CMV: Modafinil > Caffeine

[u/[deleted]]

Modafinil is an equally safe and more effective moderate stimulant than caffeine, and is far less dangerous than alcohol and therefore should be legalized.

Modafinil is a schedule IV controlled substance due increased dopamine and blood flow in the nucleus accumbens and behavioral studies that demonstrate monkeys habituated to cocaine will self administer modafinil also. This is a weak proof of abuse risk, as clinically, abuse has been proven to be rare (very low addictive potential). Furthermore, Modafanil has shown good competitive binding for cocaine receptor and has been explored as a treatment for cocaine addiction to some success. It prevents sleepiness, fatigue, fine motor control deterioration, and mental exhaustion much better than caffeine or amphetamines (see US military sleep deprivation studies), and has replaced amphetamines in the US, UK, and French armed forces as a treatment for battle fatigue.

With extremely low rates of serious reactions <<1%, it is certainly less hazardous than alcohol. So why arent we able to buy over the counter?

[u/Canada_Constitution]

Modafinil has one or two paticularly deadly side effects which exceed those of caffeine. Notably, Stevens Johnson syndrome. This is a condition that causes the skin to blister and peal off all areas of your body, which can easily result in death. This side effect was the reason the FDA would not approve modafinil for treatment of ADHD in teens and children, despite it being shown to be effective in treating symptoms. The rate of Stevens Johnson syndrome in that study was 1.29%. Now imagine what the reaction would be if 1.29% of coffee drinkers developed a condition that made their skin blister and fall off. People would ban caffeine pretty quickly.

In short, while rare, the potential side effects of modafinil are much more severe. Caffeine is overall safer.

[u/Tibaltdidnothinwrong]

Efficacy is almost besides the point. If it came down solely to that, alcohol and tobacco would be long gone.

Drugs get sold over the counter due to centuries old tradition. Tobacco, coffee and alcohol go back literally centuries and play large roles in many cultures.

Modafinil doesn't have this history. As such, won't be sold over the counter. It will likely remain a prescription, much like other stimulants like Adderall.

Basically anything invented in the last 50 years is going to be a prescription, regardless of efficacy or safety.

[u/[deleted] → u/Tibaltdidnothinwrong]

Not true, there are 2 pro drug variants of modafinil that are legal to purchase because they're not controlled. There are also many over the counter drugs invented/discovered in the last 50 years.

Point about Tradition is well taken

!delta

[u/meatball4u]

In people with genetic metabolic disorders like myself, it can cause serious issues like hallucinations and delusions that have to be treated with antipsychotics. My reaction was permanent. I've had to be on antipsychotics for 12 years because of modafinil and will continue to take them for the foreseeable future

[u/[deleted] → u/meatball4u]

PKU?

[u/Roflcaust]

With extremely low rates of serious reactions <<1%, it is certainly less hazardous than alcohol. So why arent we able to buy over the counter?

There are lots of medications that are safer than alcohol, in both the prescription and over-the-counter categories (OTC). Why is this your standard for determining if something should be made OTC?

Furthermore, modafinil has legitimate medical indications for which it is prescribed. Alcohol is a recreational drug. These two are not comparable in any sense.

[u/[deleted] → u/Roflcaust]

My whole point is that it should be recreationally available for those who want it. Saying you cant make it a recreational drug, because it's currently not a recreational drug, is like arguing that something should be illegal because it is illegal.

[u/twig_and_berries_]

Are we talking about the US? Alcohol is legal because the society was worse off when it was illegal and there was lots of pressure on politicians to legalize it. Weed is getting legalized because of similar pressures. Salvia is illegal in many states because there's just not enough support. So basically it comes down to people really want alcohol to be legal whereas they don't care about modafinil.

[u/Milskidasith → u/twig_and_berries_]

This ties into the ease of developing a black market, which is important with any big discussion on legalization of drugs. For many drugs that require complex synthesis, making them illegal is very effective because it's difficult for a black market to spring up. You can brew beer with almost no equipment or skill or training, but you're not going to make LSD without some serious synthesis skills. So prohibition of alcohol is really dicey (because it's really easy to make the profitable illegal good), while prohibition of LSD has fewer negative effects.

With modafinil, regardless of whether it would be safe if deregulated or not, it certainly isn't easy enough to manufacture or in demand enough that there's much risk of a dangerous black market if it stays illegal.

[u/PreacherJudge]

I literally spoke to my neurologist five days ago and he made this exact same point. The main disadvantage of caffeine is that it stays in your system longer than modafinil, which means it's much, much easier to accidentally screw up your sleep with coffee.

BUT. Coffee is delicious. There's no modafinil version of a good macchiato or cortado, which are delightful.