Modafinil Is The Official Drug Of The Rationalist Movement

The New York Times has finally published its long boring piece on Slate Star Codex and its psychiatrist author, Scott Alexander Suskind. That led me to revisit the blog and its new substack and to realize that Modafinil, a wonderful safe drug that transformed my life beginning in 2013, is the drug of the rationalist community.

Incidentally, I can’t get as worked up as Steve Sailer does over the Times supposedly “doxxing” Scott Alexander. Revealing someone’s name that’s already widely available is hardly much of a dox. Google identifies “dox” as “search for and publish private or identifying information about (a particular individual) on the internet, typically with malicious intent.”

June 22, 2020, Scott Alexander posted June 22, 2020: “NYT Is Threatening My Safety By Revealing My Real Name, So I Am Deleting The Blog.”

I have a lot of reasons for staying pseudonymous. First, I’m a psychiatrist, and psychiatrists are kind of obsessive about preventing their patients from knowing anything about who they are outside of work. You can read more about this in this Scientific American article – and remember that the last psychiatrist blogger to get doxxed abandoned his blog too. I am not one of the big sticklers on this, but I’m more of a stickler than “let the New York Times tell my patients where they can find my personal blog”. I think it’s plausible that if I became a national news figure under my real name, my patients – who run the gamut from far-left to far-right – wouldn’t be able to engage with me in a normal therapeutic way. I also worry that my clinic would decide I am more of a liability than an asset and let me go, which would leave hundreds of patients in a dangerous situation as we tried to transition their care.

That somebody, including a psychiatrist, has a lot of reasons for why they want other people to accommodate their desires
is irrelevant to most people with conflicting desires. We don’t generally live our lives accommodating the desires of strangers if they interfere with what we want. I’m usually amused when people peripheral to my life go to great lengths to tell me why they want what they want from me. Relying on the kindness of strangers is not a life that works.

If we follow the principle that people acting in the public square should not be named if they don’t want to be named would end much of reporting because any story with a sting will inevitably threaten somebody’s safety while simultaneously enhancing other people’s safety by making them better informed. There’s no right to privacy, particularly not when you regularly present your ideas to the public and gain a large following. People confuse “freedom of speech” with the fantasy that there should be no negative consequences for your speech.

Alexander wrote June 22: “Last week I talked to a New York Times technology reporter who was planning to write a story on Slate Star Codex. He told me it would be a mostly positive piece about how we were an interesting gathering place for people in tech, and how we were ahead of the curve on some aspects of the coronavirus situation. It probably would have been a very nice article.”

Alexander is hilariously out of touch with reality. So the journalist told him it would be a mostly positive piece? That should carry as much weight as what blokes say to sheilas when they’re trying to get laid. Journalists emphasize the positive possibilities of a story to enhance the odds that a subject will grant an interview. That’s it. Alexander took a pitch as though it truly reflected the writer’s intentions.

It turns out there were zero mentions of coronavirus in the final article.

Alexander wrote:

some people want to kill me or ruin my life, and I would prefer not to make it too easy. I’ve received various death threats. I had someone on an anti-psychiatry subreddit put out a bounty for any information that could take me down (the mods deleted the post quickly, which I am grateful for). I’ve had dissatisfied blog readers call my work pretending to be dissatisfied patients in order to get me fired. And I recently learned that someone on SSC got SWATted in a way that they link to using their real name on the blog. I live with ten housemates including a three-year-old and an infant, and I would prefer this not happen to me or to them. Although I realize I accept some risk of this just by writing a blog with imperfect anonymity, getting doxxed on national news would take it to another level.

Don’t participate in the public square if you can’t the pay the price of fear about your safety.

Steve Sailer writes: “The New York Times has finally published their notorious article doxing Scott Alexander, the pseudonymous psychiatrist who wrote the Slate Star Codex blog (which is now revived as Astral Codex Ten on Substack). The author prudently shut down his blog because his patients, which include numerous crazy people, might lash out violently if informed by the NYT of his writing.”

How many psychiatrists have suffered grievous bodily harm because of their blogs? Anything you do publicly increases the odds that good and bad things will happen to you. As author Rory Sutherland noted on a recent podcast, “You make yourself widely known and famous because you increase your chances of getting lucky in some way you can’t predict in advance. One point of fame is to simply increase your surface area exposure to lucky accidents.” Fame, like everything else in life, is a blessing and a curse. If you can’t handle your fears about the consequences that might come from writing a blog, delete your blog. It is not the job of third parties to cater to your fears.

Also, what ideas you express and how you express them will play a major role in how people react to them. It pays to encourage the better angels of human nature.

Alexander wrote: “After considering my options, I decided on the one you see now. If there’s no blog, there’s no story. Or at least the story will have to include some discussion of NYT’s strategy of doxxing random bloggers for clicks.”

He was bizarrely out of touch with reality. Deleting your blog just adds to the story. The New York Times article was never going to be part of an alleged NYT “strategy of doxxing random bloggers for clicks.” There’s no such strategy except in Alexander’s delusional mind.

Alexander wrote: “…this was just going to be a nice piece saying I got some things about coronavirus right early on.”

Grow up, man.

Alexander: “In my ideal world, the New York Times realizes they screwed up, promises not to use my real name in the article, and promises to rethink their strategy of doxxing random bloggers for clicks.”

Grow up, man.

January 21, 2021, Alexander posts:

No, seriously, it was awful. I deleted my blog of 1,557 posts. I wanted to protect my privacy, but I ended up with articles about me in New Yorker, Reason, and The Daily Beast. I wanted to protect my anonymity, but I Streisand-Effected myself, and a bunch of trolls went around posting my real name everywhere they could find. I wanted to avoid losing my day job, but ended up quitting so they wouldn’t be affected by the fallout. I lost a five-digit sum in advertising and Patreon fees. I accidentally sent about three hundred emails to each of five thousand people in the process of trying to put my blog back up.

Yes, it was awful in large part because of your tone deaf reactions to reality.

Alexander wrote:

An SSC reader admitted to telling a New York Times reporter that SSC was interesting and he should write a story about it. The reporter pursued the story on his recommendation. It wasn’t an attempt by the Times to crush a competitor, it wasn’t retaliation for my having written some critical things about the news business, it wasn’t even a political attempt to cancel me. Someone just told a reporter I would make a cool story, and the reporter went along with it.

If you don’t want attention, don’t publish, even on a blog.

Alexander wrote: “As for the Times’ mistakes: I think they just didn’t expect me to care about anonymity as much as I did.”

That’s not on the Times. That’s your problem, not theirs.

Alexander wrote:

…back in the early 2010s I blogged under my real name. When I interviewed for my dream job in psychiatry, the interviewer had Googled my name, found my blog, and asked me some really pointed questions about whether having a blog meant I was irresponsible and unprofessional. There wasn’t even anything controversial on the blog – this was back in the early 2010s, before they invented controversy. They were just old-school pre-social-media-era people who thought having a blog was fundamentally incompatible with the dignity of being a psychiatrist. I didn’t get that job, nor several others I thought I was a shoo-in for. I actually failed my entire first year of ACGME match and was pretty close to having to give up on a medical career. At the time I felt like that would mean my life was over.

There are consequences to our choices. Many of our desires are incompatible. If you feel like your life is over because things don’t go your way, you need to grow up.

Alexander: “In the New York Times’ worldview, they start with the right to dox me, and I had to earn the right to remain anonymous by proving I’m the perfect sympathetic victim who satisfies all their criteria of victimhood.”

Yes, everybody has the right to say your name. There’s no right to remain anonymous.

Alexander wrote: “For the first ten or twenty years of its history, the Internet had a robust norm against doxxing. You could troll people, you could Goatse or Rickroll them, but doxxing was beyond the pale.”

Yes, there was likely a better class of people online then.

Alexander wrote: “If me setting myself on fire got the New York Times to rethink some of its policies, and accidentally helped some of these people win their own fights, it was totally worth it.”

These are delusional thoughts but I get that everybody wants to see himself as a hero, particularly when he’s publicly acted like an idiot and brought about the very attention he said he did not want.

Alexander wrote:

Almost everything good in my life I’ve gotten because of you. I met most of my friends through blogging. I met my housemates, who are basically my family right now, through blogging. I got introduced to my girlfriend by someone I know through blogging. My patients are doing better than they could be – some of them vastly better – because of things I learned from all of you in the process of blogging. Most of the intellectual progress I’ve made over the past ten years has been following up on leads people sent me because of my blogging.

Every rose has its thorn.

Alexander wrote:

So I’ve taken the steps I need to in order to feel comfortable revealing my real name online. I talked to an aggressively unhelpful police officer about my personal security. I got advice from people who are more famous than I am, who have allayed some fears and offered some suggestions. Some of the steps they take seem extreme – the Internet is a scarier place than I thought – but I’ve taken some of what they said to heart, rejected the rest in a calculated way, and realized realistically I was never that protected anyhow.

The world, not just the internet, is a far more dangerous place than we think because the human being is fundamentally dangerous.

Alexander: “I wondered if I’d enjoy the break. I didn’t particularly; it felt at least as much like trying to resist an addiction as it did resting from a difficult task.”

I identify with that.

Sailer: “Cade Metz’s article now goes off in weird directions, like linking Scott to the the comparably verbose Mencius Moldbug despite their massive ideological differences, because the point is that there are smart guys in Northern California who aren’t part of what The Resistance has turned into: The Submission. And they … must … be … destroyed. Because independent thinking threatens the hegemony of the Woke.”

This Times article is not a hit piece. People often lead fractured lives and then become angry when their delusions are exploded by reality. The word “integrity” comes from “integral” meaning one. Ideally, we lead a unified life where the various components of our life are not at war with each other but rather in a beneficial tension (perhaps part of us wants to spend more time blogging and another part of us may want to spend more time making money).

Sailer: “I suspect that David Friedman, who, like many readers of Scott Alexander, is a brilliant but naive nerd didn’t realize the NYT was out to destroy a lovely intellectual playground simply because it was outside the NYT’s control.”

It’s not much of a hit piece.

Sailer: “Doxing people seems to be a big thing lately at the New York Times.”

The “Who” of stories is usually important. For Sailer, naming the Who if the Who does not want to be named is doxing. Giving a routine and expected action a really scary name like “doxing” is not a compelling form of argument.

We all depend upon the consent of the community (if a community decides to be rid of us, it usually can), thus it behooves us all to behave and publish in ways that serve the public interest.

It is not the job of third parties to accommodate our disproportionate sensitivities. It is incumbent upon us to accept reality and when we do so and change the things we can change and accept the things we can’t change, our needless fears drop away.

Sailer: “I’m struck by how the NYT is obsessed with the doxing the identities of bloggers Scott Alexander and Mencius Moldbug, but not with the doxing that Ben Horowitz is the son of David Horowitz, much like they won’t report that David Friedman is the son of ultra-famous Nobel Laureate Milton Friedman. All six of these brilliant people are Jewish, but for some reason mentioning their dads is off limits, probably because NYT subscribers won’t notice that that Metz’s article is anti-Semitic unless he mentions the elder Friedman and Horowitz.”

The New York Times did not dox either Scott Alexander or Mencius Moldbug. Their real names were widely known prior to this Times piece. Revealing that Ben Horowitz is the son of David Horowitz is not doxing.

Sailer: “And therefore he must be burned at the stake like all heretics.”

That seems a tad melodramatic.

Here are some comments on Sailer’s blog:

* Of course, The Name That Shall Not Be Spoken in the Times continues: Steve Sailer.

One of the problems I have with Scott Alexander is his refusal to entertain at any length the possibility that there exist between group differences on socially relevant traits.

I get, of course, how much more “toxic” that topic is than those he does consider.

But, in the end, if it is truth you seek, how do avoid such a basic, consequential truth? How do you understand a world in which this fact plays such a pivotal role, and, indeed, is figuring larger and larger over time?

Our current culture is simply built upon the dogmatic belief in the opposite. If you do believe that all differences between groups are socially constructed, on what grounds, other than procedural, can you reject attempts to right disparities in outcome by blunt, even gross corrections? Isn’t something like Critical Race Theory nearly unavoidable if you believe that all groups are the same, except for environment? What, other than some great, systematic, structural oppression, could explain the deep disparities we see?

The agnostic views of Scott Alexander and company are really helpless to understand these issues, or to correct them. He and they must instead point out the downsides and limitations of, say, Affirmative Action without addressing the full force of the arguments in its favor. I don’t see this to be an effective way of opposing them in the long run, nor does it allow a deep understanding of how the world really works.

If you wish to understand the world, you need to start from true premises, and follow them to true conclusions. That’s the only way knowledge can be advanced.

* David Friedman: I see two possible interpretations of the article. One is that the author wanted to trash SSC but didn’t realize that many readers would approve of its virtues, which he described, and not be bothered by, perhaps even approve of, the fact that it permitted “toxic ideas” to be defended on it. The other is that he didn’t want to trash SSC, was merely giving what he saw as a balanced picture, and didn’t realize that other people might think “white supremacist” meant someone who argued for white supremacy, of which I don’t remember any on SSC, and not realize that to Cade it meant anyone who thought part of the black/white difference in outcome might be due to genetic differences, of which there were many on the blog.

On net, I thought it moderately dishonest and moderately negative, but well short of a full out hatchet job.

Here are some points on Modafinil that resonate with me:

* From Reddit: Modafinil is a force multiplier that’ll probably push you over your baseline levels of motivation, focus, mental agility, and earlier on at least, your subjective wellbeing, but there’s no such thing as a free lunch; you probably shouldn’t use it as means to minimise sleep, and you should probably plan to cycle on and off the drug at regular intervals. Whilst I’m able to cycle off the stuff seamlessly—no addictive qualities to speak of—the contrast between life with and without it is palpable. I am a better Me when I take it.

* I do find that these substances give its user a sense of omnipotence, which translates for me into confidence. So I am able to socialize easier, in turn covering up the empathy.

* It has utterly changed my life, as someone who started the year (and ended many previous) in a deep pit of depression, primarily related to procrastination and perfectionism, and though absent of a diagnosis as yet, a cornucopia of adult ADHD symptoms. Moda gave me a much-needed mood and motivation boost, allowing me to be alert <1hr after waking (which I've never otherwise experienced). It made the imaginary version of doing a chore/task one goes through before actually completing a chore/task much less unattractive. I am a Philosophy student, and I think the drug is bad for 'philosophical intuition'. 'Tunnel vision' is a good way to describe it - it's as though your working memory is less capable of including novel or creative abstractions when reasoning or learning about a thing, but better capable of grasping tightly-related concepts or 'styles'. When it comes to my STEM/formal logic/comp sci obsessions, comprehension and 'overstanding' becomes a breeze. I tend to find it makes me speak my mind more, which can be a good and bad thing. I enjoy the mild emotional dampening, as someone that can over-empathise and lose sense of self during social interactions. * I have been taking modafinil since 2013, and it has changed my life for the better. It increases motivation, ability to do tedious tasks and wakefulness. I still take the same dose as I started with and haven't experienced any noticeable tolerance. I do though relate to the experience in the article of emotional stuntedness. So I usually do not take it days I expect to be social. I now use it 2 or 3 days a week, and have those days as focused work days. * From Slate Star Codex: “To my knowledge, nicotine is the most reliable cognitive enhancer that we currently have, bizarrely,” said Jennifer Rusted, professor of experimental psychology at Sussex University in Britain when we spoke. “The cognitive-enhancing effects of nicotine in a normal population are more robust than you get with any other agent. With Provigil, for instance, the evidence for cognitive benefits is nowhere near as strong as it is for nicotine.”

* SlateStarCodex: The most effective nootropics were caffeine – which pretty much everyone in the world knows works – and modafinil (along with its fellow -afinils) which has been proven to work by countless studies and is a prescription drug much used by the medical establishment.

* SlateStarCodex: modafinil is a prescription medication for sleep issues which makes users more awake and energetic.

* This may be a good place for me to mention two related aspects of my modafinil experience that are a bit unusual.

The first is that I can take it legally – my GP is willing to prescribe it – for a reason unrelated to sleep disorders.

The second is the specific reason he’s prescribing it. A little-known off-label effect of modafinil is that it reduces spasticity in people with cerebral palsy – it is in fact the only drug or intervention of any kind that does this reliably.

That said, I admit that I view this as a pleasant side effect of what it’s really good for, which is helping me concentrate on creative work for long periods of time in which I would ordinarily need to sleep.

Also I owe some thanks to the rationalist community in general for having tested and (informally but effectively) certified a good offshore supplier – Sun Pharma – so that I can actually afford to take it.

My experience with occasional use of this drug has been extremely positive. I would go so far as to recommend it to other software engineers. Provided you can take it safely and legally, modafinil is a superb for putting you in a zone of optimal productivity. I won’t advocate daily use, as I have not done that out of a desire to avoid developing tolerance. But for occasional use when you want to be at peak performance and can block out a long stretch undistracted time, it’s brilliant.

* Modafinil is actually a rather interesting mystery, because most of the other drugs with similar wakefulness effects have nasty side effects and high addictive potential. Nobody expected to find such a benign drug in this rather seedy and dangerous neighborhood.

* What you experienced on modafinil as “emotional blunting” I experience as “taking me to a calm, cerebral place where I like to be”. That is, I became aware that it was damping out minor mood swings but found the effect positive.

When I’m on modafinil I still love my wife and like our cat a lot, I’m just maybe less expressive about it. And one part of emotional range is not at all suppressed by modifinil – my sense of humor. I think I may be slightly more amusing and more easily amused when I’m on it.

* Drugs like Modafinil and Adderall , and caffeine/nicotine are all used by academics, fighter jet pilots, and pro gamers to *temporarily* improve performance. And its all temporary, with none of them recommended for long term continuous daily usage. Coffee is probably the only decently vetted one, and it stops working well with continuous usage.

* At some point I started looking at my life and realized that something wasn’t quite right with me.
I went and saw a psychiatrist who determined that I was borderline for ADHD.
Given the circumstances, the easiest way to get a definitive diagnosis was to write me a script for modafinil. He said one of two things would happen:
1) I would have a significant reduction in symptoms, providing solid evidence of some ADHD-like condition.
2) I would be up on the roof of my house shooting at news helicopters, at which point I shouldn’t mention his name.

The first day I took it I cried. I was able to go outside and just *be* with the wind and the birds flying and be content. No more constant distraction by everything that I didn’t realize didn’t need to be there. It’s awesome.

* As far as I can tell sites like ModafinilCat and Canadian shipping pharmacies are illegal – that’s what ignoring the appropriate regulations means – but tolerated because elderly people who want cheap drugs have good lobbyists and nobody wants a “GOVERNMENT ARRESTS AREA GRANDMOTHER WITH CANCER” story on the front page.

* Scott Alexander: The modafinil you get from sketchy Internet sites works pretty well and I have heard of zero recorded cases of serious side effects. The nootropics sold by the nootropics communtiy tend to be pure and safe (effectiveness possibly limited by the science itself but not by the manufacturing process). There were a few cases where some people got bad batches of nootropics, sent them off for analysis, found they were indeed bad, posted about it, everyone heard, those companies went out of business, and the companies that the clued-in people buy from now are pretty legit.

* the sort of people who buy modafinil are exactly the (rare) sort of people who would go through the process of sending a drug they weren’t sure about for analysis.
(That said, I agree that the level to which we enforce regulations should be pretty flexible, and in some cases it is – modafinil is technically illegal, but apparently no one’s ever been prosecuted for it and you can get it pretty easily despite it.

* I’ve taken modafinil only twice in my life, but I had a major reduction in anxiety.

(But I think the anxiety was driven by my general fatigue/low energy, which modafinil obviously completely removes but which I don’t know what else to do about. I’d get more modafinil but I’d first have to remove my aversion to ordering things online.)

* I personally found that armodafinil has a lot fewer unwanted side effects (i.e. light jitters on normal modafinil) and for that reason is harder/more subtle to detect that it’s working.

* I have been taking Nuvigil (armodafinil) for a couple years, not for its nootropic effects, but because, thanks to a sleep disorder and a completely bizarre work schedule, I had become narcoleptic. If I am not actively working on something, I can literally fall asleep, standing up, in a noisy room with 1,000 people in it. This is the main reason modafinil/armodafinil is officially prescribed, and it works quite well for that.

* Customs and laws differ tremendously from country to country, which is why a pack of modafinil might cost you $3 in an Indian pharmacy, and $80 in the USA when ordering from the greymarket.

* From Gwern.net:

Modafinil is a wakefulness stimulant drug developed in the 1980s. It is prescribed for narcolepsy but is widely used off-label for its stimulating effects and to deal with sleep deficits. As such, many believe it helps their cognitive performance & productivity. (However, comparing it to the fictional drug NZT in the 2011 movie Limitless is a gross exaggeration.) I would describe its advantages over other common stimulants as: more powerful and less addictive & tolerating than caffeine or khat; much longer-lasting than nicotine; less likely to alter mood or produce ‘tweaking’ behavior than Adderall or Vyvanse; and much more legal & with almost no side-effects compared to methamphetamine or cocaine. On any specific aspect, there may be a stimulant superior to modafinil, but few stimulants come close to modafinil’s overall package of being a long-lasting, safe, effective, non-mood-altering, quasi-legal stimulant, and that is why it has become so popular.

Its development stems from adrafinil, a wakefulness drug developed back in the late 1970s…

The elimination half-life is approximately 12-15 hours…

It is overall a better stimulant than caffeine or the amphetamines11, and targets different receptors than the amphetamines.12 The picture is good enough that some bioethicists are daring enough to go off their usual script (“the long-term effects are unclear; there may be unexpected side-effects or long-term consequences13—more study is required”) and abandon the Precautionary Principle and suggest that maybe healthy people using modafinil might be a good thing14.

Besides compensating for sleep-related mental deficits in general15 especially combined with short naps (Batéjat & Lagarde 1999), it may make you smarter16—even if you’re healthy:

In addition, modafinil (at well-tolerated doses) improves function in several cognitive domains, including working memory and episodic memory, and other processes dependent on prefrontal cortex and cognitive control. These effects are observed in rodents, healthy adults, and across several psychiatric disorders.17

The FDA in general seems to take a pretty optimistic view about any side-effects or long-term issues…

* New York Times Sept. 26, 2003:

An advisory panel to the Food and Drug Administration endorsed yesterday new uses for a stimulant that keeps people awake with fewer side effects than caffeine or amphetamines.

The panel said the drug, Provigil, now approved only for narcolepsy, could also be used to fight sleepiness in workers who cannot adjust to night shift jobs and in people who do not sleep well because of a breathing disorder known as obstructive sleep apnea…

Doctors say that Provigil, known generically as modafinil, can keep people awake with less of the jitteriness and risk of addiction of caffeine or amphetamines. It was approved in 1998 to treat sleepiness from narcolepsy, a rare disease in which people uncontrollably fall asleep.

But most prescriptions have been written for other uses, like the sleepiness or fatigue associated with depression or multiple sclerosis. There has been concern in the medical community that Provigil could become a lifestyle drug, used as a substitute for sleep by those who want to work or play longer…

F.D.A. officials suggested during the meeting that they were not overly concerned with use of the drug by healthy people because the drug was generally safe. Robert Temple, an F.D.A. official, said it was ”not completely obvious” that use of the drug just to keep healthy people alert would be a bad thing, because sleepy people could endanger others.

”If they’re driving next to me, I think I’d prefer they be on it,” he said.

* I’ve found Modafinil is one of the few of these sorts of things I’ve taken that has a noticeable cognitive enhancement effect – one seems to be able to thread one’s way through complex thoughts or actions in a calm, laser-like fashion.

* I can take modafinal/armodafinil legally because my GP has prescribed it for the improvement of my cerebral-palsy-impaired motor control. Sometimes I take it for the nootropic effect.

Is it a lightbulb going off that I can more or less feel it when the dose reaches by brain, because my relationship to my palsied limbs changes? (So does my mental state, in ways that are subtle but hard to mistake once experienced.) Does a chemically induced state of concentrated flow that lasts all night when I’d normally be sleeping count as a lightbulb going off?

About Luke Ford

I've written five books (see Amazon.com). My work has been followed by the New York Times, the Los Angeles Times, and 60 Minutes. I teach Alexander Technique in Beverly Hills (Alexander90210.com).
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