful as one might assume. I don't feel the need to ever switch to smoking or vapes, or even gums and pouches.
I smoked my first cigarette at 6, really started at 13 and smoked 2 packs a day for 30 years. Patches are the best way.
I smoked for roughly 30 years and was not in very good shape when I gave up eight years ago - that improved rather a lot.
The problem is that nicotine is not the only addictive substance involved. If it was then you could chew gum, wear patches or whatever and off you go. There is an extremely complicated set of chemicals involved in fag smoke. There is also the habit effect and other complications.
In the end I think that boring old will power is the only way and any trick or tool or whatever that you can deploy to bolster that is how you give up.
My initial plan was to vape but I soon found that unsatisfying and it looked to me like trying to substitute one habit with another.
Once I started stopping, I didn't want to stop! It was extremely hard but I always reminded myself that I had got so far and that that time would be wasted if I had to start again. I followed doubled up time periods - one day, two days, 1/2 a week, a week, a fortnight, a month, two months ("cripes, this might work") and so on.
A mental tool I developed was a couple of mantras: "I don't want to smell" and "I don't want to die". Whenever I felt the cravings I repeated those to myself and I have no idea why but it did work for a while at a time. Gradually the need tailed off (say around two years)
I remember having quite vivid dreams where I would "crack" and start smoking again. I had to do quite a lot of mental verification to prove to myself that it was just a dream. At one point I even smelt my clothes to prove to myself it was all a dream.
We are all different and there is no right or wrong way to quit. One thing we can all agree on is it is hard, very hard but not impossible. Pick a strategy that might work for you and be prepared to change it but please do have a go. It really is worth it.
How did you taper off patches? Are you still on them?
Hey, another person with addiction-intolerant ADHD! I have run into so few people who encountered and noted it. Most people can’t just treat a compulsion by curtailing it through willpower, though I still don’t comprehend why. Ironic that the willpower disorder wins the day versus the baseline.
I always wondered if ADHD and smoking were related.
I’m ADHD boy for sure, and my dad and his younger sister are both very much not like my aunt, who is more like me. Shes in her 80s now, and was the only smoker - literally smoked cartons a week for about as long as I remember.
ADHD people get hooked to smoking quite easily. Nicotine's a stimulant after all.
>For the past 3 years I have replaced my ADHD stimulant medication with nicotine patches
My first thought was "That's a no brainer why didn't I think of that".
Then I remembered that I grew up during peak anti-smoking and so they made nicotine out to be some sort of borderline meth boogeyman rather than just extra addictive extra effective caffeine that comes in bad for your health form factors and that all that propaganda got sent straight to long term memory and I was indoctrinated by it at such a young age it didn't even occur to me to think outside the box like that.
Nicotine patches are expensive for what they are but they're basically free compared to meds.
Nicotine isn't just 'extra effective caffeine.'
The research seems to indicate it's a cancer accelerant -- it doesn't cause cancer directly, but it promotes the growth and spread of existing tumors.
Studies suggest it does this through several pathways including:
(a) preventing cancer cells from self-destructing (b) making tumor cells divide more quickly (c) stimulating the growth of new blood vessels in and around tumors, helping them grow; and (d) helping cancer cells metastasize more easily by increasing mobility via epithelial-mesenchymal transition.
It also lowers the effectiveness of chemo and radiotherapy.
Admittedly, most of these are animal/lab studies, in part because it's hard to design a good study in humans since so many patients also use/used cigarettes and vapes, which confounds the results. Still, there's enough evidence out there to be cautious.
> rather than just extra addictive extra effective caffeine
That is a severe understatement. Nicotine is consistently ranked as one of the most addictive drugs, near cocaine and heroin.
Only about 6% nicotine users manage to quit every year.
https://nida.nih.gov/publications/research-reports/tobacco-n...
It's two very touchy subjects: nicotine and ADHD. I'm not fond to talk about it because misinformation and ignorance is just rampant. Nicotine has indeed been turned into the boogeyman.
Anyway, I told my psych about my plan, and he agreed there is research indicating nicotine works as a third-line stimulant medication for ADHD. In many modern, Western countries adult ADHD is not even recognized, let alone medicated, so one has to make do with what's available.
In my experience it is almost as effective as amphetamines, with fewer side effects, much longer lasting (a patch lasts 16+ hours), and very cheap - if you get them on ebay from China. Addiction potential is null: addiction is a function of how quickly the effect peaks, and it takes 3 hours. Not even lisdexamfetamine can compare with how unaddictive patches are.
That said, if I had access to prescription amphetamines, I'd go back to them, but I sure don't miss the days all it did was making me incredibly horny and focused scrolling social media all day long. It was a little too effective at keeping me engaged for my own good, so using a subpar medication means learning to live with ADHD, adjusting your life around your own quirk, rather than only relying on the medication to fix everything for you.
I've come to a similar conclusion.
On one hand, yes, nicotine in many ways does deserve the reputation it's received. Then again, a lot of the blame should go more towards smoking rather than nicotine the substance.
Nicotine is highly addictive, but as you mentioned, the delivery method plays a huge role in its addictive potential, and most people don't realize this. The chances that you'll become addicted to patches is incredibly low. If they were that addictive, then they'd likely be way more effective in helping people quit smoking; in reality, it's somewhere between 10 and 20 percent of patch users who successfully end up quitting smoking that way. Even with the highest dose patches, the addiction potential is still relatively low because the patches release the nicotine over a very long period of time and make it difficult or impossible to associate the use of the substance with a ritualistic activity like lighting and puffing on a cigarette.
And yeah, it's not a subject you can really bring up with anyone besides recreational drug users. Very few will be receptive to the idea that nicotine has legitimate uses and can be used without getting addicted.
as a medication alternative there's saffron, which also helps (not as good)
Did you read gwerns post on it by any chance?
https://gwern.net/nicotine
Isn't that way shorter acting ?
And carcinogenic
What is?